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September 1967

Use of Topical Silver Nitrate, Mafenide, and Gentamicin in the Burn Patient: A Comparative Study

Author Affiliations

From the Department of Surgery, University of Cincinnati College of Medicine and the Cincinnati General Hospital.

Arch Surg. 1967;95(3):472-481. doi:10.1001/archsurg.1967.01330150148019

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