Burn treatment

[Apollyon]

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When I was in South Carolina, I sent more patients to the JM Still Center than anyone else in my group. I am cognizant of critical burns, and the need for early treatment. I am also concerned about burns in darker pigmented individuals. One day in SC, I had a Hispanic patient with 2nd degree facial burns, and one of the people at Still said they had some things they could do there that would help minimize scarring/white patches (as it is more noticeable in darker skinned people).

Here in Hawai'i, I had a similar case, but the burn guy (who is plastics) said he didn't know of any tricks - just Silvadene for the body and Neosporin for the face.

Am I missing something? What can I do to help darker skinned folks not end up with white patches from their burns (beyond telling them not to get a sunburn on top)?

 

[Apollyon]

I'm bumping my own post, because there are a bunch of people posting here, but no one has any advice to offer?

 

[igap]

When I was in South Carolina, I sent more patients to the JM Still Center than anyone else in my group. I am cognizant of critical burns, and the need for early treatment. I am also concerned about burns in darker pigmented individuals. One day in SC, I had a Hispanic patient with 2nd degree facial burns, and one of the people at Still said they had some things they could do there that would help minimize scarring/white patches (as it is more noticeable in darker skinned people).

Here in Hawai'i, I had a similar case, but the burn guy (who is plastics) said he didn't know of any tricks - just Silvadene for the body and Neosporin for the face.

Am I missing something? What can I do to help darker skinned folks not end up with white patches from their burns (beyond telling them not to get a sunburn on top)?

I don't think you're missing anything. Having worked in a very busy burn center, I can't think of anything that will affect scarring in a dark-skinned person other than the things that you have mentioned.

The Still center is probably the busiest burn center in the country. If they said that they have "some things" to minimize scarring in darker pigmented people, then I would e-mail your contacts there and ask them. And then share their wisdom with the rest of us.

 

[Apollyon]

If they said that they have "some things" to minimize scarring in darker pigmented people, then I would e-mail your contacts there and ask them. And then share their wisdom with the rest of us.

I have done so, and am awaiting a response.

 

[maxheadroom]

Sorry, I'm not familiar with anything new or special for that type of injury. For a while, people were saying that biologic dressings like Transcyte (no longer on the market, I believe) would reduce scarring and keep deeper partial thickness burns from converting, but I don't think there was much success.

I'm a big fan of early referral to a good Burn Center. I did my residency at a place with an excellent Burn Center and my fellowship at a place with a lousy pseudo-Burn Center. The difference in the quality of care was astounding! I've become a big believer in sending patients to ABA-certified Burn Centers when they need anything more than outpatient care.

 

[Apollyon]

The result was...nothing new. The person who got back to me (don't know what she looks like, but has a smooth voice on the phone) just said early surgical debriding and cadaver or pig skin as needed.

 

[MOHS_01]

I know of nothing new either. I'm not aware if there is much that can be done to prevent the pigmentary alterations. At our institution we used a lot of Acticoat and Mepitel for the dressings.