What are the treatment guidelines for pediatric finger burns?

From the Guidelines

The treatment of pediatric finger burns should begin with immediate cooling of the burn with cool running water for 10-20 minutes, as recommended by the 2024 American Heart Association and American Red Cross guidelines for first aid 1. This initial step is crucial in limiting tissue damage and reducing pain.

• Cooling with running water has been shown to decrease the need for subsequent care in patients with thermal burns, according to a meta-analysis of observational data 1.
• After cooling, the burn area should be cleaned gently with mild soap and water.
• For minor burns (first-degree or small second-degree), a thin layer of petrolatum, petrolatum-based antibiotic ointment, honey, or aloe vera may be applied, along with a clean nonadherent dressing 1.
• Pain management is also essential and can be achieved with over-the-counter pain medications such as acetaminophen or ibuprofen, as suggested by the guidelines 1.
• It is also important to loosely cover the burn with a clean cloth or nonadherent dry dressing while awaiting evaluation by a healthcare professional, especially for burns with intact skin or an intact blister 1.
• For deeper second-degree or third-degree burns, or those involving the face, hands, feet, and genitals, immediate medical attention is necessary, as these may require specialized care, including surgical intervention 1.
• Proper positioning of the finger during healing and keeping the burned area elevated can help reduce swelling and maintain function.
• Ensuring the child stays well-hydrated and receives adequate nutrition is also vital to support the healing process.

From the FDA Drug Label

Prompt institution of appropriate regimens for care of the burned patient is of prime importance and includes the control of shock and pain. The burn wounds are then cleansed and debrided; silver sulfadiazine cream, USP 1% is then applied under sterile conditions. The cream should be applied once to twice daily to a thickness of approximately one sixteenth of an inch. Treatment with silver sulfadiazine cream, USP 1% should be continued until satisfactory healing has occurred or until the burn site is ready for grafting.

The treatment guideline for pediatric finger burn includes:

• Cleansing and debridement of the burn wound
• Application of silver sulfadiazine cream, USP 1% under sterile conditions
• Applying the cream once to twice daily to a thickness of approximately one sixteenth of an inch
• Continuing treatment until satisfactory healing has occurred or until the burn site is ready for grafting 2 For children under 2 years of age, it is recommended to ask a doctor before applying bacitracin 3

From the Research

Treatment Guideline for Pediatric Finger Burn

• The primary goal of treating pediatric burns is to allow the patient to heal with as little scarring as possible 4.
• Pediatric burns require special consideration due to anatomic differences, such as thinner skin, which can lead to a higher risk of full-thickness burns 4.
• Treatment strategies for pediatric finger burns include:
  • Optimizing reepithelialization in superficial burns to reduce scarring 4.
  • Using skin grafting techniques, such as "sheet" autograft skin, for deeper burns 4.
  • Applying topical antimicrobial agents to prevent infection, with silver-containing dressings being a commonly recommended option 5, 6, 7.
• The choice of topical antimicrobial agent may depend on the depth and severity of the burn, as well as the clinical scenario 7.
• Early management of pediatric hand burns may involve a nonoperative approach, with emphasis on antimicrobial therapy, escharotomy, and wound care 8.
• Techniques such as splinting, positioning, and exercising the burned hand can help prevent contracture and promote healing 8.