Burn Wound Management
1. Cleanase wound to eliminate or decrease dead tissue and debris; source as media for bacterial growth.
2. Prevent distraction of skin
3. Determine burn area depth and then debridement ( remove necrotizing tissue and contamination), cleaning and then dressing.
4. Circumferential burns of digits, limbs or chest, need surgical release of burnt skin, Escharotomy; to prevent problem with circulation and ventilation.
Analgesics and sedation; ibuprofen/acetaminophen and narcotics.
Burn wound care;
Wound cleaning
Topical antibiotic therapy
Wound dressing
Dressing changes
Wound debridement
Wound grafting
c. Pain management
d. Nutritional support
c. Clean burn area and change bandages.
d. Skin graft need to cover burns
Topical Antibiotics
1. 0.5% silver nitrate
2. Silver sulfadiazine
3. Mycostatin
4. Bacitracin/ polymyxin B
5. Mefenide acetate
6. Mupirocin
7. Povidone-iodine (betadine) ointment (10%)
8. Gentamicin
Note - Mycostatin not combined with mefenide; both became inactived.
Wound Care
Prevent from infection
Limiting pain of exposed burn surface
Wound Covering
Cover wound with dressing or graft.
Wet dressing used with silver nitrate or normal saline application.
A single layer of fine mesh gauze placed over the wound, coverd with thick gauze pads to maintain moisture. Dressing must kept wet.
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