Wound bed preparation is a fundamental step in good burn wound management. Creating an optimal wound-healing environment will promote wound healing and early wound closure minimizing the risk of scarring, making the new skin look and function better.
Blisters, loose skin, slough, environmental contamination and/or necrotic tissue can often be present following burn injury. Their removal is a crucial first step in the natural wound healing process before healthy granulation and epithelial tissue can be formed which will then close the wound.
Dead tissue, slough and debris in a wound can:
- Prevent or delay a wound’s normal healing process (87);
- Mimic or hide infection;
- Attract bacteria to the wound, increasing the risk of infection (88);
- Prevent clinicians from assessing the extent and depth of the wound (87);
- Increase odour and exudate (85);
- Prolong inflammation;
- Delay wound healing.
Burn Wound Bed Preparation involves the following steps:
Cleaning the wound of debris and environmental contaminants will remove foreign bodies and reduce the bacterial load.
2. Remove Blisters and non viable tissue
Remove loose skin, blisters, slough or necrotic tissue. This facilitates the natural wound healing process, minimizes the risk of infection and promotes early wound closure (Strohal et al, 2013).
Shave the burn within the wound to a 2cm margin beyond the burn edge. Hair and hair follicles harbor bacteria that increase the bacterial load, delaying wound healing and increasing the risk of infection.
Detailed steps in wound bed preparation are outlined on the Initial Management of Minor Burn Injury “C – Clean” tab.