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Use
of Silver Delivery System in Partial Thickness Burns
(Wound
Characteristics)
CASE
1: Patient is a 35 year old black pilot
(policeman) who suffered deep partial and full thickness
burns, plus a fractured pelvis in a plane crash. He was
quite heavy at 310 pounds. The burns involved 62% of his
body. Full thickness burns to chest, flank, arms, upper legs
were excised and grafted.
The back burn which
appeared to be deep dermal was treated with the silver
delivery system (ACTICOAT), changed every 3 days. The right
flank was excised and grafted. The ease of wound care to the
back was very advantageous because of his size and the
pelvic fracture.
The back burn healed in
21 days. He was transferred to our acute rehabilitation
center on day 32.
Case
1: Burn Wound Bacteriology
| Surface
Cultures |
Wound
Appearance |
Day
1: +2 gram positive bacteria
Day 7:
no growth
Day
14: +1 gram positive entercoccus
Day
21: +1 gram positive entercoccus
Day
28: +1 gram positive staph aureus
|
Dry
Eschar
Red
appearance
moist surface
minimal exudate
Evidence of re-epithelialization
Minimal exudate near complete re-epithelialization
Complete
re-epithelialization
|
*
Cultures reported as no growth to +4 bacteria
Deep
Dermal and Full Thickness Burns to Back and Buttocks
Managed with Silver Delivery System (ACTICOAT)
Admission
Image 2
(Click to Enlarge)
Burn 10 Days
Post Injury
(Click to Enlarge)
Note:
ACTICOAT Day 2 post placement. Lack of exudate on edges.
Silver
Delivery System on back moistened and covered with gauze.
(Click
the Image to Enlarge)
Note: moist wound
surface and absence of exudate on buttocks where ACTICOAT has
been pulled back.
Burn
Day 21:
(Click
the Image to Enlarge)
Note: Deep partial
thickness burn now completely re-epithelialized with new
pigmentation evident.
  
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