2023-07-21 燒燙傷水泡處置 from uptodate

2023-07-21 07:45AM 另一篇 "摩擦引起的水泡" 連結在此

下面內容來自 uptodate 章節
Treatment of superficial burns requiring hospital admission
Literature review current through: Jun 2023.
This topic last updated: Mar 02, 2023.

燒燙傷引起的水泡到底要不要戳破. 目前的醫學研究資料仍不足. 有些醫師認為完整封閉的水泡會增加感染機率, 有些醫師則認為水泡能作為抵抗細菌感染的屏障


Burn blisters — The management of burn blisters depends, in part, upon whether the blister has ruptured. Ruptured blisters should be debrided. The best treatment for an intact burn blister remains a matter of debate [18]. There is no universal standard of practice regarding intact burn blisters, and, in the absence of good data, experts may come to differing conclusions. As an example, some feel that there is an increased risk of infection in intact blisters, while others feel that the blister acts as a barrier to infection.
Potential reasons to rupture intact blisters include:
●Large and expanding blisters may exert pressure onto the underlying wound surface.
●Large blisters can impair range of motion or movement (eg, hand, fingers, foot, toe).
●Intact blisters can hinder the accurate assessment of burn depth.
●The risk of infection is increased in intact blisters.
●Components of blister fluid are harmful to wound healing.

Potential reasons for preserving a burn blister include:
●Blisters form a natural barrier against infection.
●Blister fluid provides wound healing benefits.
●A wound may become desiccated in the absence of adequate dressings and topical antimicrobial agents.


2015-04-28 11:39AM
下面內容來自急診專科醫師教科書　Rosen 第八版
FROM ROSEN 第八版 PAGE 814 Management of Burn Blisters
有些人認為水泡內的液體會造成密閉空間細菌感染, 但也有人認為完整的水泡可以創造潮濕的環境適合傷口癒合, 研究同時有正向負向的結果, 有些小規模研究發現, 完整的水泡癒合比較快, 比較不會感染, 如果水泡已經破裂, 所有壞死的皮膚應該移除, 大的水泡, 可以用無菌空針抽吸.

The management of burn blisters is a controversial topic. Some suggest that the fluid confined by the necrotic skin can lead to a closed-space infection, whereas others have argued that the intact blister creates a moist wound environment that is beneficial to wound healing. In vitro studies show both positive and negative effects of the burn blister fluid. Small clinical studies show that intact blisters heal faster and are less likely to become infected.75,76 However, in these studies the débrided burns were not treated with any of the advanced dressings currently available, limiting the conclusions. With blisters that have already ruptured, any necrotic epidermis should be gently removed while adherent epidermis is left intact. With large or tense blisters, the unruptured blister may be aspirated with a sterile needle.