Which of the following statements regarding burns is false: A. Low-temperature burns with prolonged contact produce mild injuries, B. Epithelium remains intact with erythema, C. Every burned patient requires tetanus (Tetanus Toxoid) vaccination, or D. All facial burns should be referred to a burn unit?

From the Guidelines

The statement "Every burned patient must receive tetanus vaccination" is false. Not every burn patient requires tetanus vaccination, as tetanus prophylaxis in burn patients depends on the patient's immunization status and the nature of the burn, as outlined in the guide to tetanus prophylaxis in routine wound management 1. For patients with clean minor burns who have completed a primary tetanus series and received a booster within the last 10 years, no tetanus vaccination is needed, according to the recommendations of the Advisory Committee on Immunization Practices (ACIP) 1. Some key points to consider in tetanus prophylaxis include:

• The number of doses of adsorbed tetanus toxoid–containing vaccines the patient has received
• The type of wound, with clean and minor wounds having different recommendations than all other wounds
• The use of tetanus immune globulin (TIG) in certain cases, such as contaminated wounds or uncertain tetanus immunization history The other statements are true:
• Burns from low temperature with prolonged contact can indeed produce mild injuries despite the lower temperature due to the extended exposure time
• Epithelium remains intact with erythema in first-degree burns
• Burns affecting the face should be referred to a burn unit due to potential complications involving airway, functional concerns, and cosmetic outcomes. Tetanus prophylaxis is only indicated for patients with more severe burns, contaminated wounds, or those with incomplete or uncertain tetanus immunization history, as specified in the guide to tetanus prophylaxis in routine wound management 1.

From the Research

Analysis of Burn Injury and Tetanus Vaccination

• The statement "Every burned patient must receive tetanus vaccination" is not entirely accurate, as tetanus vaccination is not always necessary for every burned patient 2, 3, 4.
• According to the studies, tetanus vaccination is recommended for patients with tetanus-prone wounds, such as severe crushing injuries, piercing wounds, blisters, and burns, particularly if contaminated with dirt, grass, or other debris 3, 5, 6.
• The decision to administer tetanus vaccination should be based on the patient's immunization history and the risk of tetanus infection 3, 4, 5.
• Burns of low temperature but long contact can produce mild injury, and the epithelium may be intact with erythema 2.
• Referral to a burn unit is recommended for any burn affecting the face, as well as for other severe burns or those with a high risk of complications 2, 5.

Exceptions to Tetanus Vaccination

• Not every burned patient requires tetanus vaccination, as the need for vaccination depends on the patient's immunization history and the risk of tetanus infection 2, 3, 4.
• Patients who have received a tetanus vaccine within the past 10 years may not require a booster dose 2, 4.