What is the proper care and treatment for a patient with a second-degree burn?

Patient Education for Second-Degree Burns

For a second-degree burn, immediately cool the wound with clean running water for 5-20 minutes, apply a petrolatum-based antibiotic ointment (like triple antibiotic ointment), and cover with a clean non-adherent dressing. 1

Immediate First Aid (What to Do Right Away)

Cooling the Burn:

• Run clean, cool water over the burn for 5-20 minutes to limit tissue damage and reduce pain 1, 2, 3
• If you are treating a young child, watch for signs of getting too cold during this cooling process 1
• Do not apply ice directly to the burn as this causes additional tissue damage 2, 3

Remove Jewelry:

• Take off any rings, bracelets, or tight clothing from the burned area before swelling starts 1, 2, 3
• This prevents constriction that could cut off blood flow as the area swells 1

Pain Management:

• Take over-the-counter pain medications like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) for pain relief 1, 2

Wound Care at Home

Cleaning:

• After cooling, gently clean the burn with tap water or saline solution 3

Applying Ointment:

• Apply a thin layer of petrolatum-based antibiotic ointment such as triple antibiotic ointment (containing bacitracin, neomycin, and polymyxin B) 1, 3
• Alternative options include plain petrolatum, honey, or aloe vera 2

Covering the Burn:

• Cover the ointment with a clean, non-adherent dressing 1, 3
• Change the dressing 1-2 times daily and reapply ointment with each change 3

Managing Blisters

If Blisters Form:

• Do not pop or break blisters as this significantly increases infection risk 1, 2
• Leave intact blisters covered with a clean, non-adherent dressing 2
• The blister roof acts as a natural biological dressing that helps with pain and promotes healing 2

What NOT to Do (Common Mistakes)

• Never apply ice directly to burns 2, 3
• Never use butter, oil, or other home remedies on burns 1
• Never break blisters yourself 1, 2
• Avoid silver sulfadiazine cream (Silvadene) for prolonged use on superficial burns as it may delay healing 4, 3

When to Seek Medical Attention Immediately

Go to a doctor or emergency room if:

• The burn involves your face, hands, feet, or genitals—these areas require specialized care regardless of burn size 1, 2, 3
• The burn covers more than 10% of your body surface area (about the size of your entire back, or 5% in children) 1, 2
• You have signs of smoke inhalation such as soot around your nose or mouth, or difficulty breathing 1
• You notice signs of infection: increasing pain, redness spreading beyond the burn, swelling, pus, or foul-smelling drainage 3
• The burn is not healing after 2-3 weeks 3

Daily Monitoring

Watch for these warning signs:

• Increased pain after the first few days 3
• Redness extending beyond the original burn margin 3
• Increased swelling 3
• Pus or cloudy drainage 3
• Fever or feeling unwell 3

Expected Healing Timeline

• Most second-degree burns heal within 2-3 weeks with proper care 1
• Continue treatment until the burn is completely healed 5
• Keep the area clean and protected even after it appears healed to prevent scarring 3