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Related Experiment Videos

Preventing postoperative burn wound aspergillosis.

C Levenson1, P Wohlford, J Djou

  • 1Department of Surgery, University of Southern California Medical Center, Los Angeles 90033.

The Journal of Burn Care & Rehabilitation
|March 1, 1991
PubMed
Summary

Implementing enhanced air filtration and specific wound irrigation significantly reduced Aspergillus infections in burn patients. This strategy proved effective in preventing invasive aspergillosis and improving patient outcomes at a specialized burn center.

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Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Burn Care

Background:

  • Aspergillus species pose a significant threat in burn wound infections, leading to high morbidity and mortality.
  • Previous infection control measures, including air duct cleaning and topical antimicrobials, were insufficient to prevent Aspergillus colonization and infection.

Purpose of the Study:

  • To evaluate the effectiveness of comprehensive environmental and therapeutic interventions in controlling Aspergillus burn wound infections.
  • To reduce the incidence of post-operative burn wound aspergillosis and associated mortality.

Main Methods:

  • Installation of high-efficiency particulate air (HEPA) filters and new air ducts.
  • Implementation of wound irrigation with mafenide hydrochloride and nystatin during and after surgery.

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  • Sealing of the burn ward's false ceiling.

    • Main Results:

    • A significant reduction in Aspergillus wound culture positivity was observed, from a high rate in 1984 to one occurrence in 1988 (p < 0.01).
    • No cases of Aspergillus burn wound infection occurred in the 18 months following the sealing of the false ceiling.
    • Clinical aspergillosis and associated mortality rates, initially high at 66% and 53% respectively, were effectively reduced by the implemented strategies.

    Conclusions:

    • A multi-faceted approach combining advanced air filtration, updated ventilation systems, and targeted wound irrigation is highly effective in preventing Aspergillus infections in burn patients.
    • Environmental controls, particularly HEPA filtration and sealed ventilation systems, are critical in managing airborne fungal contamination in high-risk settings like burn centers.