What advice should be given to a patient with 25% second (2nd) and third (3rd) degree burns being discharged home after wound healing?

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Last updated: September 23, 2025View editorial policy

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Post-Burn Care Recommendations for Patients Being Discharged Home

For a patient with healed 25% second and third-degree burns being discharged home, you should advise them to apply skin emollient regularly to the healed burn areas to maintain skin integrity and prevent complications. 1

Skin Changes After Burn Healing

When burn wounds heal, patients commonly experience several skin changes that require ongoing care:

  • The healed burn areas will likely be erythematous (red) and itchy for some time after healing 1
  • Skin may be dry, tight, and prone to cracking due to damage to oil glands
  • Newly healed skin is more fragile and requires special attention to maintain integrity

Key Recommendations for Home Care

Moisturization and Skin Protection

  • Apply emollients (moisturizers) regularly to the healed burn areas:
    • Use a thin layer of moisturizer containing 50% white soft paraffin with 50% liquid paraffin 1
    • Apply at least twice daily or more frequently if the skin feels dry
    • Choose fragrance-free products to minimize irritation risk

Pressure Garment Use

  • Pressure garments should be worn throughout the day but can be removed at night 1
  • Benefits of pressure garments include:
    • Reducing hypertrophic scarring
    • Improving scar appearance
    • Minimizing contracture formation
    • Providing support to fragile healing tissues

Managing Skin Complications

  • If skin fissuring (cracking) occurs:
    • Apply sterile dressing to the area
    • Increase frequency of emollient application
    • Contact your healthcare provider for assessment 1

Additional Important Recommendations

  • Protect healed burn areas from sun exposure using sunscreen (SPF 30+) and protective clothing
  • Maintain adequate hydration by drinking plenty of fluids
  • Monitor for signs of infection including increased pain, redness, swelling, discharge, or fever 1
  • Continue prescribed range of motion exercises to prevent contractures 1

Follow-up Care

  • Attend all scheduled follow-up appointments with your burn care team
  • Report any concerning symptoms promptly, including:
    • Increased pain or itching not relieved by recommended treatments
    • New areas of skin breakdown
    • Signs of infection
    • Difficulty with movement or function

Common Pitfalls to Avoid

  • Neglecting regular moisturization, which can lead to skin dryness, cracking, and potential infection
  • Using fragranced products that may irritate sensitive healing skin
  • Discontinuing pressure garments too early, which can result in suboptimal scar formation
  • Failing to protect healed burn areas from sun exposure, which can cause hyperpigmentation

By following these recommendations, patients can optimize healing, minimize scarring, and improve functional outcomes after significant burn injuries.

References

Guideline

Thermal Burn Management

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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