AFTER thermal burns local and systemic infection, especially with Pseudomonas aeruginosa, is a major cause of death. The use of soluble sodium sulfonamides in wounds and burns was investigated during World War II,1 and in studies of extensive burns,2 topical antibacterial therapy was combined with treatment for the burn wound by using a neutralized mixture of tannic acid and sodium sulfadiazine. Although the results were good, emphasis shifted to the role of sodium salts in systemic therapy in an era of disbelief in the efficacy of local antibacterial therapy. As predicted in 1952 by Meleney,3 there is now a renaissance of topical antibacterial therapy with the introduction of dilute silver nitrate solutions4 and mafenide-containing ointments.5 Both agents are effective in burn wound sepsis, especially that caused by P aeruginosa, but both also produce characteristic fluid and electrolyte alterations. The hypotonic (29.4 millimol/liter) silver nitrate solution
Fox CL. Silver Sulfadiazine—A New Topical Therapy for Pseudomonas in Burns: Therapy of Pseudomonas Infection in Burns. Arch Surg. 1968;96(2):184–188. doi:10.1001/archsurg.1968.01330200022004
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