Even minor burns in areas without sensation can become serious injuries requiring skin grafts if proper first aid treatment is not used.
This was a simple burn which wasn’t treated immediately. It then blistered:
And then quickly became this, which required a skin graft followed by skin flap surgery
How serious is the burn?
- First degree burn – there is redness/swelling/pain but no blister
- Second degree burn – redness/swelling/pain and blistering
- Third degree burn – white/blackened skin, may also be numbness.
When to get urgent medical attention
- All third degree burns
- Burns to hands, feet, face, groin, buttocks, major joints (eg knee, elbow)
- Chemical and electrical burns
- If you are unsure of the severity of the burn
- Second degree burn larger than 5 cm
First aid for burns
- Stop the burning process
- Remove the heat source and extinguish the flames on any clothing.
- Remove clothing from the affected area if possible, do not remove clothing if it is stuck to the skin
- Cool the burn
- Cool running water should be applied for 20 minutes (such as water from a tap or a shower).
- OR Spray with cool water.
- OR Sponge with wet towels, but change the towels frequently to keep the temperature cool.
- Do not overcool. Do not use ice. Cool the burn but keep yourself warm if possible.
- Remove jewellery such as rings or necklaces if the burn is in that area (as the area may swell).
- Prevent infection by covering the burn with a loose and light non-stick dressing or plastic cling film.
- Use ice
- Touch the injured area, remove peeled skin or burst blisters
- Remove clothing or anything else stuck to skin
- Do not apply creams or ointments except on medical advice
For minor burns a pharmacist can help you with dressing choices, depending on your general health you may require a silver dressing if the chance of an infection is high. If the wound appears to be worsening, or does not heal properly, see your doctor or nurse.
Call a health professional if the wound is very deep and may have exposed bone or tendon. This requires urgent assessment.
- Apply pressure using a clean cloth, gauze or dressing and if on an arm or leg elevate it. Keep firm pressure on for at least 5 minutes if you are on blood thinning medication or prone to bleeding with previous injuries, you may have to repeat if still bleeding
- If bleeding doesn’t stop within 10 -15 minutes you will need to see your GP or seek other health professional assistance
Clean the wound
- Clean the wound by gently flushing the area with warm tap water (drinkable) and patting dry.
- If there is a large flap the flap can be lifted or rolled back to clean underneath
Treating the skin
- If there is skin left on the wound, gently pull or roll the skin flap back over the wound as best as possible using a moistened cotton tip bud, clean tweezers or gloved fingers
- Applying a dressing
- Silicone dressings (eg Biatain silicone) are designed not to cause damage when taken off and are good for fragile skin
- Allevyn foam dressing absorbs fluid from the wound and provides some protection by padding the area
- DuoDERM is a water repellent dressing which should be changed every 3-5 days
- Melolin low absorbent dressing should only be used for wounds which do not ooze very much or to protect recently healed wounds
- If no dressing is available use gauze dampened with saline and change twice a day
Signs of trouble
- Wound increases in size or oozing increases
- Increased redness around the wound
- Increased pain
Broken skin on seating area
- Do not apply any pressure until skin is unbroken and normal colouring has returned to the area
- Sit first time for 15 minutes and look for redness, see how long it takes to fade. If redness fades in 15 minutes or less, wait 1 hour and repeat. Do 3×15 minute trials, if they are all successful then try 3 x 30 minute trials. The time can be increased by 30 minutes a day. If redness does not fade in 15 minutes, stay at that time level until all 3 trials are successful