Wound management in burn centres in Europe

Abstract

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.

Octylcyanoacrylate for the Treatment of Partial‐thickness Burns in Swine: A Randomized, Controlled Experiment

“…To date, silver sulfadiazine (SSD) 1% cream is the most commonly used local treatment for burns. 22,23 Its popularity stems from the fact that prior studies have demonstrated the ability of SSD to reduce bacterial contamination, 24 to speed the rate of re-epithelialization of wounds, 25 and to retard wound contracture. 25 Tissue adhesives, such as the cyanoacrylates, have been available outside the United States for many years.…”

A Randomized Controlled Trial of Silver Sulfadiazine, Biafine, and Saline‐soaked Gauze in the Treatment of Superficial Partial‐thickness Burn Wounds in Pigs

“…13,14 In the treatment of patients with superficial partialthickness burns, SSD was shown to reduce bacterial contamination, speed re-epithelialization of wounds, and retard wound contracture. 1 Biafine is an oil-inwater emulsion containing alginate that may be used in the treatment of superficial partial-thickness burns. Biafine has been shown to be chemotactic for macrophages and to increase IL-1/IL-6 ratio in suction blister wounds in human volunteers, 9 suggesting that it may have a role as an anti-inflammatory agent for treatment for cutaneous wounds.…”

“…A commonly used local treatment for burns is silver sulfadiazine 1% cream (SSD). 1 Previous studies have shown that SSD reduces bacterial contamination, speeds re-epithelialization of wounds, and retards wound contracture. [2][3][4][5][6][7][8] Biafine (Labortoires Medix, Houdan, France) is an oil-in-water emulsion containing alginate, which may be used in the treatment of superficial partial-thickness burns.…”