From the Guidelines
Second-degree burns should be treated by immediately cooling the burn with cool running water for at least 10 minutes, followed by covering the burn with a nonadherent bandage or clean cloth to protect the wound and reduce pain, as recommended by the 2024 American Heart Association and American Red Cross guidelines for first aid 1. The treatment of second-degree burns involves several key steps to promote healing, prevent infection, and reduce scarring.
- Cooling the burn with cool running water for at least 10 minutes to stop the burning process and reduce pain, as supported by the 2015 American Heart Association and American Red Cross guidelines for first aid 1.
- After cooling, gently cleaning the area with mild soap and water to prevent infection.
- Applying an antibiotic ointment to the affected area to further prevent infection.
- Covering the burn with a nonadherent bandage or clean cloth, as recommended by the 2024 guidelines 1, to protect the wound and reduce pain.
- Changing the dressing daily or whenever it becomes wet or soiled to maintain a clean environment and promote healing.
- Managing pain with over-the-counter medications like acetaminophen or ibuprofen as needed.
- Keeping the burned area elevated if possible to reduce swelling. It is also important to note that second-degree burns damage both the outer layer of skin (epidermis) and part of the underlying layer (dermis), causing blistering, redness, and pain.
- Blisters should not be popped as they protect against infection.
- Medical attention should be sought if the burn is larger than 3 inches in diameter, affects the face, hands, feet, genitals, or major joints, or if signs of infection develop such as increasing pain, redness, swelling, oozing, or fever, as indicated by the 2024 guidelines 1.
From the FDA Drug Label
Silver sulfadiazine cream, USP 1% is a topical antimicrobial drug indicated as an adjunct for the prevention and treatment of wound sepsis in patients with second and third degree burns. The treatment for second-degree (partial-thickness) burns includes the use of silver sulfadiazine cream, USP 1% as an adjunct for the prevention and treatment of wound sepsis.
- The drug is used to prevent and treat wound sepsis in second-degree burns.
- It is a topical antimicrobial drug. 2
From the Research
Treatment Options for Second-Degree Burns
- Prehospital first aid, nonsurgical treatment, surgical treatment, and infection treatment are all crucial aspects of managing second-degree burns 3, 4, 5
- The application of Biobrane to partial-thickness burns has been shown to be superior to topical treatment with 1% silver sulfadiazine, resulting in less pain, reduced pain medication requirements, and shorter wound healing time and hospital stay 6
- Silver-sulfadiazine-impregnated collagen dressing has also been found to be effective in treating second-degree burns, promoting improved wound healing, controlling infection, and reducing pain without serious complications 7
Recommendations for Treatment
- The Consensus on the Treatment of Second-Degree Burn Wounds (2024 edition) provides 58 specific recommendations for the management of second-degree burns, covering prehospital first aid, nonsurgical treatment, surgical treatment, and infection treatment 3, 4
- The Expert Consensus on the Treatment of Second-Degree Burn Wounds (2024 edition) Ⅱ: Surgical Treatment and Infection Prevention and Treatment offers 29 specific recommendations for surgical treatment and infection prevention and treatment of second-degree burns 5
Considerations for Treatment
- The choice of treatment for second-degree burns requires consideration of factors such as burn site, patient age, and burn area 3, 4, 5
- The lack of unified standards and specifications for diagnosis, classification, surgical procedure, and infection diagnosis and grading of second-degree burn wounds can affect the formulation of clinical treatment plans and the consistency of clinical studies 3, 4, 5