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Related Experiment Videos

Subeschar clysis in deep burns.

Rajeev Sinha1, Neeta Sharma, R K Agarwal

  • 1Department of Surgery and Microbiology, M.L.B. Medical College, 284128, U.P., Jhansi, India. singharga@yahoo.com

Burns : Journal of the International Society for Burn Injuries
|November 26, 2003
PubMed
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Povidone iodine subeschar clysis (PVP-SEC) significantly reduced infection in deep burn patients. This burn treatment also improved graft acceptance rates, offering a promising approach for managing severe burns.

Area of Science:

  • Burn Care and Management
  • Infectious Disease Control in Surgery
  • Wound Healing and Tissue Regeneration

Background:

  • Deep burns present a significant challenge in patient management, with infection being a primary cause of morbidity and mortality.
  • Current topical antimicrobial strategies may not always achieve adequate bacterial reduction in the complex burn wound environment.
  • Subeschar clysis offers a potential route for delivering antimicrobial agents deeper into the burn wound.

Purpose of the Study:

  • To evaluate the efficacy of povidone iodine subeschar clysis (PVP-SEC) combined with topical antimicrobial crusts in reducing burn wound infection.
  • To compare the infection rates and time to grafting in patients treated with PVP-SEC versus conventional topical therapy alone.
  • To assess the graft acceptance rate in patients undergoing PVP-SEC treatment.

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Main Methods:

  • A comparative study involving 613 patients with deep burns (up to 50% total body surface area [TBSA]) treated with PVP-SEC plus topical agents.
  • A control group of 595 matched patients received only topical antimicrobial crust application.
  • Quantitative bacterial counts were performed on days 7 and 8 post-treatment; time to grafting and graft acceptance were recorded.

Main Results:

  • PVP-SEC treatment group demonstrated significantly lower incidence of infection on days 7 and 8 (P<0.001), predominantly against Staphylococcus aureus and Pseudomonas aeruginosa.
  • A significantly greater number of patients in the PVP-SEC group were eligible for grafting within 20 days.
  • The graft acceptance rate in the PVP-SEC group was notably high at 90%.

Conclusions:

  • Povidone iodine subeschar clysis is an effective adjunctive therapy for deep burn management, significantly reducing infection rates.
  • This method facilitates earlier surgical intervention, enabling timely grafting in a majority of patients.
  • PVP-SEC shows promise for improving outcomes in patients with extensive deep burns, evidenced by high graft acceptance.