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Melting graft-wound syndrome
H Matsumura1, N A Meyer, R Mann
1University of Washington Burn Center, Harborview Medical Center, Seattle 98104, USA.
The Journal of Burn Care & Rehabilitation
|August 26, 1998
Summary
Progressive epithelial loss, termed melting graft-wound syndrome, is an increasing problem in burn care. This study identifies Staphylococcus aureus as a common cause, distinct from previous assumptions of Streptococcus.
Area of Science:
- Burn injury management
- Wound healing complications
- Infectious disease in dermatology
Background:
- Progressive epithelial loss, or melting, is a significant challenge in treating burn injuries.
- Historically, Streptococcus spp. were implicated, but recent cases show melting without significant Streptococcus colonization.
- The pathophysiology and clinical course of melting graft-wound syndrome are poorly understood.
Purpose of the Study:
- To describe the clinical features of melting graft-wound syndrome.
- To identify potential causative agents.
- To understand the incidence and treatment outcomes.
Main Methods:
- Retrospective review of 1035 burn patients (Jan 1994 - Jul 1996).
- Prospective data collection from 324 burn patients (Aug 1996 - May 1997).
- Analysis of wound cultures and treatment responses in patients with melting graft-wound syndrome.
Main Results:
- Melting graft-wound syndrome occurred in 29 patients.
- Wound cultures predominantly grew Staphylococcus aureus; Streptococcus spp. were absent.
- Twenty-seven patients healed with systemic antibiotics and local wound care; two required debridement and re-grafting.
Conclusions:
- Melting graft-wound syndrome is an emerging clinical issue, potentially increasing in incidence.
- Staphylococcus aureus appears to be a significant pathogen in this syndrome.
- Further research into the pathophysiology and optimal treatment is warranted.