Scalded and swollen-beware the underlying compartment syndrome.
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The non-adherent siliconised dressing Mepitel is excellent for burns, especially in children. It provides a moist wound environment, promotes wound healing and is easy and relatively painless to use. However, surgeons should be aware that in black children its use has been associated with pigmentation abnormalities.
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Biobrane remains an excellent biosynthetic dressing for thermal injury coverage. The present report of a probable case of toxic shock syndrome associated with its use does not question its efficacy as temporary coverage for partial thickness thermal burns. Instead, attention is focused on raising the index of suspicion of toxic shock syndrome in burn patients treated with Biobrane, or other occlusive dressings, who develop early signs or symptoms which may be consistent with the diagnosis.
An experimental study was carried out using rats to evaluate the effectiveness of prolonged and excessive cooling on the burned wound just immediately after injury. The wound was produced by applying a lint immersed in boiled water at 99 degrees C. The wound produced by applying a lint for 3 s, and then immediately soaking with tap water for 1 min, resulted in little damage. However, the wound produced by applying a lint for 10 s, and immediately after an ice cube applied for 10 min, resulted in the most severe damage. The wound produced by applying a lint for 10 s, and no treatment applied thereafter, and the wound produced by applying a lint for 10 s and immediately after soaked with tap water for 1 min, resulted in moderate damage. From this experiment, it is suggested excessive and prolonged cooling of the burn wound, such as using an ice cube immediately after injury, is harmful in some instances.
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