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Cellulitis associated with burn scars: a retrospective review
G J Mukhdomi1, R L McCauley, M H Desai
1Department of Surgery, Shriners Burns Institute, Galveston, TX 77550-2721, USA.
The Journal of Burn Care & Rehabilitation
|July 1, 1996
Summary
Burn scar cellulitis, a complication of burn wound healing, occurred in 1.6% of patients. Fascial excision and 4:1 meshed grafts increased risk, with Methicillin-sensitive Staphylococcus aureus being the primary pathogen.
Area of Science:
- Plastic Surgery
- Infectious Disease
- Burn Care
Background:
- Burn scar cellulitis is a significant complication requiring hospital readmission.
- Understanding risk factors and causative agents is crucial for effective management.
Purpose of the Study:
- To evaluate the incidence and risk factors associated with burn scar cellulitis in patients requiring readmission.
- To identify the most common pathogens and guide initial antibiotic therapy.
Main Methods:
- Retrospective study of 55 patients readmitted for burn scar cellulitis between January 1977 and July 1994.
- Analysis of surgical procedures (fascial excision, tangential excision, nonoperative therapy) and wound coverage techniques (meshed grafts 4:1 vs. 2:1).
Main Results:
- Overall incidence of burn scar cellulitis was 1.6%.
- Higher incidence observed after fascial excision (17.1%) and with 4:1 meshed grafts (17.1%) compared to tangential excisions (1.5%) or nonoperative therapies (0.7%).
- Methicillin-sensitive Staphylococcus aureus (MSSA) was the most common organism (69%). Lower extremity involvement (80%) and age group 11-15 years were most frequent.
Conclusions:
- Fascial excision and 4:1 meshed grafts are associated with increased risk of burn scar cellulitis.
- Initial antibiotic treatment should target MSSA due to its prevalence.
- Burn scar cellulitis primarily affects the lower extremities in adolescents.