Management of Superficial Burns
Immediate cooling with clean running water for 5-20 minutes is the primary intervention with proven efficacy for superficial burns and should be performed first, once the patient is removed from the thermal source. 1, 2
Initial Management
- Immediately cool the burn with clean running water for 5-20 minutes to limit tissue damage and reduce pain 2
- Remove any jewelry from the affected area before swelling occurs to prevent constriction 2
- For adults with burns covering <20% of total body surface area (TBSA) and children with <10% TBSA, cooling should be performed in the absence of shock 2
- Monitor children closely for signs of hypothermia during cooling, especially with larger burns 2
Post-Cooling Treatment for Superficial Burns
- After cooling, apply petrolatum, petrolatum-based antibiotic ointment, honey, or aloe vera to the burn area 2
- Cover with a clean, non-adherent dressing to protect the wound 2, 3
- Administer over-the-counter pain medications like acetaminophen or NSAIDs for pain control 2
- Loosely cover burn blisters with a sterile dressing but leave blisters intact as this improves healing and reduces pain 1
Wound Care Considerations
- Burn wound care should be performed in a clean environment 2
- The type of dressing depends on the appearance of the wound and patient's condition 2
- Superficial burns can be treated with topical application of lotions, honey, aloe vera, or antibiotic ointment 3
- Wounds heal better with less infection if they are covered with an antibiotic ointment or cream and a clean occlusive dressing 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 2
- Do not break blisters, as this increases infection risk 2
- Avoid using silver sulfadiazine for prolonged periods on superficial burns as it may be associated with prolonged healing 2
- Do not use external cooling devices for prolonged periods to limit the risk of hypothermia 2
When to Seek Medical Attention
- Seek immediate medical care for burns that involve the face, hands, feet, or genitals 2
- Seek immediate medical care for partial-thickness burns covering >10% body surface area (>5% in children) 2
- Seek immediate medical care for burns showing signs of infection or that are very painful 2
- Seek immediate medical care for burns with signs of inhalation injury (soot around nose/mouth, difficulty breathing) 2
Follow-up Care
- Monitor the burn for signs of infection such as increased pain, redness, swelling, or discharge 4
- Keep the burn area clean and dry, changing dressings as recommended 4
- Continue pain management as needed with over-the-counter medications 4
- Physicians must reevaluate patients frequently after a burn injury to monitor healing progress 3