Self Care 2025: Minor Burns, Sunburns, Wounds - MB

What is the rule of nines?

Method for quickly establishing the percentage of adult body surface burned.

What is a superficial partial-thickness injury?

Involves all of the epidermis and superficial dermis

What is a deep partial-thickness injury?

Extends deeper into the dermis.

What is a full-thickness skin injury?

Extends beyond the dermis with damage to subcutaneous tissue.

What is a subterminal skin injury?

Extends beyond the subcutaneous layer and may damage muscle, bone, and interstitial tissue.

Treatment Exclusions of burns

-Burn to BSA of 2% or more

-Burns involving eyes, ears, face, hands, feet, or perineum

-Chemical burns (use first-aid measures then seek medical attention)

-Electrical or inhalation burns

-Persons of advanced age

-Patients with diabetes or multiple medical disorders

-Immunocompromised patients

Treatment goals for minor burns, sunburns, and wounds

-relieve symptoms

-promote healing by protecting the burn or wound from infection and further trauma

-minimize scarring

What is the role of systemic analgesics for burns/minor wounds?

NSAIDs or acetaminophen for pain

What is the role of skin protectants for burns/minor wounds?

Protect from irritation and drying of the wound

What is the role of topical anesthetics for burns/minor wounds?

-Use for temporary relief of pain

-Use only on small areas to avoid systemic toxicity.

What is the role of first aid antiseptics for burns/minor wounds?

-Hydrogen peroxide, iodine, chlorhexidine gluconate

-Use on intact skin areas (only up to edges of damaged skin) for disinfection

Nonprescription therapies for burns/minor wounds.

-Treat the affected area with a thin application of a skin protectant.

-Topical skin protectants may be as effective as topical antibiotics to promote moist wound healing and prevent infection

-For temporary pain relief take acetaminophen, ibuprofen, or naproxen.

Gauze dressings

Advantages: Cost effective, nonocclusive, comfortable, highly absorbant

Disadvantages: no moist healing environment, nonselective debridement, secondary dressing required, frequent changes required

Nonadherent (gauze-type) dressings

Advantages: readily available, less adherent than plain gauze

Disadvantages: no moist healing environment, secondary dressing required, removal cause bleeding/pain, frequent dressing changes

Adhesive bandages

Advantages: Readily available, Cost effective, Less adherent than plain gauze, Special characteristics with some products (clear bandages, waterproof adhesion, antibacterial fabric, etc.)

Disadvantages: no moist healing environment, Removal cause bleeding/pain, Frequent dressing changes

Hydrocolloids

Advantages: moist healing environment, particle swelling, Long wear time, Self-adherent, Occlusive, Impermeable to fluids/bacteria, Protective, Thermal insulation, Reduce pain

Disadvantages: uninfected wounds only, Periwound trauma on removal, Impermeable to gases, residue on skin or in wound, Less cost effective

Transparent adhesive films (tegaderm)

Advantages: moist healing environment, Self-adherent, Semiocclusive, Gas-permeable

•Easy inspection of wound, Impermeable to fluids/bacteria, Reduce pain

Disadvantages: Not absorptive, uninfected wounds only, Periwound trauma on removal, removal of bandage may reinjure wound, With large amounts of exudate, maceration may occur, Less cost effective

Differences in wound dressings summaryish

-gauze: absorbent and nonocclusive

-adhesive bandage: may require frequent changing

-hydrocolloids: promotes moist healing environment and absorbents; great for weeping wound / blisters

-tegaderm: promotes moist healing environment; for dry minor wounds

Non-Pharm therapy for superficial burns with no blistering

-Irrigate the affected area with cool (not cold) tap water for 20 minutes.

-If the patient did not cool the area in the first 20 minutes after the burn, benefit is still observed by cooling a burn up to 3 hours after it occurred.

-Cleanse the area with cool (not cold) tap water.

-Apply a skin protectant and wound dressing to promote moist wound healing

Importance of moist wound healing

Critical for scar prevention. Use of skin protectants or silicon and prevention of sun exposure are useful for preventing and treating scars.

Can you pop the blisters?

Blisters should not be ruptured. If large blisters are present, the patient should be referred for medical treatment.