From the Guidelines
To treat a second-degree burn, cooling with running water is the first established and beneficial intervention with little risk of harm, as suggested by the 2024 American Heart Association and American Red Cross guidelines for first aid 1. When managing a second-degree (partial-thickness) burn, it is crucial to prioritize interventions that reduce morbidity, mortality, and improve quality of life. The initial step involves cooling the burn with running water, which has been shown to decrease the need for subsequent care in patients with thermal burns 1.
Key Interventions
- Cooling of the burn with running water is recommended, with a meta-analysis of observational data suggesting its benefits in reducing the need for subsequent care 1.
- For pain management, giving over-the-counter pain medications is reasonable, as stated in the guidelines 1.
- After cooling, for small partial-thickness burns being managed at home, applying petrolatum, petrolatum-based antibiotic ointment, honey, or aloe vera and a clean nonadherent dressing to open burn wounds may be reasonable 1.
- Loosely covering a burn that has intact skin or an intact blister with a clean cloth or nonadherent dry dressing while awaiting evaluation by a healthcare professional is also a consideration 1.
Additional Considerations
- It is essential to monitor for signs of infection, such as increased pain, redness, swelling, oozing, or fever, and seek medical attention if these signs develop.
- Burns that are larger than 3 inches, affect the face, hands, feet, genitals, or major joints, or do not show improvement within two weeks should prompt medical evaluation.
- Elevating the burn, if possible, can help reduce swelling, and keeping the burn clean and covered can aid in the healing process.
From the FDA Drug Label
Reduction in bacterial growth after application of topical antibacterial agents has been reported to permit spontaneous healing of deep partial-thickness burns by preventing conversion of the partial thickness to full thickness by sepsis. 2 The treatment for a second-degree (partial-thickness) burn may involve the application of topical antibacterial agents, such as silver sulfadiazine, to reduce bacterial growth and prevent sepsis, allowing for spontaneous healing.
- The goal is to prevent the conversion of partial-thickness burns to full-thickness burns.
- Topical antibacterial agents can help achieve this by reducing bacterial colonization.
From the Research
Treatment Options for Second-Degree Burns
- The treatment of second-degree burns can involve various methods, including the use of dressings and topical agents 3, 4, 5.
- Studies have compared the effectiveness of different dressings and ointments, such as fundermol herbal ointment and 1% silver sulfadiazine cream, in promoting wound healing 4.
- The use of hyaluronic acid plus silver sulfadiazine has been shown to be effective in treating second-degree burns, with a significantly shorter time to healing compared to silver sulfadiazine alone 5.
Surgical Treatment and Infection Prevention
- Surgical treatment and infection prevention are crucial aspects of managing second-degree burns 6, 7.
- Expert consensus recommends a standardized approach to surgical treatment and infection prevention, taking into account factors such as burn site, patient age, and burn area 6, 7.
- The development of guidelines and consensus statements aims to provide a unified standard for the treatment of second-degree burns, addressing the lack of consistency in clinical studies and treatment plans 6, 7.
Topical Agents and Dressings
- Topical agents, such as silver sulfadiazine and hyaluronic acid, can be effective in promoting wound healing and preventing infection 4, 5.
- Dressings, including polymeric hydrogels, can provide a protective barrier, absorb wound exudate, and facilitate wound evaluation 3.
- The choice of dressing and topical agent may depend on the specific characteristics of the burn wound and the patient's individual needs 3, 4, 5.