Related Experiment Videos
Topical treatment of pediatric patients with burns: a practical guide
Tina L Palmieri1, David G Greenhalgh
1Shriners Hospitals for Children-Northern California, 2425 Stockton Boulevard, Suite 718, Sacramento, CA 95817, USA. tina.palmieri@ucdmc.ucdavis.edu
Insights
Topical antimicrobial agents are crucial for managing burn wound infections in children, reducing complications and promoting healing. Appropriate use of these agents helps control microbial colonization and prevent systemic infections.
Area of Science:
- Pediatric Burn Care
- Wound Infection Management
- Dermatology
Background:
- Burn injuries affect over 440,000 children annually in the US, with infections posing significant morbidity and mortality risks.
- Burn wound complications are influenced by wound size and depth, with deeper burns (second and third-degree) requiring specialized care.
- Delayed healing and increased scarring are common in burns not resolving within two weeks, necessitating surgical consultation.
Purpose of the Study:
- To highlight the importance of topical antimicrobial agents in preventing and treating burn wound infections.
- To emphasize the role of proper wound care in minimizing burn injury progression.
- To discuss the goal of topical antimicrobial therapy in controlling microbial colonization and preventing invasive infections.
Main Methods:
- Review of current literature on burn wound infections and their management.
- Discussion of burn depth classification and criteria for surgical referral.
- Overview of available topical antimicrobial agents and their mechanisms of action.
Main Results:
- Topical antimicrobial agents, when used appropriately, decrease wound-related infections and morbidity.
- Effective wound care and resuscitation are vital to prevent the increase in burn size or depth.
- Commonly recommended topical antimicrobials include bacitracin, neomycin, silver sulfadiazine, and mafenide.
Conclusions:
- Topical antimicrobial therapy is essential for controlling microbial colonization in burn wounds.
- Proper burn wound management, including timely referral and appropriate antimicrobial use, is critical for optimal patient outcomes.
- Preventing invasive infections through effective microbial control reduces healing time and long-term complications.
Abstract:
Over 440 000 children receive medical attention for burn injuries each year in the US. Burn wound infections are a major source of morbidity and mortality in these patients. Infected wounds not only heal more slowly, but also may lead to systemic infections. The factors that contribute to wound complications are both the size and depth of the wound. Burn depth is usually categorized into first-degree (superficial, involving only the epidermis), second-degree (partial thickness, involving both epidermis and dermis), and third-degree (full thickness, through the epidermis, dermis, and into fat). Burns that will not heal within 2 weeks are at least second-degree and should generally be referred to a burn surgeon for possible excision and grafting, due to the increased risk of infection and scarring. The burn wound is dynamic. Proper treatment minimizes the extent of the burn injury, whereas improper treatment (lack of proper wound-care, edema formation, lack of resuscitation) may actually increase the size and/or depth of the wound. Topical antimicrobial agents have been shown to decrease wound-related infections and morbidity in burn wounds when used appropriately. The goal of topical antimicrobial therapy is to control microbial colonization, thus preventing development of invasive infections. A wide variety of agents are available for treatment of burn wounds, including ointments, creams, biological and nonbiological dressings. Topical antimicrobials of choice include bacitracin, neomycin, silver sulfadiazine and mafenide.