Basic dressing — Particularly for emergency treatment, a basic gauze dressing provides adequate burn coverage. It is placed after the application of topical antibiotic and consists of a first layer of nonadherent gauze (eg, Adaptic or Xeroform) placed over the burn, a second layer of fluffed dry gauze, and an outer layer of an elastic gauze roll (eg, Kerlix). Care should be taken to individually wrap and separate with fluffed gauze all toes or fingers to prevent adherence and maceration. The following video clips show a basic burn dressing being applied in the operating room . In patients with less severe burns that are dressed in an outpatient setting, and who are not being treated with IV analgesics, cleaning is performed more gently and splints are generally not needed.
Some patients with minor burns may need to be transferred to a burn center for reevaluation and treatment. In such cases, all burns should be dressed in dry, nonstick gauze only. Dry gauze is preferred for several reasons. First, properly dressing a moderate-sized wound takes time, resources, and knowledge on the part of the referring hospital staff. Moreover, once the patient arrives at the burn center, dressings are immediately removed. Thus, application of ointments or creams delays definitive wound care without benefit, as these must be washed off to assess the wound.
Dry gauze is the simplest, fastest, and most economical way to dress an acute burn wound in a patient being transferred. Moist gauze dressings increase the likelihood of hypothermia, macerate wounds, and subsequently increase burn depth. When in doubt, or if there will be a significant delay before transfer, a discussion should be held with the accepting burn center about what dressings they would like placed. The key in transferring a burn patient is to keep their body warm and prevent unnecessary delays.