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Topical mafenide hydrochloride aqueous spray in initial management of massive contaminated wounds with devitalized
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Abstract:
Since at least WWII, some open, contaminated wounds involving massive soft tissue injury and vascular damage have resulted in "irreversible shock," despite prompt rescue, hemorrhage control, and blood and fluid replacement, without signs of clinical infection. In animal studies, survival time was related statistically to the dosage of Clostridium perfringens in multicontaminated explosive wounds. Survival time was lengthened by the application of some topical antibacterial agents, but actual recovery was achieved only with topical mafenide hydrochloride solution aqueous spray, which resulted in negative clostridium. perfringens cultures. Although not related statistically to survival time, the mafenide hydrochloride spray also controlled the Pseudomonas aeruginosa in these wounds. Mafenide hydrochloride had the American trade name of Sulfamylon from about 1942 until 1998, when another pharmaceutical company patented Sulfamylon as the trade name for mafenide acetate, a weaker antibacterial agent. However, mafenide hydrochloride still is available from chemical companies. Mafenide hydrochloride solution spray has been used successfully in treatment of patients with severe by contaminated wounds and deep burns, and its use in initial care should be revisited.
Insights
Topical mafenide hydrochloride spray effectively treated severe contaminated wounds in animal models by eliminating Clostridium perfringens and controlling Pseudomonas aeruginosa, leading to recovery.
Area of Science:
- Wound healing
- Infectious disease
- Trauma care
Background:
- Severe contaminated wounds with massive tissue injury can lead to irreversible shock, even with prompt medical intervention.
- Clostridium perfringens dosage in explosive wounds correlated with survival time in animal studies.
- Pseudomonas aeruginosa is a common pathogen in contaminated wounds.
Purpose of the Study:
- To evaluate the efficacy of topical antibacterial agents in treating contaminated wounds.
- To determine if mafenide hydrochloride can eliminate Clostridium perfringens and control Pseudomonas aeruginosa in wound models.
- To assess the potential of revisiting mafenide hydrochloride spray for initial wound care.
Main Methods:
- Animal models with multicontaminated explosive wounds were used.
- Survival time was statistically analyzed in relation to Clostridium perfringens dosage.
- The effect of topical antibacterial agents, including mafenide hydrochloride solution spray, on bacterial cultures was assessed.
Main Results:
- Survival time was statistically linked to Clostridium perfringens dosage in contaminated wounds.
- Topical mafenide hydrochloride solution spray achieved negative Clostridium perfringens cultures and actual recovery.
- Mafenide hydrochloride spray also controlled Pseudomonas aeruginosa, though not statistically related to survival time.
Conclusions:
- Mafenide hydrochloride solution spray demonstrated significant efficacy in treating severe contaminated wounds by eradicating Clostridium perfringens.
- The study suggests revisiting the use of mafenide hydrochloride spray in the initial management of contaminated wounds and deep burns.
- Mafenide hydrochloride, historically known as Sulfamylon, remains a viable therapeutic option for wound infections.