Silver sulfadiazine may be used for deep partial thickness burns.Avoid occlusive dressings, as they do not allow drainage of exudates and may provide an environment conducive to the development of infection.The following are some points to keep in mind when considering dressing options for second degree burns: In addition, patient comfort must be considered. Whether to leave blisters intact should be decided on an individual basis.ĭressing second degree burns should take into account keeping the wound bed moist and protected, as well as clean. There are valid arguments on both sides of the issue. 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 also inhibits immune function. 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. There are two schools of thought in regards to how to treat blisters associated with second degree burns. 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 first and second degree burns. These burns may take up to a month to heal, and scarring may be extensive. They are less red and are drier than superficial second degree burns. Deep partial thickness burns - these burns involve the epidermis and extend through most of the dermis.Superficial partial-thickness burns normally heal in approximately two weeks. Scarring may result, but is generally minimal. These burns are very painful due to the fact that nerve endings are intact but are exposed due to loss of the epidermis. The dermis is only involved superficially. Superficial partial-thickness burns - these burns involve the epidermis and the dermis.Second degree burns, also referred to as partial-thickness burns, are divided into two categories: Patients may be advised to apply a moisturizer containing a sun block to the burned area(s) until the burns have healed entirely. Antimicrobials are not required for first degree burns. Some patients may even require hospitalization briefly in order to control pain. Analgesics may be required for patients who experience large first degree burns. In addition, moisturizers may increase comfort. Cool compresses may provide some relief from pain. These burns generally heal quickly and do not cause scarring.įirst degree burns are not considered to be open wounds therefore, they require no dressings. The injured epidermis will slough off after a few days. When touched, skin that is burned superficially will blanch. They are dry, red and can be very painful. First Degree Burnsįirst degree burns, often referred to as superficial burns, affect only the epidermis or outermost layer of skin. The following is an overview of first and second degree burns, including pathophysiology and treatment. Health care professionals encounter burns in their patient populations frequently, and must be able to differentiate between types of burns, as well as know how to treat burn injuries using current practice standards. By Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS
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