phr 913wounds, burns, and sunburns

define burn

burns are wounds caused by UVR or contact with chemical, electrical or thermal sources

what types of burns should not be self treated

electrical burns, chemical, and inhalation

what types of burn can be treated?

thermal burns and sunburns

define abrasions

caused by rubbing or friction, just involves epidermis and outermost layers

Define lacerations

caused by cutting through multiple layers of skin

what are the three phases of wound healing

inflammation--> proliferation--> maturation

how do you classify a wound/injury

1. cause

2. timing of injury

3. depth of injury

4. size

explain the timing component of injury classification

acute- heals within 30 days or sunburn is gone in 3 days

chronic- does not heal or shows no progress within 30 days (e.g., if you have pressure ulcers, diabetic foot

ulcers)

explain depth of injury

superficial

superficial partial

deep partial-not self treatable

full thickness-not self treatable

explain size of injury

BSA- rule of nines: you are excluded to self treatment if...

BSA>10% adults, 5% children, BSA >2% if your depth is in full thickness

what are the major exclusions for self treatment of wounds and burns

Large: cut > ½ inch, burn > 3 inches, or BSA >10% adults / >5% children

Severe: deep/full-thickness, circumferential, chemical/electrical/inhalation

Bleeding: continues after 10 min pressure

Infection: signs of infection or wound worsens/not healing after 7 days

Bites: human or animal

High-risk locations: face, hands, feet, major joints, genitals/perineum

Other: foreign body remains, chronic wound, suspected abuse/non-accidental injury, or conditions like diabetes affecting healing

🧠 Quick memory: "BIG, DEEP, DIRTY, DANGEROUS, or NOT HEALING → REFER."

what are exclusions to sunburns

1.large blisters

2.fever

3.dizzy

4.headache and confusion

5.chronic redness and extreme pain

6.signs of infection like redness, red streaks moving away from

open blisters, open blisters draining pus)

7. swelling

TIP: "Big Fevers Make Heads Confused, Red, Infected & Swollen."

explain a non pharm treatment that involves wound cooling/ cleaning

1. wound cooling and cleaning

- remember as 3 C's

Cool: Cool tap water 20 min if within 3 hrs → ❌ no ice

Clean: Irrigate with tap water or saline

Cover: Leave skin & blisters intact

explain a non pharm treatment that involves minimize scarring

- Decreasing UVR exposure

- Silicone therapy (Gold Standard)

-Moist wound healing--> not as important but aquaphor has a lot of benefits

what are the five pharm treatments for injury

1. Systemic analgesics --> pain meds

2. Skin protectants

3.First aid antibiotics

4.Topical anesthetics

5.First aid antiseptics

describe systemic analgesics to treat injury

two options

1. NSAIDs

-Ibuprofen, naproxen, aspirin

-Anti-inflammatory → ↓ redness + swelling

-Side effects → GI upset + sun sensitivity

2. Acetaminophen

-can be alternative

-Relieves pain + lowers fever.

describe skin protectants

-Protects wound → keeps moisture in + prevents rubbing/friction

-Apply as often as needed

-apply ointment or cream on gauze then wound

describe first aid antibiotics

Neosporin and polysporin

-Prevent infections in minor cuts, wounds, and burns

-Apply after cleansing and before dressing 1 - 3 times/day

-When to stop/seek help: → If not healing or getting worse after 24-48 hrs

describe topical anesthetics

benzocaine and lidocaine

-short acting pain relief

-good cause it's a spray but not an ideal option because it's expensive

when should i use an ointment

it's good because

-Forms a protective layer

-Keeps skin from drying out

-Use on intact (unbroken) skin

when is cream good

Preferred for broken skin

Medications that Impair Wound Healing

Anticoagulants, Antimicrobials, Antineoplastics, NSAIDs

what are counseling tips to remember

If blister breaks: Wash with soap + water → apply moist dressing

Don't peel/pull skin → prevents infection + delayed healing

Keep wound moist → helps new cells grow + heal

Check tetanus shot → make sure up to date

🧠 Remember: "Wash → Moist → Don't Peel → Change if Dirty → Tetanus"

what are good Complement Therapy options

aloe, honey, and calendula (pot marigold) which has anti-inflammatory properities

following up, When should a sunburn be reassessed, and when should the patient be referred?

Reassess: 24-48 hours

Refer if: worsening/not healing

🚩 Redness, pain, swelling spreading beyond wound

Watch for infection

Follow-up: ~7 days

What medications can cause photosensitivity and increase the risk of sunburn?

Antibiotics + NSAIDs + Psych meds + Retinoids

examples: Tetracyclines, ibuprofen, SSRIs, phenytoin, isotretinoin, amiodarone.

What are the major risk factors for UVR complications?

Fair skin + hx of Burned + Freckled + Family history + Lots of sun + Immunosuppressed."

Explain each letter of ABCDE for detection of melanoma

a- asymmetry

b-borders are uneven

c-color is black or multiple

d-diameter is >6mm

e-evolving and changes size/shape

How can sunburn be prevented?

Limit/avoid sun exposure

Use sunscreen

Wear protective clothing → dark, tightly woven fabrics

Wear UV-blocking sunglasses

🧠 Memory: "Less Sun + Sunscreen + Cover + Shades" ☀️🕶️

How should sunscreen be selected and used?

SPF 30+ → preferred, especially for people who burn easily/outdoor activities

Chemical → absorbs UVR

Physical → reflects/scatters UVR

Apply 15-30 min before sun exposure

Reapply every 2 hrs + after swimming, towel drying, or heavy sweating

Higher SPF = more UVB protection: SPF 15 = 93% | 30 = 97% | 50 = 98%

🧠 Remember: "30+, Before, Every 2, After Water/Sweat."

Where are corns typically located?

Over bony prominences of the feet.

What do corns look/feel like clinically?

Raised, sharply demarcated, hyperkeratotic lesions with a central core.

Are corns painful?

Yes, typically painful.

What is the typical size of a corn?

Usually a few millimeters to 1 cm.

What causes corns?

Friction.

What are the main management approaches for corns?

Reduce/relieve the causative friction or pressure and treat with salicylic acid

Where are calluses typically located?

On weight-bearing areas of the feet.

What do calluses look like clinically?

Raised, yellowish thickening of the skin with broad-based/diffuse borders; the normal skin ridges remain intact.

Are calluses usually painful?

Usually not, but they can become painful when located where there is significant pressure (e.g., soles of the feet).

What is the typical size of a callus?

A few millimeters to several centimeters.

What causes calluses?

Friction, walking barefoot, and structural foot problems.

What is the main management approach for calluses?

Alleviate the causative factors/pressure and treat with salicylic acid.

How can you distinguish a corn vs. callus?

Corn: bony prominence → sharply demarcated + central core + painful

Callus: weight-bearing area → diffuse/broad-based thickening + skin ridges remain + usually painles