Wound Care for Burn Injuries

Burn InjuriesFor a patient with a burn injury, wound care mainly aims at preventing infection. Burns maybe caused by heat, chemicals, friction or electricity. Burn wounds may result in severe skin damage that causes the affected skin cells to die.

Different Types of Wound Burns

Based on the severity of damage to the skin, there are four primary types of burns: first, second, third and fourth-degree. First degree burns affect the epidermis, the outermost layer of the skin. Signs at this stage include redness, pain and minor inflammation. Second degree burns affect both the epidermis and the dermis. This type of burn causes the skin to blister and become extremely red and sore.

Third degree burns are severe as they extend through every layer of the skin.Compared to first and second degree burns, this wound carries the highest risk for complications, such as infections, blood loss, and shock, which may even lead to death. The most serious fourth degree burns require immediate medical attention, as they extend through the entire skin as well as the underlying fat, muscle and bone.

Major challenge with all these burns is the risk of infection, as there are chances for bacteria to enter the broken skin. Immediate surgical debridement may be necessary, if infection develops.

Biological dressings can provide a temporary protective covering for burn wounds and for clean granulation tissue. Wound debridement can be used to remove debris, dead skin and blisters.Certain topical antimicrobials that are ideal for the prevention and treatment of burn wound infection include mafenide acetate, silver sulfadiazine, silver nitrate solution, and silver-impregnated dressings. These therapies differ in their ability to penetrate eschars, antimicrobial activities, and adverse-event profiles.

Wound Assessment and Documentation

Burn wound injuries most often require medical attention for proper wound assessment and treatment. Documentation is an essential component of wound assessment and successful treatment of burns.

It is crucial to record every wound assessment thoroughly with an accompanying signature, date and time of service. Adequate documentation with wound specific EMRs provides guidance for appropriate treatment decisions, evaluation of the healing process and support for reimbursement claims. Certain details that help better wound assessment include cause, depth of burn; wound location, age of wound, wound measurement in cm or mm, color, consistency and odor, presence of sepsis, description of surrounding tissues and patient’s pulses. Progress related to wound size, granulation, and wound drainage should also be documented. Clear records also help in on-going wound management and later follow up.