Burn Injury — Guidelines for Wound Care — Clinical Pathway: Emergency

Burn Injury Clinical Pathway — Emergency

Guidelines for Wound Care

Step 1, Debridement

The majority of burns can be gently cleaned with soaked gauze

Consider debridement of blisters if:

  • Causing significant pain from pressure
  • Limits joint ROM
  • Concern for full thickness burn

Step 2, Topical Antimicrobial Agents

Apply topical ointment directly to non-adherent dressing preferably.
If burns on face, finger or toe pads, ointment can be applied directly on burns.
Face, Head Bacitracin/Polymyxin B
Periorbital Bacitracin/Polymyxin B ophthalmic ointment
Perineum Bacitracin/Polymyxin B
Fingers, Toes Bacitracin/Polymyxin B, if risk of ingestion
Can apply Mepilex AG with or without border
All Other Burns Mepilex AG with or without border, bacitracin/Polymyxin B

Step 3, Dressings

Non-adherent Dressing Any non-adherent dressing such as Adaptic or conformant
Secondary Dressing Kerlix or Kling, and Elastinet (if needed)
Elastinet not always needed if using Mepilex AG with Border

Note

  • If using bacitracin/Polymyxin B, change dressing BID unless otherwise indicated
  • Mepilex AG does not need to be changed for 7 days unless otherwise specifically directed to change more frequently
    • When using Mepilex AG you do not need to apply bacitracin/Polymyxin B or other antibacterial ointment
    • If Mepilex AG falls off patient can use bacitracin/Polymyxin B and non-adherent dressing until seen in Burn Clinic
    • Can change outer dressings as frequently as needed if becomes soiled