Pharmacy Times

Ouch! Relief for Minor Wounds and Burns

Author: Yvette C. Terrie, BSPharm,RPh


Proper wound and burn care can help prevent the development of scars and infections.
Pharmacists are likely to encounter patients seeking guidance on which non-prescription topical products to use for self-treatment of minor wounds and burns.

Since proper wound and burn care is critical to the overall healing process and essential in preventing scar formation and secondary bacterial skin infections, it is important that patients receive informed guidance on how to handle these injuries.1

Classification of Wounds and Burns

Wound and burn care must be tailored to the type and severity of a particular wound or burn. In general, wounds are classified according to their acuteness and depth.1 Acute wounds can be classified as abrasions, punctures, or lacerations.1 In general, if acute wounds such as abrasions or puncture wounds do not extend beyond the dermis, self-care is appropriate.1 However, pharmacists should advise patients with chronic wounds to immediately seek medical attention to prevent further complications such as infection.

Burns are defined as wounds caused by thermal, electrical, chemical, or ultraviolet radiation.1 In general, only superficial and some superficial partial-thickness burns are suitable for self-treatment.1 Patients with more severe burns should be referred for medical treatment.

A number of nonprescription topical first aid products are available for self-treatment of minor wounds such as scrapes, scratches, cuts, and burns. Proper wound and burn care promotes proper healing, prevents infection or other complications, provides physical protection, and minimizes the incidence of scarring.1 Nonprescription wound care products for self-treatment include topical antibiotics (eg, bacitracin, neomycin, and polymixin B sulfate), wound irrigants, wound antiseptics, bandages (including medicated bandages with topical antibiotics), and products that help reduce the appearance of scars. Bandages are also available in waterproof form and liquid bandage form as well as in latex-free versions for those with allergies. Nonprescription products available for minor burns include skin protectants, such as formulations with antiseptics and local anesthetics. In some cases, patients experiencing pain associated with a minor burn may ben- efit from taking an OTC NSAID or APAP on a short-term basis if no contraindications are present.1,7




Study results have demonstrated that failing to cover wounds with proper dressing increases one’ s chance of scarring, infection, and re-injury. Studies have also indicated that covering the wound to create a moist healing environment accelerates healing and may minimize scarring and reduce the incidence of infection.1,4,5 Wound dressings should typically be changed every 3 to 5 days unless otherwise directed, as frequent dressing changes may remove resurfacing epithelial layers, potentially hindering the healing process.1,4,5

Table 4: Examples of Nonprescription Products Available for Minor Wound/Burn Care
Topical nonprescription antibiotic products
Brand Name Active Ingredients Per Gram
Bacitracin Ointment Bacitracin 500 units
Neosporin Ointment Bacitracin 400 units
Neomycin 3.5 mg
Polymyxin B 5000 units
Neosporin Plus Pain Ointment Polymyxin B 10,000 units
Bacitracin 500 units
Neomycin 3.5 mg
Pramoxine HCl 10 mg
Polysporin Ointment Bacitracin 500 units
Polymyxin B 10,000 units
 
Examples of nonprescription antiseptic/anesthetic products
Brand Name Active Ingredients
Bactine Original First Aid Liquid Benzalkonium Cl 0.13% w/w
Lidocaine HCl 2.5% w/w
Bactine Pain Relieving Cleansing Spray Benzalkonium Cl 0.13% w/w
Lidocaine HCl 2.5% w/w
Band-Aid Hurt Free Antiseptic Wash Benzalkonium Cl 0.13%
Lidocaine HCl 2%
Campho-Phenique Pain Relieving Antiseptic Liquid Camphor 10.8%
Phenol 4.7%
Dermoplast Hospital Strength Antibacterial Pain Relieving Spray Benzocaine USP 20%
Benzethonium Cl USP 0.2%
Neosporin Wound Cleanser for Kids Benzalkonium Cl 0.13%
Unguentine Maximum Strength Pain Relieving/Antiseptic Cream Benzocaine 5%
Resorcinol 2%

Simply Saline Anti-Bacterial Wound Wash

Benzethonium Cl 0.13%

Scar Zone Burn Gel

Lidocaine 2%
Benzalkonium Cl 0.13%
 
 
Wound Irrigants

Brand Name

Active Ingredient
Wound Wash Sterile Saline Aerosol 0.9% Sodium Cl
 
Scar Treatment Products

Brand Name

Ingredients
Mederma Advanced Scar Gel (available in children’s formulation as well) Water (purified), Peg 200, Alcohol, Xanthan Gum, Allium Cepa (Onion) Bulb Extract, Lecithin, Methylparaben, Sorbic Acid, Panthenol, Sodium Hyaluronate, Fragrance.
Scar Zone Topical Scar Diminishing Cream Octinoxate 7.5%; Zinc Oxide 3.93%; Dimethicone (Silicone) 4%
New-Skin Scar Fade Topical Gel Dimethicones
 
Examples of nonprescription products for minor burns
First Degree Therapeutic Burn Cream Calendula officinalis Tinc, Cantharis vesicatoria 3x, Echinacea augustifolia Tinc
Water-Jel Burn Jel Plus External Analgesic Gel
Lidocaine HCl 2.5%
 
Examples of nonprescription skin protectants
Brand Name Active Ingredients
A + D Ointment Petrolatum 53.4%
Lanolin 15.5%
Desitin Multi-Purpose Ointment White Petrolatum 60.4%

Conclusion

Pharmacists can help patients select appropriate products for care of burns and wounds and help determine whether self-treatment is appropriate for a given patient. Patients should be referred to seek medical care from their primary health care provider when self-care is not deemed appropriate.

During counseling, pharmacists should remind patients that minor wounds and burns typically heal on their own. In addition, patients should be advised to seek medical care for wounds that exhibit no sign of healing after 5 days of self-treatment or if the affected area shows signs of infection. Patients should be advised to continue using wound dressings until the wound shows signs of healing.

Patients should be reminded to not use ice on minor burns since it can cause vasoconstriction and actually make the burn worse.7 In addition, patients should be advised to seek further medical care if a burn does not show signs of healing, appears to worsen, or shows signs of infection after 7 days of treatment.7


Ms. Terrie is a clinical pharmacy writer based in Haymarket, Virginia.

References
  1. Benard D. Minor burns, sunburn and wounds In: Krinsky D. Berardi R, Ferreri S, et al, eds. Handbook of Nonprescription Drugs. 17th ed. Washington, DC: American Pharmacists Association; 2012.
  2. Lacerations. Merck Manual for Healthcare Professionals Online. www.merckmanuals.com/professional/sec22/ch328/ch328a.html#v1110280. Accessed March 29, 2013.
  3. Hollander JE, Singer AJ. Evaluation of wounds. In: Tintinalli JE, Kelen GD, Stapczynski JS, Ma OJ, Cline DM, eds. Emergency Medicine: A Comprehensive Study Guide. 6th ed. Columbus, OH: McGraw-Hill; 2006:Chapter 40.
  4. Clean, treat, protect: wound care. Band Aid website. http://www.bandaid.com/proper-wound-care/clean-treat-protect. Accessed April 1, 2013.
  5. Neosporin website. www.neosporin.com/firstaid/pdf/sciencefactsheet.pdf. Accessed April 1, 2013.
  6. How to care for a minor wound. Centers for Disease Control website. www.bt.cdc.gov/disasters/woundcare.asp. Accessed April 1, 2013.
  7. Basic burn care/first aid burn treatment. Massachusetts General Hospital website. www2.massgeneral.org/burns/patients/. Accessed March 29, 2013.