Management of Superficial Burns
Immediate cooling with clean running water for 5-20 minutes is the primary intervention for superficial burns to limit tissue damage and reduce pain. 1, 2
Initial Management
- Immediately remove the patient from the thermal source 3
- Cool the burn with clean running water (15-25°C) for 5-20 minutes 3, 1
- Remove any jewelry from the affected area before swelling occurs to prevent constriction 1
- For adults with burns covering <20% of total body surface area (TBSA) and children with <10% TBSA, cooling should be performed while monitoring for hypothermia 1
- Do not apply ice directly to burns as this can cause further tissue damage 1, 2
Post-Cooling Treatment for Superficial Burns
- After cooling, apply one of the following:
- Cover with a clean, non-adherent dressing 1, 2
- Administer over-the-counter pain medications such as acetaminophen or NSAIDs for pain control 1, 5
- Leave burn blisters intact as this improves healing and reduces pain 3
- Do not apply butter, oil, or other home remedies to burns 1, 2
Wound Care Considerations
- Burn wound care should be performed in a clean environment 1
- The type of dressing depends on the appearance of the wound and patient's general condition 1
- When applying dressings on limbs, prevent bandages from inducing a tourniquet effect 1
- In the case of circular dressings, monitor distal perfusion 1
- Ideally, dressings should be re-evaluated daily 1
When to Seek Medical Attention
- Seek immediate medical care for:
- Burns that involve the face, hands, feet, or genitals 1, 2
- Partial-thickness burns covering >10% body surface area (>5% in children) 1, 2
- All full-thickness (third-degree) burns 1, 2
- Burns showing signs of infection or that are very painful 1, 2
- Burns with signs of inhalation injury (soot around nose/mouth, difficulty breathing) 1, 6
Special Considerations
- Silver sulfadiazine cream may be used for more significant burns under medical supervision, applied to a thickness of approximately 1/16 inch once to twice daily 7
- However, silver sulfadiazine may be associated with prolonged healing if used for a long time on superficial burns 1
- Newer occlusive dressings can provide faster healing and are often more cost-effective than silver sulfadiazine for partial-thickness burns 4, 8
- Monitor for complications such as infection, slow healing, scar formation, and contracture 9
Common Pitfalls to Avoid
- Failing to cool the burn immediately 3
- Applying ice directly to burns 1, 2
- Using butter, oil, or other home remedies 1, 2
- Breaking blisters, which increases infection risk 3, 1
- Using routine antibiotic prophylaxis, which is not recommended for burns patients 1
- Underestimating the need for specialized care for burns in high-risk areas 6
Remember that proper initial cooling is the most critical intervention for superficial burns, followed by appropriate dressing and pain management.