The Burn Wound — Topical Therapy for Infection Control

Abstract

The treatment of infection in burn victims presents a unique challenge to the clinician. The nature of the burn wound does not lend itself to standard systemic anti-infective therapy. The pathophysiology of the burn wound and the reparative process is briefly described. The common invading pathogens and the clinical signs of bum wound sepsis are also discussed. The manuscript deals with the various topical antibacterial agents employed. Because of the avascularity of many deep burn wounds, topical agents become the mainstay of therapy. Systemic antibiotics have a place in the treatment of burn victims, but their use is limited in comparison with the benefits of topical preparations. The various topical agents are not without hazards and significant systemic absorption is common. The nature and extent of the burn injury, as well as other concurrent patient problems, often necessitate the choice of a particular topical preparation. With proper care of the wound and the correct choice of a topical anti-infective preparation, systemic antibacterial agents will often be unnecessary. Finally, the value of grafting, whether temporary or permanent, is discussed and attention is paid to drug effects on skin grafts and the prevention of bacterial destruction of permanent autografts.