Burn injuries, whether from a fire, hot liquids, chemicals, or electricity, require prompt and appropriate treatment to minimize damage, reduce pain, and promote healing. In a hospital setting, medical professionals use a combination of specialized treatments and medications to manage burns based on their severity. This comprehensive guide will explore what hospitals use to treat burns and how these treatments vary depending on the type and degree of the burn.

Types of Burns and Hospital Treatments

Burns are generally classified into three categories based on their severity:

1. First-Degree Burns: Affect the outermost layer of the skin (epidermis), causing redness and mild swelling.
2. Second-Degree Burns: Affect both the outer layer and the underlying layer (dermis), causing blisters, severe pain, and swelling.
3. Third-Degree Burns: Extend through the entire skin, affecting deeper tissues such as fat, muscle, and bone. They may appear white, charred, or leathery, and often result in nerve damage, making them painless at the injury site.

Hospitals have different protocols for treating burns depending on the severity. Let’s break it down:

First-Degree Burns (Minor Burns)

First-degree burns are typically treated on an outpatient basis and usually don’t require advanced medical intervention. However, hospitals will use the following to treat these types of burns:

1. Cool Compresses: The first step in treatment is to cool the burn with cool (not cold) water or a cool, wet compress to reduce pain and swelling.
2. Burn Creams & Gels: Topical treatments such as Aloe Vera Gel, Hydrocortisone Cream, or Silver Sulfadiazine (SSD) are commonly used to soothe the skin, reduce inflammation, and help prevent infection.
3. Pain Relief: Hospitals may administer over-the-counter pain relievers like ibuprofen or acetaminophen to reduce discomfort and inflammation.
4. Hydration: If the burn causes dehydration or fluid loss, patients might receive fluids intravenously (IV) to replenish hydration levels.

Second-Degree Burns (Moderate Burns)

Second-degree burns are more serious and often require medical treatment. These burns may involve blistering and moderate to severe pain. Hospital treatments for second-degree burns may include:

1. Cool Water and Pain Relief: The burn is initially cooled with water or a compress to prevent further tissue damage. Pain relief medications, like ibuprofen or opioid pain relievers, may be administered, especially if the pain is intense.
2. Topical Antibiotics: Silver Sulfadiazine (SSD Cream) is often applied to second-degree burns. It’s an antimicrobial cream that prevents infection while promoting healing. Other alternatives may include bacitracin or Neosporin for smaller burns.
3. Dressings: Specialized dressings, such as hydrocolloid dressings, non-stick gauze, or hydrogel burn dressings, are used to cover the burn and protect it from infection. These dressings also help reduce pain and keep the area moist to accelerate healing.
4. Blister Management: For blisters, doctors may drain them carefully (if needed) to reduce pressure and prevent infection. However, intact blisters are typically left untouched.
5. Fluid Resuscitation: In cases of moderate to severe second-degree burns, patients may receive intravenous fluids to replenish lost fluids and electrolytes.

Third-Degree Burns (Severe Burns)

Third-degree burns are the most serious and can cause significant damage to all layers of the skin and even deeper tissues. Hospital treatment for third-degree burns is more intensive and may include:

1. Initial Assessment & Stabilization: The first priority is stabilizing the patient. If the burn is large, the patient may need fluid resuscitation (IV fluids) to prevent hypovolemic shock due to significant fluid loss from the body.
2. Airway and Breathing Support: In cases of smoke inhalation or burns affecting the face or airway, oxygen therapy and mechanical ventilation may be necessary.
3. Topical Treatments for Severe Burns:
   • Silver Sulfadiazine (SSD): This antimicrobial cream is often used to treat third-degree burns as it prevents infection and promotes healing.
   • Mafenide Acetate (Sulfamylon): This is another topical treatment that helps prevent infections, particularly for burns covering large areas of the body.
   • Collagenase Enzyme Creams: These are used in cases where the burn involves dead tissue (eschar) that needs to be debrided (removed) to promote healing.
4. Wound Care & Debridement: Doctors often need to perform debridement, which involves the removal of dead tissue to prevent infection and promote healthy tissue regeneration. This is typically done through surgical procedures, either through mechanical or enzymatic debridement.
5. Skin Grafts and Surgery: For severe third-degree burns, skin grafts (either autografts—using the patient’s own skin—or allografts—using donor skin) may be necessary to cover the burn area and promote healing.
6. Pain Management: Because third-degree burns can cause severe pain (despite nerve damage), pain management is a top priority. Doctors may use strong opioids like morphine or fentanyl along with local anesthetics.
7. Infection Control: Since third-degree burns are highly susceptible to infection, broad-spectrum antibiotics may be administered intravenously to prevent bacterial infections. In some cases, burn patients may also be given tetanus shots.
8. Nutritional Support: Since burns increase metabolic rate, patients with severe burns may receive nutritional support through IV feeding (parenteral nutrition) or feeding tubes to help their bodies recover and heal.

Advanced Burn Treatments in Hospitals

For more advanced burns, particularly those that affect a large portion of the body, specialized treatments may be used, including:

1. Hyperbaric Oxygen Therapy (HBOT): This involves placing the patient in a pressurized chamber where they breathe pure oxygen to promote tissue repair, decrease swelling, and prevent infection.
2. Regenerative Medicine: Hospitals may use stem cells or biologic dressings (like biological skin substitutes) to promote faster healing in patients with extensive burns.
3. Pain Management Units: For severe burns, specialized burn centers may manage chronic pain and offer psychological support to help patients cope with long recovery periods.

Burn Care in Specialized Burn Centers

Burn centers are hospitals or units dedicated to treating burn injuries. They are equipped with specialized staff, including burn surgeons, wound care specialists, and therapists, to provide advanced care for burn patients. These centers offer:

1. Advanced wound care
2. Pain management
3. Reconstructive surgery (for severe scars or deformities)
4. Physical therapy (to restore mobility and function)
5. Psychological counseling (to support burn victims dealing with trauma)

Conclusion

The treatment of burns in a hospital depends heavily on the severity of the injury. While minor burns can typically be treated with topical treatments, pain relief, and cool compresses, severe burns require intensive care, including fluid resuscitation, wound debridement, skin grafts, and specialized pain management. Hospitals use a combination of advanced therapies to ensure that burn victims receive the best possible chance for recovery and healing.

For anyone who is at risk of burn injuries, such as those working in kitchens or near open flames, it’s critical to have access to professional burn care when needed. Always be aware of the severity of a burn and seek medical attention if the injury seems severe.