Minor burns are generally self-healing. Treatment aims to prevent dehydration and infection, and should be followed on an outpatient basis:
- irrigate wound under copious running cold water until pain relieved
- clean with saline or an antiseptic
- provide analgesia - such as dihydrocodeine for an adult, or trimeprazine syrup for a child
- in general, blisters should be left to protect the healing epithelium - but - deroof large blisters which have broken; aspirate tense blisters
- apply silver sulphadiazine cream - Flamazine - and dress with a non-adherent paraffin - impregnated gauze - such as Jelonet
- cover dressing with thick absorbent layer of cotton wool or a Gamgee pad, then a crepe bandage
- elevate arm and hand burns in a sling
- give tetanus prophylaxis and analgesia to take home
Follow-up:
- repeat the dressing after 2 days but omit the silver sulphadiazine
- do not remove dressing which has become adherent otherwise the newly forming epithelium will be destroyed
- change dressing every 5 days
- once epithelialised, leave exposed or cover with dry, non-adherent dressing
- burn which have not re-epithelialised within 14 to 21 days should be considered for skin grafting
Do not forget the possibility of non-accidental injury in a child especially if circumstances are suspicious:
- delay in attending for treatment
- burn to face, hand, foot, perineum
- explanation untenable