Dear Editor
One of the biggest challenges in burn treatment is the pain experienced by patients. This difficulty is exacerbated in treatment of pediatric patients, as fear can be an additional factor.¹ Practitioners in our clinic first explain to children with burn injury that no painful procedures will be performed; practitioners also introduce children to the wireless electrical stimulation device that is used, showing children that the device only emits light. Practitioners begin treatment after these explanations.
For small- to medium-sized burns, practitioners in our clinic avoid laying the children on a bed. Instead, after a sterile cover is placed on the lap of their parent, the child is placed on the parent’s lap. The agent polyhexamethylene biguanide (PHMB) is applied, sprayed from a distance of 15 cm without touching the wound and without wiping it off, taking care not to burst any blisters. A wireless electrical stimulation is then applied for 10 minutes, and dressing with is completed with gauze pads soaked in PHMB gel, ensuring the process is pain free. Any necrotic tissue left from blisters is removed after epithelialization is complete.
One of the biggest problem in treatment of second-degree burn is pain with combined anxiety, which occurs when dressings are changed. Efforts to ease the pain by administration of general anesthesia, sedation, or analgesic medication during dressing changes are either complicated or barely effective. Intact blisters are shown to decrease the pain by preventing air contact with the wound bed. However, blister fluid provides a milieu for bacteria, necessitating removal of fluid but preserving the walls of the intact blister.
Wireless microcurrent stimulation, developed by John Wetling, can help with the pain with minimal side effects or less complicated interventions.²
In my clinic practice, after removing the fluid and preserving the blister walls, I routinely use wireless microcurrent stimulation. The stimulation device is applied over the intact walls from which the fluid was removed, and the membrane is allowed to adhere to the wound bed.
The microcurrent stimulation speeds epithelization. The blister wall is left to dry, covering the wound and its moist environment.
The biggest advantage of this method is the elimination of the pain. Various dressings have been developed to reduce fluid and heat loss from the burn wound and prevent infection. The biggest disadvantages of these dressings are their cost. In second-degree burns, the blister wall is inexpensive and the least reactive ready-made biologic cover. This methods allows dressings and experiences to be painless.

REFERENCES

1. Morgan M, Deuis JR, Frøsig-Jørgensen M, et al. Burn pain: a systematic and critical review of epidemiology, pathophysiology, and treatment. Pain Med. 2018;19(4):708-734. doi:10.1093/pm/pnx2282.
   CrossRef - PubMed
2. Wetling JF, Barutçu A, Aydın OE. Treatment of difficult wounds by wireless microcurrent stimulation. Türkiye Klin J Plast Surg. 2015;4(1),80-82.