Use of Topical Silver Nitrate, Mafenide, and Gentamicin in the Burn Patient

Abstract
BURN wound sepsis continues to be the greatest threat to survival for the patient sustaining a major burn.1-4 Since 1962, 562 burn patients have been treated in the Burn Unit of the Cincinnati General Hospital. Deaths during this period have ranged from 10 to 25 a year, and have accounted for an overall yearly mortality rate ranging from 13% to 18%. Deaths from septicemia accounted for 24% to 45% of these deaths. Fatal pulmonary complications ranged from 4% to 33⅓%. During the year of 1966, fatal septicemia accounted for 24%, and pulmonary infections for 33%, together comprising a total of 57% of the deaths occurring during this period (Table 1). The chief gram-positive organism causing septicemia since 1960 has been the coagulase-positive Staphylococcus aureus. The gram-negative organisms causing septicemia have included Pseudomonas aeruginosa, Proteus mirabilis, Paracolobactrum aerogenoids, and the Aerobacter-Klebsiella group (Table 2). During this seven-year period, there has

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