How is Picric Acid Used for Treatment of Burns?

Throughout history, specific remedies for burns have been used, all of which changed through time. During the 14th century, it was common practice to apply gunpowder to battlefield burns, but this practice caused even more accidents.

The use of picric acid was very popular in the 19th and early 20th centuries. It is an explosive, similar to TNT and highly unstable in its dry form. It is also highly poisonous, particularly when used on deep burns.

History

• Picric acid dressings were first used in France

  In 1896, the British Medical Journal published a paper describing the use of picric acid on burns. The author stated that it reduced pain and infection and allowed the formation of a scab under which healing took place.

  D'Arcy Power, a surgeon at the Victoria Children's Hospital in London, England, described his method, which he states originated in hospitals in France.

Method

• Dressing bandaged in place

  Using a one percent solution of picric acid, the wound was cleansed and then all blisters were pricked to release the serum (blister fluid), taking care not to remove the blister itself.

  The burn was covered with sterilized gauze soaked in the picric acid solution. The gauze was padded with cotton wool and held in place with a light bandage.

  After three or four days, the dressing was soaked off and the wound redressed.

History

• By 1908, the American Journal Ellingwood's Therapeutist indicated that the picric acid dressing had been used in the U.S.A. for "four or five years."

  The method had been revised and now blisters were removed completely, along with any dead tissue, and a five percent solution of picric acid used. To retain moisture, the acid-soaked gauze was covered with paraffin paper prior to padding and bandaging.

  Dressings were initially changed once or twice daily, reducing to every two or three days as the wound began to heal.

Benefits

• Picric acid was a valuable treatment for burns

  Ellingwood reports that, although the treatment was initially painful, pain subsided "under the slow anesthetic influence of the remedy".

  The pain-relieving effect of picric acid had also been noted by Power and confirmed in a report in the British Medical Journal in 1903.

  The 2001 edition of "Disinfection, sterilization, and preservation" by Seymour Stanton Block states that picric acid has a "modest history of antimicrobial activity".

  In an era before antibiotics and simple analgesia, picric acid was regarded as the definitive treatment for burns.

Expert Insight

• Picric acid has been displaced by modern medicine

  Current medical practice, as described in "The Basic Principles of Wound Care", is to maintain wound hygiene and moisture which facilitate the growth of new tissue.

  Modern wound dressings incorporate substances for maintaining moisture and antibiotic agents to prevent wound infection and additional antibiotics are available to treat any infections which may arise.

  The use of picric acid has therefore been superseded by research and developments in medicine.

Summary

• Many substances have been used for the treatment of burns over thousands of years and picric acid is one of these. Like most other treatments, its use has been superseded by the discovery of new and improved treatments.

  Modern western medicine has no place for picric acid in the healing of burns.