title: The role of topical treatment as a determinant of infection in outpatient burns.
abstract: Up to 95% of all burned patients are treated as outpatients. While uniform guidelines exist to evaluate the severity of an outpatient's burn, treatment forms vary greatly. Furthermore, the relative merits of one treatment modality over another have not been demonstrated. This study reviews 262 patients with uncomplicated, thermal partial-thickness burns. All of these patients were treated with either a petrolatum fine-mesh gauze (FMG = 102), a topical penetrating antibacterial agent (TPA = 58), or a topical nonpenetrating antibacterial agent (TNA = 102). The size of the injury along with its location and etiology, the age of the patient, the time from injury to treatment, and comorbid factors were comparable among the major treatment groups. On follow-up, a wound was classified as infected if it exhibited erythema, tenderness, increased warmth, and edema (cellulitis). Infection rates were 2.0% (2/102) in the FMG group, 5.2% (3/58) in the TPA group, and 2.0% (2/102) in the TNA group. The differences among the rates did not reach statistical significance (P = 0.41). Given the cost of treatment, frequency of dressing changes and overall patient comfort, we advocate FMG as the optimal method for the care of uncomplicated partial-thickness outpatient burns.
authors.affiliation: Yale University School of Medicine, New Haven, Connecticut 06510.
authors.forename: J J
authors.initials: JJ
authors.lastname: Heinrich
authors.forename: D A
authors.initials: DA
authors.lastname: Brand
authors.forename: C B
authors.initials: CB
authors.lastname: Cuono
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001414:Bacitracin / Q000008:administration & dosage*; D001458:Bandages; D002056:Burns / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D002986:Clinical Trials as Topic; D004338:Drug Combinations / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009355:Neomycin / Q000008:administration & dosage*; D011112:Polymyxin B / Q000008:administration & dosage*; D011113:Polymyxins / Q000008:administration & dosage*; D012837:Silver Sulfadiazine / Q000008:administration & dosage*; D013411:Sulfadiazine / Q000008:administration & dosage*; D014946:Wound Infection / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents; D004338:Drug Combinations; D011113:Polymyxins; D013411:Sulfadiazine; D001414:Bacitracin; C001816:bacitracin zinc, neomycin sulfate, polymyxin B, drug combination; D009355:Neomycin; D011112:Polymyxin B; D012837:Silver Sulfadiazine