management of minor burns

Last reviewed 10/2022

Minor burns are generally self-healing. Treatment aims to prevent dehydration and infection, and should be followed on an outpatient basis:

• irrigate wound under copious running cold water until pain relieved
• clean with saline or an antiseptic
• provide analgesia - such as dihydrocodeine for an adult, or trimeprazine syrup for a child
• in general, blisters should be left to protect the healing epithelium - but - deroof large blisters which have broken; aspirate tense blisters
• apply silver sulphadiazine cream - Flamazine - and dress with a non-adherent paraffin - impregnated gauze - such as Jelonet
• cover dressing with thick absorbent layer of cotton wool or a Gamgee pad, then a crepe bandage
• elevate arm and hand burns in a sling
• give tetanus prophylaxis and analgesia to take home

Follow-up:

• repeat the dressing after 2 days but omit the silver sulphadiazine
• do not remove dressing which has become adherent otherwise the newly forming epithelium will be destroyed
• change dressing every 5 days
• once epithelialised, leave exposed or cover with dry, non-adherent dressing
• burn which have not re-epithelialised within 14 to 21 days should be considered for skin grafting

Do not forget the possibility of non-accidental injury in a child especially if circumstances are suspicious:

• delay in attending for treatment
• burn to face, hand, foot, perineum
• explanation untenable