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Informational/Educational Report
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Basic guidelines for the management of small burns in a non-specialized setting Michel H.E. Hermans, MD Burn management is considered difficult by many non-specialized health care providers but treating guidelines are easy to follow:..1. Remove the heat source by cooling the burn with running tap water for at least 10 minutes. 2. Decide if referral to a burn center is necessary, based on the patient suffering from: . Partial thickness burns > 10% of the body surface.. Full thickness burns.. Burns involving face, hands, feet, genitalia, perineum, major joints.. Chemical injuries.. Electrical burns (including lightning injuries).. Concomitant trauma, where burn injury poses the greatest (acute) risk. Inhalation injuries. Pre-existing medical conditions that could complicate management, prolong recovery, or affect mortality. The non-presence of a hospital with qualified personnel and/or equipment for the care of critically burned children 3. If referral is necessary, seek advice from the burn center on measures to be taken prior to transportation (fluid regime, pain relief, intubation, local therapy) The non referred burns are, by definition, small and partial thickness. These lesions are painful, with blisters or a moist pink surface. If treated properly, most of them will heal within 2 weeks, without a significant risk of scarring. Management focuses on pain relief, rapid healing, prevention of infection, and minimizing scarring. Moisture retentive dressings, particularly those with silver, generally meet the treatment objectives for superficial partial thickness burns and are to be preferred over silver sulphadiazine cream. .Some burns may not heal with 2Ð3 weeks: the wound may have become deeper secondarily or infected and spontaneous healing, should it still occur, will lead to serious scarring. Therefore, secondary surgical intervention probably is necessary after all, to excise and graft the wound. With these guidelines, small partial thickness burn can be safely managed outside a burn center, and with the best possible results.. |
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