From the Guidelines
For second-degree burns, immediately cool the burn with cool (not cold) running water for 10-15 minutes to stop the burning process and reduce pain, as recommended by the 2024 American Heart Association and American Red Cross guidelines for first aid 1.
Key Considerations
- After cooling, gently clean the area with mild soap and water, then apply an antibiotic ointment like bacitracin or petroleum jelly to keep the wound moist, as suggested by the guidelines 1.
- Cover the burn with a sterile, non-stick bandage or gauze and secure it loosely with medical tape, taking care to avoid heat entrapment and promote wound protection 1.
- Change the dressing daily or whenever it becomes wet or dirty to prevent infection and promote healing.
Pain Management
- For pain management, take over-the-counter medications like acetaminophen (Tylenol) or ibuprofen (Advil) as directed, as recommended by the guidelines 1.
Monitoring and Follow-up
- Second-degree burns typically heal within 2-3 weeks but should be monitored for signs of infection such as increased pain, redness, swelling, warmth, or pus.
- Avoid breaking blisters as they protect against infection, and keep the burn elevated when possible to reduce swelling.
- Seek immediate medical attention if the burn is larger than 3 inches, affects the face, hands, feet, genitals, or major joints, or if you notice signs of infection.
Wound Care
- Burn wound care should be performed in a clean environment, and the wounds should be cleaned with tap water, isotonic saline solution, or an antiseptic solution before applying the dressing 1.
- The type of dressing depends on the size and location of the wound, as well as the patient's general condition, and should be re-evaluated daily to prevent complications and promote healing.
From the FDA Drug Label
Silver sulfadiazine cream, USP 1% is a topical antimicrobial drug indicated as an adjunct for the prevention and treatment of wound sepsis in patients with second and third degree burns. For the treatment of 2nd degree burns, silver sulfadiazine (TOP) can be used as an adjunct for the prevention and treatment of wound sepsis 2.
- The drug is applied topically.
- It is used for the treatment of wound sepsis in patients with 2nd degree burns.
From the Research
Treatment Options for 2nd Degree Burns
- Prehospital first aid, nonsurgical treatment, surgical treatment, and infection treatment are crucial aspects of managing second-degree burns, as outlined in the Consensus on the Treatment of Second-Degree Burn Wounds (2024 edition) 3, 4.
- Topical antibacterial agents, such as silver sulfadiazine, have been used to prevent infection in burn wounds, with low toxicity and few side effects 5.
- The development of effective topical antimicrobial agents has been a significant advance in burn care, but gaps remain, particularly in treating complicated burn wounds and preventing fungal infections 6.
- Hydrogels are a promising option for managing second-degree burns, offering a protective, absorbent, and transparent dressing that can facilitate wound evaluation and dressing changes 7.
Key Considerations
- Burn site, patient age, and burn area are essential factors to consider when choosing a treatment plan for second-degree burns 3, 4.
- The lack of a unified standard for diagnosis, classification, and treatment of second-degree burns can pose challenges to clinical management and research consistency 3, 4.
- Ongoing research is needed to address the remaining gaps in burn care, including the development of new topical antimicrobial agents and improved wound dressings 6, 7.