Assessing the depth of a burn usually requires the skill of a doctor or nurse. Dead skin covering a burn often disguises its depth. Bacteria also grow in dead skin, which antibiotics cannot reach and kill. A doctor who feels confident that a burn is only shallow will choose from a number of techniques to treat it. These shallow burns should heal within two weeks without scarring.
After carefully cleaning a burn, a "synthetic skin" dressing can be adhered to a wound. Two versions of this dressing include Biobrane and TransCyte. The latter combines neonatal human cells with porcine (pig) ones. First, the dressing fastens to the skin with adhesive. A compress applied causes the synthetic skin to fully adhere. Biobrane and TransCyte protect the skin with minimal pain when compared with petroleum jelly and gauze, which are traditional methods of dressing. Dead skin and fluid coming to the surface requires that the synthetic skin come off for cleaning, a process which is difficult and sometimes painful. TransCyte showed better results than Biobrane where pain and healing are concerned.
Once dead skin and fluid are no longer present, after 24 to 48 hours with minor burns, the wounded area no longer requires covering. Synthetic skin adheres so closely to the wound that no doctor wants to make a mistake and have to take this off of a patient with a deeper burn. Biobrane and TransCyte have been proven effective and far surpass the petroleum jelly and gauze method, which often introduced gauze fibers into the wound, encouraging infection.
"Silver" cream dressings (Silvazine) discourage bacterial growth and encourage quick healing. After no more than a week, fluid and dead skin should be gone and a regular dressing applied. Compared to wounds treated with synthetic skin, the skin treated with Silvazine repaired itself more slowly and some patients need grafting. Like Biobrane and TransCyte, Silvazine more effectively treats burn wounds than petroleum jelly and gauze dressings, especially against the growth of bacteria. Though skin heals more quickly under synthetic skin than with just silver cream, silver cream comes off with relatively little discomfort.
The soft silicone of Silflex (formerly known as Siltex: Advance Medical) covers the wound without adhering. A moist layer (usually of a silver-based cream) ensures that the wound does not dry out, a critical factor in healing. When dressings are changed, there is less or no pain than with traditional dressings or adherent ones. Wound depth will guide the choice of dressing, but a mistake can cause a patient tremendous pain.