What is the management for a 2nd degree burn on the hand?

Management of Second-Degree Burns on the Hand

For second-degree burns on the hand, immediately cool the burn with clean running water for 5-20 minutes, remove any jewelry before swelling occurs, apply a non-adherent dressing, and seek medical attention as hand burns are considered special areas requiring specialized care to prevent functional impairment. 1, 2

Immediate First Aid

• Immediately cool the burn with clean running water for 5-20 minutes to limit tissue damage and reduce pain 1, 2
• Remove any jewelry from the affected area before swelling occurs to prevent constriction and vascular compromise 1, 2
• After cooling, administer over-the-counter pain medications such as acetaminophen or NSAIDs for pain management 1, 2

Blister Management

• Do not break or pop blisters as this significantly increases infection risk 1
• Preserving the blister roof acts as a biological dressing that helps with pain management and promotes healing 2
• If blisters need to be managed, this should ideally be done by a burn specialist, especially for hand burns 1

Wound Care

• After cooling, clean the wound with tap water, isotonic saline solution, or an antiseptic solution 1
• Cover the burn with a clean, non-adherent dry dressing 1, 2
• For open burn wounds, apply petrolatum, petrolatum-based antibiotic ointment, honey, or aloe vera before applying a clean non-adherent dressing 2

Special Considerations for Hand Burns

• Hand burns require specialized care regardless of size due to the risk of functional impairment 1, 2
• A burn specialist should be consulted to determine the most appropriate treatment plan 1
• Early debridement (within 24 hours) may enhance the rate of epithelialization compared to late debridement or no debridement 3

Topical Treatment Options

• Silver sulfadiazine cream 1% can be applied to a thickness of approximately one-sixteenth of an inch once to twice daily 4
• If using silver sulfadiazine, reapply immediately after hydrotherapy and continue until satisfactory healing has occurred 4
• Avoid using silver sulfadiazine for prolonged periods on superficial burns as it may delay healing 1, 2
• Alternative treatments like topical heparin have shown better outcomes in terms of wound healing and pain control in some studies 5

When to Seek Medical Attention

• All hand burns should receive medical attention regardless of size due to the risk of functional impairment 1, 2
• Burns covering >10% body surface area in adults or >5% in children require medical evaluation 6
• Signs of infection such as increased pain, redness, swelling, or discharge require immediate medical attention 1

Common Pitfalls to Avoid

• Do not apply ice directly to burns as this can cause further tissue damage 1, 2
• Do not apply butter, oil, or other home remedies to burns 1
• Do not delay seeking medical attention for hand burns 1, 2
• Do not use dressings that may adhere to the wound surface 1, 2

Follow-up Care

• Monitor the burn for signs of infection 1
• Keep the burn area clean and dry, changing dressings as recommended by healthcare providers 1
• Continue pain management as needed with over-the-counter medications 1, 2
• Monitor for any signs of functional impairment during the healing process 1