Caring for burns *bit of description*

[Criminy]

About 9 days ago I got some burns on my leg. One in particular was starting to look a bit dodgy last Fri, so I went and saw the nurse at my GP surgery. She said it did look a bit infected, so prescribed me antibiotics and dressed it. I asked her how long I should keep the dressing on, she said until Monday or Tuesday.

I took the dressing off today and it looks even worse. Very, very red, swollen and painful. I gently wiped with wet tissue, but the skin just peeled off. A couple of the burns don't hurt at all though, they're white in them and I can't feel it if I poke them. They seem quite indented. I have no idea how to care for them - whether I should cover them or leave them open, clean off the peely skin or not.

I called the GP surgery, but the next available appointment to see the nurse that I can make is next Monday (there is one Friday afternoon but I can't make it). Even if I go on Monday I don't know what to do with it until then.

I just don't know what I should do, so any advice very gratefully received.

If the skin has broken, recover them for now. Have you still got anti biotics? If not I would consider getting it looked at tomorrow. Have you a walk in centre you can get to? They would deal with it for you

Thank you for your reply.
I've just finished the antibiotics. Our nearest walk-in centre is about 25 miles away, I don't think I'll have time between school runs. I think there's a minor injuries unit nearer, would they look at it, or do they only deal with new/fresh injuries?

If you can't feel them it means they're a bit deeper than the milder forms of burn.

They'll have to heal from the bottom up so you should start to see areas of granulation tissue soon (patches of whitish soft grainy stuff). Trouble is it's fragile stuff and dry dressings often end up sticking to it and pulling it off when removed.

Gelatinous dressings (like jelonet which is a gauze embedded with vaseliney stuff) work well though it's still a good idea to remove them verrrrry slowly and squirt with water if they are sticking. Leaving the wounds to the air is good too if you can do so for periods of time without risk of them brushing off anything.

It's hard to say without looking but that sloughy perky skin may be granulation tissue in which case it's best to leave it. But I don't like the sound of red and swollen. You probably need an antibiotic as that's a sign they may be getting infected.

Have you a decent pharmacy nearby? They should have the jelonet dressings (you sit the dressing over the wound and then cover or wrap with dry gauze over it as it's too slimy to use alone. Change daily and remove verrry gently, with some open air time if poss.) and they may be able to cover you with a loan for antibiotics if GP can't see you sooner.

Sorry xpost and also that should say peely skin not perky skin. I doubt the skin is particularly perky at present. But you do probably need further antibiotics

Don't use Jelonet - it's not a recommended dressing now and certainly not for burns. You can get over granulation between the mesh and there are better dressings. Buy some Mepitel or Atrauman and cover the burns with that, and then some sterile gauze and a bandage or dry dressing like Mepore.

Please prioritise seeing the practice nurse, or maybe a walk in centre or minor injuries unit. I'm surprised the nurse didn't tell you to make another appointment for redressing the burns on Monday or Tuesday when they needed changing. If you call your surgery and say the burns are worse they should find you an appointment ASAP. If they seem redder, swollen or more weepy then you need to see someone sooner rather than later.

Don't use tissue to clean them (fibres can stick in the wound bed) and don't leave them to dry out as they'll become scabby and won't heal too well and will be more likely to scar or become infected again. If you can't get to see someone imminently then buy some dressings, cover it and see someone as soon as you can.

Ouch.

No advice, sorry (as I'd probably slather them in Elizabeth Arden 8 hour cream so I'm best ignored). But that sounds very sore, poor you.

Hope it starts to heal very soon.

Well that's me told!

Thank you

They're definitely more swollen, red and weepy. I think I'll call the GP surgery in the morning and explain that they're looking very dodgy, and can I please see somebody, anybody. I have to be done in time to pick DC up from school, so don't think walk-in will work.

Sorry for harping on about this.
Would a minor injuries unit see me? Or do they only deal with "fresh" wounds? The GP surgery reiterated that the next available appointment is Friday afternoon. I just don't know what to do, I'm very tearful. Maybe it's fine and I should just not see anybody. But then I still don't know whether to cover or not, and if so, then what with.

I can't go to a walk-in centre because it's 25 miles away and I have to pick DC up from school at 3:10pm. DH doesn't know about the burns and I'm dreading him finding out. I hate myself for this, I was so very stupid.

If you're struggling to be seen pop to a pharmacy and ask their advice.

They'll at least tell you if and how to home care, if you can wait for your GP, or need it seen more urgently,

DH doesn't know about the burns and I'm dreading him finding out. I hate myself for this, I was so very stupid

What? Why?

Was it self harm? In which case please tell someone, the GP, or go to A+E.

Why do you dread your DH finding out?

I shall try pharmacy then, thank you.

Yes, it was self-harm

I saw the nurse last Fri, she knew I'd done it, but didn't say a lot. I'm supposedly under community psychiatry, I have a psychiatrist anyway.

DH will be a mix of angry and disgusted. It will either tip him over the edge into some kind of breakdown, or he'll throw me out of the house. He's going to find out at some point, I can't hide it forever, but it looks properly awful at the moment.

I'm really sorry for bothering you with this, same as I was for bothering the nurse.

I would go to the minor injuries and explain the situation. At the very leaat they should be able to offer you advice. And please do tell your DH, you're not stupid at all.

Yep, our minor injuries unit definitely says in its blurb that it covers burns, cuts etc.
Go. They an always point you somewhere else if you really really should not be there.

Have you flagged up the Sh with your psych? You know that you need to.

I've been to minor injuries with a week old bash, and they were fine with seeing me.

You could try 111. They are sometimes quite good at pointing you to suitable services, ie there might be nurses available somewhere else sooner, and sometimes they can even help with getting into your gp.

Ok, thank you very much.
I'm going to go to the minor injuries unit and hope I get seen fairly quickly. Fingers crossed. This is going to be painfully awkward and embarrassing.

I don't know how to contact psych - I saw him mid-Jan, no idea when my next appointment will be.

Sorry Diggum I did get on my high horse a bit! Just rather passionate about wound care...

Criminy please don't think you're bothering anyone. That's what us HCPs are here for. I fairly regularly see people with wounds/injuries from self-harming. I never stand in judgement but admit I'm not a mental health nurse so wouldn't say much to the patient apart from encouraging them to see their CPN or MH team.

I would encourage you to go to minor injuries and explain that you can't see your practice nurse until Friday and you're worried about your burns. I'm sure they won't mind seeing you at all - they just tend not to deal with ongoing conditions and chronic problems.

And try and contact your Mental Health team - do you have a contact number for your psych, or a CPN or Crisis Team? Call them, explain you've been self harming and hopefully they can review you ASAP.

Good luck

No worries sidge! I'm always glad to get a tutorial

Hope you're getting on okay criminy!

Just thought I'd update.
I saw two nurses at minor injuries. One thought I have pretty bad cellulitis, the other thought the redness and swelling was just an inflammatory reaction. They're not allowed to prescribe second course antibiotics though, you have to go through GP to swab it. I said I couldn't get a GP appointment until next week, so they called the GP and I have an appointment for tomorrow.

I don't know how to contact psych team at all. I'm supposed to have an appointment with a CPN end of next week, but they've already cancelled and rearranged three times. The psychiatrist wanted me to see CPN, even though last year she said she couldn't do anything for me and discharged me. So not really sure she's going to do much.

Great to hear that you got seen, but not great that there might be an issue.
But you're seeing your GP tomorrow? Excellent. Please please make sure that you talk about the self harm to GP, and get across that you've had your CPN apps cancelled.

Best wishes for tomorrow!

How did it go at GP, Criminy ?

Turned out my appointment wasn't with the GP, it was with the nurse. She got me a prescription for a different antibiotic, and also for some dressings, and said she needs to see me every day for at least the next week. This is making it harder to hide from DH, although I have a feeling he knows but just hasn't said anything.

Oh my goodness it is so very itchy!

Not the burns themselves, but the skin between them. Very red and swollen, and just unbelievably itchy. It's taking all my willpower not to rip the dressings off and scratch. Currently rubbing it over the dressings. Argh!!!

Do you by any chance have a latex allergy? A lot of the glue on adhesive dressings are latex based. Do try not to scratch at it, it will aggravate it further