Interventions for minor burns

First aid is essential to cool the burn and prevent conversion to a deeper injury. Cool the burn with running water (ideally at 15°C) for 20 minutes. This is effective for up to 3 hours after the burn occurred. Do not apply ice because this can cause further injury. If using a hose or tap, consider the likely temperature of the water—allow the water to run until it reaches an appropriate temperature. If there is limited water or access, consider:

  • spraying with cool water
  • sponging with a wet cloth (ensure the cloth remains cool)
  • using a water gel product (eg an antiseptic hydrogel such as Burnaid) in adults.
Note: Cool the burn with running water (ideally at 15°C) for 20 minutes.

Cooling can be associated with hypothermia. Keep the patient warm (cover nonaffected areas) and observe for signs of hypothermia. Cut away adhered or constrictive clothing and remove jewellery from the burn area.

Initial management of a minor burn also consists of:

  • providing adequate analgesia
  • ensuring adequate hydration
  • cleansing with potable water, or if available, 0.1% aqueous chlorhexidine or saline (0.9% sodium chloride)
  • removing foreign material and loose or nonviable skin or tissue
  • deroofing blisters (see Practice points for deroofing blisters)
  • removing hair in and around the burn to a 2 cm radius
  • reviewing the need for tetanus vaccination (see Tetanus-prone wounds).

Deroofing blisters allows assessment of burn depth, removal of nonviable tissue and, in tense blisters, relief of pain.

Figure 1. Practice points for deroofing blisters
  • obtain consent
  • provide adequate analgesia
  • take photograph before and after deroofing
  • to deroof, use:
    • moist gauze rubbed across the blister, for thin-walled blisters
    • sterile forceps and scissors, for thick-walled blisters
  • choose an appropriate dressing

Treatment of burns depends on thickness and is detailed in c_lwg2-c05-s3.html#lwg2-c05-s3__tlwg2-c05-tbl2. Information sheets for clinicians and patients are available from the Victorian Adult Burns Service and the Australian and New Zealand Burn Association.

For burns on a limb, manage oedema with limb elevation and appropriate support (eg gentle compression).

Although silver dressings are recommended for contaminated or infected burns, silver sulfadiazine cream is not. It may delay healing compared to other antiseptics, it only provides antimicrobial activity for approximately 8 hours, and it impedes reassessment of the wound. For these reasons, it is only considered appropriate when silver dressings are not available.