A much debated question, to pop or not to pop that blister. Blisters can form from a burn injury at different stages depending on the severity of the burn. The the body’s immune system responds to the injury by releasing fluid to help protect and heal the affected area. In general, blisters can form within minutes to hours after the burn occurs, and are more likely to occur with second-degree or more severe burns.
When the skin is exposed to high temperatures, it can become damaged and cause the skin cells to die. The damage can result in the separation of the layers of skin, allowing fluid to accumulate between them, leading to blister formation. The fluid that accumulates in a blister is typically a clear or yellowish liquid called serum, which contains a variety of proteins and other substances that can aid in the healing process.
When the skin is burnt, it triggers the body’s inflammatory response, which causes blood vessels to dilate and increases the permeability of blood vessels. This allows white blood cells and fluid to leak into the damaged skin tissue, resulting in swelling and the accumulation of fluid beneath the skin. The pressure from this fluid causes the top layer of skin to separate from the underlying layers, resulting in a blister.
Blisters serve as a protective barrier that helps to prevent infection and promote healing of the damaged skin tissue. It’s important to avoid popping blisters, as they can become infected and slow down the healing process. Instead, blisters should be left intact and covered with a sterile dressing to protect the skin from further damage and infection.
The options for the management of blisters
Keeping the blister intact
Keeping a blister intact can help to protect the underlying skin from further damage and reduce the risk of infection. When a blister forms, it serves as a natural protective barrier that helps to keep the underlying skin clean and moist, which is essential for the healing process. If you have a blister, it’s important to avoid popping or puncturing it, as this can increase the risk of infection and slow down the healing process. Instead, cover the blister with a sterile dressing or bandage to protect it from further damage and to help absorb any fluid that may leak from the blister. If you have a blister that is causing significant discomfort or concern, it’s important to seek medical attention to determine the best course of treatment.
Deroofing the blister
Deroofing a blister refers to the intentional removal of the roof or top layer of skin from a blister. This is usually done to relieve pressure and pain caused by the blister, and to prevent further damage or infection. It’s important to note that deroofing a blister should only be done if necessary, as it can increase the risk of infection and slow down the healing process. If the blister is large or causing significant discomfort, it may be best to have a healthcare professional drain it to reduce the risk of infection and promote healing.
Aspiration of the blister
Aspiration of a blister involves using a needle and syringe to remove the fluid from within the blister. This procedure is typically performed by a healthcare professional and can help to relieve pain and pressure, reduce the risk of infection, and promote healing. Aspiration of a blister may be recommended if the blister is large, painful, or in an area that is prone to further irritation. It’s important to seek medical attention if the blister is severe, if it is accompanied by signs of infection, such as redness, swelling, or pus, or if you have a medical condition that affects the healing of the skin.
Using the blister fluid as an adjunct to wound healing
The fluid within a blister contains a variety of substances that can help to promote healing, including growth factors, proteins, and enzymes. One potential benefit of using blister fluid is that it contains growth factors that can help to stimulate the growth of new skin cells and blood vessels, which are essential for the healing process. Additionally, the fluid can help to keep the wound moist, which can promote healing and prevent scarring.
However, it’s important to note that using blister fluid as an adjunct to wound healing should only be done under the guidance of a healthcare professional. The fluid should be collected in a sterile manner and applied to the wound using sterile techniques to prevent infection. Additionally, if the blister is caused by a burn or if there are signs of infection, such as redness, swelling, or pus, it’s important to seek medical attention before using the blister fluid as a treatment.
Can you apply Burnshield on a blister?
Absolutely. Burnshield can be applied on top of the blister, bearing in mind that everything under the blister is sterile. And if the blister happens to break, Burnshield can still be used on top of it.
The phases of wound healing
The phases of wound healing occur in overlapping, but biologically distinct phases:
- Inflammatory phase
- Proliferative phase
- Remodelling phase
The inflammatory phase is the first stage of the burn wound healing process, which typically begins immediately after the burn injury and lasts for several days. During this phase, the body’s immune system responds to the injury by releasing various chemical signals and cells to initiate the healing process. The main goals of the inflammatory phase are to remove damaged tissue and debris from the burn site, control bleeding, prevent infection and lay the foundation for the formation of new tissue. It’s important to provide proper wound care during this phase to prevent infection and promote healing.
The proliferative phase of wound healing begins at Day 4 and lasts until 21 days following injury. The re-epithelialization aspect of the proliferative phase, however, may begin within several hours following an injury and end after 2 to 3 days in the superficial burn injury wound.
The remodeling phase is the final stage of burn wound healing, which typically begins several weeks after the initial injury and can last for several months or even years. During this phase, the body continues to repair and rebuild the damaged tissue, with the ultimate goal of restoring the normal structure and function of the skin.
To pop that blister or not?
In conclusion, blister management is an important aspect of burn wound care, as blisters can serve as a natural protective barrier and aid in the healing process. Proper blister management can help to promote healing and reduce the risk of complications, such as infection or scarring. If you have a burn injury or a blister that is causing significant discomfort or concern, it’s important to seek medical attention to determine the best course of treatment for your specific injury.
Dr Saajida Ghoor, Plastic and reconstructive surgeon: Ahmed al kadi hospital. President of South Africa Burn Society
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