What is the plan for treating grease burns?

Treatment Plan for Grease Burns

The recommended initial treatment for grease burns is immediate cooling with cold running tap water (15-25°C) for 20 minutes, followed by appropriate wound care based on burn severity. 1

Initial Management

1. Immediate Cooling

   • Apply cold running water (15-25°C) for 20 minutes to the burned area 1
   • Never apply ice directly to burns as this can worsen tissue damage 1
   • Cooling reduces burn depth and decreases the likelihood of requiring hospital admission

2. Blister Management

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

Wound Care

1. Cleaning

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

2. Topical Treatment

   • For minor burns: Apply greasy emollient (50% white soft paraffin with 50% liquid paraffin) 1
   • For second and third-degree burns: Apply a thin layer (approximately 1/16 inch) of 1% silver sulfadiazine cream 1, 2
   • Reapply silver sulfadiazine once to twice daily or whenever removed by patient activity 2

3. Dressing

   • Use non-adherent dressings for denuded areas (e.g., Mepitel™ or Telfa™) 1
   • Consider silver-containing products for sloughy areas only 1
   • Dressings are optional with silver sulfadiazine but may be used if needed 2

Monitoring for Infection

• Watch for signs of infection: increasing pain, redness, swelling, discharge, fever, or systemic symptoms 1
• Take swabs for bacterial and candidal culture from lesional skin on alternate days if concerned about infection 1
• Do not administer systemic antibiotics prophylactically 1

When to Seek Immediate Medical Attention

Seek immediate medical attention for burns that:

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

Special Considerations

• Pain Management: Use multimodal analgesia based on validated comfort and pain assessment scales 1
• Silver Sulfadiazine Cautions: Be aware of potential side effects including allergic reactions, silver staining of the wound, and rarely methemoglobinemia 3
• Treatment Duration: Continue treatment with silver sulfadiazine until satisfactory healing occurs or the burn site is ready for grafting 2

Rehabilitation

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

Pitfalls to Avoid

• Delaying cooling treatment (should be immediate)
• Using ice directly on burns
• Applying home remedies like butter, oil, or toothpaste
• Neglecting to reassess burn depth, which may evolve over 24-48 hours
• Failing to recognize signs of infection requiring medical attention
• Discontinuing silver sulfadiazine prematurely while infection risk remains 2

The management approach should be adjusted based on burn severity, with minor burns typically manageable with topical treatment alone, while moderate to severe burns may require systemic management and possibly skin grafting 4.