From the Guidelines
The treatment for scalds involves immediate cooling with running water to decrease the need for subsequent care and reduce pain.
Key Treatment Steps
- Cooling: Cool the scald with clean running water as soon as possible, but no later than 30 minutes after the injury, to reduce the risk of further damage and promote healing 1.
- Pain Management: Give over-the-counter pain medications, such as acetaminophen or NSAIDs, to manage pain from thermal burns 1.
- Wound Care: After cooling, loosely cover the burn with a clean cloth or nonadherent dry dressing to protect the wound and reduce pain, while avoiding heat entrapment 1.
- Special Considerations: For partial-thickness burns, it may be reasonable to apply petrolatum, petrolatum-based antibiotic ointment, honey, or aloe vera and a clean nonadherent dressing to open burn wounds 1.
- Referral to Specialist: Burns involving the face, hands, feet, and genitals, or those with a large surface area, may require surgical intervention and should be treated in a specialized burn center 1.
From the Research
Treatment Options for Scalds
- Various treatment options are available for scalds, including the use of biological dressings such as xenografts 2, 3 and silver-based dressings like silver sulphadiazine and nanocrystalline silver 4.
- Omiderm, a thin, transparent, hydrophilic polyurethane membrane, has also been used as a temporary dressing for scald wounds in children, with no significant advantages or disadvantages compared to conventional exposure treatment 5.
- Operative treatment, including tangential necrectomy and split-thickness autologous skin grafting, may be considered for deep dermal partial-thickness scalds in children, although conservative treatment is also an option 6.
Comparison of Treatment Outcomes
- A study comparing the outcomes of scald management protocols in two different time periods found that the use of biological dressings was associated with a lower proportion of autograft operations and shorter hospital stays 2.
- Another study found that treatment with xenografts was associated with low pain scores and a median length of stay/TBSA% of less than 1 3.
- A comparison of silver sulphadiazine and nanocrystalline silver dressings found that nanocrystalline silver was associated with faster healing times, shorter hospital stays, and lower costs 4.
Treatment Considerations
- The choice of treatment for scalds may depend on the extent and depth of the injury, as well as the patient's age and overall health.
- The use of biological dressings and silver-based dressings may be considered for patients with partial-thickness scalds, while operative treatment may be necessary for deeper injuries 2, 6, 4.
- Further studies are needed to investigate the functional and aesthetic outcomes of different treatment modalities for scalds 2.