A Randomized Prospective Study of Topical Antimicrobial Agents on Skin Grafts after Thermal Injury

Livingston, David H.; Cryer, H. Gill; Miller, Frank B.; Malangoni, Mark A.; Polk, Hiram C.; Weiner, Leonard J.; Herndon, David N.

doi:10.1097/00006534-199012000-00002

Cited by 4 publications

(9 citation statements)

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“…Its major side effect is transeschar leaching of electrolytes, which mandates increased sodium and potassium administration, with careful attention to serum electrolyte activity. It can also be used on freshly grafted wounds [141] and donor sites, making it an excellent topical agent for use in situations where donor sites, fresh grafts, and eschar are adjacent to each other.…”

Section: Wounds Of Special Typesmentioning

confidence: 99%

Management of Burn Wounds with Prompt Excision and Immediate Closure

Sheridan

Tompkins

Burke

1994

J Intensive Care Med

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The past 30 years have been witness to significant improvements in the overall care and prognosis of those suffering burn trauma. At the heart of this success is an aggressive approach to burn wounds. This approach, which is detailed in this review, involves early operative removal of devitalized tissue and biological coverage of resultant wounds, with particular attention to wounds in specialized areas.

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Section: Wounds Of Special Typesmentioning

confidence: 99%

Management of Burn Wounds with Prompt Excision and Immediate Closure

Sheridan

Tompkins

Burke

1994

J Intensive Care Med

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“…Otro problema por considerar con el uso de antibióticos no absorbibles empleados en forma local es la selección de gérmenes resistentes, tal como se hizo en el trabajo de Livingston y cols., 10 que informa un alto porcentaje de resistencia en los pacientes en los que se empleó bacitracina más neomicina. Esto alerta sobre la posibilidad de generar resistencia con el uso de antibióticos no absorbibles tópicos.…”

Section: Discussionunclassified

“…Livingston y cols., 10 realizaron un estudio prospectivo y aleatorizado (el resumen no explicita el método de asignación empleado) en 52 pacientes, niños y adultos, a los que se les realizó escarectomía tangencial e injerto al ingreso (nivel de evidencia 2b). Compararon la eficacia de 2 agentes tópicos: nitrato de plata al 0,5% y neomicina (1g/L) más bacitracina (50 000 U/L) contra solución de Ringer lactato (que actuó como placebo), para la prevención de la pérdida del injerto secundaria a infección.…”

Section: Estudios Que Comparaban Agentes Tópicos Con Placebounclassified

Revisión sistemática:¿Cuál es el agentetópico más eficaz en la prevención de infecciones en el paciente quemado?

Rosanova

Stamboulián

Lede³

2012

Arch Argent Pediat

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Revisión sistemática: ¿Cuál es el agente tópico más eficaz en la prevención de infecciones en el paciente quemado? SUMMARYTopical agents are often used in burn patients; however the efficacy to prevent local infections and or sepsis had not been cleared established in high level evidence studies. With the aim to evaluate the comparative efficacy between different topical agents we performed this systematic review. Material and methods. Data source was Medline. MESH terms were: (burn* or scald*) AND (antibacterial or antibiotic*) AND (topic*) AND (therap* or prophylax*). Randomized and quasi randomized clinical trials, with a primary outcome of infections and or sepsis were included. Each study was scored and classified for methodological key issues according to level of evidence. Results. The search identified 457 studies of which 14 were eligible for inclusion and full text was available for 11 of them. Conclusion. Our review does not support differences in efficacy of topical agents to reduce sepsis and or local infections in burn patients. INTRODUCCIÓNSegún algunos autores, los agentes tópicos junto con el desbridamiento quirúrgico temprano han logrado disminuir la morbimortalidad de pacientes con quemaduras graves. 1-3Cuando el tejido quemado se coloniza, la cicatrización se enlentece porque la presencia de bacterias produce una respuesta inflamatoria exagerada y deletérea que entorpece la cicatrización de la herida y favorece la infección. 2-4Los objetivos de utilizar agentes antimicrobianos tópicos son evitar la colonización bacteriana y favorecer la cicatrización temprana de la herida al reducir la posibilidad de infección. Sin embargo, su eficacia no ha sido establecida fehacientemente en estudios controlados. La evidencia sobre su utilidad para prevenir infecciones en las quemaduras es escasa, pero su utilización muy extendida. Por ello, surge el interrogatorio ¿cuál agente tópico antiinfeccioso es más eficaz para la prevención de infecciones en el manejo de las quemaduras?Para responderlo se decidió llevar a cabo una revisión sistemática de la bibliografía biomédica, pero como existe una amplia diversidad de agentes tópicos antinfecciosos en la práctica clínica, consideramos que podía resultar de interés presentar previamente una breve descripción sobre ellos: 1 Compuestos con plataSulfadiazina de plata al 1%: Su mecanismo de acción no está claro. Es bactericida contra bacilos aerobios gramnegativos y puede ser eficaz

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“…Tulle gras dressings were particularly popular in Italy and most units using them excised the burn wound early. Silver sulphadiazine is effective in limiting colonisation by Pseudomonas aeruginosa and reducing graft failure in moderate burns [19,28]. Pseudomonas infection and colonisation have declined since silver sulphadiazine was introduced [12].…”

Section: Discussionmentioning

confidence: 99%

“…Tulle gras and gauze dressings (39 units 41%) were more popular in Italy ( (9) 6 (67%) Czech Rep/Slovakia (9) 6 (67%) Eire (3) 1 (33%) France (24) 12 (50%) Germany (33) 25 (76%) Greece (8) 2 (25%) Israel (10) 5 (50%) Italy (19) 15 (79%) Netherlands (3) 3 (100%) Portugal (6) 4 (67%) Spain (4) 2 (50%) NB -Some units indicated more than one antibiotic was used days). Chlorhexidine-soaked gauze was used by nine units.…”

Section: Dressings and Topical Antibioticsmentioning

confidence: 99%

Wound management in burn centres in Europe

et al. 1995

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Infection remains a common cause of death in burned patients. A recent survey of UK burns units showed a range of opinion on the timing of burn wound excision and the use of therapeutic and prophylactic antibiotics. The same questionnaire was sent to other European burns units to assess their practice. Answers were obtained from 96 of the 164 units contacted. A written policy on antibiotic treatment was used by 35 (36%) units, imipenem being the single most popular antibiotic, but courses often lasted more than 10 days. Excisions were covered routinely by prophylactic antibiotics in 44 (45%) units, and 10 of these covered all procedures where the wound was manipulated. All units took surface swab cultures, and 26 (27%) took punch biopsies of the wounds. Silver sulphadiazine was used in 66 (69%) of the units while others preferred sulfamylon, povidone iodine or flamacerium. In 40 hospitals (42%) reporting proven cases of toxic shock syndrome, the median number was only six cases in two years. Nineteen (20%) excised burns within 48 hours of admission. The use of very broad spectrum antibiotics for prolonged courses was the most marked difference from the UK.

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A Randomized Prospective Study of Topical Antimicrobial Agents on Skin Grafts after Thermal Injury

Cited by 4 publications

References 0 publications

Management of Burn Wounds with Prompt Excision and Immediate Closure

Management of Burn Wounds with Prompt Excision and Immediate Closure

Revisión sistemática:¿Cuál es el agentetópico más eficaz en la prevención de infecciones en el paciente quemado?

Wound management in burn centres in Europe

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