Superficial dermal burn

Superficial dermal burns are characterised by blistering with a palid surface beneath. The remaining dermis blanches and is painful. Again, analgesia should be the first consideration before dressing changes.

Healing should be spontaneous but prolonged and as such the principle of management should be to prevent dessication and infection. Both may increase scarring. A corollary is that dressings may hide the onset of these complications and as such, regular dressing changes are required to review the burn. Also, regular early review will aid the discovery of burns that have become deeper. These may require surgery.

Superficial dermal burns may be treated with:

• plastic film dressings:
  • eg Opsite (R), Tegaderm (R)
  • a collection of exudate may gather beneath the dressing that can be treated with regular aspiration
• hydrocolloids:
  • eg Granuflex (R), Comfeel (R)
  • need changing at intervals of at least 3 days
• alginates:
  • eg Kaltostat (R)
  • useful for absorbing high volume exudates
  • advantageous in children as can be soaked off with minimal discomfort
  • needs changing once it has become fully saturated
• 'biological dressings':
  • eg bovine skin, human cadaveric skin
  • not as widely available
  • tends to shed from the periphery as epithelialisation occurs

Traditional dressings such as tulle gras are disadvantageous as they permit dessication of the burn.