Is it necessary to take anti-inflammatory drugs after a burn?

This is the 5286th article of Da Yi Xiao Hu

"Doctor, since I'm in the hospital, why don't you give me some anti-inflammatory drugs?", "If you don't give me anti-inflammatory drugs, can you at least sprinkle some anti-inflammatory powder on my wound?", I'm afraid every doctor in the burn department has encountered questions like these.

In fact, anti-inflammatory drugs are "common names", that is, antipyretic, analgesic and anti-inflammatory drugs in medicine. It is a class of drugs with antipyretic and analgesic effects, and most of them also have anti-inflammatory and anti-rheumatic effects. Commonly used ones include aspirin, paracetamol, ibuprofen, etc. Except for paracetamol, most of the other classes have anti-inflammatory effects. They are directly aimed at inflammation and are symptomatic treatments; antibacterial drugs have inhibitory or killing effects on bacteria, including antibiotics and synthetic antibacterial drugs. Most of the anti-inflammatory drugs that ordinary people refer to are antibacterial drugs. But in fact, the two are different drugs. Commonly used antibacterial drugs are not directly aimed at inflammation, but at various bacteria that cause inflammation, inhibiting or killing pathogens. After a large area of ​​burns, the body surface is damaged and the immune function is reduced, and infection is difficult to avoid. Clinically, local infection and infection-related complications will occur, and severe cases may even lead to death. Antibacterial treatment is an important part of the treatment process, but surgical treatment of the wound surface is the fundamental treatment measure for preventing and treating infection, rather than relying solely on systemic application of antibacterial drugs. Generally speaking, there is no need to use systemic antibiotics for small-area mild burns encountered in daily life. Burn doctors will choose to use local antibacterial drugs to treat the wound to prevent and treat wound infection. Moreover, the random use of antibacterial drugs will not only contaminate the wound and make it more difficult for doctors to judge the depth of the burn, but also cause the abuse of antibiotics, leading to an increase in bacterial resistance and toxic side effects. The local antibacterial drugs frequently used in burn clinics include: 1% silver sulfadiazine cream, mupirocin ointment (Bactroban), and compound polymyxin B ointment, which not only have good antibacterial effects, but also provide the necessary moist environment for wound healing, thereby accelerating wound healing.

Therefore, the use of antibiotics after burns needs to be based on the patient's specific situation, but it is not a must.

Burns and Plastic Surgery Department, Electric Power Hospital

Contributed by Song Guorong

Reviewer: Guo Yufeng