Cutaneous burns can usually be managed in an outpatient setting. Early management affects long-term outcome.
Severity is assessed by burn size (% total body surface area) and depth (first to fourth degree).
Initial treatment of minor burns consists of wound cooling, cleaning, and dressing. Pain management and tetanus prophylaxis are important.
Serious burns are most effectively managed in regional burn centers.
Prognosis varies from excellent to poor depending on the severity of the burn. Associated injuries (such as inhalation injury or trauma) adversely affect the prognosis.
The majority of patients will have satisfying outcomes.
Burns are very common injuries, predominantly to the skin and superficial tissues, caused by heat from hot liquids, flame, or contact with heated objects, electrical current, or chemicals.
History and exam
Key diagnostic factors
- dry and painful burns
- wet and painful burns
- dry and insensate burns
- burns affecting subcutaneous tissue, tendon, or bone
- clouded cornea
- young children
- age >60 years
- male sex
1st investigations to order
- complete blood count
- metabolic panel
- arterial blood gas
- fluorescein staining
- computed tomography scan of head and spine
- wound biopsy culture
- wound histology
suitable for outpatient care
requires inpatient care
- Rash in children
- Toxic epidermal necrolysis (Stevens-Johnson syndrome)
- Staphylococcal scalded skin syndrome
- International first aid and resuscitation guidelines
- Management of burns in pre-hospital trauma care
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