title: Efficacy of debridement and wound cleansing with 2% hydrogen peroxide on graft take in the chronic-colonized burn wounds; a randomized controlled clinical trial.
abstract: BACKGROUND
  Severe burns are associated with dramatic outcomes which are potentially detrimental. Nowadays the standard treatment for deep partial thickness and full-thickness burn is early excision and grafting, which is not always feasible this leads to chronicity and microbial colonization of burn wounds. Interesting properties of hydrogen peroxide 2% soaked gauze convinced us to use it in management of chronic burn wounds.
  
  
  METHODS
  From January 2009 to September 2011, in a prospective clinical trial, 49 patients (98 limbs) with chronic-colonized burn wounds in both limbs were included in this study. Tissue cultures were taken from all the wounds. For the right, after debridement of granulation tissue and washing with hydrogen peroxide 2% soaked gauze for 5min followed by normal saline irrigation, grafting was done; debridement and skin grafting was performed in the conventional method in left limb wounds. The success rate of graft take was compared between two groups, after 21 days by the surgeon using the formula: Graft take surface area (cm2) x 100%/Total grafted area (cm2).
  
  
  RESULTS
  The study group was composed of 98 limbs in 49 patients with mean age of 26.44±5.66 and burn in 28.3±7.23% TBSA. The most common causes of the burn wounds chronicity was delayed admission associated with poor compliance. (44.8%) Staphylococcus was the most frequent isolate bacterial wounds colonization in our patients. (59.2%) Mean graft take was 82.85% in right limbs, and 65.61% in left limbs; which was significantly different (P<0.05).
  
  
  CONCLUSIONS
  Our study showed that, administration of hydrogen peroxide intraoperatively appears to be safe and significantly increases the mean success rate graft take in chronic-colonized wounds. Therefore, it can be recommended in management of chronic burn wounds management.
authors.affiliation: Shiraz Burn Research Centre, Division of Plastic and Reconstructive Surgery, Department of Surgery, Shiraz University of Medical Sciences, Iran. mohamadiaa@sums.ac.ir
authors.forename: Ali Akbar
authors.initials: AA
authors.lastname: Mohammadi
authors.forename: Seyed Morteza
authors.initials: SM
authors.lastname: Seyed Jafari
authors.forename: Mandana
authors.initials: M
authors.lastname: Kiasat
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Pakyari
authors.forename: Iman
authors.initials: I
authors.lastname: Ahrari
mesh_terms: D000328:Adult; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D002056:Burns / Q000382:microbiology / Q000601:surgery*; D003646:Debridement; D005260:Female; D006085:Graft Survival; D006801:Humans; D006861:Hydrogen Peroxide / Q000627:therapeutic use*; D007430:Intraoperative Care / Q000379:methods; D008297:Male; D011446:Prospective Studies; D016038:Skin Transplantation / Q000379:methods; D014946:Wound Infection / Q000382:microbiology / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D000891:Anti-Infective Agents, Local; D006861:Hydrogen Peroxide
keywords: Burn; Chronic wounds; Hydrogen peroxide