What is the treatment for intact skin blisters resulting from thermal burns caused by touching a very hot object?

From the Guidelines

For intact skin blisters from touching a hot pot, it is recommended to leave the blister unbroken if possible, as this approach has been shown to improve healing and reduce pain, according to the most recent guidelines 1. When managing intact skin blisters, consider the following steps:

• Gently clean the area with mild soap and water to prevent infection.
• Apply a topical antibiotic ointment, such as petrolatum-based antibiotic ointment, to the affected area, as suggested by recent guidelines 1.
• Loosely cover the blister with a clean cloth or nonadherent dry dressing, as recommended by the 2024 American Heart Association and American Red Cross guidelines for first aid 1.
• Take over-the-counter pain relievers, such as acetaminophen or ibuprofen, as needed for pain management, which is supported by the guidelines 1.
• Monitor for signs of infection, including increased pain, redness, warmth, swelling, or pus, and seek medical attention if necessary. It is essential to prioritize the integrity of the blister to promote healing and prevent infection, as evidenced by the consensus on science 1 and the treatment recommendations 1.

From the Research

Treatment of Intact Skin Blisters

To treat intact skin blisters resulting from touching a very hot pot, it is essential to consider the following steps:

• Keep the blister intact to reduce the risk of infection
• Apply a topical antimicrobial agent to prevent infection
• Use a dressing to protect the blister and promote healing

Topical Antimicrobial Agents

Some effective topical antimicrobial agents for burn wounds include:

• Silver sulfadiazine 2, 3, 4, 5, 6
• Bacitracin 3, 6
• Neomycin 3, 6
• Mafenide 6
• Polymyxin B sulfate 4

Treatment Recommendations

According to international guidelines, silver-containing dressings are recommended over antiseptics or antibiotics, regardless of the depth of the burn 5. Silver sulfadiazine is the most recommended topical antimicrobial in low-resource settings 5. However, there is currently no ideal topical antimicrobial agent that can be recommended for all clinical scenarios 5.

Burn Wound Care

Proper treatment minimizes the extent of the burn injury, whereas improper treatment may actually increase the size and/or depth of the wound 6. The goal of topical antimicrobial therapy is to control microbial colonization, thus preventing development of invasive infections 6.