Treatment of Partial Thickness Burns to the Chest
Apply petrolatum or petrolatum-based antibiotic ointment as first-line treatment after cooling the burn with clean running water for 5-20 minutes, then cover with a clean, nonadherent dressing changed daily. 1
Immediate Initial Management
Cooling Phase:
- Cool the burn immediately with clean running water for 5-20 minutes to limit tissue damage and reduce pain 1
- Remove any jewelry from the affected area before swelling occurs to prevent vascular compromise 1
- Never apply ice directly to the burn, as this causes additional tissue damage 1
- Avoid butter, oil, or home remedies, which exacerbate injury 1
Pain Control:
- Administer over-the-counter analgesics such as acetaminophen or NSAIDs for pain management 1
Wound Preparation and Cleaning
- After cooling, cleanse the wound with tap water, isotonic saline, or antiseptic solution 1
- Do not break intact blisters, as this significantly increases infection risk and delays healing 1, 2
Topical Treatment Selection
First-Line Agent:
- Petrolatum or petrolatum-based antibiotic ointment is the preferred first-line treatment due to faster reepithelialization, reduced scar formation, and superior healing outcomes 1
- Apply a thin layer to the open burn wound 1
Alternative Agents (if petrolatum unavailable):
- Honey shows benefit with decreased mean healing time of 7.8 days compared to silver sulfadiazine, plus reduced hypertrophic scarring 1
- Aloe vera may be reasonable for small burns managed at home 1
Agent to AVOID:
- Do not use silver sulfadiazine as first-line therapy - it delays healing and worsens scarring compared to petrolatum-based treatments 1, 2, 3
- Multiple studies demonstrate that silver sulfadiazine increases time to wound healing and number of dressing applications 3
Dressing Protocol
- Cover the treated burn with a clean, nonadherent dressing 1
- Change dressing daily or as needed 1
- Reapply topical agent with each dressing change 1
Monitoring and Red Flags Requiring Immediate Specialized Care
Assess for these critical indicators:
- Burns greater than 10% total body surface area in adults require burn center evaluation 1
- Circumferential burns to the chest require immediate specialized care due to risk of respiratory compromise 1
- Blue, purple, or pale extremities indicating vascular compromise 1
- Signs of inhalation injury (though less likely with isolated chest burns) 1
Expected Healing Timeline
- Superficial partial-thickness burns typically heal within 3 weeks with appropriate moisture-retentive dressings 4
- Inadequate pain control and failure to use appropriate moisture-retentive dressings compromise healing 2