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MOIST
HEALING AND WOUND CARE INCLUDING BURNS
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(Advantages
and Current Approaches)
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Section
IV. MOIST WOUND HEALING FOR THE BURN WOUND?
A.
What About a Topical Antibiotic Solution?
There appears to be a difference in
infection risk between the burn and non-burn wound. Topical
antibiotic coverage for burns with surface non-viable tissue
would appear to be justifiable given the historical risk of
infection.
A re-examination of the
care of the deep burn in man without surface antibacterial
coverage would appear unjustified given the historical data
available.
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Why increased infection risk? |
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B.
A Novel Antibacterial Solution (The Properties of 5%
Sulfamylon Solution)
Sulfamylon: also known as Mafenide
acetate is a white crystalline powder freely soluble in water.
It was developed as a powder, a solution, and a cream and
first studied for clinical use in 1940 for prevention of
gangrene in war injuries. The product was first used in burns
as a cream and was found to have excellent antibacterial
properties and penetration into devitalized tissue.
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History |
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The
complications of pain on application of sulfamylon cream and
the side effects of carbonic anhydrate inhibition, leading to
metabolic acidosis, led to a decrease in its use with the
development of silver sulfadiazine. However, its use as a 5%
solution continued in a number of major burn centers for use
on wide meshed skin grafts and excised wounds to protect
against potential post-graft infection as well as on deep
dermal burns. The 5% sulfamylon solution was recently FDA
approved for use on meshed grafts and excised burn wounds)
The solution is isosmolar compared to the hyperosmolar 11%
sulfamylon cream, maintaining surface moisture.
Mechanism
of Action:
Sulfamylon has bacteriostatic action against many gram
positive and gram negative organisms including Pseudomonas
aeruginsa but is not active against fungi. The solution
penetrates thru eschar as effectively as the cream form. Once
absorbed systemically, the compound is rapidly converted to an
inactive metabolite and cleared thru the kidneys. The product
is completely cleared from the body 24 hours after an
application.
Complications
of Solutions
Characteristics
of 5% Sulfamylon Solution
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Antibacterial Properties
Treatment
of Infected Burn Wound
(Comparison
of 5% Sulfamylon Solution with Other Agents |
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*
5% Sulfamylon as effective as Sulfamylon cream and
more effective than Silver Sulfadiazine |
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