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December 1967

Combined Systemic and Topical Therapy of Experimental Burn Wound Sepsis

Author Affiliations

From the Department of Surgery, Tufts University School of Medicine and the New England Medical Center, Boston.

Arch Surg. 1967;95(6):1009-1012. doi:10.1001/archsurg.1967.01330180157025

TOPICAL mafenide (Sulfamylon) acetate B in a hydrophilic base has recently been shown to effectively reduce the mortality from burn wound sepsis both in the laboratory and clinically. This therapy has been based largely on the work of Teplitz1 and Lindberg2 and subsequently substantiated in our laboratory showing that the mortality is directly related to the degree of burn wound sepsis as measured by eschar and subeschar bacterial counts and that the bacterial invasion of a burn wound occurs at a predictable rate. Topical mafenide has been shown by Lindberg3 to be progressively less effective if the initial application is delayed until 48 hours postburn or longer. Systemic antibiotics have not significantly reduced burn mortality probably due to their inability to achieve effective concentrations in the burn with its damaged vascularity,4,5 and still remain within safe systemic levels of the antibiotic. Sodium colistimethate (Coly-Mycin Injectable) has