Burn Treatment for Children: Common Questions Answered

Q: Burn Treatment for Children: Common Questions Answered

Hello, reader's mother： If a burn is properly cleaned and disinfected immediately, and if the amount of exudate is minimal and the wound is not large, it is reasonable to consider changing the dressing every two days. <br>The method of dressing change also matters; for example, i

Inquiry about burn injuries in a 3-year-old?

Dear Doctor,
My daughter suffered a second-degree burn on the back of her hand, approximately 10 cm in size, from hot water on the afternoon of October 17.
During the emergency treatment, we were instructed to use saline solution daily to clean off the original ointment before applying a new ointment and covering it with fresh gauze.
She was also prescribed Amoxicillin capsules and Tinten for two days.
However, when we visited another hospital's orthopedic department on the afternoon of October 19, the doctor informed us that daily dressing changes were not necessary and that the medications provided were for backup (in case of wetness, requiring self-care).
We were advised to return for a dressing change in about three days.
During the dressing change, the doctor punctured a 3 cm blister and did not remove the original ointment.
Additionally, the doctor stated that no further medications were needed.
I have the following questions:
1.
Is it true that burns do not require daily dressing changes? How can we monitor the healing process and check for any signs of infection or odor? Can the ointment remain effective for that long?
2.
If dressing changes do not require the removal of the original ointment, won't this lead to a buildup of residue from different ointments?
3.
Is puncturing the blister not more likely to lead to infection?
4.
Amoxicillin and Tinten are an antibiotic and a pain reliever, correct? Shouldn't antibiotics be taken continuously for 3-5 days? Is a two-day supply sufficient?
I would appreciate your clarification on these matters.
Thank you.

anny, 0~9 year old female. Ask Date: 2009/10/19

Dr. Shi Wenbin reply Plastic Surgery

Hello, reader's mother: If a burn is properly cleaned and disinfected immediately, and if the amount of exudate is minimal and the wound is not large, it is reasonable to consider changing the dressing every two days.
The method of dressing change also matters; for example, if using artificial dressings, changing every two days is acceptable, while if using ointment with gauze, it should be changed every one to two days, depending on the condition of the wound.
If there is a risk of infection, the frequency of dressing changes should be increased.
During dressing changes, unless the patient is experiencing severe pain, it is preferable to thoroughly remove the existing ointment.
Blisters can be drained under sterile conditions; if a blister is larger than two centimeters, it is generally advisable to drain it.
If the wound is clean and there is no risk of infection, oral antibiotics can be taken for 24 hours; long-term use is only necessary if an infection is present.
I hope this information helps you!

Reply Date: 2009/10/19

More Info

When it comes to treating burns in children, especially second-degree burns like the one your daughter has sustained, there are several important considerations and best practices to keep in mind. Your questions reflect common concerns that many parents have when navigating the complexities of burn care.

1. Frequency of Dressing Changes: The frequency of changing dressings for burns can vary based on the severity of the burn and the specific treatment protocol recommended by healthcare providers. In general, for second-degree burns, daily dressing changes are often recommended initially to monitor for signs of infection and to keep the wound clean. However, if the burn is healing well and there are no signs of infection (such as increased redness, swelling, or discharge), some healthcare providers may recommend changing the dressing every two to three days instead. This approach can help minimize trauma to the healing tissue and reduce discomfort for the child. It’s essential to assess the wound regularly to ensure it is healing properly.

2. Removing Old Ointment: When changing dressings, it is typically advisable to remove any old ointment unless otherwise directed by a healthcare professional. This is because different ointments can interact, and leaving old ointment on can lead to buildup, which may impede healing or create an environment conducive to infection. If a healthcare provider suggests not removing the old ointment, it may be due to specific characteristics of the ointment being used or the condition of the wound.

3. Blister Management: Blisters are a common occurrence with second-degree burns. While some practitioners may choose to drain large blisters to relieve pressure, this should always be done in a sterile environment to minimize the risk of infection. If a blister is punctured, it is crucial to keep the area clean and covered to protect it from bacteria. If you notice any signs of infection, such as increased redness, warmth, or pus, it is important to seek medical attention promptly.

4. Antibiotics and Pain Management: Amoxicillin is an antibiotic that is often prescribed to prevent or treat infections, while Tinten (which is likely a pain reliever) is used to manage discomfort. The duration of antibiotic treatment can vary based on the individual case. In many instances, if the wound is clean and there are no signs of infection, a short course of antibiotics (like two days) may be sufficient. However, if there are concerns about infection or if the wound is not healing properly, a longer course may be necessary. Always follow your healthcare provider's recommendations regarding medication.

In summary, managing a burn in a child requires careful attention to the wound's healing process, regular monitoring for signs of infection, and adherence to the treatment plan provided by healthcare professionals. If you have any doubts or if the wound appears to be worsening, do not hesitate to reach out to your healthcare provider for further guidance. It’s always better to err on the side of caution when it comes to the health and well-being of your child.

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