Many burn patients go around to different doctors and use different medications. Sometimes even in the same hospital, different doctors change the medication used for the wound. Patients may be confused as to what is the right medication to use.
To address this question, the following is a summary that I hope will help you. If you don’t have the patience to read it all, you can read the summary section directly.
1.First aid medication
Refers to the medicine just after the burns, folk have various “secret recipes”: soy sauce, toothpaste, rat oil and so on. In fact, are not reliable, use cold water rinse as soon as possible to send to the doctor is the right way. If you have the conditions, you can use plastic wrap to cover temporarily.
2.Early medication
This refers to the immediate to 5-7 days after the scald. The characteristics of the wound during this period are: more exudation and a higher possibility of infection, so you should usually use some topical antibacterial drugs, such as: Bactrim, silver sulfadiazine and other gel or cream preparations. The custom varies from place to place, but no matter what kind of agent is used, the principle is good absorbency and timely drainage of exudate, and then in layman’s terms, the outside gauze can be seen on the liquid slowly being sucked out. It is best not to use oil-based preparations such as moist burn cream, which can cause infection.
3.Later medication
After 1 week of injury, depending on the depth of the wound, the late medication varies greatly, and many clinicians are not sure to choose the right medication and therapy accurately.
3.1 Uninfected degree II wounds (common in boiling water burns)
This type of wound will recover quickly with any ointment. Note: Try not to dry the wound too much, for example with exposure therapy, as too much dryness will delay healing.
3.2 Infected wounds
By infection, we mean: “redness, swelling, heat and pain”. The most visual impression is a ring of redness around the wound, which can expand to the whole lower limb in severe cases, as shown in the figure. This condition requires the use of strong topical antibacterial medications and oral antibiotics, as well as avoidance of lower extremity activities. The use of any medication that does not contain antibacterial drugs, especially oil-based drugs, is strictly prohibited.
3.3 Necrotic tissue adherent wounds
This type of wound is more suitable for the use of oil-based drugs, such as moist burns cream, which can promote the detachment of necrotic tissue, but once infection occurs, the oil-based drugs should be stopped immediately and replaced by water or antibiotic cream.
3.4 Granulation trauma
Deeper wounds go through the infection stage, the necrotic tissue shedding stage, and finally come to the granulation wound stage, which means the wound is in its final stage. The good news is that you can take a shower and there is no risk of infection. The bad news is that the granulation tissue you see now is the future scar. At this point, topical application of some oil-based ointment or oil gauze is possible, mainly through cleaning to reduce the number of local bacteria, and topical ointment is not so important anymore.
4. Summary
It is not recommended to use oil-based ointment within a week, but after a week without infection, you can use oil-based ointment.
The drier the trauma, the less conducive to long skin and the less likely to be infected.
The wetter the wound, the more conducive to long skin and the easier it is to get infected.
Oil-based ointment makes the wound moist; water-based ointment makes the wound dry; cream is moist; gel is dry.