They recommended keeping the blister intact. showed that burn blister fluid is similar to plasma and contains immunoglobulins along with prostaglandins and other proteins. attributed prostaglandins in the burn blister fluid for vasodilatation, increased microvascular permeability, and accumulation of polymorphonuclear leucocytes following burn injury. The child was discharged with physiotherapy and nutrition counseling.Īrturson et al. Postoperative scar therapy was provided using silicone sheets and compression garments. On 18th post-burn day, complete wound was found to be healed. The pixel graft had started proliferating over the deep burn areas. On 11th post-burn day, the wound was again opened, and it was found that all areas of second-degree superficial burns were completely epithelialized. All wounds were provided adjuvant wound therapy using low-level laser, autologous platelet-rich plasma (APRP), and regulated oxygenation and negative pressure therapy. Only patchy areas were having deep burns, which were debrided, and pixel grafting was carried out to minimize donor-site problems. It was found that the second-degree superficial wounds were healing well. Wounds were cleared of debris from dead skin and collagen sheets, using hydrojet debridement. After 5 days of burn injury, the child was taken to the operation theater, and her wounds were reassessed. During postoperative period, fluid resuscitation and supportive treatment was provided to the child. After that, all the wounds were covered with bovine collagen dry sheets, followed by a non-adherent layer, then a layer of absorbing dressing with connections for regulated oxygenation and negative pressure therapy, and a last layer of occlusive dressing. These areas were around 5% of the total body surface area. The aspirated blister fluid was sprayed over the exposed parts of second-degree superficial burn areas immediately. Quantity of burn blister fluid aspirated was 3 mL. Intact burn blisters were aspirated in sterile way using 1-mL syringes, and the overlying skin was kept intact over the wound. All the wounds were cleaned with warm saline carefully keeping the blisters intact.

After stabilization, she was shifted to burns procedure room for wound management. On arrival to the burn center, the child was managed according to the WHO (World Health Organization) burn management guidelines. Some of the second-degree superficial burn and all of the second-degree deep burn wounds were exposed and were not having intact skin or blisters over them.

There were multiple blisters formed over second-degree superficial burn areas. The depth of scald burn wound was mixed, having areas of second-degree superficial and second-degree deep burns. This is a single case report of a 3-year-old girl child with 20% total body surface area with scald burns over trunk and right thigh, managed at the tertiary burn care center of our institute. Here, we share a case report where we applied the same principle. We suggest that instead of discarding burn blister fluid, it may be collected in a sterile way and sprayed over the wound of the same patient. Hence, the local application of burn blister fluid may improve wound healing. Numerous studies have found beneficial effect of local application of autologous plasma in wound healing. Moreover, burn blister fluid is similar to autologous plasma, thus rich in cytokines and growth factors. In some studies, blister fluid is shown to cause vasodilation, increased inflammatory reaction, and increased keratinocyte and fibroblast activity. Another more accepted approach is to puncture the blister to drain the blister fluid and keep the overlying skin intact as a biological cover to the wound.īlister fluid is rich in proteins and arachidonic acid metabolites (prostaglandins and leukotrienes). Recommendations for the management of blisters are varied and range from leaving blisters intact to immediate complete debridement of the blisters, followed by biological dressing. Management of burn blisters is controversial. This fluid gets collected beneath intact superficial layers of epidermis, forming a blister. In acute burn injury, vasodilation and increased capillary leakage in the zone of hyperemia leads to ultrafiltration of the plasma into the wound due to hydrostatic and plasma oncotic pressure changes. Blister separates epidermis from the dermis. Burn blister is formed in stratum spinosum layer of epidermis.

Blisters are characteristic finding of second-degree superficial burns.

I have a burn blister should i pop it