Treating Burn Wounds
Infection Can Be a Problem
More than two million major burn accidents occur each year in the U.S. Burns are classified by their severity. Most first degree burns can be treated at home; second and third degree burns smaller than three inches in diameter may often be treated at home. All third degree burns must be treated by a physician. Burns occurring on the hands, feet, face, groin, buttocks or a major joint should be treated by a physician.
Burns result in 12,000 deaths each year. Serious burns are most common in persons under age 17. The number of deaths due to burns has dropped sharply since 1950 as a result of stricter safety standards, use of flame retardant fabrics and better treatment for serious burns.
Burns Can Be Life Threatening: Depending on the amount of damage to tissues and the extent of the area affected, burns can range from very minor to life-threatening. Many burns can be treated at home, but others require the help of a health care professional. The correct first aid treatment of a burn can prevent infection and help the injured area heal quickly. A burn can be caused by heated objects, hot liquids, fire, the sun, chemicals and electricity. Most burns occur in the home, from cooking or a heating appliance. The most common burn occurring outside the home is a sunburn.
Burn Classification: Burns are classified according to their severity. First degree burns affect the surface layer of the skin (epidermis). The area is red and painful, but blisters do not form. First degree burns heal in a few clays without scarring. Second degree burns affect the layer of tissue under the epidermis (dermis). The skin appears red and is very painful, with blistering and oozing. If the burn is deep, scarring will occur. Superficial burns will heal without a scar in a few weeks. Third degree burns affect the full thickness of the skin. Because the nerve endings in the area are dead, they are not as painful as first and second degree burns. Most first degree burns can be treated at home. Second degree burns smaller than three inches in diameter may often be treated safely at home. All third degree burns must be treated by a physician. If in doubt, always have the burn looked at by a health care professional.
Treatment: The goals of treatment are to relieve pain, protect the area from the air, prevent the skin from drying out and allowing the burn to heal without infection. If the skin is not broken, cool water is the best treatment for a minor burn. The area should be soaked in a bowl of cool water or placed under running water for two to five minutes. This stops the burn from getting worse and cuts down on the swelling and pain in the area. After the burn is washed, it should be covered with a sterile, nonadhering bandage to which an antibacterial ointment has been applied. The bandage should be changed every 48 hours. If the area is not easily bandaged, a skin protectant, which helps the burn area remain moist and relieves any irritation, may be applied. Certain burn products contain local anesthetics to relieve pain. These should not be used for serious burns, burns over large areas or on blistered and damaged skin. Since their anesthetic action is short, they are best used on very minor burns when pain is most intense. Hydrocortisone ointment is a safe and effective alternative, especially for mild-to-moderate sunburns. If the area is weeping, such as with a second degree burn, the area may be soaked in water, normal saline or diluted Burow’s solution 3-6 times a day to reduce inflammation. Acetaminophen or aspirin can be used for pain. Most minor burns heal by themselves. Signs of infection (increased swelling, redness or worsening pain) should be watched closely.