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Outpatient burn care

Delayed wound healing

In most cases, superficial wounds usually heal within a period of up to three weeks without any further consequences. If healing occurs without any complications, one should not expect the formation of excessive scars and the resulting functional and aesthetic effects. If during the course of treatment, the physician ascertains that the wound is healing slowly or not at all without any epithelialization, and instead discovers the formation of granulation tissue, the patient should be admitted to a specialized facility. Incorrect diagnoses during the primary evaluation, the wound deepening due to toxic substances in the dressing, and an infection can all cause the aforementioned to occur. Depending on the location and extent of the wound, the selected treatment regime should be changed. It may be necessary to remove the granulation tissue and/or remaining necrotic tissue once again, with subsequent skin grafting. In individual cases, the use of a keratinocyte cell spray to close the wound has proven to be successful, particularly when dealing with partial-thick- ness wounds [35].

It is important to know that if the wound does not heal, the treatment regime must be changed in order to achieve the best healing results for the patient.

Follow-up care

Patients with burn wounds that receive outpatient treatment still require adequate follow-up care after the epithelialization process is complete. This includes providing the patient with extensive information regarding the further course of action [36]. The patient should avoid applying shear force to the area of the former wound, since this could result in the formation of new tension blisters. In addition, depending on the type and dryness of the patient’s skin, it is recommended that they apply lubricant to the formerly burned area [37]. Systematically protecting the area from UV rays should also be recommended to the patient. Besides avoiding exposure, this can be achieved through the use of suntan lotion with an SPF around 30.

Since the focus of outpatient burn care is on superficial burn wounds, additional follow-up care

methods using silicone gel sheets and/or compression bandages will not be discussed here in detail. However, if hypertrophic scars do form after a burn victim receives outpatient care, these products should be used as described in another section of this book.

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