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The effect of 5% mafenide acetate solution on bacterial control in infected rat burns
Abstract:
Mafenide acetate is commonly available as a 10% cream and has been shown to be effective in the prevention and control of burn wound sepsis. The high osmolarity of the cream has been implicated in the pain upon application and the neoeschar formation often seen with its use. Mafenide acetate as a 5% solution has a lower osmolarity, and clinical trials with this agent have shown it to be both well accepted by patients and effective in wound preparation. Information concerning its antibacterial efficacy in comparison with other agents, however, has been lacking. Utilizing the Walker burn model, we have found the 5% mafenide acetate solution used as gauze soaks to be equal to mafenide acetate cream and better than silver sulfadiazine in attaining bacterial control of this experimental burn wound in the rat. The 5% solution provided prompt decrease in bacterial counts to less than 10(5) bacteria per gram of tissue in a majority of wounds by 48 hours of treatment. In addition, such wounds showed no evidence of neoeschar formation. In light of the efficient bacterial control and rapid preparation of the wound for grafting seen in this model, more extensive clinical use of the 5% mafenide acetate solution appears justified.
Insights
A new 5% mafenide acetate solution effectively controls burn wound bacteria, matching the 10% cream and outperforming silver sulfadiazine. This lower osmolarity formulation reduces pain and avoids neoeschar, making it ideal for wound preparation.
Area of Science:
- Burn wound management
- Infectious disease
- Dermatology
Background:
- Mafenide acetate cream (10%) is used for burn wound sepsis but causes pain and neoeschar due to high osmolarity.
- A 5% mafenide acetate solution offers lower osmolarity, improved patient acceptance, and effective wound preparation.
- Comparative antibacterial efficacy data for the 5% solution was previously limited.
Purpose of the Study:
- To evaluate the antibacterial efficacy of 5% mafenide acetate solution compared to mafenide acetate cream and silver sulfadiazine.
- To assess the impact of 5% mafenide acetate solution on neoeschar formation and bacterial counts in a burn wound model.
Main Methods:
- Utilized the Walker burn model in rats to assess treatment efficacy.
- Applied 5% mafenide acetate solution as gauze soaks.
- Compared bacterial counts and observed neoeschar formation against mafenide acetate cream and silver sulfadiazine.
Main Results:
- 5% mafenide acetate solution demonstrated bacterial control equal to mafenide acetate cream and superior to silver sulfadiazine.
- Bacterial counts decreased to <10(5) bacteria/gram in most wounds within 48 hours.
- No evidence of neoeschar formation was observed with the 5% solution.
Conclusions:
- 5% mafenide acetate solution provides efficient bacterial control for burn wounds.
- The solution rapidly prepares wounds for grafting without causing neoeschar.
- Further clinical investigation of 5% mafenide acetate solution is warranted.