What is the dressing plan for a superficial (partial-thickness) dermal burn?

From the Guidelines

For superficial dermal burns, I recommend covering the wound with a nonadherent bandage or clean cloth to protect the wound and reduce pain while avoiding heat entrapment until the burn can be assessed by a health care professional. This approach is supported by the 2024 American Heart Association and American Red Cross guidelines for first aid 1. The use of a nonadherent bandage or clean cloth is crucial in preventing further injury to the wound and promoting a comfortable environment for healing.

When creating a dressing plan, consider the following key points:

• Gentle handling of the wound to prevent further damage
• Avoiding heat entrapment to prevent increased pain and potential infection
• Protecting the wound from external contaminants
• Regular assessment by a healthcare professional to monitor for signs of infection or other complications

It is essential to prioritize the patient's comfort and wound protection, as outlined in the guidelines 1. By following this approach, patients with superficial dermal burns can receive appropriate care and attention to promote healing and prevent potential complications.

In terms of specific dressing materials, a nonadherent bandage or clean cloth is recommended, as stated in the guidelines 1. This type of dressing allows for easy removal and reapplication without causing further trauma to the wound.

Overall, the primary goal of a dressing plan for superficial dermal burns is to promote a safe and comfortable healing environment while preventing potential complications, and covering the wound with a nonadherent bandage or clean cloth is the most appropriate initial step.

From the FDA Drug Label

The grafted area should be covered with one layer of fine mesh gauze. An eight-ply burn dressing should be cut to the size of the graft and wetted with Mafenide Acetate 5% Topical Solution using an irrigation syringe and/or irrigation tubing until leaking is noticeable The irrigation dressing should be secured with a bolster dressing and wrapped as appropriate. The gauze dressing should be kept wet Wound dressings may be left undisturbed, except for the irrigations, for up to five days

The dressing plan for a superficial dermal burn involves:

• Covering the grafted area with one layer of fine mesh gauze
• Using an eight-ply burn dressing cut to the size of the graft, wetted with Mafenide Acetate 5% Topical Solution
• Securing the irrigation dressing with a bolster dressing and wrapping as appropriate
• Keeping the gauze dressing wet, with irrigations every 4 hours or as necessary if using irrigation tubing, or every 6-8 hours if not using irrigation tubing
• Leaving wound dressings undisturbed for up to five days, except for irrigations 2

From the Research

Dressing Options for Superficial Dermal Burns

• Topical petrolatum gel alone has been shown to be as effective as topical silver sulfadiazine with standard gauze dressings for the treatment of superficial partial thickness burns in adults, with a mean time to re-epithelialization of 6.2 days compared to 7.8 days for silver sulfadiazine 3.
• Petrolatum gel without top dressings may be an effective, affordable, and widely available alternative in the treatment of minor superficial partial thickness burns in adults, with no wound infection or dermatitis observed in the study group 3.
• A systematic overview of treatments for partial-thickness burns found insufficient evidence to support or refute the use of antimicrobial prophylaxis, and suggested that dressings with petrolatum gel may be as effective as silver sulfadiazine 4.

Comparison of Dressing Types

• Hydrofiber dressings saturated with mafenide acetate have been shown to extend the duration of antimicrobial activity, with sustained activity against Staphylococcus aureus and Pseudomonas aeruginosa for at least 72 hours without repeated soaks 5.
• Mafenide acetate solution dressings have been used as an adjunct in burn wound care, with effective debridement, granulation tissue protection, and bacterial control, and have been shown to be comfortable for patients and not hinder epithelialization 6.
• Silver sulfadiazine has been compared to maphenide (Sulfamylon) in a clinical study, with silver sulfadiazine showing superior results in relation to clinical infection rate and culture rate, and a reduced mortality rate 7.

Key Considerations

• The choice of dressing for superficial dermal burns should be based on the individual patient's needs and the specific characteristics of the burn wound.
• Further research is needed to fully understand the effectiveness of different dressing types and to guide clinical practice 4.