STUDIES at the US Army Surgical Research Unit dating from 1954,1 established septicemia as a major cause of death following burns. The relationship between colonization of the burn wound by gram-positive organisms and death resulting from septicemia was clearly indicated by repeated positive blood cultures associated with a gradually deteriorating clinical course which often ended in death. However, with the emergence of gram-negative organisms as the major cause of death in burns, the relationship between the wound and the clinical course of the patient was not clear until the classic studies of Order,2 Rittenbury,3 Teplitz,4,5 and associates established the burn wound as the source of the gram-negative organisms responsible for the patient's death. Their work demonstrated that the bacterial invasion of the burn wound occurs at a predictable rate and that the prognosis is related to the bacterial colony counts obtained from the wound.
Dressler DP, Rozin RR, Skornik W, Bellas AE, Soroff HS. An Evaluation of Mafenide Acetate in Experimental Burn Wound Sepsis. Arch Surg. 1967;95(6):1000-1008. doi:10.1001/archsurg.1967.01330180148024