Annette Kempster: Burn Treatment

Flamazine is a silver sulfodiazepine cream and silver is a very very good antimicrobial and used in for healing burns quite a lot. We also use other silver dressings such as Acticote and other dressings containing silver. There is a use of flamazine in burns but we don't normally like it to be used in the initial stages of the burn. This is because it creates a pseudo-S scar which then disguises how deep the burn actually is. So if the patient is being referred to a burns unit, then we can't get a full picture of how the burn actually looks. We do use it in the burns unit. We use it a lot for burns to the genitalia and the perineum. It's useful because patients can actually change the dressings themselves at home. They can, when they go to the toilet, they are able to just reapply the flammazine afterwards. It is a cream that needs to be changed at least daily, at least once a day, so we do use it on the burns unit. It's also very good for lifting and softening up thick air scar as well. We always advise patients to keep the dressings on, keep them intact, keep the dressings dry. It's very important. Quite often they want to have a bath or shower and water can actually get into the dressings without them realising it, so it's very important to keep the dressings dry and intact. We also encourage them to have a high-protein diet, which will aid the healing process, and to be very aware of the signs and symptoms of infection. So if they become unwell at all, high temperature, or if they develop diarrhoea or vomiting or a rash anywhere on their body, then it's very important that they contact either their local hospital or the burns unit. You must be aware in children aged two to five, there's a risk of children developing toxic shock syndrome. They may have a superficial, fairly small superficial burn, which you're quite happy is going to heal within 10 days to 2 weeks and doesn't actually need any specialist review. If they return to you within that 2 to 5 day period with high temperature, again diarrhoea, vomiting, a rash anywhere on their body, potentially it could be toxic shock syndrome. Children can become ill very, very fast if they get this, so it's very important that they're either referred to a burns unit straight away or to the nearest paediatric unit. On the burns unit we have therapists who run scar management clinics. The advice for patients is for any burn even if it's not going to potentially not going to leave a scar because it's healed within two to three weeks the advice would be to moisturize the area at least four times a day just with a simple moisturising cream. If the burn has taken over the two to three weeks to heal, then potentially there could be scarring. So these patients would be referred to the therapist. The treatment that therapists use is the use of silicon sheets. They also use silicon creams for massaging with, and they use pressure garments as well. For first aid, there's a lot of misinformation on the internet and stuff with correct first aid for burns. First aid for burns is 20 minutes of cool running water which is beneficial for up to three hours post-injury. You don't want to apply anything onto the burn. People apply toothpaste, flour, butter, eggs. Anything like that is actually going to hold the heat in and can potentially make the burn worse. So 20 minutes of cool running water.