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April 1978

'Lethal' Burns: A Progress Report

Author Affiliations

From the Department of Surgery, St John's Mercy Medical Center, St Louis.

Arch Surg. 1978;113(4):397-401. doi:10.1001/archsurg.1978.01370160055007

• Sixteen consecutive patients, nine of whom also had inhalation injury, had burns over 72% body surface area or more. The expected death rate was 94%. In fact, all of the eight patients still alive after 48 hours survived. The early deaths were primarily due to inhalation injury, the treatment of which remains an unsolved problem. A mixture of cerium nitrate and silver sulfadiazine was used for topical wound antisepsis. The wound flora was sparse: 447 of 814 wound-surface cultures were sterile; Gram-negative bacteria were recovered in 13%. This efficacious wound bacteriostasis appeared primarily responsible for the absence of late death.

(Arch Surg 113:397-401, 1978)

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