Abstract

Two million burns occur annually in the USA, of which 95% are treated in an out-patient setting. The treatment of burns is controversial. There are few data from controlled studies to provide rational guidelines for the frequency of both dressing changes and patient visits for the physician. Conclusions concerning infection drawn from studies on major burns are misleading when applied to the management of minor burns. Trauma to regenerating epithelium caused by frequent dressing change is of relatively less importance in treating major burns, because the control of infection is of overriding importance. In the treatment of minor burns, the traumatic consequences of too frequent changes of dressing may assume greater importance. There is a clear need to study the variables in the treatment of minor burns and to generate criteria for their clinical management that are distinct from those of major burn management. Collaborative studies of out-patient populations by providers of primary health care are suggested as a useful approach to such investigation. The effects of several additional therapies are reviewed, including initial cold therapy, debridement of blisters and antibiotics.

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