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April 1969

The Topical Therapy of Burns in Children

Author Affiliations

Oklahoma City
From the Department of Surgery, University of Missouri School of Medicine, Columbia, and the Children's Mercy Hospital, Kansas City, Mo. Dr. Smith is now at Oklahoma University School of Medicine, Oklahoma City.

Arch Surg. 1969;98(4):462-468. doi:10.1001/archsurg.1969.01340100094012

The goal of therapy in the burn patient is to secure coverage of the injured area with the body's own tissues with or without operative assistance. Apart from the problems of initial resuscitation, burn wound sepsis constitutes the greatest threat to recovery. Studies of burn wound sepsis and the vascular destruction causing death of tissue have shown that topically applied antibacterial agents are more effective than those systemically administered.1,2 The agent must, however, be applied often enough and in such concentrations as to make it effective. Topical therapy does not include the application of a medically impregnated gauze which is not changed for several days. Topical agents in water-soluble bases can be used without any dressings or bandages. Daily hydrotherapy removes topical agent and dead tissue and a progressive debridement is achieved.

During the four year period (1964-1967), 282 children, ranging in age from 1 month to 15 years,

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