How Often To Change Dressing On 2nd Degree Burn

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By Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS

Health care professionals encounter burns in their patient populations oftentimes, and must be able to differentiate between types of burns, as well as know how to treat burn injuries using current practice standards. The following is an overview of commencement and second degree burns, including pathophysiology and treatment.

First Degree Burns

Showtime degree burns, often referred to as superficial burns, touch on simply the epidermis or outermost layer of skin. They are dry out, cherry and tin be very painful. When touched, skin that is burned superficially will flinch. The injured epidermis will slough off after a few days. These burns mostly heal quickly and do non cause scarring.

Showtime caste burns are non considered to be open up wounds; therefore, they require no dressings. Cool compresses may provide some relief from pain. In improver, moisturizers may increase comfort. Analgesics may exist required for patients who experience large first degree burns. Some patients may even crave hospitalization briefly in order to command pain. Antimicrobials are non required for start caste burns. Patients may be advised to apply a moisturizer containing a sunday block to the burned expanse(s) until the burns accept healed entirely.

Second Degree Burns

Second degree burns, also referred to every bit partial-thickness burns, are divided into 2 categories:

Superficial partial-thickness burns - these burns involve the epidermis and the dermis. The dermis is only involved superficially. Second degree burns are moist and red. There may be cicatrice germination. These burns are very painful due to the fact that nerve endings are intact only are exposed due to loss of the epidermis. Scarring may outcome, simply is by and large minimal. Superficial partial-thickness burns usually heal in approximately ii weeks.
Deep partial thickness burns - these burns involve the epidermis and extend through near of the dermis. They are less scarlet and are drier than superficial second degree burns. They may also be less painful. These burns may take up to a month to heal, and scarring may be all-encompassing.

It is important to remember that burns often contain a mixture of burn depths; therefore it is possible for a patient to have areas of both get-go and 2nd caste burns.

There are two schools of idea in regards to how to care for blisters associated with 2d caste burns. Some experts favor leaving blisters intact, as they believe that blister formation protects the wound bed, keeping it moist, protected and clean, and that purposefully breaking or debriding blisters increases the risk of infection. Experts in favor of puncturing or debriding blisters believe that the fluid contained in blisters may provide a medium for bacterial growth, and that this fluid besides inhibits immune office. There are valid arguments on both sides of the outcome. Whether to go out blisters intact should be decided on an private basis.

Dressing second degree burns should accept into account keeping the wound bed moist and protected, every bit well equally clean. In addition, patient comfort must be considered. The following are some points to keep in mind when considering dressing options for second caste burns:

Avert occlusive dressings, as they do not permit drainage of exudates and may provide an environment conducive to the evolution of infection.
Silver sulfadiazine may be used for deep partial thickness burns. Information technology is a broad spectrum antimicrobial. Do non utilize if the patient is allergic to sulfa drugs, is pregnant, or is an baby less than 2 months of age.
Wrap fingers individually when dressing burn wounds to fingers.
When dressing burns that are over a joint, be sure to allow full range of motion.
Hydrofibers, alginates and foam dressings may be used on superficial partial thickness burns. These products may crave fewer dressing changes. In addition, they absorb exudate and keep the wound bed moist.
Bacitracin may be used on superficial fractional thickness wounds. The ointment should be covered with a not-adherent dressing and dry gauze to secure it in place. Dressings may crave irresolute twice a day, just should exist changed once per day at a minimum.
Burns should be cleansed initially with a commercial wound cleanser or a gentle lather and water.

Information technology may be a simple matter to differentiate betwixt first and second caste burns, but it is oftentimes more difficult to differentiate betwixt superficial and deep partial-thickness burns. Deep second degree burns sometimes require grafting and a surgeon should be consulted if there is whatever doubt, specially when burns are extensive.

Sources
Moss, L. (2010) Treatment of the burn patient in primary care. Advances in Skin and Wound Care 2010, 23: 517- 524.

Singer, A & Dagum, A. (2008). Current management of acute cutaneous wounds. N Engl J Med 2008; 359:1037-1046.

About The Writer
Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS is a Certified Wound Therapist and enterostomal therapist, founder and president of WoundEducators.com, and advocate of incorporating digital and computer applied science into the field of wound care.

The views and opinions expressed in this weblog are solely those of the author, and practice not represent the views of WoundSource, Kestrel Health Information, Inc., its affiliates, or subsidiary companies.

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