16. Burns – treatment

Burns – Treatment

Topical (Local) Treatment

• Clean wounds using physiological saline
• Small necrotic tissue is removed with forceps
• Larger wound edges are preserved
• Aspirate blister fluid (bullae)
• Choose dressing type depending on wound:
• Open (exposed)
• Closed (dressed)
• Administer:
• Pain relief (analgesics)
• Anti- inflammatory agents
• Tetanus prophylaxis as needed

General (Systemic) Treatment

• Intravenous Fluids:
• Indicated if >15–20% TBSA burned
• Prevents burn shock
• Parkland formula:
• 4 mL × body weight (kg) × %TBSA
• 50% in first 8 hrs, rest in next 16 hrs
• Example: 80 kg, 25% burn → 4×80×25 = 8000 mL
• Analgesics – pain control
• Hemotransfusion – in cases of major blood loss
• Antibiotics – to prevent or treat infection
• Symptomatic therapy – antipyretics, antacids, nutritional support

Plastic Surgery / Surgical Interventions

• Required in the 5th phase (complications)
• Indicated for:
• Deep 3rd or 4th- degree burns
• Scar contractures
• Disfigurement
• Skin grafts, flaps, or reconstructive procedures may be performed

Key Clinical Points for Oral Exam

• Always estimate TBSA using Rule of Nines
• Calculate fluid needs using Parkland formula
• Remember 5 phases of burn progression
• Burn depth determines severity and healing
• 2nd and 3rd-degree burns are clinically most significant
• Facial or inhalational burns = emergency airway management
• Chemical burns: rinse thoroughly, no neutralizing agents unless instructed