What is the recommended treatment for a mild burn?

Treatment of Mild Burns

For mild burns, immediate cooling with cold running water (15-25°C) for 20 minutes is the recommended first-line treatment to reduce burn depth, decrease pain, and improve healing outcomes. 1

Initial Management

1. Cooling the burn:

   • Apply cold running tap water (15-25°C) for 20 minutes
   • Do NOT apply ice directly to the burn as this can cause further tissue damage
   • This intervention reduces burn depth and decreases the need for hospital admission 1

2. Blister management:

   • Keep blisters intact when possible to maintain a sterile environment
   • If decompression is necessary, pierce the blister but leave the roof intact to act as a biological dressing 1

3. Wound cleansing:

   • Gently irrigate the wound with warmed sterile water, saline, or dilute chlorhexidine (1/5000) 1

Wound Dressing

1. For superficial burns:

   • Apply a greasy emollient (50% white soft paraffin with 50% liquid paraffin) over the epidermis 1
   • Very superficial burns may only require emollient application to limit inflammation, reduce pain, and prevent desiccation 2

2. For partial thickness burns:

   • Apply a thin layer (approximately 1/16 inch) of topical antimicrobial agent such as 1% silver sulfadiazine cream 1
   • Use non-adherent dressings for denuded areas (e.g., Mepitel™ or Telfa™) 1
   • Consider bacitracin for minor burns in adults and children over 2 years of age, applying a small amount 1-3 times daily 3

3. For sloughy areas:

   • Consider silver-containing products 1

Monitoring for Infection

• Watch for signs of infection including:

  • Increasing pain
  • Redness extending beyond the burn area
  • Swelling
  • Purulent discharge
  • Fever or systemic symptoms 1

• Do not administer systemic antibiotics prophylactically 1

• Only use antibiotics when there are clinical signs of infection 1

Pain Management

• Use multimodal analgesia based on validated comfort and pain assessment scales 1
• Offer analgesia prior to any blister procedure 1
• For minor burns, topical treatments like bacitracin can provide temporary relief of pain or discomfort 3

When to Seek Medical Attention

Immediate medical attention is required for burns that:

• Involve the face, hands, feet, or genitalia
• Are full-thickness burns
• Cover >10% total body surface area (TBSA) in children
• Cover >20% TBSA in adults 1

Common Pitfalls to Avoid

1. Applying ice directly to burns - This can cause vasoconstriction and worsen tissue damage
2. Using butter, oil, or home remedies - These can trap heat and increase the risk of infection
3. Delaying cooling - Immediate cooling is crucial for limiting burn progression
4. Breaking blisters unnecessarily - This increases infection risk
5. Applying adhesive dressings directly to burns - These can damage healing tissue when removed
6. Neglecting pain management - Adequate pain control is essential for patient comfort and compliance

Special Considerations

• For children under 2 years of age, consult a doctor before applying topical antimicrobials like bacitracin 3
• Maintain ambient temperature between 25°C and 28°C during treatment to prevent hypothermia, especially in patients with larger burns 1
• Begin early range of motion exercises to prevent contractures in burns crossing joints 1