Burns Home care For burns on the hands or feet (1108)
Key points below
Your child has a burn injury that you can care for at home. Read and follow these important instructions. Doing so will help prevent infection and will help your child’s wound heal properly.
You will need to change the bandages every day. Changing your child’s bandages every day will help keep the wound clean, free of infection and help it heal.
What supplies will I need?
- Fine mesh gauze. You will put medicine (burn cream) on this gauze and then put it on your child’s burn.
- Burn wrapping: used to wrap over the burn gauze.
Rolled gauze.
Pronet® or Ace wrap. This is used to secure all of the dressings.
Twill tape. This is used to tie the Pronet together.
Gloves to hold dressings in place. Thin winter gloves work best as they are not bulky and can be washed easily. - Clean applicators to put medicine on dressings.
- Mild, unscented soap to help clean the wound. Use Johnson & Johnson (yellow), Ivory, or Dial soap.
- Clean washcloth to clean the wound.
- Clean towel or paper towel to lay the new dressings on. Clean towel to dry your child after the bath.
What medicines might be used for my child’s burns?
Bring any prescribed creams or medicines to your child's follow-up appointment.
Silvadene®. This cream is used on the burn wound to help prevent infection. Do not use this cream on your child’s face.
Sulfamylon
Antibiotic ointment
Pain medicine. Give as ordered by the doctor.
Give your child this medicine for relief of pain before dressing changes and in between dressing changes as needed.
• For dressing changes, give your child this medicine ½ to 1 hour before you do the dressing change.
• For doctor appointments, give your child this medicine so that the medicine has a ½ hour to work before the follow-up appointment.
Medicines as ordered by the doctor.
Multi-vitamin. Give as ordered by the doctor.
Benadryl®. Give as ordered by the doctor. This medicine is to help with itching.
How do I change the dressing?
The dressing has three layers: burn gauze, wrapping, and Pronet or glove. Your provider will tell you how often to change the dressing.
First, get ready for the dressing change.
1. Gather all the supplies and medicines that are on the supply list.
2. Clean the bathtub with cleanser. Rinse the bathtub well so all the cleanser grit is gone.
3. Wash your hands with soap and water.
4. Prepare the burn gauze.
a. For fingers or toes, cut strips of gauze wide enough to cover the top half of the finger or toe and long enough to cover the end of the finger or toe. On other areas of the body, the gauze should be large enough to completely cover the burn. It is ok to go onto healthy skin around the edges. It is better to be a little too big than to be too small.
b. Lay a clean towel or paper towel on a counter to make a clean surface.
c. Use clean applicator to take medicine out of the container.
d. Spread the medicine on the fine mesh gauze to cover the surface. It should be thick enough that you can no longer see through the gauze.
e. Lay the cream-covered burn gauze on the towel.
5. Fill the bathtub with warm water. Check to make sure the water is not too hot.
Second, clean your child’s burn wounds.
1. Remove the old dressings. If the dressing is stuck, soak the area with water to help loosen it. You can do this while your child is in the bathtub.
2. Check the burn wound for signs of infection:
• Redness
• Swelling
• Drainage that smells bad
• Green-colored drainage
Note: Old medicine will look slimy on the wound. This is normal. It is not a sign of infection.
3. Put your child in the bathtub. Wash the burn wound using a mild soap and a soft, clean washcloth. As you wash the wound, you may notice a thin layer come off of the wound. This is old medicine and some wound drainage. This needs to come off for the wound to heal well. The wound should look pink, but not actively bleeding. It's ok to see small amounts of blood. This is healthy skin growing back.
4. Try to have your child play with toys while the dressings are off. This will exercise all of the joints. It will also help distract your child.
5. Rinse the wound with clean, warm tap water.
6. Take your child out of the bathtub. Lightly pat your child’s skin dry with a clean towel. Do not rub the skin.
Third, put on new dressing: gauze and wrapping.
1. Cover your child’s burn wounds with the gauze that you put the medicine on. Put the gauze on so that the medicine covers the wounds completely. It is ok to go onto healthy skin around the edges.
2. Wrap fingers and toes as the nurse shows you. Put one piece of gauze on the top and one piece under the finger or toe. The burned fingers or toes should not touch another burned area.
3. Wrap the burn wound and gauze with:
Rolled gauze. Wrap as directed with rolled gauze. Wrap it loosely around each finger or toe. Keep each finger or toe separate!
ProNet. Put a piece of ProNet over each finger or toe and on the hands. Make a glove by securing the ProNet with ties.
4. Use twill tape to tie the ProNet finger covering to the ProNet hand covering.
5. Instead of ProNet, you can use thin, winter gloves from the store to hold the dressings on. These can be washed and reused.
What if the dressing gets dirty before the next dressing change?
1. Wash your hands.2. Remove the top wrap.
3. Take the dressing off in layers.
a. If the gauze with the medicine on is not dirty, leave it in place and put on a new outer wrap.
b. If the gauze with the medicine on is dirty, clean the wound and do a complete dressing change.
Where do I get supplies for the dressing changes?
• If your child has been seen in the Emergency room and is going home the same day, you may be given some supplies to take home.• If your child has been a patient in the hospital, you may be given some supplies to take home.
• A special nurse called a discharge planner can help you make arrangements to get more supplies. Talk to your child’s healthcare team for a referral to the discharge planner.
Note: Home care supplies may not be covered 100% by your insurance. You may need to buy some supplies on your own.
What else can I do to help my child heal?
• Your child may need special exercises. The exercises will help keep or recover function of a burned area. Please follow exercise instructions given by the physical or occupational therapist.• If the doctor says it’s ok, have your child:
o Use the burned hand for play and eating.
o Stand and walk on the burned foot.
• Good nutrition will help your child’s burns heal.
o Have your child eat a healthy diet that may include whole milk. Choose foods that are high in protein and calories.
o Limit the amount of junk food your child eats. Avoid candy, chips and soda even though these foods often have higher calorie content.
o Follow the advice on teaching sheet #1963 - Nutrition for the Child with Burns.
Does my child need to see the doctor or nurse again?
• Your child’s burns may need to be checked by the doctor or nurse in the Burn Clinic to see that they are healing well.
• Make an appointment to have the burn wounds checked by the doctor or nurse. Remember to bring any prescribed medicines and ointments to this visit.
• For more information about burns, visit our website www.childrenswi.org.