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Suggest medication for burn scar

Jan 2014
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Practicing since : 2002
Answered : 5924 Questions
My wife got burn due deep on her back 12/12/2013 with 45% burn.She under treatment for 1 month in hospital.Now she is at after doctor discharged because only dressing part is required.Her left hand (inside) is reddish upto wrist little wet.outer area is pink.Her left thigh (behind) from below buttock 02 inch below knee is wet.Some parts are showing pink skin some portion is bleeding.Our local doctor is applying silver x soframysin neosporin powder.Can you help me to guise how much time it will take to heel.Any good medication and ointment can you suggest.i am given her protien rich foods. Thank You XXXX Hyderabad
Posted Tue, 11 Feb 2014 in Beauty
Answered by Dr. Kakkar S. 29 minutes later
Brief Answer: Oral antibiotic+topical silverex Detailed Answer: Hi. Thanks for posting your concern at XXXXXXX First of all i empathize with you and your wife for going through all this. I have seen a lot of burn patients in my practice and the two most important complications that burn patients encounter are: Infections and Hypertrophic/keloidal scaring. As you told here that the burnt area is mostly covered with pink skin (scar) which is wet/moist and also bleeding at places. I would advice that you continue with topical silver sulphadiazine at the raw and oozing areas since they are prone to infection. If i was your treating doctor i would have even added oral antibiotics empirically (penicillin group like Amoxycillin in combination with clavulanic acid) for 1-2 weeks along with topical antibiotics to thwart away any risk of infection. It should heal within 2 weeks provided it is not complicated by infection (infection can delay healing). The second important complication that needs to be considered in this case is risk of hypertrophic scar/keloid scar which can cause pain, itching, oozing and contractures thus restricting joint mobility(at knee joint). This can be managed with either Silicone gel sheet dressings, Intra lesional steroids, in consultation with plastic surgeon and dermatologist etc. I would advice that you see a dermatologist if your wife complains of itching in the scar which is a sign that she could be developing hypertrophic/keloid scaring. Continue with protein rich diet. take care regards
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Follow-up: Suggest medication for burn scar 3 days later
her left leg thigh is taking time ,two three inch new came while removing the gauge.That part is taking time,docter is applying silver x and soframycin neosporin powder.HER LEFT HAND BOTTOM is upto wrist is still wet after dressing it is becoming wet with blood or cream.Antibiotics amoxy + clavulate cefixine is contnuing Gen Physician.She feeling little problem to fold the knee.Any further important req please advice Thanks for your advice.
Answered by Dr. Kakkar S. 34 minutes later
Brief Answer: Culture sensitivity frm raw area+Topical Mupirocin Detailed Answer: Hi. If the wound is slow to heal then as a treating doctor, i would have continued her on empirical oral antibiotics and also simultaneously send sample for culture and sensitivity from the raw area which would guide future antibiotic therapy. I prefer topical Mupirocin over silverex because it is also effective against MRSA staph (Multidrug resistant staph aureus). Wish her a speedy recovery take care regards
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Follow-up: Suggest medication for burn scar 2 days later
Her left thigh is improving 4 or 5 small portion are need to get dry.We are cleaning and appying silver-X cream on the wound.After dressing when left knee is kept on pillow to avoid contact with bed her knee is paining.After removing the pillow then it is alright. Her left hand inner part towards the top is wet, cream is dripping after applying cream.She is feeling like itching on right thigh on a small spot.Applied soframycin to stop itching.Can you brief the Clinical Test to be conducted,when she will sit and walk can you suggest when she will walk. suggest good antibiotics,protien diet any goods tips which will helf her speedy recovery.Any other test to carried out.Banana is good for her at this time Thanks Regards
Answered by Dr. Kakkar S. 19 minutes later
Brief Answer: Culture sensitivity+Topical Mupirocin+oral antibio Detailed Answer: Hi. I would like to do a ''Culture and Antibiotic Sensitivity from the raw areas'' which would reveal if their is any possible infection at the site of raw areas, that might be delaying healing of wound and would also suggest appropriate antibiotic. Empirical antibiotics like either Amoxycillin+clavulanic acid OR Cefpodoxime+clavulanic acid would provide her good broad spectrum antibiotic coverage. In such a case it is important to clean the raw areas daily with betadine solution and then dress it with topical antibiotic like mupirocin. If any areas that develop itching and hardness, it could indicate early development of hypertrophic/keloidal scaring which can be managed by intralesional steroids. Of course a high protein diet would help in her case. You could give her Egg white, Paneer, Pulses, Milk and curd, Soyabean etc to boost her protein intake. take care regards
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