Treatment of minor thermal burns
- Arek Wiktor, MD
Arek Wiktor, MD
- Assistant Professor of Surgery
- Burn, Trauma, Critical Care
- University of Colorado School of Medicine
- David Richards, MD, FACEP
David Richards, MD, FACEP
- Assistant Professor of Emergency Medicine
- University of Colorado School of Medicine
Of the more than one million burn injuries incurred annually in the United States alone, the majority is minor and can be managed on an outpatient basis without the need for burn specialist consultation [1,2]. The severe metabolic derangements associated with severe burns rarely occur with minor burns. However, it is important for clinicians treating burns to be able to classify them accurately in order to ensure appropriate therapy.
The evaluation and treatment of minor thermal burns will be reviewed here. The treatment of moderate and severe thermal burns and other injuries associated with burns are discussed separately. (See "Emergency care of moderate and severe thermal burns in adults" and "Emergency care of moderate and severe thermal burns in children" and "Environmental and weapon-related electrical injuries" and "Topical chemical burns" and "Inhalation injury from heat, smoke, or chemical irritants".)
Burns are classified according to their depth and size (size is defined as a percentage of the total body surface area, or TBSA). Treatment and prognosis are based largely upon these two characteristics. When assessing what appear to be minor burns, the most important aspects of classification are to distinguish superficial burns (picture 1 and picture 2) from partial-thickness burns (picture 3 and picture 4), and to determine the overall non-superficial burn size (ie, the size of all partial thickness and full thickness burns). These two assessments largely determine which patients are appropriately managed in the outpatient setting.
Accurate classification is not always possible initially and may require up to three weeks [3,4]. The classification of burns, including burn depth and size, is discussed in detail separately. (See "Classification of burns", section on 'Classification' and "Classification of burns", section on 'Percent body surface area estimates'.)
Minor burns — Minor burns are defined by the American Burn Association as (table 1):
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- Minor burns
- Pain management
- - Basic dressing
- - Biologic and synthetic dressings
- - Dressing changes
- Oral burns
- FOLLOW-UP CARE
- Timing of visits
- Diagnosis and management of infection
- SUMMARY AND RECOMMENDATIONS