Materiały źródłowe

• #1 Current therapy of burns – Surgical Treatment – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK6954/

  The current therapy of the acutely burned patient is based on adequate resuscitation, early wound debridement and closure, support of post burn hypermetabolic response and control of infection. […] Treatment begins by removing the victim from the continuing source of injury. […] Fluid resuscitation is aimed at restoring circulating intravascular volume. […] Burn wounds can be classified as first; second or third degree based on surface appearance. […] Need for surgical intervention/debridement depends on the depth of the injury. […] It is generally accepted that early debridement and grafting of wounds requiring surgery reduces hospital stay and morbidity/mortality. […] After the eschar has been excised, the wound must be closed. […] Infection remains a significant problem until the integrity of the skin, lungs and gut can be restored and resolution of post burn immunosuppression occurs. […] Rehabilitation begins with wound coverage to prevent burn scar contracture. […] Burn wound mortality and morbidity have steadily decreased over the last 30 years. Recognition of the potential complications, early excision and wound closure has led to these changes.

• #1 Burns: First aid

  https://www.mayoclinic.org/first-aid/first-aid-burns/basics/art-20056649

  Major burns need emergency medical help. Minor burns can usually be treated with first aid. […] For major burns, apply first aid until emergency help arrives: Protect the burned person from further harm. If you can do so safely, make sure the person you’re helping is not in contact with the source of the burn. For electrical burns, make sure the power source is off before you approach the burned person. Make certain that burned person is breathing. If needed, begin rescue breathing if you know how. Remove jewelry, belts and other tight items, especially from the burned area and the neck. Burned areas swell quickly. Cover the burn. Loosely cover the area with gauze or a clean cloth. Raise the burned area. Lift the wound above heart level if possible. Watch for symptoms of shock. Symptoms include cool, clammy skin, weak pulse and shallow breathing.

• #1 Burns: First aid

  https://www.mayoclinic.org/first-aid/first-aid-burns/basics/art-20056649

  For minor burns, follow these first-aid guidelines: Cool the burn. Hold the area under cool not cold running water for about 10 minutes. If this isn’t possible or if the burn is on the face, apply a cool, wet cloth until the pain eases. For a mouth burn from hot food or drink, put a piece of ice in the mouth for a few minutes. Remove rings or other tight items. Try to do this quickly and gently, before the burned area swells. Apply lotion. After the burn is cooled, apply a lotion, such as one with aloe vera or cocoa butter. This helps prevent drying. Bandage the burn. Cover the burn with a clean bandage. Wrap it loosely to avoid putting pressure on burned skin. Bandaging keeps air off the area, reduces pain and protects blistered skin. If needed, take a nonprescription pain reliever, such as ibuprofen (Advil, Motrin IB, others) or acetaminophen (Tylenol, others).

• #1 Treatment of minor thermal burns – UpToDate

  https://www.uptodate.com/contents/treatment-of-minor-thermal-burns

  Cleaning — Burn wounds should be cleaned. Although some clinicians use skin disinfectants, these cleansers can inhibit the healing process and we discourage using them. Instead, we suggest washing minor burn wounds using only mild soap and tap water, an approach supported by a growing number of burn centers. Patients should be instructed to wash their burns daily with mild soap and water during dressing changes. […] Debridement — Sloughed or necrotic skin, including ruptured blisters, should be debrided before applying a dressing. Necrotic blister skin remnants may increase the risk of infection and limit the contact of topical antimicrobial agents to the burn wound. […] Blisters — Blisters may develop with superficial or deep partial-thickness burns. Ruptured blisters should be debrided. However, small intact blisters <2 cm in diameter may be left alone.

• #1 How to treat a first-degree, minor burn

  https://www.aad.org/public/everyday-care/injured-skin/burns/treat-minor-burns

  Although first-degree burns are not as serious as higher-degree burns, they can hurt quite a bit and can leave a scar if not properly treated. […] To treat a first-degree burn at home, follow these tips from dermatologists. […] Most first-degree burns can be treated at home; however, its important to know what to do. […] To treat a first-degree burn, dermatologists recommend the following tips: […] Cool the burn. Immediately immerse the burn in cool tap water or apply cold, wet compresses. Do this for about 10 minutes or until the pain subsides. […] Apply petroleum jelly two to three times daily. Do not apply ointments, toothpaste or butter to the burn, as these may cause an infection. Do not apply topical antibiotics. […] Cover the burn with a nonstick, sterile bandage. If blisters form, let them heal on their own while keeping the area covered. Do not pop the blisters.

• #1 Burns: Types, Symptoms, and Treatments

  https://www.healthline.com/health/burns

  Burns are classified from first to third degree. Most people recover without serious health consequences, but more severe burns require emergency medical care to prevent complications and death. […] Burns are characterized by severe skin damage that causes the affected skin cells to die. […] Read on to learn how to identify first, second, and third-degree burns and how theyre treated. […] First-degree burns usually heal within 7 to 10 days without scarring. […] First-degree burns are usually treated with home care. Healing time may be quicker the sooner you treat the burn. Treatments for a first-degree burn include: soaking the wound in cool water for five minutes or longer, taking acetaminophen or ibuprofen for pain relief, applying lidocaine (an anesthetic) with aloe vera gel or cream to soothe the skin, using an antibiotic ointment and loose gauze to protect the affected area.

• #1 Home Remedies for Burns: What You Should Use

  https://www.healthline.com/health/home-remedies-for-burns

  You can treat most first-degree burns and second-degree burns less than 3 inches in diameter at home with a number of home remedies. Higher-degree burns need to be treated by a doctor. […] The goal of burn treatment is to reduce pain, prevent infections, and heal the skin faster. […] Mild burns typically take around a week or two to completely heal and usually dont cause scarring. […] Aloe vera is often touted as the burn plant. Studies show evidence that aloe vera is effective in healing first- to second-degree burns. Aloe is anti-inflammatory, promotes circulation, and inhibits the growth of bacteria. […] Honey may help heal a minor burn when applied topically. Honey is an anti-inflammatory and naturally antibacterial and antifungal. […] Third-degree burns should never be treated at home. They carry the risk of serious complications, including infections, blood loss, and shock. […] Symptoms of third-degree burn include waxy, white-colored skin, char, dark brown color, and raised and leathery texture. […] Burns caused by an electrical shock are also too risky for home treatment. These burns often reach layers under the skin and can even cause damage to internal tissues.

• #1 How to treat a first-degree, minor burn

  https://www.aad.org/public/everyday-care/injured-skin/burns/treat-minor-burns

  Consider taking over-the-counter pain medication. Acetaminophen or ibuprofen can help relieve the pain and reduce inflammation. […] Protect the area from the sun. Once the burn heals, protect the area from the sun by seeking shade, wearing protective clothing or applying a broad-spectrum, water-resistant sunscreen with an SPF of 30 or higher. This will help minimize scarring, as the redness from a burn sometimes persists for weeks, especially in those with darker skin tones. […] First-degree burns usually heal on their own without treatment from a doctor. However, if your first-degree burn is very large, if the victim is an infant or elderly person, or if you think your burn is more severe, go to an emergency room immediately.

• #1 Outpatient Burn Care: Prevention and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/0415/p463.html

  Most patients with burn injuries are treated as outpatients. Two key determinants of the need for referral to a burn center are burn depth and percentage of total body surface area involved. Initial treatment is directed at stopping the burn process. Superficial (first-degree) burns involve only the epidermal layer and require simple first-aid techniques with over-the-counter pain relievers. Partial-thickness (second-degree) burns are subdivided into two categories: superficial and deep. 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. Deep partial-thickness burns require immediate referral to a burn surgeon for possible early tangential excision. Full-thickness (third-degree) burns involve the entire dermal layer, and patients with these burns should automatically be referred to a burn center. Prophylactic antibiotics are not indicated for outpatient management and may increase bacterial resistance. People with diabetes mellitus are at increased risk of complications and infection, and early referral to a burn center should be considered.

• #1 Topical agents and dressings for local burn wound care – UpToDate

  https://www.uptodate.com/contents/topical-agents-and-dressings-for-local-burn-wound-care

  Measures to reduce the likelihood of infection include good infection control practices, topical antimicrobial therapy, and burn wound debridement/excision when needed. […] A variety of antimicrobial agents can be applied to the burn wound surface, which is then covered with one of several dressing materials. […] Commonly used topical agents include combination antimicrobial ointments, silver sulfadiazine, bismuth-impregnated petroleum gauze, mafenide, and chlorhexidine. […] When contamination with methicillin-resistant Staphylococcus aureus (MRSA) is suspected/confirmed, directed topical antimicrobial treatment (eg, mupirocin ointment/cream) should be added as a treatment. […] Aggressive wound care that includes topical agents with antimicrobial activity has been associated with a reduced incidence of invasive wound infections, but the efficacy of topical therapy has not been definitively proven.

• #1 Outpatient Burns: Prevention and Care | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/0101/p25.html

  Most burn injuries can be managed on an outpatient basis by primary care physicians. […] Superficial burns can be treated with topical application of lotions, honey, aloe vera, or antibiotic ointment. […] Partial-thickness burns should be treated with a topical antimicrobial agent or an absorptive occlusive dressing to help reduce pain, promote healing, and prevent wound desiccation. […] Topical silver sulfadiazine is the standard treatment; however, newer occlusive dressings can provide faster healing and are often more cost-effective. […] More than 95 percent of burn wounds can be successfully managed in the outpatient setting. […] Excellent results can be achieved by primary care physicians with knowledge of basic concepts of burn care. […] Goals of burn management include rapid healing, pain control, return of full function to the injured area, and good aesthetic results.

• #1 Burns | MSF Medical Guidelines

  https://medicalguidelines.msf.org/en/viewport/CG/english/burns-18482397.html

  Regular dressing changes are essential, and the first dressing procedure should be performed in the operating room under general anaesthesia. […] Pain management is crucial, with morphine being the treatment of choice for moderate to severe pain. […] Minor burns are treated as outpatients with wound care and pain management.

• #1 Burns Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/condition/burns

  While minor burns may be treated at home, all other burns require immediate emergency medical attention because of the risk of infection, dehydration, and other potentially serious complications. […] If you are burned seriously, you will be admitted to a hospital. There, doctors will concentrate on keeping the burned area clean and removing any dead tissue through a process called debridement. You will receive medicines to reduce pain and prevent infection. You will also get a tetanus shot if you have not had one in 5 or more years. […] Burns often cause pain and anxiety, even during recovery. You may also experience emotional distress if a burn changes his or your appearance. People with massive burns require early psychological and social support. Complementary therapies that may help alleviate such pain and anxiety include: Massage therapy, Hypnosis, Therapeutic touch, Acupuncture.

• #1 Outpatient Burn Care: Prevention and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/0415/p463.html

  Patients with burns expected to take longer than 14 days to heal should be referred to a burn specialist because of the risk of hypertrophic scarring. […] Burn patients with diabetes who develop complications, such as cellulitis, should be referred to a burn center for further treatment. […] Pain medication should be given early during treatment. […] Prophylactic antibiotics do not affect morbidity and may increase bacterial resistance. […] A significant proportion of childhood burn injuries are the result of child abuse or neglect. […] Identification of high-risk populations and common mechanisms of injury is key to developing an effective burn prevention strategy.

• #1 Burns: Types, Symptoms, and Treatments

  https://www.healthline.com/health/burns

  Treatments for a mild second-degree burn generally include: running the skin under cool water for 15 minutes or longer, taking over-the-counter pain medication (acetaminophen or ibuprofen), applying antibiotic cream to blisters. […] Never attempt to self-treat a third-degree burn. Call 911 immediately. […] Its important to gain adequate physical treatment for burns, but dont forget to find help for your emotional needs. There are support groups available for people who have experienced severe burns, as well as certified counselors.

• #1 Burn Triage and Treatment of Thermal Injuries in a Radiation Emergency – Radiation Emergency Medical Management

  https://remm.hhs.gov/burns.htm

  Treatment/avoidance of burn shock requires fluid resuscitation carefully titrated to maintain perfusion. […] Inadequate volumes of fluid resuscitation will allow hypoperfusion, resulting in both secondary end organ damage as well as further expansion of the initial burn injury. […] Over-resuscitation (administration of excessive volumes of fluids) can also cause serious injury and mortality via the life- and limb-threatening complications of edema. […] The cornerstone of modern burn care is to get source control of the inflammatory nidus by excising all burned tissue from the body. […] Early excision refers to the practice of surgically excising burn wounds down to healthy tissue. […] All wounds excised through full thickness of skin will require reconstruction, generally via autologous skin graft.

• #1 Burn – Hospital Care, Treatment, Recovery | Britannica

  https://www.britannica.com/science/burn/Hospital-treatment

  Nutrition can be a particularly vexing problem because the caloric needs are often greater than the patient can consume in a normal fashion. Thus, supplementary feedings administered intravenously or through a feeding tube placed into the stomach are commonplace in treating severe burns. […] The goals in managing the burn lesion are to prevent infection, to avoid further injury to the damaged tissues, and to close the wound as soon as possible. There are three major methods of therapy for the burn wound: exposure, occlusive dressings, and primary excision. […] Exposure therapy is indicated for surfaces that are easily left exposed, such as the face. […] Occlusive dressings, usually combined with topical antibacterial agents, are more commonly used in the treatment of extensive burns. […] Primary excisionthat is, the surgical removal of necrotic tissues within 24 to 48 hours of the injuryis used to prepare full-thickness burns for grafting at the earliest possible time.

• #1 Burns – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/burns/diagnosis-treatment/drc-20370545

  Medicines and products that may help with healing major burns include: Water-based treatments. Your care team may use techniques such as whirlpool baths to help remove dead tissue. […] Pain and anxiety medicines. Healing burns can be incredibly painful. You may need morphine and anti-anxiety medicine. These also might be needed when your bandages are changed. […] Burn creams and ointments. If you aren’t transferred to a burn center, your care team may use a variety of topical products for wound healing. Examples are bacitracin and silver sulfadiazine (Silvadene). These help prevent infection and prepare the wound to close. […] Skin grafts. A skin graft is a surgery that uses sections of your own healthy skin to replace the scar tissue caused by deep burns. Donor skin from deceased donors or pigs can be used for a short time.

• #1 Burn Wound Infections Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/213595-treatment

  Topical antimicrobials for the prevention and treatment of burn wound infection include mafenide acetate, silver sulfadiazine, silver nitrate solution, and silver-impregnated dressings. These various therapies differ in their ability to penetrate eschars, antimicrobial activities, and adverse-event profiles. […] In the event of a localized MRSA burn wound infection, fusidic acid and gentamycin sulfate can be used as topical treatment. Topical vancomycin is also available and has been demonstrated to be more effective than the systemic formulation with a lower adverse effect rate. […] Antibiotic prophylaxis at the time of wound manipulation has also been studied in patients with burns. Only a few studies have supported this use of systemic antibiotics during acute burn surgery. Antibiotics appear to be of no value in the preoperative setting; however, surgical prophylaxis in patients with burns of more than 40% TBSA appears to reduce the rate of burn wound infections, although it does not affect mortality.

• #1 Burn Triage and Treatment of Thermal Injuries in a Radiation Emergency – Radiation Emergency Medical Management

  https://remm.hhs.gov/burns.htm

  Aggressive nutritional support is essential to sustain the patient through the process of wound healing. […] The compromised skin barriers, inflammatory dysregulation and malnutrition all predispose patients with massive thermal injuries to opportunistic infections. […] The trauma of the initial injury and that associated with acute burn represent tremendous psychological stressors.

• #1 Module 3 Basic: Burn Treatment and Stabilization – MN Dept. of Health

  https://www.health.state.mn.us/communities/ep/surge/burn/module3basic.html

  The Parkland Formula was written about and described by a Charlie Baxter in Parkland, Texas, back in the 60s. […] The guidelines for safe transport is, again, keep the patient warm and dry. […] To prep a patient for outpatient clinic or to be followed either after being admitted or being discharged from the emergency department, make sure that they have the ability to receive the appropriate topical ointments such as Bacitracin or Neosporin or triple antibiotic ointment. […] Special circumstance surrounding burns are that of electrical injuries, inhalation injuries, and chemical burns. […] Electrical injuries are largely considered and inside-out injury, meaning muscle and internal compartments are damaged rather than from an outside-in, meaning that a lot of times that they develop what we call compartment syndromes of their extremities from the fascial exposure and the muscle injury as opposed to the eschar that develops from our normal thermal injuries.

• #1 Burns – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/burns/diagnosis-treatment/drc-20370545

  If you go to a healthcare professional for burn treatment, the health professional figures out how bad your burn is by examining your skin. […] Most minor burns can be treated at home. They usually heal within a couple of weeks. […] For major burns, after first aid and after a healthcare professional looks at your burns, treatment may involve one or more of the following: medicines, wound dressings, therapy and surgery. The goals of treatment are to control pain, remove dead tissue, prevent infection, lower scarring risk and restore function. […] People with major burns may require treatment at specialized burn centers. They may need skin grafts to cover large wounds. And they may need emotional support and months of follow-up care, such as physical therapy. […] If the burned area is large or covers any joints, you may need to do physical therapy exercises. These can help stretch the skin so that the joints remain flexible. Other types of exercises can improve muscle strength and coordination. And occupational therapy may help if you have difficulty doing your daily activities.

• #1 Rehabilitation: Key to Recovery from Burn Injury

  https://www.templehealth.org/about/blog/rehabilitation-important-step-in-recovering-from-burn-injury

  When a person experiences a serious burn, their life can be turned upside down. While initial treatment is focused on healing the burn itself, it’s also important to begin the process of rehabilitation as soon as possible so the patient can regain a sense of normalcy. […] Burn recovery starts almost as soon as you are admitted to the hospital with a serious burn. In fact, we can begin therapies even before you’re able to get out of bed and actively participate in your care. […] As I tell my patients, how long recovery takes varies from person to person. Some people will need burn rehab for a couple of months, while others may need therapies for years. […] Early on, many patients need therapies to help prevent conditions called contractures. Contractures occur when tissues such as scars, skin, and even joints, tighten.

• #1 Burn Therapy & Burn Treatment | University of Utah Health

  https://healthcare.utah.edu/burn-center/services/burn-therapy

  Burn therapy is an essential part of the healing process and focuses on getting patients back to their previous lifestyle and activity level. Our specialist team will help you: […] The therapy team consists of occupational and physical therapists, and rehabilitation aides. The burn therapy team will assess your condition and create a customized rehabilitation plan. […] Most patients will see the burn therapy team once or twice a day while they are in the hospital. Burn therapy can be done at the bedside to accommodate those who are sedated or on a ventilator. […] Exercise stimulates circulation, reduces swelling, and maintains strength and functional movement. It also helps to prevent scar contractures (a tightening of the skin). Exercise may prevent medical conditions, such as blood clots, pneumonia, and bone density loss.

• #1 Rehabilitation: Key to Recovery from Burn Injury

  https://www.templehealth.org/about/blog/rehabilitation-important-step-in-recovering-from-burn-injury

  To help prevent contractures, we use range-of-motion exercises. Generally, these involve stretching an affected area of the body. […] With these therapies, the goal is to help maintain the patients mobility and ability to perform daily activities. We also aim to improve quality of life for example, by preventing face tightening that can stop people from blinking, smiling, or even eating properly. […] I strongly encourage my patients to take an active role in their burn rehab therapies. Stretching an injured limb can be uncomfortable, and in many cases, painful. But participating fully in rehab therapies is necessary for getting the best possible outcome. […] I remind my patients that participating in burn rehab can help them maintain their independence and quality of life. The rehab is also important for a person’s social and psychological health. It allows patients to fully participate in the things they want to do, which may include daily living tasks like going to work or school, as well as enjoying their favorite activities with their family and friends.

• #1 Burn Therapy & Burn Treatment | University of Utah Health

  https://healthcare.utah.edu/burn-center/services/burn-therapy

  Once able, patients will be given a range of motion, strengthening, activity, and mobility program. A therapist will help with this program until the patient or their loved one feels comfortable and is able to manage independently. […] Our therapists follow patient progress and therapy needs after discharge from the hospital. Discharged patients will work with therapists at the burn outpatient clinic as needed. […] Burn therapists will evaluate for scarring and make recommendations for treatment. Scars may require compression, stretching, and scar massage. […] For this reason, it is important to maintain proper positioning during rest, which therapists achieve through: […] Compression garments or anti burn scar support (ABSS) are made to apply constant pressure to help scars to be flatter and smoother. […] ABSS are measured by our burn therapy team and custom made for each person. They come in a variety of colors. When wounds are healed, compression garments are to be worn 23 hours a day for the entire healing process, often for up to 18 months.

• #1

  https://www.nhs.uk/conditions/burns-and-scalds/recovery/

  More severe and deeper burns can take months or even years to fully heal, and usually leave some visible scarring. […] If your burn has caused a blister, you should get medical attention. […] Your healthcare professional will advise you about the best way to care for your blister and what type of dressing you should use. […] Whether your burn required medical attention or not, you should get urgent medical advice from your GP or contact NHS 111 if the wound becomes painful or smelly, you develop a high temperature of 38C or higher, the dressing becomes soaked with fluid leaking from the wound, the wound hasn’t healed after 2 weeks.

• #1

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=abq6005

  Burns can occur when a harmful chemical, such as a cleaning product or an acid, splashes onto the skin. The treatment for most chemical burns is to remove the chemical from the skin by flushing the area with plenty of water. […] Follow-up care is a key part of your treatment and safety. […] If your doctor told you how to care for your burn, follow your doctor’s instructions. […] Call your doctor or nurse advice line now or seek immediate medical care if: Your pain gets worse. […] Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if: The burn is not getting better each day.

• #1 How to Treat a Burn | The Hand Society

  https://www.assh.org/handcare/condition/how-to-treat-a-burn

  Full-thickness burns mean that all layers of the skin have been damaged. The dead skin will need to be removed to prevent infection. […] Before and after surgery, deep burns will need to be kept clean to prevent infection. […] Your doctor or therapist will recommend you wear a splint during healing to prevent stiffness. Therapy may be recommended during or after healing to improve hand function. […] Many patients with severe burn injuries will require more than one operation.

• #1 Sorry, your browser isn’t supported

  https://www.bapras.org.uk/public/patient-information/surgery-guides/burns

  Burns are one of the many forms of injury that plastic surgeons treat. Fortunately most burns are minor and require only first aid and a dressing. However burns that affect a large area of the body are much more serious, can be life-threatening, involve intensive-care treatment and possibly several operations. Even some small burns, if they are deep, are treated with an operation. Plastic surgeons are an important part of the burns team that look after patients with burns from the moment they are admitted to the burns service, through their initial treatment, after their discharge from hospital and, if they have long term scarring or disability, during rehabilitation and further treatment. A surgical operation can improve scars and the problems that they cause, but cannot remove scars completely. Wherever possible, post-burns problems should be dealt with by a burns specialist who will be able to advise on the best and most appropriate course of action. The treatment of burns is considered in two main timescales. These are: Acute The initial phases of treatment which starts immediately after the burn happens (first aid) and continues on arrival in hospital. This will involve a careful assessment of the extent and depth of the burn, whether there are any other injuries and the general health of the patient. If surgery is not necessary, the burnt skin will be treated with a special dressing which promotes healing and helps prevent infection. If the burns are serious it is usual for surgery to remove the burnt skin and tissues to start within the first day or two after admission to help prevent infection and other problems. Surgery to remove the burnt skin and replace it to heal the wound is only part of the treatment of a patient with burns. There will be an extensive burns team comprising nurses, therapists, anaesthetists and intensive care specialists who all play a vital part in the care of a patient with burns: getting them over their acute injury and the helping with their rehabilitation. Reconstructive Surgery to improve the functional or visual impact of scarring can be carried out months or years after a burn injury has occurred. The success of this surgery depends upon the extent and severity of the scarring, but patients should not assume or expect that surgery will be a quick fix. There are a number of specific surgical techniques involved in the treatment of burns which are described in the guide sections below. A skin graft involves taking a healthy patch of skin from one area of the body, known as the donor site, and using it to cover another area where skin is missing or damaged. Flap reconstruction is a technique used to aid recovery in burns victims. Flap surgery involves the transfer of a living piece of tissue from one part of the body to another, along with the blood vessel that keeps it alive. Free flap reconstruction also involves the transfer of living tissue from one part of the body to another, along with the blood vessel that keeps it alive. Tissue expansion is a procedure that enables the body to grow extra skin by stretching surrounding tissue. Other techniques used in the treatment of burns include: Allograft or Xenograft skin, Artificial skin, Splints, Steroid injections, Pressure garments and dressings, Silicone gel, Cosmetic camouflage. The surgical and non-surgical treatment of burns is available on the NHS for both the acute phase and the reconstructive phase. Patients with burns injuries will be seen by a multi-disciplinary team. The amount of treatment required and the period of recovery is dependent upon the severity of the burns that have been sustained, the age of the patient and their general health. Surgery or treatments to improve function or appearance may be needed months or years after the original burn, particularly in children who are growing.

• #1 Strategies for Managing Pain After a Burn Injury | MSKTC

  https://msktc.org/burn/factsheets/managing-pain-after-burn-injury

  Pain and discomfort are an unfortunate part of burn injury and recovery. Many of our patients tell us that ongoing pain continues to be a problem after discharge from the hospital. […] Burn pain is complex and requires careful assessment by your health care provider in order to find the best treatment. Pain management often requires a multidisciplinary approach that may include both medication and non-medication treatments and involve a team of health providers, such as psychologists or physical therapists, working with your physician. […] There are many different types of burn pain, and each person’s pain is unique. Understanding the type, intensity, and duration of your pain is important for getting the best treatment. […] Over-the-counter pain medications, such as acetaminophen and nonsteroidal antiinflammatory drugs (NSAIDs; ibuprofen and naproxen are examples) can be used for long term pain relief.

• #1 Strategies for Managing Pain After a Burn Injury | MSKTC

  https://msktc.org/burn/factsheets/managing-pain-after-burn-injury

  Opioids are commonly given in the hospital, after discharge from the hospital, and to help with pain from open wounds. […] Anticonvulsant medications, such as gabapentin and pregabalin, are useful for managing nerve pain or itching in some situations. […] Sleep medications, such as melatonin, might be used if pain is interfering with sleep. […] Antidepressants can provide pain relief for some people with chronic pain, even if they are not depressed. […] Rarely do medications take away all of the pain. You may also need to use behavioral approaches to help make pain more manageable. […] Physical activity can help manage pain. […] Relaxation techniques can be used to lessen the stress placed on your body. […] Daily activity and regular exercise are crucial in order to rebuild your strength and stamina and increase your range of motion. […] Cognitive (thinking) techniques use the power of your thoughts to relieve stress. […] Mindfulness meditation has been shown to be a very effective treatment for pain. […] Hypnosis has been shown to be a powerful tool in relieving both acute and chronic pain.

• #1 Burns: Symptoms, Degrees, How To Treat & Healing

  https://my.clevelandclinic.org/health/diseases/12063-burns

  Burns can cause varying levels of damage to your skin, and are more severe the deeper the damage goes. […] Treating burns depends on how deep they go and how much of your body’s surface area they cover. Superficial burns are always minor and you can treat them yourself. […] You always need professional medical care for partial-thickness burns that are too large to cover with your hand. You also always need professional care for all full-thickness burns. […] Professional care can include the following treatments: Treatments for pain. These range from over-the-counter or prescribed medications to treatments like nerve blocks. […] Therapy. Physical and occupational therapy care can help you recover from serious physical injuries from a burn. […] Mental health care. This can help with anxiety, depression or injury-related post-traumatic stress disorder (PTSD).

• #1 Rehabilitation: Key to Recovery from Burn Injury

  https://www.templehealth.org/about/blog/rehabilitation-important-step-in-recovering-from-burn-injury

  Many types of rehab specialists may be involved in the care of burn survivors. At the Temple Burn Center, our team works together to provide whole-person care. […] A burn is a life-changing event. Support groups help to show our patients especially those who have new injuries, who are at their most vulnerable that they can work through their physical and emotional stress.

• #1 Occupational Therapy’s Role Working with the Burn Patient Population – myotspot.comOccupational Therapy’s Role Working with the Burn Patient Population – myotspot.com

  https://www.myotspot.com/occupational-therapys-role-with-burn/

  Part of OT intervention in burn treatment may include managing swelling tissue with compression programs in order to minimize infection and to increase skin integrity. […] For severe burn injuries, the occupational therapist can create a regular splinting program combined with appropriate range-of-motion and stretching regimens to prevent contractures. […] If burn injuries are a result of self-harm or mental illness, OT can address psychosocial needs to promote adherence to healing strategies and overall functional safety. […] This could include employment, volunteer work, social opportunities, transportation use, and all sorts of community-related activities. […] Along with standalone interventions, OT should expect to work side-by-side with additional disciplines including wound care, nursing, physiatrists, respiratory therapy, physical therapy, psychologists/psychiatrists, and social work in order to promote the patient’s recovery in a holistic manner. […] As you can see, occupational therapists are well-equipped to step in and help to provide optimal rehabilitation for these patients in order to get them back on track and living their lives to the fullest extent.

• #1 Hyperbaric Treatment of Thermal Burns – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470524/

  Thermal burns are common in the United States, and approximately 2 million people are injured every year, with about 155 per million patients needing admission to a hospital, and 6500 cases resulting in death. […] Medical treatment of burns is critical, especially when they are a second degree or worse and when a substantial amount of body surface area is affected. […] Hyperbaric oxygen therapy (HBO) may be used as part of the treatment regimen to reduce healing time and improve outcomes. […] HBO addresses these physiological derangements and can be beneficial to patients. […] HBO is indicated for burns that extend into the dermis and beyond. […] If used, HBO treatment should be initiated as soon as possible after the injury. […] Though hyperbaric therapy is generally well tolerated, it is important to consider potential complications that can arise in patients receiving treatment.

• #1 Hyperbaric Treatment of Thermal Burns – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470524/

  In summary, HBO therapy during the first 24 hours of burn has shown to: Decrease edema by vasoconstriction and decrease the chance of burn shock, Decrease wound infections, Promote epithelialization, Increase the viability of skin flaps and grafts, Be effective against carbon monoxide and smoke inhalation injury, Reduce fluid requirements of the patient, Counteract ischemia in tissue by raising oxygen levels in hypoxic tissue to supraphysiologic levels. […] Thermal burns are best managed by an interprofessional team, including a wound care nurse. While the treatment in most patients is supportive, recent evidence indicates that HBO therapy may help wounds heal faster.

• #1 Burns Wound Care | Bangkok Hospital Headquarter

  https://www.bangkokhospital.com/en/content/burns

  Advanced wound dressing and proper wound care given by highly expert specialists and multidisciplinary team substantially help to heal the wound faster alleviate physical pain and emotional distress caused by burns. […] If burns inevitably occur, immediate medical assistance must be sought in order to receive timely and appropriate treatments.

• #1 Burns – medical treatment

  https://www.rch.org.au/kidsinfo/fact_sheets/Burns_medical_treatment/

  The aim of the dressing is to keep the wound clean and to prevent infection. The RCH uses dressings that contain silver, which releases for up to seven days. Silver is an antimicrobial, which means it prevents the growth of microbes such as bacteria. Its antibacterial properties help with healing. […] Burns on the face or perineum (the area between the anus and the scrotum or between the anus and the vulva) require different dressings than other parts of the body. […] If your child has been in hospital, they will be able to go home once they are eating and drinking enough, their pain is under control and their condition is stable. The burns do not have to be completely healed before your child is discharged from hospital. […] Good nutrition is needed to help burns heal. Your child needs a diet high in protein and calories and plenty to drink.

• #1 Burns – medical treatment

  https://www.rch.org.au/kidsinfo/fact_sheets/Burns_medical_treatment/

  See our fact sheet Burns prevention and first aid if you are looking for what to do when your child has first received a burn. […] Once your child has been seen by a doctor for a burns assessment, they will be given treatment depending on what kind of burn they have and where it is. […] Burns usually heal on their own with time, as long as they are looked after well. Proper burns management will also help minimise scarring. A physiotherapist and/or an occupational therapist can help with this. See our fact sheet Burns rehabilitation. […] Treatment for burns involves applying special dressings, or in some cases (e.g. for burns on the face), Vaseline. The dryness, size, depth and location of the burn need to be taken into consideration when choosing the type of dressing. […] Most burns are treated by placing slightly damp dressings over the wounds. Burns dressings used at The Royal Children’s Hospital (RCH) usually involve a closed dressing technique, where the wound is covered with a dressing and not left open to the air. This not only protects the wound, but also reduces stress on the child and their family.

• #1

  https://www.healthxchange.sg/medicine-first-aid/first-aid/burn-injuries-treatment-tips

  There is a team of doctors at SGH exploring a newer occlusive Biobrane dressing for burn patients. This new intervention can provide faster healing, resulting in better rehabilitation outcomes and a shorter hospital stay, says Ms Pamela Ng, Senior Occupational Therapist fom the Department of Occupational Therapy at Singapore General Hospital (SGH), a member of the SingHealth group. […] Because of the pain associated with burns, patients may restrict their movements, but they should be encouraged to return to school or work, and their normal daily activities as soon as possible, she added.

• #1 A Regenerative Medicine Breakthrough for Burn Patients | MUSC Health | Charleston SC

  https://muschealth.org/patients-visitors/about-us/2020-year-in-review/burn-center

  The South Carolina Burn Center at MUSC Health made an important leap forward as the first US center reported to successfully use a novel combination of two revolutionary products in a minimally invasive skin graft procedure. […] Nexobrid is an enzymatic burn debridement product that uses bromelain, which is an enzyme extracted from pineapple stems, to remove burns instead of traditional surgery with a knife. […] The second product, Recell, is a point-of-care regenerative skin-grafting therapy that allows surgeons to harvest a sample of autologous skin and reduce it to a solution that can be sprayed over the burned area to grow new cells. […] Overall, burn patients who get this treatment are three times less likely to need a graft. […] Furthermore, the skin spray forms a better scar and doesn’t leave gaps that contract during healing like a graft can.

• #1 Light therapy helps burn injuries heal faster by triggering growth protein – University at Buffalo

  https://www.buffalo.edu/news/releases/2021/08/003.html

  Light therapy may accelerate the healing of burns, according to a University at Buffalo-led study. […] The research, published in Scientific Reports, found that photobiomodulation therapy a form of low-dose light therapy capable of relieving pain and promoting healing and tissue regeneration sped up recovery from burns and reduced inflammation in mice by activating endogenous TGFbeta 1, a protein that controls cell growth and division. […] The findings may impact therapeutic treatments for burn injuries, which affect more than 6 million people worldwide each year, says lead investigator Praveen Arany, DDS, PhD, assistant professor of oral biology in the UB School of Dental Medicine. […] The treatment triggered TGFbeta 1, which stimulated various cell types involved in healing, including fibroblasts (the main connective tissue cells of the body that play an important role in tissue repair) and macrophages (immune cells that lower inflammation, clean cell debris and fight infection). […] The effectiveness of photobiomodulation in treating pain and stimulating healing has been documented in hundreds of clinical trials and thousands of academic papers.

• #1

  https://www.nhs.uk/conditions/burns-and-scalds/treatment/

  Appropriate first aid must be used to treat any burns or scalds as soon as possible. This will limit the amount of damage to your skin. […] You should also go to hospital if you or the person who has been burned: is under the age of 10 […] Electrical burns may not look serious, but they can be very damaging. Someone who has an electrical burn should seek immediate medical attention at an AE department. […] Acid and chemical burns can be very damaging and require immediate medical attention at an AE department. […] If you have any pain, paracetamol or ibuprofen should help relieve it. Always read the manufacturer’s instructions and do not give aspirin to children under the age of 16.

• #1 Module 3 Basic: Burn Treatment and Stabilization – MN Dept. of Health

  https://www.health.state.mn.us/communities/ep/surge/burn/module3basic.html

  Inhalation injury or smoke inhalation is basically when people breathe in the combustible particles from a fire. […] Another gas that people can breathe in that’s commonly encountered when they have a smoke inhalation injury is cyanide poisoning. […] Chemical burns, another specialty area of burn care is basically made up of an exposure to a chemical of either an alkaline or an acid.

• #1 Treating Pain Caused by Burns: 1st, 2nd, and 3rd Degree

  https://www.webmd.com/pain-management/pain-caused-by-burns

  Your treatment depends on how much electricity got into your body and how long the contact lasted. Cool the area right away and then seek medical help. […] Ask your doctor what else you can do if OTC drugs and home remedies don’t help enough. You may need a more aggressive pain management plan if you have a serious burn. […] Pain management for burns might include: […] It’s important to get treatment for major burns right away because they can lead to serious health issues, including: […] Burns can also affect your mental health. You may have depression, nightmares, or recurrent thoughts about the event that hurt you. […] Mild burns usually heal within a couple of weeks with home treatment. But you may need medical care for more serious burns. This might include prescription medication, special wound care, or surgery. […] For minor burns, you’ll want to cool the area right away and clean it with mild soap and water. You’ll need medical attention for serious burns. This may include medication, wound care to remove dead skin and prevent infection, or surgery.

• #1 Burn Triage and Treatment – Thermal Injuries – CHEMM

  https://chemm.hhs.gov/burns.htm

  Burn therapy adds significant logistical requirements and complexity to the medical response in a chemical mass casualty incident. […] Health care providers with burn expertise are needed to optimize burn care. […] Consultation with American Burn Association Verified Burn Centers is recommended. […] All burn patients should initially be treated with the principles of Advanced Burn and/or Trauma Life Support. […] Verified Burn Centers provide advanced support for complex cases. […] Burn Unit Referral Criteria. […] Extensive burns may lead to massive edema. […] All patients with deep burns 35-40% TBSA should be endotracheally intubated. […] Smoke inhalation injury doubles the mortality relative to burn size. […] Supportive pulmonary management. […] Aggressive respiratory therapy.

• #1 Burns – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/burns/

  Burn depth is classified as first degree (superficial), second degree (superficial partial thickness or deep partial thickness), third degree (full thickness), or fourth degree (deep injury). […] Early treatment for major burns includes airway management, supplemental oxygen, and large volumes of IV fluid; IV fluid resuscitation is initiated using a protocol but guided by clinical response, e.g., urine output and blood pressure. […] All burns are initially managed with pain management, topical ointments, and nonadherent dressings, and major burns often require further management such as debridement of necrotic tissue followed by interventions such as skin grafting or flap reconstruction. […] Major burns (e.g., 20% TBSA) result in increased capillary permeability, causing significant intravascular hypovolemia requiring IV fluid resuscitation.

• #1 Module 3 Basic: Burn Treatment and Stabilization – MN Dept. of Health

  https://www.health.state.mn.us/communities/ep/surge/burn/module3basic.html

  Typically in America, the American Burn Association has stemmed away from putting cold compresses or cold, wet dressings onto patients as they quickly become hypothermic, but if they’re continuing to be burned or continuing to have things such as chemicals, you do want to remove those and reverse those processes. […] The referral criteria for a burn center is laid out pretty nicely by the American Burn Association, and it’s available on their website. […] Typically, any burn greater than 10% total body surface area, burns that involve the hands, face, feet, genitalia, or burns that what we — what are considered at that time to be third-degree, those patients should be referred. […] When getting a patient ready for transfer, the thing I want to make sure that people do is to secure all the lines and tubes, cover the wounds with dry, sterile dressings, don’t delay transfers for imaging and labs.

• #1 Outpatient Burns: Prevention and Care | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/0101/p25.html

  A systematic review showed that prophylactic systemic antibiotics administered in the hospital setting did not improve mortality; therefore, they generally are not recommended for burns. […] Referral to a burn specialist is indicated in patients with full-thickness burns; burns to the hands, feet, perineum, or genital areas; and circumferential burns. […] Referral to a surgeon or burn specialist should be considered for patients with wounds that worsen over the first 72 hours or that begin to cause significant scarring or any degree of contracture.

• #1 Module 3 Advanced: Burn Treatment and Stabilization – MN Dept. of Health

  https://www.health.state.mn.us/communities/ep/surge/burn/module3advanced.html

  The fluid of choice for burn resuscitation is Ringer’s Lactate. […] Escharotomy through third-degree burns are indicated to alleviate the pressure and restore perfusion. […] Pain and analgesic treatment should be assessed hourly and also needs to be added on for procedural pain such as if you’re going to perform escharotomies or dressing changes. […] And finally, we’re going to discuss the follow-up care and transfer criteria. […] Our referral criteria for burn patients is nicely laid out by the American Burn Association, and typically, if you have a total body surface area burn greater than 10%, a third-degree burn, burns that encompass the face, hands, feet or genitalia or injuries that are resulting from electrical injuries should be referred to our burn center.

• #1 Burn Wound Infections Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/213595-treatment

  Burn wound infections are often the source of bacteria responsible for other systemic infections, including bloodstream infections and pneumonia. This can lead to sepsis, multisystem organ failure, and death. […] The prevention of burn wound infection is a team approach that includes the support of surgeons, nurses, infection-control providers, and infectious disease physicians. Emphasis on early wound care, infection-control practices, and long-term rehabilitative care is necessary to improve the morbidity and mortality associated with burns.

• #1

  https://www.shrinerschildrens.org/en/pediatric-care/burn-care

  Pediatric burn injuries can be hard on the entire family. While not all burns are life-threatening, they all involve stress and a scared child and require care that is personalized to that child and their family. […] Shriners Childrens treats all levels and types of burns, including chemical burns, electrical burns and flame burns. […] Our physicians and care teams have contributed to most of the significant advancements in acute and reconstructive burn care since we began treating burns in the 1960s. […] Your childs Shriners Childrens burn care team might include skilled acute burn and trauma surgeons, reconstructive plastic surgeons, anesthesiologists, nurses and nurse practitioners. […] Pediatric burn care and skin-related support services at Shriners Childrens are innovative, backed by research and designed to support a child and their family throughout their healing journey.

• #1 Home burn care do’s and don’ts | UCI Health | Orange County, CA

  https://www.ucihealth.org/blog/2018/05/treating-burns

  The UCI Regional Burn Center at UCI Medical Center uses a multidisciplinary team of burn-specialist surgeons, nurses, wound care specialists, physical therapists, social workers, case managers and psychologists to manage all aspects of burn care. […] Many minor burns can be treated at home. Bernal offers these dos and donts: […] For first-degree or second-degree burns smaller than about two inches in diameter, Bernal recommends the following home-treatment steps:

• #1

• #1 Physical therapy for burns | Regions Hospital Burn Center

  https://www.healthpartners.com/care/hospitals/regions/specialties/burn-center/exercise-therapy/

  Exercising and stretching is especially important once your burn wound has healed. Scar tissue can cause the skin to become tight (contractures), making it difficult to move and causing the skin to lose flexibility. […] Doing physical therapy during burn recovery can help retain your range of motion. Our team of therapists will guide you through targeted exercises and stretches to stretch the skin over your burn wounds. […] Yes, many of our patients need to continue physical therapy for burns after theyve been discharged from the Regions Hospital Burn Center. Our physical and occupational therapists will give you a home exercise plan so you can continue to make progress once youre back at home.

• #1 Treatment of minor thermal burns – UpToDate

  https://www.uptodate.com/contents/treatment-of-minor-thermal-burns

  Follow-up care — Follow-up care involves surveying for signs of infection, increasing depth of the burn, and scarring. Patients with an infected wound should be hospitalized to minimize the risk of sepsis or extension of the burn. Scarring and contracture can result in long-term disfigurement and disability, both of which are indications for specialized care. Any questionable or complex burn wounds should be referred to a local burn center for further evaluation. […] Diagnosis and management of infection — Diagnosing infection in burn patients is challenging. Fortunately, the incidence of infections among ambulatory patients with partial-thickness or superficial burns is low. Infection can extend the depth and extent of a burn, converting a superficial partial-thickness burn into a deep partial-thickness burn or even a full-thickness burn. In addition, burn infections are more susceptible to blood invasion and sepsis. Because of these risks, all infections of suspected partial or full-thickness burns warrant aggressive management including hospital admission and parenteral antibiotics.

• #1 Initial Evaluation and Management of the Burn Patient: Overview, Initial Evaluation and Resuscitation, Evaluation of the Burn Wound

  https://emedicine.medscape.com/article/435402-overview

  After successful resuscitation, a hypermetabolic response occurs, with near doubling of cardiac output and resting energy expenditure. […] Burn patients demonstrate a graded capillary leak, which increases with injury size, delay in initiation of resuscitation, and the presence of inhalation injury for the first 18-24 hours after injury. […] Most formulas recommend that all crystalloid be isotonic during the first 24 hours, generally Ringer lactate solution. […] The modified Brooke or Parkland formulas are reasonable consensus formulas and are used to help determine the initial volume of infusion. […] An accurate estimate of burn size is important for treatment and transfer decisions. […] Burn depths are routinely underestimated during the initial examination. […] The management of burn blisters remains controversial, yet intact blisters help greatly with pain control.

• #1 Topical agents and dressings for local burn wound care – UpToDate

  https://www.uptodate.com/contents/topical-agents-and-dressings-for-local-burn-wound-care

  Superficial burn wounds are ideally protected by applying dressings that not only promote healing and re-epithelialization but aid in minimizing pain and further trauma. […] Deep burn wounds ultimately require burn wound excision and graft/flap coverage. […] Following eschar debridement and/or excision, if grafting will not take place immediately, for interim wound management, fine mesh gauze in combination with topical antimicrobials, typically silver-containing agents or dressings, is often used to provide a moist and minimally adherent provisional dressing until definitive debridement or surgical excision can be performed.

• #1 Burn Wound Infections Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/213595-treatment

  Propranolol has been studied for its potential benefits in burns. It is suggested that this drug may restore glycemic control, reduce peripheral lipolysis, and enhance the immune response to sepsis by modulation of the catecholamine release during severe burn injury. […] A meta-analysis in the use of recombinant growth hormone (rhGH) in burn patients could not find any study reporting burn wound infection as an outcome. […] This response augments the metabolic rate, leading to muscle catabolism and immunosuppression. The loss of body mass associated with severe burns has been associated with higher infection rates, delayed wound healing, and longer hospital stays; therefore, the initiation of early and aggressive nutritional support is required. […] Early enteral nutrition should be started in patients with burns larger than 20% TBSA, even in patients who can be fed orally, as orally fed patients have higher complications and infection rates.

• #1 Treatments for Burns | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/skin-hair-and-nails/burns/treatments.html

  Because so many functions and systems of the body can be affected by severe burns, the need for rehabilitation becomes even more crucial. […] Many hospitals have a specialized burn unit or center and some facilities are designated solely for the rehabilitation of burn patients. […] Burn rehabilitation begins during the acute treatment phase and may last days to months to years, depending on the extent of the burn. Rehabilitation is designed to meet each patient’s specific needs; therefore, each program is different. The goals of a burn rehabilitation program include helping the patient return to the highest level of function and independence possible, while improving the overall quality of life – physically, emotionally, and socially. […] In order to help reach these goals, burn rehabilitation programs may include the following: Complex wound care, Pain management, Physical therapy for positioning, splinting, and exercise, Occupational therapy for assistance with activities of daily living (ADLs), Cosmetic reconstruction and skin grafting, Counseling to deal with common emotional responses during convalescence, such as depression, grieving, anxiety, guilt, and insomnia, Patient and family education and counseling, Nutritional counseling. […] Advances in the understanding and treatment of burns, state-of-the-art burn units and facilities, comprehensive burn rehabilitation services, and integrated medical care have all contributed to the increase in survival rate and recovery of burn patients.

• #2 Topical agents and dressings for local burn wound care – UpToDate

  https://www.uptodate.com/contents/topical-agents-and-dressings-for-local-burn-wound-care

  Topical agents and dressings for local burn wound care […] Optimal local treatment of burn wounds depends on gentle cleansing and debridement to minimize the incidence of complicating infection as well as further injury to the wound bed. […] The selection and application of burn wound dressings and topical agents depend upon the nature and extent of the burn wound, the particular wound quality or state (eg, presence and degree of contamination, infection, exudate), and the patient’s allergy history. […] Local burn wound care aims to protect the wound surface and maintain an appropriately moist environment, one that is neither too dry nor too wet to prevent desiccation or maceration, respectively, in an effort to promote burn wound healing, limit burn wound progression while minimizing discomfort for the patient, and protecting surrounding skin and tissues.

• #2 Burns and scalds – first aid, treatments, causes and prevention | healthdirect

  https://www.healthdirect.gov.au/burns-and-scalds

  Burns are damage to body tissue caused by heat, too much sun, chemicals or electricity. […] Scalds are caused by hot water or steam. […] Burns and scalds can range from being a minor injury to a life-threatening emergency. […] First aid includes removing the source of the burn (such as chemicals, fire or electricity) and putting the burnt area under cool running water for at least 20 minutes. […] Treatment for serious burns includes pain relief medicine, dressings, possible admission to hospital and sometimes surgery. […] Most small burns will heal themselves in 10 to 12 days. If the burn does not have any blisters or broken skin, such as sunburn, a simple moisturiser such as sorbolene is the best treatment. For all other burns seek medical treatment for appropriate dressings. […] The treatment for serious burns includes: pain relief medicine, dressings, possible admission to hospital, in some situations, surgery. […] If the wound gets worse, or if you are not up to date with tetanus injections, see your doctor. […] Immediate first aid for all burns is to hold the burn under cool running water for at least 20 minutes.

• #2 Outpatient Burn Care: Prevention and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/0415/p463.html

  The American Burn Association has published criteria for burn center referral. Burn injuries are considered trauma, and all patients with burns, even in the outpatient setting, should be assessed for concomitant injuries according to Advanced Trauma Life Support or Advanced Burn Life Support guidelines. […] For all types of minor burn injuries, the goals of initial treatment are to minimize the extent of the burn, clean the wound, and address pain. […] Active cooling of the burn surface with running tap water (at 46.4F [8C] to 77F [25C]) for at least 20 minutes has been shown to reduce burn depth, improve healing time, and decrease grafting requirements. […] Superficial partial-thickness burns require a moist, protected environment to promote reepithelialization while preventing desiccation, burn progression, and secondary infection.

• #2 Burns: First aid

  https://www.mayoclinic.org/first-aid/first-aid-burns/basics/art-20056649

  For minor burns, follow these first-aid guidelines: Cool the burn. Hold the area under cool not cold running water for about 10 minutes. If this isn’t possible or if the burn is on the face, apply a cool, wet cloth until the pain eases. For a mouth burn from hot food or drink, put a piece of ice in the mouth for a few minutes. Remove rings or other tight items. Try to do this quickly and gently, before the burned area swells. Apply lotion. After the burn is cooled, apply a lotion, such as one with aloe vera or cocoa butter. This helps prevent drying. Bandage the burn. Cover the burn with a clean bandage. Wrap it loosely to avoid putting pressure on burned skin. Bandaging keeps air off the area, reduces pain and protects blistered skin. If needed, take a nonprescription pain reliever, such as ibuprofen (Advil, Motrin IB, others) or acetaminophen (Tylenol, others).

• #2 Burns: Types, Symptoms, and Treatments

  https://www.healthline.com/health/burns

  Burns are classified from first to third degree. Most people recover without serious health consequences, but more severe burns require emergency medical care to prevent complications and death. […] Burns are characterized by severe skin damage that causes the affected skin cells to die. […] Read on to learn how to identify first, second, and third-degree burns and how theyre treated. […] First-degree burns usually heal within 7 to 10 days without scarring. […] First-degree burns are usually treated with home care. Healing time may be quicker the sooner you treat the burn. Treatments for a first-degree burn include: soaking the wound in cool water for five minutes or longer, taking acetaminophen or ibuprofen for pain relief, applying lidocaine (an anesthetic) with aloe vera gel or cream to soothe the skin, using an antibiotic ointment and loose gauze to protect the affected area.

• #2 Burn Wound Infections Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/213595-treatment

  The goal of medical care is to prevent infection. Early excision and grafting is the current standard of care and the primary surgical method for reducing infection risk and length of hospital stay and increasing graft take. A fast and permanent closure of full-thickness burns can be obtained with autografts (a split-thickness skin graft from an uninjured donor site on the same patient). Nonetheless, donor sites are painful and impose their own wound-healing burden on the patient. If donor sites are insufficient owing to an extensive burn area, allografts, xenografts, skin substitutes, or a dermal analog should be considered. […] Wound care should be directed at thoroughly removing devitalized tissue, debris, and previously placed topical antimicrobials. A broad-spectrum surgical antimicrobial topical scrub such as chlorhexidine gluconate should be used along with adequate analgesia and preemptive anxiolytic in order to permit adequate wound care.

• #2 Outpatient Burns: Prevention and Care | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/0101/p25.html

  Immediate treatment of minor thermal burns with cool running water is controversial but often recommended. […] Topical burn care is the topic of many studies and discussions. […] Topical agents provide pain control, promote healing, and prevent wound infection and desiccation. […] Superficial burns can be treated successfully with topical application of lotion, honey, aloe vera, or antibiotic ointment. […] Partial-thickness burns should be treated with a topical antimicrobial agent or an absorptive occlusive dressing to reduce pain, promote healing, and prevent wound desiccation. […] Topical silver sulfadiazine (Silvadene) is the standard antimicrobial treatment for partial-thickness burns; however, it is relatively contraindicated in patients with sulfa allergy, pregnant and lactating women, and newborns.

• #2 Burn Triage and Treatment of Thermal Injuries in a Radiation Emergency – Radiation Emergency Medical Management

  https://remm.hhs.gov/burns.htm

  Following a radiation mass casualty emergency, especially a nuclear detonation, physical trauma with or without thermal burns (flash burns or flame burns) will be an immediate concern. […] The medical response to the thermal-injury aspect of radiological/nuclear mass casualty incidents will require immense resources to comprehensively manage patients burns. […] The management of seriously burned patients in the first few hours can significantly affect their long-term outcome. It is important that the patient be managed optimally in the early hours after injury to optimize the outcome. […] With the limited number of available and dedicated burn beds and burn specialists in any one region of the US, transfer of patients to specialized burn centers throughout the country will likely be needed. Consultation with an American Burn Association-verified burn center is recommended.

• #2 Initial Evaluation and Management of the Burn Patient: Overview, Initial Evaluation and Resuscitation, Evaluation of the Burn Wound

  https://emedicine.medscape.com/article/435402-overview

  After successful resuscitation, a hypermetabolic response occurs, with near doubling of cardiac output and resting energy expenditure. […] Burn patients demonstrate a graded capillary leak, which increases with injury size, delay in initiation of resuscitation, and the presence of inhalation injury for the first 18-24 hours after injury. […] Most formulas recommend that all crystalloid be isotonic during the first 24 hours, generally Ringer lactate solution. […] The modified Brooke or Parkland formulas are reasonable consensus formulas and are used to help determine the initial volume of infusion. […] An accurate estimate of burn size is important for treatment and transfer decisions. […] Burn depths are routinely underestimated during the initial examination. […] The management of burn blisters remains controversial, yet intact blisters help greatly with pain control.

• #2 Initial Evaluation and Management of the Burn Patient: Overview, Initial Evaluation and Resuscitation, Evaluation of the Burn Wound

  https://emedicine.medscape.com/article/435402-overview

  An ability to make the diagnosis of burn wound infection is important. […] Most burns are small; patients with small burns are appropriately treated in an outpatient setting if the burns do not involve critical areas such as the face, hands, genitals, or feet. […] The management plan for patients with large burns that require inpatient care is usually determined by the physiology of the burn injury. […] Early excision and closure of full-thickness wounds changes the natural history of burn injury, avoiding the otherwise common occurrence of wound sepsis. […] Temporary skin substitutes provide protection from mechanical trauma, a vapor barrier, and a physical barrier to bacteria. […] The choice of medication or membrane for a wound is a never-ending source of discussion and argument. […] The diagnosis of inhalation injury is primarily clinical, based on a history of closed-space exposure, facial burns, singed nasal hairs, and carbonaceous debris in the mouth and pharynx or sputum. […] The final phase of burn care is rehabilitation and reconstruction.

• #2 Proper Wound Care After a Burn Injury | MSKTC

  https://msktc.org/burn/factsheets/wound-care-after-burn-injury

  Burn care providers use skin grafts to treat areas of deep second-degree and third-degree burns. This surgery removes dead skin and replaces it with healthy skin from another part of the body. […] Full-thickness grafts can be used to reconstruct smaller areas and are frequently used later in recovery for reconstructive surgeries on tight scars. […] Once the skin closes and is no longer draining, it is important to keep it well moisturized. This decreases the chances of developing blisters or skin tears. […] Follow your providers instructions for wound care.

• #2 Burn Wound Infections Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/213595-treatment

  Treatment of airway colonization is not recommended, as local airway antibiotic prophylaxis does not influence sepsis or mortality rates. […] When an infection is identified, antimicrobial therapy should be directed at the pathogen recovered on culture. In the setting of invasive infection or evidence of sepsis, empiric therapy should be initiated. […] Antimicrobial-resistant bacterial infection among burn patients is associated with prolonged stays in the hospital. […] If an multidrug-resistant pathogen is isolated, colistin should be considered. […] If fungi are observed on histopathology, culture samples to detect the infecting genus and species are necessary, as the available antifungals have varying activity against different fungi. […] Hyperglycemia is associated with an increase in inflammatory response and occurs in burned patients because of the increased rate of glucose production and impaired tissue glucose extraction. Tight glucose control has been suggested to improve survival and to reduce the sepsis risk.

• #2 Burn Wound Infections Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/213595-treatment

  Propranolol has been studied for its potential benefits in burns. It is suggested that this drug may restore glycemic control, reduce peripheral lipolysis, and enhance the immune response to sepsis by modulation of the catecholamine release during severe burn injury. […] A meta-analysis in the use of recombinant growth hormone (rhGH) in burn patients could not find any study reporting burn wound infection as an outcome. […] This response augments the metabolic rate, leading to muscle catabolism and immunosuppression. The loss of body mass associated with severe burns has been associated with higher infection rates, delayed wound healing, and longer hospital stays; therefore, the initiation of early and aggressive nutritional support is required. […] Early enteral nutrition should be started in patients with burns larger than 20% TBSA, even in patients who can be fed orally, as orally fed patients have higher complications and infection rates.

• #2 Physical therapy for burns | Regions Hospital Burn Center

  https://www.healthpartners.com/care/hospitals/regions/specialties/burn-center/exercise-therapy/

  One of the most common parts of healing after a burn injury is that the skin feels tight and is difficult to move. This is a normal and frustrating part of healing from a burn. As it heals, burned skin shrinks, becoming tight and limiting your range of motion. […] The best way to reduce skin tightness after a burn injury is through exercise. Occupational and physical therapy for burns is an important part of your rehabilitation. Well guide you through a personalized burn rehabilitation treatment plan designed to help you heal. […] Physical and occupational therapy is usually needed to help you heal properly from your burn injuries. Exercise following a burn injury is an extremely important part of your treatment. Moving and stretching will help you regain your range of motion so you can move comfortably when you heal.

• #2 Physical therapy for burns | Regions Hospital Burn Center

  https://www.healthpartners.com/care/hospitals/regions/specialties/burn-center/exercise-therapy/

  Our physical and occupational therapists will create a personalized treatment plan for you that uses targeted exercises and stretches to heal your burns. This program will help loosen tight skin and improve your mobility. […] Exercising your arms and hands after a burn is key to maintaining your range of motion and fine motor skills. When burns occur over the joints, scar tissue can tighten the skin and make it hard to move. Stretches and exercises help keep the skin loose so you can move more easily. […] Stretching and moving the injured skin is often very painful. Our team of burn experts will work with you to help manage your pain so you can do the exercises you need to promote healing. […] Yes, you can exercise with a burn wound. In fact, moving the part of your body that has been burned is necessary for proper healing.

• #2 Physical therapy for burns | Regions Hospital Burn Center

  https://www.healthpartners.com/care/hospitals/regions/specialties/burn-center/exercise-therapy/

  Exercising and stretching is especially important once your burn wound has healed. Scar tissue can cause the skin to become tight (contractures), making it difficult to move and causing the skin to lose flexibility. […] Doing physical therapy during burn recovery can help retain your range of motion. Our team of therapists will guide you through targeted exercises and stretches to stretch the skin over your burn wounds. […] Yes, many of our patients need to continue physical therapy for burns after theyve been discharged from the Regions Hospital Burn Center. Our physical and occupational therapists will give you a home exercise plan so you can continue to make progress once youre back at home.

• #2 A Regenerative Medicine Breakthrough for Burn Patients | MUSC Health | Charleston SC

  https://muschealth.org/patients-visitors/about-us/2020-year-in-review/burn-center

  The South Carolina Burn Center at MUSC Health made an important leap forward as the first US center reported to successfully use a novel combination of two revolutionary products in a minimally invasive skin graft procedure. […] Nexobrid is an enzymatic burn debridement product that uses bromelain, which is an enzyme extracted from pineapple stems, to remove burns instead of traditional surgery with a knife. […] The second product, Recell, is a point-of-care regenerative skin-grafting therapy that allows surgeons to harvest a sample of autologous skin and reduce it to a solution that can be sprayed over the burned area to grow new cells. […] Overall, burn patients who get this treatment are three times less likely to need a graft. […] Furthermore, the skin spray forms a better scar and doesn’t leave gaps that contract during healing like a graft can.

• #2 Strategies for Managing Pain After a Burn Injury | MSKTC

  https://msktc.org/burn/factsheets/managing-pain-after-burn-injury

  Opioids are commonly given in the hospital, after discharge from the hospital, and to help with pain from open wounds. […] Anticonvulsant medications, such as gabapentin and pregabalin, are useful for managing nerve pain or itching in some situations. […] Sleep medications, such as melatonin, might be used if pain is interfering with sleep. […] Antidepressants can provide pain relief for some people with chronic pain, even if they are not depressed. […] Rarely do medications take away all of the pain. You may also need to use behavioral approaches to help make pain more manageable. […] Physical activity can help manage pain. […] Relaxation techniques can be used to lessen the stress placed on your body. […] Daily activity and regular exercise are crucial in order to rebuild your strength and stamina and increase your range of motion. […] Cognitive (thinking) techniques use the power of your thoughts to relieve stress. […] Mindfulness meditation has been shown to be a very effective treatment for pain. […] Hypnosis has been shown to be a powerful tool in relieving both acute and chronic pain.

• #2 Burns Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/condition/burns

  Good nutrition is important during recovery. Vitamins and minerals have been shown to promote wound healing and prevent the spread of infection. […] In the case of severe burns, a doctor may perform debridement and skin grafting. Debridement is the removal of dead tissue. In skin grafting, a piece of skin is surgically sewn over the burn after dead tissue is removed. […] Minor burns can be treated with natural products. However, severe burns always require immediate medical attention. It is especially important for people who have been seriously burned to get enough nutrients in their daily diet. Burn patients in hospitals are often given high calorie, high protein diets to speed recovery. […] Although few studies have examined the effectiveness of specific homeopathic therapies in the treatment of burns, professional homeopaths may consider the following measures to treat first- and second- degree burns, and to aid recovery from any burn. […] Several studies suggest that hypnosis may reduce pain and anxiety and enhance relaxation in people with burns. […] One study of people hospitalized for severe burns suggests that TT may reduce pain and anxiety associated with burns.

• #2 A Regenerative Medicine Breakthrough for Burn Patients | MUSC Health | Charleston SC

  https://muschealth.org/patients-visitors/about-us/2020-year-in-review/burn-center

  Recell can be used on burns without a conventional skin graft up to a deep second-degree level but not on third-degree burns. […] Although this young man’s burns did not have enough dermis left to heal on his own, the enzyme allowed preservation of just enough dermis to activate the spray and replace the missing cells. […] Not creating a large donor site can reduce complications, and the patient went home sooner with less pain and scarring. […] Kahn estimates that a conventional graft would have required using almost all of the skin from this patient’s anterior thighs. […] Burn teams have waited decades for a major new development in burn surgery. […] This new generation is really driven to improve burn care. […] We’ve talked about combining them for a while to treat deep second degree burns without a traditional meshed graft, and several major U.S. centers have been gearing up to do it.

• #2 Module 3 Advanced: Burn Treatment and Stabilization – MN Dept. of Health

  https://www.health.state.mn.us/communities/ep/surge/burn/module3advanced.html

  The fluid of choice for burn resuscitation is Ringer’s Lactate. […] Escharotomy through third-degree burns are indicated to alleviate the pressure and restore perfusion. […] Pain and analgesic treatment should be assessed hourly and also needs to be added on for procedural pain such as if you’re going to perform escharotomies or dressing changes. […] And finally, we’re going to discuss the follow-up care and transfer criteria. […] Our referral criteria for burn patients is nicely laid out by the American Burn Association, and typically, if you have a total body surface area burn greater than 10%, a third-degree burn, burns that encompass the face, hands, feet or genitalia or injuries that are resulting from electrical injuries should be referred to our burn center.

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