What is the treatment for grease burns?

Treatment for Grease Burns

The most effective initial treatment for grease burns is immediate cooling with cold running water (15-25°C) for 20 minutes, followed by application of a thin layer (approximately 1/16 inch) of 1% silver sulfadiazine cream for second and third-degree burns. 1, 2

Immediate Management

1. Cooling the Burn

   • Apply cold running water (15-25°C) to the burned area for 20 minutes 1
   • Never use ice directly on burns as this can cause further tissue damage 1
   • Immediate cooling reduces burn depth and decreases the need for hospital admission 3

2. Blister Management

   • Keep small blisters intact to maintain a sterile environment and reduce infection risk 1
   • For large or painful blisters, decompress by piercing while leaving 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

Ongoing Treatment

1. Topical Medication Application

   • For second and third-degree burns, apply a thin layer (1/16 inch) of 1% silver sulfadiazine cream 1, 2
   • Reapply once to twice daily or whenever the cream has been removed by patient activity 2
   • For very superficial burns, application of a greasy emollient (50% white soft paraffin with 50% liquid paraffin) is sufficient 1, 4

2. Dressing Application

   • Dressings are optional with silver sulfadiazine but may be used if necessary 2
   • For denuded areas, use non-adherent dressings (e.g., Mepitel™ or Telfa™) 1
   • Consider silver-containing products for sloughy areas only 1
   • Reapply medication immediately after hydrotherapy 2

3. Pain Management

   • Use multimodal analgesia based on validated pain assessment scales 1
   • Offer analgesia prior to any blister procedures 1

When to Seek Immediate Medical Attention

Burns require immediate medical attention if they:

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

Monitoring for Complications

1. Infection Prevention

   • Monitor for signs of infection: increasing pain, redness, swelling, discharge, fever, or systemic symptoms 1
   • Do not administer systemic antibiotics prophylactically; use only when clinical signs of infection are present 1

2. Rehabilitation

   • Begin early range of motion exercises to prevent contractures 1
   • Consider massage therapy to soften scar tissue and improve circulation 1

Common Pitfalls to Avoid

• Delayed cooling: Failure to cool burns immediately can lead to deeper tissue damage and worse outcomes 3
• Using ice directly: This can cause additional tissue damage 1
• Applying home remedies: Avoid butter, grease, or oils on burns as these can trap heat and increase infection risk 4
• Premature discontinuation of treatment: Continue treatment with silver sulfadiazine until satisfactory healing occurs or the burn site is ready for grafting 2

The practice of cooling burns has historical roots dating back to Galen (AD 129-199) and has been consistently validated by modern research as an effective first-line treatment 5. The combination of immediate cooling followed by appropriate topical therapy represents the current standard of care for grease burns based on the most recent guidelines.