Treatment for thermal burns

Posted on 5 May 2023

Thermal burns occur when the skin comes in contact with a heat source, such as fire, hot liquids, or hot surfaces, and may require emergency treatment.

“Depending on the severity of a thermal burn, it can cause pain, swelling, blisters, damage to the underlying tissue or even complete loss of tissue,” says Dr Marisna Venter, a GP at Mediclinic Hermanus Emergency Centre. “In severe cases, get to your closest Mediclinic Emergency Centre immediately. Proper treatment is essential for healing, preventing complications such as shock, and minimising the risk of infection.”

Assessment and stabilisation

“The first step in treating a severe thermal burn is to assess the patient’s condition and stabilise them,” says Dr Venter. This involves monitoring vital signs such as blood pressure, heart rate, and breathing, as well as administering oxygen and appropriate analgesia.

“Depending on the extent of the burns, patients may also require intravenous fluids. This is particularly important in paediatric patients. Wound care for severe thermal burns is another critical component of treatment. The goal is to remove any dead tissue or debris and promote the growth of new tissue. In some cases, surgical debridement may be required to remove loose or dead tissue.”

Surgery for severe burns

“In severe cases of thermal burns involving larger areas, skin grafts or flap surgery may be required,” Dr Venter says.

Skin grafts involve taking healthy skin from an unaffected area of the body and transplanting it onto the burned area. Skin grafts can be either:

Autografts – the skin is taken from the patient’s own body
Allograftsthe skin is taken from a donor.

“The type of procedure used depends on the extent and location of the burn,” says Dr Venter. Split-thickness skin grafts are used for shallow or partial-thickness burns, while full-thickness skin grafts are used for deep or full-thickness burns. Composite skin grafts are used for large or complex burns where deeper tissue layers are involved.

“Skin grafting may be performed in stages, depending on the severity of the burn, the overall clinical condition of the patient and the amount of healthy skin available,” Dr Venter explains. “The grafts may be secured in place with sutures or staples and covered with a protective dressing.”

Flap surgery involves moving a piece of tissue, along with its blood supply, from one area of the body to another. Local flaps are used for small or medium-sized burns, while regional flaps are used for larger burns that require more tissue to be transplanted. Free flaps are used for large or complex burns that require more tissue.

Hyperbaric oxygen therapy (HBO)

This treatment requires the burn patient to breathe pure oxygen in a pressurised chamber, which can help to promote healing and reduce the risk of infection. HBO, which is given within the first 48-72 hours of a burn injury, increases the oxygen saturation in the body, which speeds up the recovery process.

Pain management

“We administer pain medication via various routes, depending on the patient’s condition and the severity of the thermal burn,” Dr Venter explains. “In some cases, nerve blocks or epidural anaesthesia may be used to provide pain relief.”

Nutritional support

Severe thermal burns can cause a significant metabolic response, which may result in malnutrition and muscle breakdown. Nutritional support is essential to promote healing and prevent complications. This may involve providing a high-protein diet, nutritional supplements, and hydration through intravenous fluids.

Rehabilitation and counselling

Rehabilitation is an essential part of treatment for severe thermal burns. “The goal is to improve the patient’s function and quality of life after the burn has healed,” says Dr Venter.“This may involve physical therapy to improve range of motion, strength, and flexibility, as well as occupational therapy to help the patient regain the ability to perform daily activities.” Psychological support is also an important aspect of rehabilitation, as scarring from a severe thermal burn can have a significant impact on the patient’s mental health and well-being. Counselling and support groups can help them and their family cope with the emotional and psychological effects.

Remember, early intervention and prompt treatment can improve your outcome and minimise the risk of complications. It’s essential to seek medical attention immediately if you’ve suffered a severe thermal burn.

In the interest of our patients, in accordance with SA law and our commitment to expertise, Mediclinic cannot subscribe to the practice of online diagnosis. Please consult a medical professional for specific medical advice. If you have any major concerns, please see your doctor for an assessment. If you have any cause for concern, your GP will be able to direct you to the appropriate specialists.