After cleaning the wound, a determination is made about the depth of the burn. The non-full-thickness burns, i.e. the partial-thickness burns, heal spontaneously over a period of time. The 1st degree burns heal in 4-7 days and the 2nd degree burns heal in 1-3 weeks. During this healing period, the burn wound is properly closed and the wound is protected from the external environment. In other words, the wound is closed with the suitable materials and the appropriate ground and time is prepared for its self-healing. In the superficial burns, it is one of the most appropriate methods to close the burn wound with a permanent dressing in the early period. If the burn area is small, the patient can be discharged home if the patient is safe and the home life and environment are suitable, and the patient can be treated as an outpatient until the depth of the burn is determined or evident. If it is to be followed in this way, the patient should be seen at least twice a week, while patient education, recognition of signs of infection, compliance with health information rules and nutritional support should be considered.
In the second or third degree burns, the analgesics, local topical antibiotic cream application and tetanus immunoprophylaxis are performed. It is difficult to decide on the depth of scalding burns in the infants and young children in the early period. It takes longer to determine the depth of the burn in the elderly patients than in the adults and children.
The wound care of the burned patient is postponed until the general condition and vital functions of the patient are completed, or it is not dealt with effectively.
The wound is initially washed and cleaned with the physiological saline solution. If the wound is dirty, it can also be washed with a mild soap. There is no need to use the antiseptic agents. Giving painkillers to the patient before any intervention is made on the wound, which relieves the patient. The removal of the foreign objects from the wound and removal of the clothes are done at the beginning. If the burned area is dirty, contaminated and not infected, if the bullae have not burst, usually only the fluid collected in it is emptied with the help of an injector and the bulla membrane is adhered to the underlying floor. Thus, the burn wound is covered with a biological cover. If the burned area is dirty, contaminated, infected, and the bullae are ruptured and scraped during transport or peeling, the remnants of the bullae are debrided.
In order to make the initial evaluation, the burn wounds of the patient with the burns should be cleaned, the dead tissues and ruptured bullae should be debrided.
In the third-degree burns, no local intervention is made at first. Only in the circular third-degree or deep second-degree burns, if the burn eschar has formed a circular band, the escharotomy is performed in the appropriate areas to relieve the pressure created by the eschar on the underlying tissues.
The cooling and, if necessary, the escharotomy should be applied to all burn wounds. In the next stage, the various operations are performed according to the depth of the burn. The excision and grafting are performed a few days after the burn. The processes of controlling the general condition and vital functions of the patient are postponed until they are completed or they are not dealt with effectively.
Three interventions are privileged here, namely washing the burn wound, cooling it and performing the escharotomy operations on the eschar tissue.
In the burns such as chemical burns, radiation burns, phosphorus burns, the burn wound should be washed with plenty of water in the early period. If it has been burned with the various acid salts, they are first brushed and then washed with the plenty of water. If water is poured without brushing at the beginning, the salts combine with the water and liquid acids are formed, and chemical burns can develop in the larger areas.