It is easy to use and adverse side effects are very uncommon. Gentamicin should not be used topically because of the emergence of gentamicin-resistant Pseudomonas aeruginosa . Once resuscitation and analgesia have been started, local care is given. The area is washed using dilute Hibitane. Intact blisters are left alone.
Loose keratin is trimmed away.
This is repeated daily, old cream and exudate being wiped off. Rising fever, vomiting, drowsiness or convulsions may be due to sepsis. Blood cultures should be taken on suspicion, and antibiotics started if the clinical situation demands or if cultures are positive in a patient with evidence of local or general sepsis. Full thickness burns require skin grafting. As well, deep partial thickness burns are frequently best treated with grafting.