Home Doctor: Practical Medicine for Every Household
If blisters form, it is important to leave them until a doctor can examine the area and see if a superficial surgical debridement must be performed. A debridement is a procedure in which bad skin and tissue is removed, secretions are cleaned, and clean tissue is left to facilitate scarring. Sometimes blisters break or begin to leak fluid. In these cases, it is better for you to proceed yourself and debride the area with this simple technique: With a clean scalpel or scissors, carefully remove only the thin layer that forms the blister, without cutting farther on the healthy skin. Underneath the blister is a pink inner layer of skin, which will help in the formation of a new epidermis. This layer should be covered with an antibiotic cream. These types of creams are oily, so apply enough to cover the wound without being excessive. Its oily consistency can become liquid from the heat of the skin and spill over the sides of the wound, which is very uncomfortable. The wound is then covered with gauze so that it is not exposed to the air, which will dry it out and make it lose its natural moisture, an important part of the process by which new epidermal cells are created. If you do not have antibiotic cream, petroleum jelly may be used. Damaged skin should be kept clean and covered with sterile gauze. Burns are usually very painful, especially those that are superficial (first and second degree). For this reason, it is important that the patient takes analgesic and anti-inflammatory treatment for at least three days. If you are not allergic to NSAIDs (aspirin, profenid, ibuprofen), an excellent option is ibuprofen, 200mg every eight hours for three days. You can take up to 600 mg of ibuprofen every eight hours without any impact on your health. Be sure not to extend the treatment too long over time. I recommend it for three days, but up to five days is also a good option. If you are allergic to those kinds of painkillers, you can use paracetamol, 500 or 650 mg every six hours for three to five days. If you see that the most superficial layer of the skin was burned, exposing the deeper tissue, the patient should be treated with oral antibiotics like Cephalexin or Ciprofloxacin for at least eight days. You’ll know that the damage is deep if you can see yellow or pearl white tissue. This is the subcutaneous cellular tissue or hypodermis that is formed by fat and fascia.
When Should I Worry? About 95% of burn injuries can be treated without specialized supervision. However, there are exceptions to this rule: • •
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When the burn involves mucous membranes, such as the eyes or esophagus (by accidental or voluntary ingestion), the patient should be evaluated in a center where he or she can be treated. In the case of fire burns, you need to know how close the person was to the accident site. Hot vapors can burn the respiratory mucosa, causing serious damage. If the person manifests pain or difficulty in breathing, it is important that they receive specialized help. When there is a high-voltage electrical burn, they are not as easily evaluated as others since they can produce alterations in the electrical mechanism of the heart that can lead to arrhythmias and even heart attacks. 45
