Conservative management of full-thickness burn wounds using advanced moist dressings: a case report

Surgical debridement and skin grafting are the standard of care in the management of full-thickness burns. Although full-thickness burns typically are not managed conservatively, such an approach may occasionally be warranted in cases of small-area full-thickness burns in which the patient does not want to undergo an operation. Published reports of conservative management in such cases are rare, however. A case of a conservatively treated small-area full-thickness burn is presented herein. Case Report. A 54-year-old female with left hemiplegia due to the aftereffects of cerebral infarction sustained a full-thickness burn injury measuring 7 cm × 18 cm on the left thigh when the patient fell indoors and came in contact with a hot stove. The patient declined hospitalization and surgery. Instead, conservative treatment with advanced moist dressings were used in an outpatient setting. These multilayered, nonadherent dressings with high exudate absorption capacity were changed once daily by the caregiver. No ointments were applied to the wound. Five days after the injury, thick necrotic tissue covered the entire wound. The patient wanted to avoid surgical procedures as much as possible, so instead of surgical debridement, several superficial incisions were made on the necrotic tissue to aid drainage of exudate. Autolysis of necrotic tissue and growth of granulation tissue progressed over time. The burn wound epithelialized after 16 weeks. No local or systemic infection occurred during the treatment period. Conclusions. This case indicates that small-area full-thickness burns can be successfully managed conservatively with advanced moist dressings, although with a prolonged healing process compared with skin grafting.