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Burns

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Scar Management

 

Minor Wounds    

 

Burns can be sustained in a number of ways. In children and the elderly, the most common cause of burns are scalds involving hot liquids, while in adults, flame burns are more prevalent. Other causes can include chemical contact, electrical and friction damage, and sunburn.

 

The seriousness of a burn injury depends on several factors including:

  • The size and depth of the burn
  • The location of the burn
  • The age and general medical condition of the burn patient

 

Clinical studies suggest that about 95% of all burns are relatively minor, however about 5% require hospitalisation and highly specialised treatment. The severity of a burn determines the type of treatment it requires. Previously, terminology used to describe burn damage included "First-degree", "Second-degree" and "Third-degree". This terminology has been replaced by the recognised grades of burns that detail the tissue depth as listed below:

  • Minor/Superficial (sometimes referred to as epidermal)
  • Superficial Partial Thickness
  • Mid Dermal Partial Thickness
  • Deep Dermal Partial Thickness
  • Full Thickness

 

Depth Characteristics  Image


Minor/Epidermal


Red

Painful

Usually not blistered

Will heal within approximately 7 days with no scarring

 

burn1

 

Superficial Dermal

 

Blistered with pale pink base

Very painful

Usually heals by epithelialisation in 10 - 14 days with no scarring

 

burn2

 

Mid - Deep Dermal

 

Blotchy

Red or white base +/- blisters

No capillary return

Predominantly painless

Prolonged healing with possible scarring and contracture

Heal in 14 - 28 days

 

burn3

 

Full Thickness

 

Leathery, white or charred

Painless

Prolonged healing with scarring and possible loss of function

 

 

For more information on the recognised grades of burn >

 

Treatment

The clinical objectives for management of burns are:

  • Stabilise the patient
  • Cool the wound
  • Debride devitalised (necrotic) tissue
  • Protect from infection
  • Close the wound by primary or secondary healing or by grafting

 

The impact of first aid cannot be overemphasized with rapid, effective first aid helping to prevent further damage and deeper tissue loss. Burn wound conversion refers to the process whereby tissue damage can extend to deeper layers resulting in prolonged healing. This increases the risk of complications post healing such as contraction and keloid or hypertrophic scarring.

 

Certain burns require assessment and/or admission to a burns unit. The Australian and New Zealand Burn Association (ANZBA) list the referral criteria to a burns unit on their website.

 

Product Selection

Depth

Product Selection

Minor/Epidermal

Moisture donating:

Exudtate Management:

Protective Dressings:

Superficial Dermal


Protective Dressings:

Exudate Management:

Antimicrobials:

 

Mid - Deep Dermal & Full Thickness

 

Referral to burns clinician:

Scar Management

 

Silicone Gel Sheet:

Compression Garments:

 

 

Related Links

--> Australian and New Zealand Burn Association (ANZBA)

--> Burns Education