A patient was admitted to an emergency hospital with an accidental burn sustained to the right upper extremity, including the hand after falling into an uncontrolled fire. Right away, the patient immersed the arm in cold water as a form of first-aid treatment. The emergency clinical assessment confirmed:
- 5% Total Body Surface Area (TBSA) burns,
- Deep thermal burn involving the right upper extremity (forearm) and hand, left hand, and two fingers with volar surface involvement
General and plastic surgeons decided on the primary treatment in form of pain medication, antibiotics, and burn resuscitation to prevent shock and hypovolemia.
L-Mesitran Hydro and Ointment help in the post-clinical healing of thermal burns.
After hospital discharge
- Dressings were changed twice a week and supervised for a period of 60 days on an outpatient basis.
- L -Mesitran Hydro, a hydro-active antibacterial barrier dressing, was used as the dressing of choice.
- Smaller areas were managed thereafter with the topical application of L-Mesitran Ointment in conjunction with hydro-application to facilitate burn-wound healing.
Treatment with L-Mesitran brought a clinical outcome of satisfactory wound healing, and burn epithelialization was completed in 60 days. Furthermore, the rehabilitation at home was successful and facilitated by strict sepsis surveillance and nutritional support.
Clinical treatment of thermal burns.
Anatomically, the thermal burn involved the cutaneous innervation regions on the dorsum, represented by the forearm’s medial, lateral, and posterior cutaneous nerves. Both radial and dorsal innervation areas were affected on the posterior aspect of the right hand.
The burn surfaces included the flexor and extensor forearm surfaces and the burn on the right extremity was larger than on the left side. On the right-volar surface, the burn infringed on the forearms’ medial and lateral cutaneous nerve regions, all being terminal branches of the brachial plexus. These surfaces were in the distribution of C6, 7, and 8 cutaneous dermatomes of the right upper extremity.
The depth, type, grading, and “The Rule of Nine ” parameters helped establish burn severity scoring prior to surgical burn-wound debridement. The conservative principles of burn wound treatment and care were applied, including moist wound dressings.
Tangential excision or skin grafting was not indicated and the wounds were initially dressed with in-hospital, silver-impregnated dressings before intentional conversion to L-Mesitran Hydro after hospital discharge.