___ Shower daily with Dial antibacterial soap. Take pain medicine 30-45 minutes before showering and wound care. Wetting the dressings in the shower will help them to come off easily without sticking to the burn. Use a different wash cloth for the burn area than you use for the rest of the body to prevent infection. If you have many burn sites, use a different wash cloth for each site for the same reason. Clean all wounds by applying light pressure to ensure that all old creams and ointments are removed, then rinse and pat dry. NO TUB BATHS.
___ Apply a thin layer of Silvadene (white cream), xeroform or Adaptic, then wrap with dry gauze and an ace bandage once daily. It is important to make sure that all of the old cream is removed before you apply a new layer. DO NOT USE THIS CREAM ON THE EARS OR FACE.
___ Apply a thin layer of Bacitracin, xeroform or adaptic, then wrap with dry gauze and ace bandage once daily.
___ Apply a thin layer of Collegenase, wrap with dry gauze once or twice daily. This ointment removes unwanted tissue or buildup.
___ Apply a thin layer of Sulfamylon Cream to the ears once or twice daily.
___ Mix a packet of Sulfamylon powder with Sterile water or 0.9% Normal Saline to form a solution. The solution will have a yellow tint. Apply a layer of adaptic to prevent bandage from sticking. Moisten kerlix gauze with this solution and place on wounds, over the adaptic. Cover with dry gauze and ace wrap. The solution is good for 48 hours. Discard any unused solution.
___ Acticoat: Keep dressings dry. If the white gauze becomes soiled or wet, remove the white gauze and put clean white gauze back on top of the Acticoat. On the day of your clinic visit, remove the white gauze and wet the Acticoat with water and wrap with saran wrap.
___ Ace wraps should be applied when you are out of bed to reduce swelling and pressure on the burn site. If the burn is on any part of the leg, the wrap should be toe to thigh to prevent swelling. Remove the wraps when bathing, doing wound care, and going to bed.
___ Moisturizer is used when burn wounds have closed or have nearly closed. Glucan Pro, Elta Swiss Cream, or Vaseline may be used and should be applied in a thin layer at least twice per day. You should apply the cream more often if your burn is dry. Doing so may also help with itching and tightness.
___ Over the counter moisturizers may be applied to all closed wounds. Some that we recommend are Aveeno lotion (unscented), Vaseline Intensive Care (unscented) and Eucerine lotion or cream.
___ Apply Tubigrip to the affected area as advised. Wear for a few hours, increasing the length of time daily until you are able to tolerate wearing it for 23 hours per day. You may wash the TubiGrip with a gentle detergent and allow to air dry.
___ Some burns will require custom compression garments to reduce scarring. We work with an outside company and have a representative available for measurements and fitting of these garments on Tuesdays and Thursdays. Our Occupational and Physical Therapist will make the referral for garments when and if it is necessary.
___ Benadryl or Zyrtec may be used for itching. Read the directions on the label and take the dose recommended for your weight and/or age.
___ Pain control: Prescription pain medicine may be used when the burn wounds are open and new. Most of the prescriptions we use contain Acetaminophen (Tylenol). If the prescribed pain medication is not enough and you have no history of stomach ulcers, bleeding disorders, or other restrictions, try alternating it with Ibuprofen (Motrin or Advil). Taking all pain medications with food is recommended to prevent stomach pain. Narcotic pain medications are only prescribed while your burn wounds are open. Once your wounds are closed, refills of narcotics will not be granted. We may make other recommendations based on how you describe your pain and the type of injury.
a. Medications: Your provider has placed you on a medicine for pain called a narcotic. These are very strong pain medicines and may cause dizziness, drowsiness, constipation, nausea and vomiting. You should not drive, operate heavy machinery or drink alcohol while taking these medicines. Do not take them with any other pain medication or sedative without consulting your healthcare provider.
b. Refills: For medication refills you must call the Burn Clinic between 8 a.m. and 4 p.m. Monda-Friday. We may require 24 hours to refill your medications. Prescriptions will not be refilled on weekends or holidays.
c. Constipation is a very common problem in patients taking narcotic pain medicines. To prevent constipation you should take a stool softener. You can buy these over the counter at your local drug store. It is also important that you increase your fluid and fiber intake while on these medications. Examples of high fiber foods are high fiber cereals, fruit, vegetables and 100% fruit juices. You should drink at least 6-8 ounces glasses of water per day.
d. Nutrition: To help with the healing process, increase your protein intake. Chicken, cheese, milk and red meat are all high in protein. You may also buy multivitamins, which will help with wound healing.