Burn Care Using Mepilex AG

Important information about second-degree (partial-thickness) burns:

• A second-degree burn happens when the top layer of skin (epidermis) is damaged or burned by something hot.

• Blisters form and can ooze clear, golden-colored fluid. The exposed skin underneath is pink or red and painful.

• Most second-degree burns heal in 2–3 weeks without surgery or skin grafts.

• All burns cause scarring, which may appear as blotchy, discolored, or thickened skin.

• Your child’s burn is being treated with a dressing called Mepilex® AG. This special dressing absorbs drainage and prevents infection. It can be worn for up to 7 days but must be kept clean and dry.

Patient instructions: 

Change the dressing every 7 days, when it becomes very wet, or if you want to bathe your child.

1. Give pain medicine 30–45 minutes before a dressing change. Use over-the-counter medicines like ibuprofen (Advil®) or acetaminophen (Tylenol®) or prescription pain relievers as directed.

2. Gather your supplies:

   • Mild soap (baby soap or Dove®)

   • Mepilex AG dressing

   • Gauze rolls

   • Tape

   • Elastic net tubing (optional)

3. Wash your hands with soap and water for 15 seconds.

4. Remove the old dressing. If it sticks, soak it in water to loosen.

5. Wash the burn with cool or lukewarm water and mild soap. Gently pat dry. Do not scrub the burn or remove dried skin or dried scabs.

6. Apply a new piece of Mepilex AG, ensuring it covers the entire burn. It’s okay if it touches normal skin. If using Mepilex AG with Border, make sure the adhesive border is not placed on the open wound. You may need to trim the border or overlap the dressing. Your healthcare provider will demonstrate how to place the dressing.

7. Wrap gauze around the burned area in a figure-8 pattern to allow easy movement. Secure it with tape.

8. Cover the gauze with elastic net tubing to keep it in place, if you would like.

Monitor for signs of infection:

• Fever over 101°F

• A bad smell or red streaks around the burn

• Increased swelling, or the burn is not healing after 1 week

• If you notice any of these signs, or you run out of dressing supplies call CHOP’s burn clinic at 215-590-5923.

Manage pain: 

• Burns are painful, and your child may need regular pain medicine for several days or weeks as the burn heals.

• In the first few days, give pain medicine regularly as directed. As the burn starts to heal, give it only when your child says they are in pain. Always follow the dosing instructions on the label.

Minimize scarring:

• Prevent infection by following the dressing instructions above.

• Avoid scratching or touching the wound. This will cause further injury.

• If the burn is over a joint, encourage your child to move and bend the joint to keep the skin flexible.

• Once healed, protect the area from sunlight with clothing and SPF 30 sunscreen year-round.

• Massage with fragrance-free lotion 3 times per day once dressings have been discontinued and the burn has healed.  

Prevent future burns:

• Set your water heater to 120°F (49°C) or lower.

• Test bath water temperature with your elbow, wrist, or a bath thermometer.

• Use back stove burners and turn pot handles toward the back of the stove. Supervise children in the kitchen.

• When cooking, put your toddler in a safe area, such as a highchair or play yard.

• Never leave a child alone in the kitchen.

• Never carry a child while carrying hot food or drinks.

• Do not use tablecloths or placemats around young children. They can pull on them and spill hot food or drinks.

• Test microwaved foods and drinks before giving them to a young child. Avoid heating baby bottles in the microwave, as the heat may be unevenly distributed.

• Open microwaved containers away from you and your child, as the steam can scald the skin.

• Keep irons, curling irons and other hot appliances and their cords out of a child's reach.

• Do not allow children to handle fireworks.

• Keep children away from kerosene lamps, space heaters and outdoor grills when in use.

Contact your CHOP’s burn team with questions, concerns or if:

• You run out of dressing supplies.

• You notice signs of infection, such as fever, redness, swelling, or a bad smell.

• The burn is over a joint, and your child cannot bend the joint due to pain or swelling.

• Your child’s pain is severe or not controlled by medicine.

Go to the emergency room if:

• You think the burn is infected or getting worse.

• Your child’s pain is severe and cannot be controlled by medicine.

Trauma Clinic at Children's Hospital of Philadelphia

• Weekdays 9 a.m.-5 p.m. call 215-590-5932

• After hours, weekends and holidays call 215-590-1000 and ask for the general surgery resident on call.

 

Reviewed December 2024 by Jessica Osipowicz, CRNP