What is the treatment for a 34-year-old female with 15 percent partial-thickness burns to the chest and buttocks?

Treatment for 34-Year-Old Female with 15% Partial-Thickness Burns to Chest and Buttocks

This patient requires immediate referral to a specialized burn center due to the burn size exceeding 10% of body surface area, which necessitates specialized treatment including possible IV fluid resuscitation and surgical intervention. 1

Initial Assessment and Management

• Immediately cool the burn areas with clean running water for 5-20 minutes to limit tissue damage and reduce pain 1, 2
• Remove any jewelry from the affected areas before swelling occurs to prevent constriction and vascular ischemia 1, 2
• Monitor for signs of inhalation injury (facial burns, difficulty breathing, singed nasal hairs, soot around nose/mouth) which would require immediate emergency medical services activation 1
• Administer over-the-counter pain medications such as acetaminophen or NSAIDs for pain management 1, 2

Burn Center Referral Criteria

• The American Burn Association recommends that patients with partial-thickness burns involving >10% body surface area (5% in children) be treated in a specialized burn center 1
• This patient has 15% partial-thickness burns, exceeding the 10% threshold for specialized care 1
• Burns to the chest and buttocks may require specialized care to prevent functional disability and optimize cosmetic outcomes 1, 2

Wound Care Prior to Transfer

• After cooling, loosely cover the burns with a clean, non-adherent dry dressing or clean cloth while awaiting evaluation by healthcare professionals 1
• Do not apply home remedies such as butter or oils to the burns 2
• Do not break any blisters that may have formed, as this increases infection risk 2

Treatment Options at Burn Center

• Silver sulfadiazine cream is a common topical antimicrobial treatment for partial-thickness burns, applied to a thickness of approximately 1/16 inch once to twice daily 3
• Biosynthetic dressings, silver-containing dressings, and silicon-coated dressings have shown better healing outcomes than silver sulfadiazine in some studies 4
• Hydrogel dressings may promote faster healing than standard care in some cases 4
• For larger partial-thickness burns, surgical debridement and possible skin grafting may be necessary 5

Ongoing Care

• Dressing changes will be required based on the specific dressing type selected 3, 6
• Silver-containing foam dressings may offer the advantage of less frequent dressing changes and better absorption of wound exudate compared to traditional gauze with silver sulfadiazine 6
• Pain management during dressing changes is essential, with foam dressings potentially offering reduced pain during early treatment phases 6
• Monitor for signs of infection, which would require systemic antibiotic therapy 7

Potential Complications to Monitor

• Fluid loss can be significant with burns covering 15% of body surface area, potentially requiring IV fluid resuscitation 1, 7
• Risk of infection increases with partial-thickness burns, requiring vigilant monitoring 7
• Scarring and contracture formation are possible long-term complications that may require specialized rehabilitation 1, 5