Burns: Classifications, Treatments, And Medications

Burns are caused by intense exposure to heat, radiation, electricity, ultraviolet (UV) rays, chemicals, or the combustion of flammable substances. It can severely damage the skin and tissues of the body. Thermal energy is one of the major causes of burns, making up 86% of burn cases.

Burn injuries can affect both adults and children. While burns can leave serious health problems to victims for the rest of their lives, most are recoverable and treatable. Burns require diligent care by experts to avoid complications and long-term loss of function that may affect the patient’s quality of life.

This article will discuss the classifications of burns, how to manage burns, proper treatment, and medications available in the US for burns.

What’s In The Article?

• Classification of Burns

• Pharmacological Management for Burns

• Proper Treatment for Burns

• Medications For Burns

Classification of Burns

• Major burn. In superficial and partial thickness burns, this covers at least 10% of the patient’s total body surface area (TBSA) in adults and 5% in older adults and children. In full-thickness burns, the extent of injury should be at least 2% to be considered a major burn.

• Minor burn. Injuries under this category have a lesser extent of injury, as far as TBSA is concerned. Because they are not as serious, it usually warrants home remedies or an outpatient visit for consultation and treatment.

Pharmacological Management for Burns

The most common medications for burns are analgesics, antibiotics, and tetanus shots. Analgesics may be given to ease the discomfort of a burn injury, especially when performing exercises to prevent contractures and when going in for dressing changes. Depending on the pain severity and frequency, the physician may prescribe OTC drugs, such as acetaminophen and NSAIDs, or prescription drugs, like opioids. In addition, NSAIDs may help address inflammation.

Antibiotic medications may be given to prevent or fight off bacterial infections. Antibiotics are usually given through an IV line that goes directly into the bloodstream. This allows for a more precise dose and more rapid delivery to the site of infection. For first-degree and second-degree burns, the physician may prescribe ointments or antibiotic creams.

A tetanus shot may be recommended after a severe burn injury since the bacteria that cause tetanus can enter through an open wound. Devitalized tissues resulting from a burn injury are conducive to tetanus proliferation.

Proper Treatment for Burns

The general approach to treating burn wounds includes:

• Assessment of the patient

• Resuscitation and fluid management

• Debridement and wound excision

• Administration of medications

• Wound dressing

Based on these established processes, researchers came up with the following developments in treating and managing burn injuries:

Bioengineered Skin Grafts For Patients With Third-degree Burns

Alfred Health and Monash University are currently developing this breakthrough that will undergo trial in 2023.

Inspired by the lack of changes in the traditional split skin graft approach for more than 100 years, the research group speculated on the “creation” of new skin derived from the activated stem cells of the patients through a combination of material engineering and stem cell science.

The research group comprises material engineers, burns surgeons, and stem cell scientists.

Stimuli-responsive dressings for pediatric patients

University of South Australia’s dressings addresses burns injuries in children through infection reduction and healing stimulation. The idea of having stimuli-responsive dressings is roughly based on the Acta Biomaterialia and Biomedicines research team’s publications that explored the antimicrobial potentials of ultra-small silver antiparticles.

Pediatric dressings work by releasing tiny silver nanoparticles that get rid of antibiotic-resistant bacteria. The release of nanoparticles is possible through a delivery system that detects temperature and pH changes in the child’s body.

These will serve as bases to identify if there is an infection nearby. Once an infection in the periphery is identified, the dressing will activate to start the wound repair process.

Light Therapy That Triggers Growth Protein For Faster Healing

Photobiomodulation therapy is a low-dose light therapy that suppresses the production of endogenous TGF-beta 1. This is one of the protein types responsible for the cascade of inflammation once an injury sets in.

Aside from this, this type of phototherapy stimulates macrophages and fibroblasts. The former helps fight off infection, clean debris from the infection process, and eventually suppress inflammation. On the other hand, the latter mainly aids in the tissue repair process.

Through these mechanisms, the University of Buffalo researchers believe that light therapy can encourage tissue regeneration after inflammation reduction, thereby promoting pain relief and healing.

After establishing photobiomodulation therapy, the research team developed the corresponding protocol to ensure optimal healing while minimizing the risks of having adverse effects due to thermal injuries and light/laser utilization.

Burn Wound Management Updates

At the moment, researchers still need to have a consensus on the best type of dressing or topical agent to use when managing burn injuries due to the need for more data that will act as bases for comparison. Because of this, medical professionals still recommend choosing the currently recommended topical agent or dressing depending on the following factors:

•  Availability of resources

• Cost of resources

• Characteristics of burn injury

• Stage of wound healing

• Prescribed frequency of changing dressings

• Current lifestyle of the patient

Medications For Burns

The U.S. Drug Updates for Burn Injuries reviews the effectiveness of commonly prescribed burn medications and management techniques. This section presents the drug updates and key points regarding burn management, treatments, and guidelines related to these changes.

RECELL System

Also known as the RECELL Autologous Cell Harvesting Device, this spray-on skin cell technology is designed to address severe burn injuries. Compared to traditional skin grafting methods, this FDA-approved system needs a smaller area of donor skin to facilitate healing on the problematic area. Moreover, it provides a more efficient healing process that results in the following:

• Reduced scarring

• Better pain tolerance

• Improved cosmetic outcomes

• Lower chances of developing an infection

• Larger joint mobility

• Shorter hospital stay, if admitted to an inpatient facility

To use this, the researchers harvest the donor skin sample from an uninjured site and immerse it in their specialized enzyme solution to create the suspension liquid sprayed on the burn injury. For reference, a skin sample of about two inches by four inches can cover the entire back of an average-sized adult. The entire process can take approximately 30 minutes.

Melanocytes, fibroblasts, and keratinocytes are incorporated into the liquid to ensure better wound healing. Since the preparation is in liquid form, it will be easier for the healthcare provider to distribute the medication on the injured site evenly.

Researchers claim that this system may be used for any type of burn injury on any part of the body. However, they prefer this approach when dealing with patients with TBSA of at least 20% or deep injury in areas that may significantly affect function or appearance if scarring is not handled carefully.

StrataGraft

Recently, the U.S. FDA (Food and Drug Administration) approved the use of StrataGraft, a regenerative type of treatment, to address severe thermal burn injuries in adults. This is applicable to burn injuries with intact deep skin layers. Researchers and developers of StrataGraft aim to provide an alternative to autograft and reduce the risks of complications that this procedure brings.

Final Thoughts

Burns are complicated types of injuries. Depending on the patient’s overall health, size of the injury, and depth of the affectation, burn injuries may require surgery, skin grafting, bandaging, and rehabilitation, among other treatment approaches.

Selecting the appropriate one for the patient will depend on the severity and extent of the burn injury and the patient’s present comorbidities.

Moreover, knowing the current updates on managing burn injuries will contribute to faster healing time, shorter hospital stay, and a better quality of life for the patient.