Burn Wound Injury Dressing Selection

Original Editor - Stacy Schiurring based on the course by Diane Merwarth

Top Contributors - Stacy Schiurring and Jess Bell

Burn Wound Injury Standard of Care

Please see this document for a growing list of wound care terminology and definitions.

The current standard of care for large and deep burn wounds is (1) early surgical excision and (2) wound closure

• wound closure can be achieved by skin grafting or temporary biological coverage for deep partial and full thickness burns

Expections to standard of care and alternatives to early excision and grafting include:

1. Surgical debridement followed by wound cleansing and regular dressing changes
   • preferred option for burns of indeterminate depth until burn depth determined
   • can be the most appropriate option to allow healing of partial thickness burn size. This will allow for a smaller area of the burn wound will need a skin graft.
2. Local wound cleansing and dressing changes
   • Indicated when surgery is not feasible or after debridement without grafting or temporary closure
   • Common for smaller burn areas, including full thickness burns
   • Standard for most superficial partial thickness burns
3. Surgery not feasible due to patient status, or resource availability
4. Grafting or skin substitutes not appropriate due to (1) contaminated wounds, (2) native skin is too damaged or of too small an area to provide a skin graft, or (3) skin substitutes are not available.

Burn wounds which (1) do not undergo surgical debridement, or that (2) underwent surgical debridement without application of a skin graft or temporary covered with a skin substitute will require ongoing dressing changes throughout the course of healing.

Those burn wounds which underwent surgical debridement and grafting or temporary coverage will not be covered in this module as the determination of wound closure or coverage and the subsequent bandaging will be at the discretion of the surgeon.  LINK TO OTHER PP PAGE HERE (Burn Wound Injury Care After Skin Graft Closure)

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