WOUND CARE IN BURN PATIENTS: A NURSING APPROACH TO INFECTION PREVENTION AND PAIN MANAGEMENT: A NARRATIVE LITERATURE REVIEW

Abstract

Burns are defined as severe injuries to organic tissues, caused by various agents such as heat, electricity, or chemical substances, and represent a serious public health problem in the Brazilian context. This condition is the second leading cause of death in childhood and results in around one million accidents annually, with a record of 9,079 hospitalizations in 2023 alone. Lesion classification is a crucial determinant for treatment and prognosis, but it is essential to recognize that, besides physical trauma, burns generate intense pain and great emotional impact. Due to the destruction of the skin barrier and the compromise of the skin's immunological functions, infection stands out as the main severe complication, being responsible for 75% to 80% of deaths recorded in Burn Treatment Centers. Given the patients' fragility and high risk, the nurse plays a fundamental role in choosing dressings and in comprehensive clinical management. In this scenario, the present work, through a narrative literature review of twelve studies published between 2017 and 2024, had as its main objective to understand how dressings influence infection prevention and pain control in burn patients, highlighting the role of nursing in selecting appropriate wound coverings. The analysis reveals that 1% Silver Sulfadiazine remains one of the most used and effective topical therapies, due to its potent antimicrobial action against pathogens such as Staphylococcus aureus and Pseudomonas aeruginosa. However, the need for frequent changes required by silver sulfadiazine increases patient pain and discomfort. The challenge of managing the balance between antimicrobial control and patient comfort demonstrated the need to seek alternatives. New technologies are addressed, such as hydrogels, which promote autolytic debridement and relieve local pain, and the promising use of the Nile Tilapia skin xenoenograft (which reduces pain and the number of dressing changes). Pain management is crucial, given that approximately 80% of patients report maximum or unbearable pain intensity. It is necessary to integrate pharmacological strategies with non-pharmacological measures, such as therapeutic conversation and establishing a bond of trust. In the face of this complex scenario, it is concluded that dressing selection should be individualized, prioritizing antimicrobial control, but always ensuring comfort and pain reduction. The nurse's role is critical for humanized care and treatment success.