Suggest Treatment For Burn Injury

Posted on Fri, 20 Jun 2014

Question: Got a burn from heating pad about 1 1/2 inches diameter. Cleaning and putting silvadene cream on twice daily. Center has been white with beefy red edges--edges of white seem to be pulling away but now have small brown spot--do i need to get this debrided or should it push off the dead skin as it heals? There is some pain-I "know it's there" and I think the brown spot might be a bit more tender.

Answered by Dr. Vivek Chail (2 hours later)

Brief Answer:
Please find detailed answer below

Detailed Answer:
Hi XXXX
Thanks for writing in to us.

Sorry to hear about your burn injury, hope its not too painful at the moment. You are dong right by applying silvadene cream and dressing it regularly. Healing granulation tissue is forming and I guess you have been taking good care of your wound and it is free from infections.

Debridement is necessary under following circumstances:

To remove tissue contaminated by bacteria, foreign tissue, dead cells, or crusting
To create a neat wound edge to decrease scarring
To aid in the healing of very severe burns or pressure sores (decubitus ulcers)
To get a sample of tissue for testing and diagnosis

As you have written the presence of central white with beefy red edges and a small brown spot, it may not require debridement as the healing process seems to be going on well. May I request you to please send across a photo by attaching it to your query so that I am sure of what you have written.

Waiting for an update from your end.
Wishing you good health.

Regards,
Dr.Vivek

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Vivek Chail (24 hours later)

Next time I clean the wound I will get a picture. What I forgot to share was that the blister popped and it was a few days before I sought help (I used medicinal honey on wound), when saw doc at emergency he said it looked better than I was afraid. The brown/black spot has now stretched and extended into center. I am afraid that is necrotic tissue from what I have read. The white center does seem to be shrinking and the red beefiness is wider in appearance as the white shrinks but I do not believe that is has grown beyond it's initial circumference. I do have an appt. with doc on Wed, but it is with PA and unsure if they have wound care experience. Should I ask for referral to wound clinic or trust the PA? I will get you a pic, but from what I have shared does it sound like necrotic tissue or could it be something else?

Answered by Dr. Vivek Chail (11 hours later)

Brief Answer:
Please find detailed answer below

Detailed Answer:
Hi XXXX
Thanks for writing in with an update.

I guess there is no foul smelling odor from your wound and it is being kept dry by regular application of cream and dressings. The crust form a type of barrier preventing infection from entering the wound and in small wounds as you have the crust falls off on its own when the skin underneath has healed. So I would suggest that you follow the PA and I am sure they would be seeing wounds regularly and providing treatment to patients on a daily routine.

Please do send in a picture for better interpretation. You must have taken tetanus toxoid immunization and been prescribed antibiotics and pain relievers.

Wishing you good health.

Regards,
Dr.Vivek

Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar