In this article, we will discuss Brief Note on Burn Wound Sepsis. So, let’s get started.
Burn Wound Sepsis
Burn wounds are basically sterile wounds. However, they are contaminated and infected from the environment by direct transfer of bacteria to the wound or by blood stream. The wound infection can be classified into:
1. Colonisation: Bacterial proliferation in dead necrotic tissue under the Eschar.
2. Invasive wound sepsis: Bacterial proliferation in viable tissue deeper to necrotic tissue.
3. Septicaemia (sepsis): Proliferation of bacteria into the blood stream.
Prevention
Colonization of bacteria can be prevented by following methods.
1. Aseptic measures:
• Isolated rooms
• Air conditioned rooms
• Avoid visitors/restrict contact
• Communication through a transmitter
• Staff should use a sterile cap, mask, gown and gloves before touching the patient
• Frequent cleaning and carbolization of the dressing rooms.
2. Local antimicrobial therapy:
• Daily dressing by closed method helps to prevent cross infection.
• Exposure method is preferred for face and perineum.
3. Topical sulphonamides: It prevents utilization of para amino benzoic acid (PABA) by bacteria to produce folic acid and induces bacteriostasis. The various sulphonamides for burn wounds are:
• Silver sulphadiazine 1% cream
• Mafenide acetate 8.5% cream
• Silver nitrate 0.5% solution (bacteriostatic agent)
• Povidone-iodine 5% ointments
• Nitrofurazone ointment/cream
• Bacitracin ointment
• Gentamicin ointment
• Polymixin B cream
• Cerium nitrate cream
4. Early excision of necrotic tissue & skin grafting.
5. Treatment for burn wound infection
• Wound biopsy is done to find out the wound invasion.
Treatment
• Systemic antibiotics
• Local antimicrobial therapy
• Surgical cleaning of the wound or wound debridement. (removal of loose Eschar, slough and deroofing of pockets of pus)
• Septicaemia should be treated according to the severity.