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'Lethal' burns. A progress report.

W W Monafo, H N Robinson, T Yoshioka

    Archives of Surgery (Chicago, Ill. : 1960)
    |April 1, 1978
    PubMed
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    Severe burn patients treated with cerium nitrate and silver sulfadiazine showed improved survival. This topical antiseptic effectively controlled wound bacteria, preventing late deaths in critical burn cases.

    Area of Science:

    • Burn care and wound management
    • Infectious disease in critical care
    • Trauma surgery and critical care medicine

    Background:

    • High mortality rates (94% expected) are associated with severe burns (>72% body surface area), especially with inhalation injury.
    • Early deaths in severe burn patients are often attributed to inhalation injury, a condition with limited treatment options.
    • Controlling wound sepsis is crucial for improving survival rates in extensive burn injuries.

    Purpose of the Study:

    • To evaluate the efficacy of a cerium nitrate and silver sulfadiazine topical antiseptic mixture in severe burn patients.
    • To assess the impact of this treatment on wound bacterial colonization and patient survival.
    • To investigate the role of wound bacteriostasis in preventing late mortality.

    Main Methods:

    Related Experiment Videos

    • A cohort of 16 consecutive severe burn patients (>72% body surface area) was studied.
    • Topical wound antisepsis was achieved using a mixture of cerium nitrate and silver sulfadiazine.
    • Wound-surface cultures were analyzed to determine bacterial flora and assess the degree of bacteriostasis.

    Main Results:

    • All eight patients surviving beyond 48 hours ultimately survived, defying the high expected mortality rate.
    • Wound cultures revealed sparse bacterial growth, with 447 of 814 cultures (55%) being sterile.
    • Gram-negative bacteria were isolated in only 13% of wound cultures, indicating effective bacteriostasis.

    Conclusions:

    • The combination of cerium nitrate and silver sulfadiazine demonstrated significant efficacy in wound bacteriostasis for severe burn patients.
    • Effective control of wound flora contributed to the absence of late deaths, suggesting a primary role in improved survival.
    • While early deaths related to inhalation injury remain a challenge, this topical antiseptic approach shows promise for improving outcomes in severe burn management.