First Aid for Skin Damage

Burns

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
1. Remove the heat source and extinguish the flames on any clothing.
2. Remove clothing from the affected area if possible, do not remove clothing if it is stuck to the skin
Cool the burn
1. Cool running water should be applied for 20 minutes (such as water from a tap or a shower).
2. OR Spray with cool water.
3. 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.

Do not:

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

Dressings

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.

Skin Tears

Call a health professional if the wound is very deep and may have exposed bone or tendon. This requires urgent assessment.

Stop bleeding

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

Dressings

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
Pus
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