This page is designed as a guide to help you care for your child at home. Very occasionally following a burn, children can develop a serious infection. This is very rare indeed but can be potentially dangerous. The infection is treatable if it is recognised early. Please observe the child in your care for the following, which may be suggestive of a problem:
Infection
A wound infection will require prompt treatment. It is important to be aware of the signs of infection which are:
- High temperature
- Skin rash
- Vomiting and diarrhoea
- Redness and swelling
- Muscle aches
- Headache
- Discharge from the wound
If you notice any of these signs please contact the Paediatric Assessment Unit (PAU) in the Emergency Department as soon as possible for advice. (See below) If your child is very unwell consider getting your child to medical help urgently.
Dressings
Your child’s dressing will protect the wound while healing takes place. To reduce the risk of infection, try to keep the dressing clean and dry. It is important that the dressings are renewed if wound fluid has leaked through the dressing or if the dressing is:
- Wet or dirty
- Loose or falling off
- Smelling
If any of these occur please contact PAU in the Emergency Department, Yeovil. Your child’s continued care will be discussed with you before discharge so it can be arranged before you go home.
Dressings may need to be changed every two or three days, but you will be guided by your nurse about your child’s individual needs.
Keep all your dressings dry and clean as this helps to prevent infection. It’s also important to keep any open wounds covered to prevent infection.
Dressing changes
Your child’s dressing changes will be arranged before leaving the department.
Please give your child some pain relieving medicine (see below) before your child’s dressing change. This may help to relieve any discomfort he or she may feel.
Diet
To help your child’s wound to heal, encourage them to drink plenty and eat foods that contain a lot of protein, for example milk, yoghurt, cheese, eggs, fish, meat and baked beans.
Pain and Itching
If your child seems to be in pain, he or she may need pain relief such as paracetamol (Calpol or Disprol); you can also give ibuprofen (Brufen or Calprofen). Please follow the instructions on the bottle or packet carefully to ensure it’s suitable for the child. If this does not help and your child is still in pain, please contact the Burns Unit , Bristol Childrens Hospital (details at bottom of page).
Itching can be a major problem for some children following treatment for a burn. Regular creaming and massage helps. Wearing loose clothes made from natural materials can also improve comfort. If your child will not settle and itching becomes a problem please speak to a pharmacist, your GP or a doctor or nurse at the hospital. There are medicines that can help with itching’.
Hygiene
When your child goes home, initially they may be unable to bath and shower, whilst there are dressings in place.
Once healed and no longer needing any dressings, you should ensure your child’s skin is cleansed daily. Your child’s skin might be more sensitive to temperature or can be numb in places. Always test the water temperature before showering or bathing (to ensure it’s not too hot). Use non-perfumed soap and cleansing products to prevent irritation.
Creaming
Healed wounds and scars all require regular creaming to prevent the area from drying, cracking and becoming sore. This is because newly healed skin is unable to lubricate itself in the same way as undamaged skin.
- Initially creams should be applied gently, gradually progressing to massage
- Creaming should be carried out two or three times per day (occasionally this may be needed more often if their skin is particularly dry)
- It is very important that the skin is cleansed each day as the build-up of cream can cause skin irritation
- Massage involves firm pressure in circular strokes over the scars
- Creams used for massage should be non-perfumed moisturising cream (e.g. Nivea, E45, Epaderm, MooGoo etc)
Managing scarring
Following a burn injury some form of scarring is likely, although it’s severity can be determined by many different factors. Sometimes scarring can take up to two years to fully settle. When a burn heals, there is a risk of developing hypertrophic scars. These are scars that are red, raised, hard, sometimes sensitive and often itchy. Once fully healed, treatment for scarring can begin. Your child will be referred to the scar management team if required at Bristol Children’s Hospital by your GP.
Changes in skin colour
You may notice a change in the colour of the child’s wound at certain times. If they get hot, angry or upset it may become redder and if they become cold it may become bluer. This is all normal, and not something to worry about. It happens because of the damage caused to the pigmentation of the skin but it will settle in time.
Sun screen advice
It is very important that the healed wounds are protected from the sun as it is new thinner skin without the normal skin protection. Your child should have high factor sun protection cream (for both UVA and UVB) and wear protective clothing over the injured areas, as the new skin will burn very quickly and blister. If it becomes tanned this can be a permanent tan that can be blotchy. It is important to protect all newly healed areas from sun damage for at least two years. After this period, you should continue to use sun protection creams as normally recommended to prevent your child’s skin from burning.
Blisters and small wounds
Newly healed skin is a lot thinner and more sensitive than normal skin. Because of this, the development of small wound breakdown and blisters can happen in the first few months after healing. This may occur due to irritation from clothing, or accidental bumps and bruises. If this should occur the child should go to the school nurse or GP. Wounds should be covered with a non-adhesive dressing to prevent any further damage and allow healing. If you have any problems regarding a wound, you can always phone the Bristol Outreach Burns Team for advice, (see details at the bottom of this page).
Handy hints
- Once at home, remember to give some pain relief to your child before having a dressing change
- Eating a healthy balanced diet will help to continue to promote healing
- Smoking can affect healing. It is advisable to try to stop smoking. Even passive smoking can influence the healing
If you have any questions or concerns, please contact:
Yeovil Hospital Paediatric Assessment Unit (09.00-21.00 hrs): 01935 384788
Children’s Ward (21.00-09.00hrs): 01935 384360
Paediatric Burn Outreach Team – Bristol Children’s Hospital
What we do:
- Provide support and education to burn injured children and their families across the South West
- Provide support and education to professionals who in turn provide a service to children who sustain a burn injury (from acute injury through to rehabilitation)
Who can be referred to the service?
- Any child that has accessed the burns service at BRHC.
- Any child that has previously sustained a burn injury and lives in the South West. A referral letter (from your GP) will be required
Contact details
The Paediatric Burns Outreach Team (in hours) 0117 342 7910
Main reception Bristol Childrens Hospital Out of hours, Burns ward: 0117 342 7900
Paediatric Burns Outpatients 0117 342 7920
Useful websites
Changing Faces - www.changingfaces.org.uk
Dan’s Fund for Burns - www.dansfundforburns.org
Children’s Burns Trust - www.cbtrust.org.uk
NHS Constitution. Information on your rights and responsibilities available at www.nhs.uk/aboutnhs/constitution
