A survey of wound monitoring and topical antimicrobial therapy practices in the treatment of burn injury.
A survey was done to determine how burn wound microbial monitoring is performed and how topical antimicrobial agents are employed. The survey was sent to 90 burn-care facilities, which comprised most of the major burn centers in the United States. The survey contained questions concerning frequency and techniques of wound monitoring, personnel involved in monitoring, as well as questions about how decisions were made to initiate topical antimicrobial therapy, which agents were selected, and how they were administered. Sixty of 90 facilities (66%) responded to the survey. Although there were few areas of unanimous agreement, several trends did emerge. Most facilities monitored burn wounds for microbes (92%). Wound monitoring was typically done at least twice weekly by either surface swab or quantitative biopsy. Nursing staff played a significant role in specimen collection in 69% of facilities and were solely responsible for obtaining biopsy specimens in 29% of facilities that used biopsies exclusively. All responding facilities used topical antimicrobial agents; silver sulfadiazine was the most popular (95%). Only 33% of facilities surveyed had their own laboratory for microbial monitoring. Rapid techniques for early diagnosis of wound sepsis were used in 20% of units, and topical antimicrobial testing was used in 17% of facilities surveyed.
Taddonio
T E
TE
Department of Surgery, University of Michigan School of Medicine, Ann Arbor.
Thomson
P D
PD
Smith
D J
DJ
Prasad
J K
JK
D000279:Administration, Cutaneous; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D002056:Burns / Q000382:microbiology*; D006801:Humans; D012837:Silver Sulfadiazine / Q000008:administration & dosage / Q000627:therapeutic use; D014481:United States; D014946:Wound Infection / Q000175:diagnosis* / Q000517:prevention & control
D000890:Anti-Infective Agents; D012837:Silver Sulfadiazine