The management of burns under conditions of limited resources using topical aqueous sulfamylon (mafenide) hydrochloride spray.
The burn unit establishment in a Vietnamese military hospital (1970 to 1971) is an example of the management of burns under conditions of limited resources. The problems encountered and methods used in their solution are still relevant. This is the first (and possibly still the only) instance of such clinical use of topical Sulfamylon (mafenide) aqueous spray as the sole pregraft antibacterial agent for patients with deep partial-thickness and full-thickness burns (and associated injuries). The mafenide spray open treatment resulted in a bacteriostatic film permitting eschars to remain uninfected while more superficial burns healed and general status improved, enabling delayed grafting to be effective. Use of operating rooms, supplies, and personnel was minimized. The study group contained 211 patients; 86 (approximately 40%) had burns that exceeded 20% body surface area, and 26 (approximately 12%) had burns that exceeded 40% body surface area. As the procedures became fully established, all of the last 110 patients of this series survived. Only 17 deaths occurred in the total series; none were attributed to infection.
Mendelson
J A
JA
D000293:Adolescent; D000328:Adult; D000336:Aerosols; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D002053:Burn Units / Q000458:organization & administration; D002056:Burns / Q000188:drug therapy*; D005260:Female; D006772:Hospitals, Military; D006801:Humans; D008272:Mafenide / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009747:Nutritional Physiological Phenomena; D009824:Ointments; D014744:Vietnam; D014857:Warfare; D014882:Water-Electrolyte Balance
D000336:Aerosols; D000891:Anti-Infective Agents, Local; D009824:Ointments; D008272:Mafenide