Variety of preparations, including topical and honey-based hydrogel-impregnated dressings Pain associated with application, may delay wound healing, associated with metabolic acidosis Pseudomonal coverage, penetrates eschar, used for deep burns or exposed cartilage, can be used on the face Water-based cream bacteriostatic against gram-positive and gram-negative bacteria Nonadherent barrier, secondary dressing over absorptive dressing, helps maintain moist environment, clings to the body Impregnated nonadherent gauze (Xeroform, Vaseline gauze) Narrow microbial coverage, need for frequent dressing changes, does not penetrate eschar, may cause urticaria or burning Inexpensive, painless, can be used on the face and near mucous membranes
CHEMICAL BURN ON FACE TREATMENT SKIN
1, 3 Surgical intervention and skin grafting are needed when burns extend beyond the superficial dermal layer, and healing usually takes three weeks or more. Pain sensation is reduced because nerve endings have been destroyed. 1, 3, 5 These burns appear white, waxy, dry, and leathery. 3, 6 Full-thickness burns ( Figure 3 7 ) extend through the entire dermis and into underlying fat and connective tissue and require automatic referral to a burn center. 3, 6 Deep partial-thickness burns should receive immediate evaluation by a burn surgeon for consideration of early operative management with tangential excision and skin grafting. 3 These usually take more than three weeks to heal and lead to loss of the dermal layer and scarring. 1, 6 Deep partial-thickness burns involve the reticular dermis, are drier, and do not blanch. Superficial partial-thickness burns are exudative, blanch with pressure, may blister, and are generally painful.
1, 3, 5 Partial-thickness burns are subclassified as superficial or deep ( Figure 2 8 ). 1, 3, 5, 6 With partial-thickness burns, the epidermis is destroyed and the dermal layer is injured.
These burns do not blister and take three to six days to heal. Superficial burns ( Figure 1 7 ) are localized to the epidermal layer and are painful, erythematous, dry, and blanching.
Targeted education initiatives may be effective in increasing patient and caregiver fire safety knowledge. In children, burns to the feet, buttocks, or posterior legs and hands a history incongruent with injury and the presence of burns with other unrelated injuries may be indicators of abuse. Patients with burns expected to take longer than 14 days to heal should be referred to a burn center because of the risk of hypertrophic scarring. 13, 14, 37īurn patients with diabetes mellitus who develop complications, such as cellulitis, should be referred to a burn center for further treatment. Patients with partial- or full-thickness burns who have unknown or inadequate tetanus immunization status should be vaccinated and given tetanus immune globulin. The burn surface should be cooled with running tap water for at least 20 minutes within three hours of the burn injury. Patient education during primary care visits may be an effective prevention strategy.īurn patients who meet American Burn Association referral criteria should be promptly transferred to a burn center. Burn injuries are more likely to occur in children and older people. Pruritus, hypertrophic scarring, and permanent hyperpigmentation are long-term complications of partial-thickness burns. People with diabetes mellitus are at increased risk of complications and infection, and early referral to a burn center should be considered. Prophylactic antibiotics are not indicated for outpatient management and may increase bacterial resistance. Full-thickness (third-degree) burns involve the entire dermal layer, and patients with these burns should automatically be referred to a burn center. Deep partial-thickness burns require immediate referral to a burn surgeon for possible early tangential excision. Superficial partial-thickness burns extend into the dermis, may take up to three weeks to heal, and require advanced dressings to protect the wound and promote a moist environment. Partial-thickness (second-degree) burns are subdivided into two categories: superficial and deep. Superficial (first-degree) burns involve only the epidermal layer and require simple first-aid techniques with over-the-counter pain relievers. Initial treatment is directed at stopping the burn process. All burn injuries are considered trauma, prompting immediate evaluation for concomitant injuries. Two key determinants of the need for referral to a burn center are burn depth and percentage of total body surface area involved.
Most patients with burn injuries are treated as outpatients.
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