Third Degree Burns and Infection

Infection remains the most common complication of burn wounds, it’s a major cause of death among burned patients. It can happen in the hospital or at home; it can be local (at the site of burn) or systemic (the spread of infection to other areas of the body).

As the skin plays an important role in protecting the body against infection and acts as a barrier that prevents Microbs from entering the body, the risk of infection increases when a burn injury happens.
Risk factors of developing a burn wound infection many include:

• The extent of burn, burns exceeding 30% of the total body surface area (TBSA) are at higher risk.
• The depth of burn, full thickness burns (third degree) are at higher risk.
• The location of burn, burns in the perineum are at higher risk of infection.
• The age of the patient, extremes of age are at higher risk because of lower immunity.
• The general condition of the patient, amonge conditions that increase the risk of infection are immunosuppression, obesity, diabetes and malnutrition.
• The type of organisims, their number and virulence.
• The quality of wound care provided for the patient.
• Duration of hospitalisation and number of days ventilated.

The incidence of infection and its mortality has significantly decreased due to the improvements in the techniques of burn wound care and infection control mesures. When infection happens, it can cause the wound to progress from a partial thickness (e.g second degree burns) to a full thickness (e.g third degree burns), can prevent or delay healing, can encourage scar formation and can result in septicemia and organ failure.

Burn wounds should be inspected daily for signs of infection especially in pediatric age group as they sometimes can’t express their feelings of being unwell.

Warning signs of infection may include:

• Increased or persistant pain.
• Increased redness in or around the wound.
• Increased swelling in or around the wound.
• Increased drainage from the wound.
• Change in the color of drainage (green discharge or puss).
• Foul smell from the wound.
• Increased warm feeling from the wound.
• Bleeding from the wound between dressing change, or soaking the bandage with blood, unless there has been a trauma (remember that bleeding at the time of dressing change itself may be expected).
• Chills or fever greater than 101.4 degrees. Burned patients should check their tempreture daily.
• Complete loss of appetite.
• Persistent vomiting or diarrhea.

Helpfull tips in preventing wound infection:.

• Keep the burned area clean.
• Look for any signs or symptoms of infection during dressing change.
• Follow a strict sterile protocol during wound dressing change (see home wound care).
• It’s important in infants to observe any change in the appearance of wound or change in activity level (not playful, fails to hold eye contact, lethargic) children can’t express what they feel. Contact the doctor immediately if you observe any sign or symptom of infection.
• Topical antibiotic ointments may be prescribed as a prophylactic (preventive) measure in burned patients.
• Infection delays wound healing, encourages scarring (as a result of collagen deposition in reaction to the infection) and may result in bacteremia and organ failure (systemic infection).

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.