Emergency and Urgent Care - Minor Burns and Scalds

Advice following a non-complex minor burn/scald

You have sustained a burn or scald injury where the skin has been damaged. The amount of damage will determine the length of time your wound will take to heal. We would expect your burn to heal within 14 days. If your burn or scald has not healed within this time you may require further treatment.

Types of Burns

Burns are often categorised into different types, depending on the severity of the burn. The management and treatments will vary from one type of burn to another.

We will let you know which type of burn that you have.

• Superficial Epidermal Burns: These affect the surface of the skin, causing redness and pain. These burns can be managed at home by you; and do not usually require any follow up treatment
• Superficial Dermal Burns: These affect the surface of the skin and a further layer underneath, and can cause blisters, as well as redness and pain. These burns can be managed by community nurses, who will redress the burn until it is healed
• Deep Dermal (Partial-Thickness) Burns: These are deeper than the superficial burns and can cause the skin to become blotchy and red or pale pink. This burn is likely to cause blistering and pain. These burns can be managed by community nurses, who will redress the burn until it is healed; but sometimes, these burns may need to be referred to a specialist burns unit
• Full Thickness Burns: This type of burn causes damage to all layers of the skin, resulting in a brown or white leathery appearance. These usually need treatment at a specialist burns unit

Blisters

These can develop soon after the original injury but can also take some time to fully form.

Blisters are collections of fluid which cover the skin that has died as a result of the burn. Blisters that are smaller than your little fingernail can be left alone, but larger blisters which may have burst are treated by having the top layer removed. This allows us to see how sever the burn is underneath the blister.

The process of removing blisters is known as “de-roofing”. It can be done by a Nurse or a Doctor. If you have a blister that needs de-roofing, this will be done in the Urgent Care Centre.

Infection Risk

The skin acts as a natural barrier against bacteria. After a burn, this protective barrier is damaged. Clean dressing will help protect the vulnerable skin.

Burn and scald wounds often leak and produce fluid, this is normal; however, if you or your wounds develop any of the following signs of infection, please return to the Urgent Care Centre:

• Excessive wound leakage (the bandages or dressings are saturated with fluid)
• Increasing pain
• Unpleasant, smelly discharge
• Swelling or warmth around the wound

Toxic Shock Syndrome (TSS):

Toxic Shock Syndrome is a rare but life-threatening bacterial infection caused by Staphylococcus aureus and Streptococcus pyogenes bacteria

If you develop any of the following symptoms, then ring 999 or attend an Emergency Department:

• High temperature/fever (38°C or above) – cold hands or feet with hot body
• Not wanting to eat or drink/diarrhoea and vomiting
• Drowsiness, feeling faint or dizzy
• Flu-like symptoms – unwell, headache, sore throat, cough, aching muscles
• Widespread flat, red skin rash

Pain and Itching

Many burn injuries will be quite painful to begin with; whilst this can be a good sign, as it shows the nerves supplying sensation are intact, it can be quite frustrating and affect everyday tasks.

Over-the-counter pain relief, such as paracetamol or ibuprofen, can help reduce any pain you may have. Remember to follow the instructions on the packet, and do not exceed the recommended dose.

It may help to take some pain relief 30 minutes before a dressing change.

If the pain continues despite taking regular painkillers, it is important you mention this to your doctor; they may be able to provide you with stronger pain relief medication.

Itching is also a common after a burn, especially as the wound starts to heal and becomes dry. To help with this, you can take an antihistamine, such as piriton (chlorphenamine) or loratadine, whilst the wound is raw, and use non-perfumed moisturiser once the wound is healed.

Dressings, Healing and Recovery

Dressings

• If you have a dressing on your burn or scald, please keep this clean and dry, and do not remove it until your next dressing change
• You will have been given either an appointment with the Burns Service or asked to make an appointment with the District Nurse Treatment Room Service to have your dressings changed and burns checked
• If your dressing gets wet or falls off before this appointment, then these needs replacing. Please return to the Urgent Care Centre
• Do not apply a plaster, sticky or fluffy dressing, as these may damage your skin, and fibres may get stuck in the burn and cause an infection

Healing

• Do not apply any creams, oils or ointments to your burn. These can irritate or stain your skin and make you more likely to develop an infection. They will not speed up the healing of your burn
• Swelling is normal with a burn or scald wound. To help relieve swelling elevate the affected area on pillows or sleep/sit upright (for facial burns) when resting
• Try not to knock or scratch your burn, as the skin will be delicate and sensitive even after it has healed
• Stopping smoking can help your skin recover, as smoking reduces the blood flow to the skin, delaying healing
• Follow a good diet, as this helps to reduce the chance of developing an infection and can help with the healing of your burn

Recovery

• After skin has been injured by a burn or scald, it can become less flexible and needs to be cared for and exercised to make sure normal movements are not affected
• Exercises should be carried out little and often throughout the day to prevent stiffness. This can be achieved by using your limbs normally in a functional way such as getting dressed and doing daily activities. For children, activities such as playing, feeding themselves or bathing will distract them from realising they are exercising
• If movement becomes painful, make sure you have taken enough pain relief. Try to time activities for 30 minutes after taking pain relief

Washing, Moisturising and Massage

• Once your burn has healed, the skin may become dry, itchy or uncomfortable. This is because your skin is not yet producing its own natural oils. It can take as long as 2 years before it is fully capable of doing this again. Your burn may appear red when first healed, but this will fade over time
• To help your scar mature, it is recommended that you massage and moisturise the affected area. The area should be washed with non-perfumed and non-coloured soap and then patted dry thoroughly. The area needs to be massaged 2-3 times a day
• It is important that the old moisturiser is washed off before applying more as a build up of moisturiser and oil can cause blackheads and pimples. If these do develop, do not try to squeeze them out
• If you are concerned about scarring or it begins to restrict your movement then please seek advice from your GP or the Urgent Care Centre

Ongoing skin care

All healed burns and scars will need extra protection from the sun for up to 2 years. This is because exposure to the sun can very easily damage newly healed skin, causing blistering, burning and risk of permanent colour change. In order to prevent this, you should:

• Wear UV clothing that protects the scar from sunlight
• Use sun cream SPF 50+ or total sun block
• Stay in the shade when outdoors
• Avoid sunbeds
• Avoid oil based or perfumed moisturisers

Dressing

Type of dressing applied: ...................................................................

Date dressing to be changed: ............................................................

• HMR/Oldham/Bury/North MCR patients should contact the District Nurse Treatment Room service to make an appointment on the following number: see separate contact details sheet
• Patients outside this area can contact their GP for details of their local treatment room service

Work

If you do not feel capable of working either due to pain or reduced movement/mobility, you are able to self-certify sickness for the first 7 days.

You must complete a self-certification form found on the government website and give this to your employer. This entitles you to statutory sick pay from your employer for up to 7 days.

To access the self-certification form, follow this link:
https://www.gov.uk/government/publications/statutory-sickpay- employees-statment-of-sickness-sc2

If you feel you need longer than 7 days off work, you must contact your GP for a sick note. The Urgent Treatment Centre does not issue sick notes.

For further advice or information contact NHS 111 via telephone or on their website, or call Rochdale Urgent Treatment Centre – 01706 517023.