Topical Burn Wound Management

Cutaneous burns challenge global health care systems with high patient morbidity and mortality rates.1 One recent study of adults admitted for 2 to 60 days to a US burn center reported that more than 7.9% of burn patients experienced at least 1 hospital-acquired infection (HAI), extending the hospital length of stay and increasing the likelihood of complications and death.2 Of these HAIs, most (35.8%) were skin and soft tissue infections, followed by respiratory (24.4%), bloodstream (18.1%), and urinary tract (17.8%) infections. A burn covering more than 5% of total body surface area (TBSA) multiplied HAI risk by 3, with higher risk as the burned TBSA increased. Other factors increasing HAI risk included inhalation injury, flame burn, patient age (≥ 60 years), and comorbidities (ie, diabetes, heart failure, myocardial infarction, renal disease, or peripheral arterial disease).2 Topical 1% silver sulfadiazine cream (SSD), introduced into burn care in the mid 20th century by Dr. Charles Fox, improved global burned patient survival rates and outcomes by reducing the likelihood of burn-related infection.3 Research in later decades explored other topical treatments capable of reducing the incidence of burn-related infections. This month's Evidence Corner describes 2 recent reviews comparing the effects of topical antiseptics4 or honey5 with SSD on burn wound healing and infections.