How to treat for a second degree muffler burn you got in Thailand

WARNING!! GRAPHIC PHOTOS OF A SECOND DEGREE BURN WILL BE IN THIS POST. SO MAN UP AND DON’T LOSE YOUR LUNCH!

Second Degree Muffler Burn: Day Two

Muffler burns, aka 2nd degree burns, are a common problem in all of Asia for both tourists and locals. Spend a good amount of time on an island and you will probably spot the tell tale sign of said burn on someone (or on yourself!). It’s usually located on the upper right calf and wrapped with a bandage of some sort. There are two ways you can care for the burn. One option is WAY better then the other in my opinion.

The first option is to go to a Thai hospital. They will proceed to scrap off the dead skin with a razor and not even give you a chance to take any pain killers or something to bite down on. Once complete they will apply an anti bacterial cream and then bandage it up and ask you to come back in 3 days to repeat the process until its all healed up. That’s right, every 1-3 days they’re going to take a razor blade and cut off the dead flesh of an open wound. It’s supposed to be an excellent treatment with very little scarring, but really, what the fuck?

Option number two is how I tended to my second degree burn out of recommendation from my mom who has had to tend to many a burn on my father. If your staying on a remote island like Phayam, try to get yourself to a more developed place for the healing process. We found Koh Phangan was excellent! Especially since its consider to be the #1 island for motorbike accidents in Thailand, meaning their pharmacies are well supplied with anything you may need. Also, try to stay somewhere that is clean with no dust and sand coming in. You can easily get an infection by going into the ocean as the water is not that clean here, and the sand is full of bacteria. It’s the infections that will cause problems and massive scarring.

WHAT YOU NEED (enough for a 3 week supply):

Cotton wrap bandages
Non Stick Gauze pads the size of the burn. (3M makes a great product)
Medical Tape
Tensor wrap
Saline Spray
Oral Anti-biotics – Amoxicillin is readily available (take 2 a day for 15 days)

and the most important: Silverderm anti-biotic cream

Silverderm is a special cream used specifically for burns. It wIll help speed the healing process and works wonders! Its more money then a regular anti biotic cream but well worth it and has silver paste in it which creates a barrier between the new growing skin and everything else.

NOTE: this cream is extremely expensive back in Canada, but in Thailand luckily it’s only a few dollars. We easily found this in a big pharmacy in Haad Rin. Just write down the name and show it to them

OTHER USEFUL ITEMS:

Valium (available over the counter all across Thailand)
Pain killers
Stiff drinks
Chill tunes or something on TV to watch
A second hand

STEP ONE: Take some valium and pain killers and turn on some chill tunes. Relax and wait for the drugs to kick in.

STEP TWO: Rinse the burn with clean water from a portable shower head and then vigorously spray the area with Saline Spray to ensure its fully clean. NEVER pop any blisters! They will pop on their own.

STEP THREE: Apply a good amount of Silverderm to the burn area. Make sure the entire area is covered including the outer edges. Don’t be cheap with it.

STEP FOUR: Apply non stick gauze on top of the burn. Shiny side down!

STEP FIVE: Wrap cotton bandage tightly around your leg and over the gauze and tape. Try to avoid taping your leg if you can. You will be removing this often and continual pulling of tape off your leg will cause an irritation.

STEP SIX: Wrap tensor bandage over cotton bandage

STEP SEVEN: You should change the bandage twice a day for at least a week or more until the ooze stops. You don’t want the ooze against your burn as this is the bad stuff. Keep your eye on the bandage throughout the day. If you can see some color coming through, or if it feels like it’s pulling on your skin then change the bandage. You want to keep the burn moist and not have it dry out, this will delay the healing process. Dead skin AND new skin will pull off each time you remove the gauze, this is why the pain killers and valium are needed! I found it best to have someone else to remove the gauze and avoid looking at it during the process. My head in a pillow and listening to music or watching TV was very helpful.

Repeat steps one to seven until you feel it’s okay. It should look just red/pink with no loose skin etc, you will be able to tell. Be sure to always keep the area clean and covered while it is healing. TIP: When you rinse the area for each changing try to remove the loose skin with the water spray from the shower head or saline bottle. It might not all come off the first time but eventually will, don’t pull it off! You may rip the new skin which is very delicate.

Don’t forget to take some oral anti-biotics twice a day. This will help with the healing process and of course help to avoid any infections.

Your burn will stop oozing and loosing skin with each changing in about 2 – 3 weeks. Stay out of the water and off the sand, keep it wrapped tight with the tensor wrap when walking around, keep some pain killers on hand and relax at some reggae bars. Tell them about your burn and they will probably hook you up with some “special” pain reliever if you wish. Honestly though, it doesn’t hurt as much as the initial burn or getting the bandage changed when its wrapped up.

I highly recommend finding yourself some Silverderm. We used just a regular anti-biotic cream for the first few days as we didn’t have access to Silverderm and the bandage changing was quite messy and painful. Soon as we started using the Silverderm we saw instant improvement on the next changing. Less loose skin, less oozing, overall better healing!

Other than that you can expect to have a bit of a scar for awhile. It goes from red to pink to a faint mark on your skin to eventually barely even there. If I look at my leg today (4 months later) I can still see a bit of a scar but it keeps fading more and more each month.

Disclaimer – If your burn is OVER 3 inches, go to a doctor. You may require a skin graft or something else. We are not doctors and this shouldn’t replace medical help. But really, what are they going to do at the clinic other than give you anti-biotics and keep it clean? Oh yah, the razors… Use your own judgement. I read the “Nurses guide to wound care” and talked to my mom who is in health care. It does take a while for a burn to heal, and almost 2 weeks before it started to look better. If it smells like rotting flesh and is septic, what the hell are you doing on the internet? It may be gangrene. Go to a doctor!