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Topical agents and dressings for local burn wound care

Authors
Mayer Tenenhaus, MD, FACS
Hans-Oliver Rennekampff, MD
Section Editor
Marc G Jeschke, MD, PhD
Deputy Editor
Kathryn A Collins, MD, PhD, FACS

INTRODUCTION

Local treatment of burn wounds includes cleansing and debridement and routine burn wound dressing changes, typically incorporating topical antimicrobial agents; however, there is no consensus on which agent or dressing is optimal for burn wound coverage to prevent or control infection or to enhance wound healing [1,2].

The selection and application of burn wound dressings and topical agents depends on the nature and extent of the burn wound, a particular wound quality or state (eg, contamination, infection), and the patient's allergy history. The dressings and topical therapies that are used at a given facility depend upon regional and individual preference and experience, availability, and costs.

The most frequently used burn wound dressings and topical agents in adults and children will be reviewed here. The classification and management of burns by depth of burn and the specialized management of burns at specific anatomic sites are reviewed separately. (See "Classification of burn injury" and "Treatment of minor thermal burns" and "Treatment of superficial burns requiring hospital admission".)

LOCAL BURN WOUND CARE

Goals — Local burn wound care (table 1 and table 2) aims to protect the wound surface, maintain a moist environment, promote burn wound healing, and limit burn wound progression while minimizing discomfort for the patient [3]. It is important to note that topical antimicrobials are used in conjunction with appropriate basic wound care. (See "Basic principles of wound management".)

Burn wound surfaces are prone to rapid bacterial colonization with the potential for invasive infection. Measures to reduce the likelihood of infection include good infection control practices, topical antimicrobial therapy, and burn wound debridement/excision, when needed [4]. Closed dressing management is often advocated to minimize cross-contamination by pathogens (eg, methicillin-resistant Staphylococcus aureus) that can cause burn wound infection, delayed wound healing, and loss of skin grafts [5]. Wounds that become infected require systemic antimicrobial therapy, in addition to the chosen regimen for local wound care. (See "Burn wound infection and sepsis".)

                     
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Literature review current through: Nov 2017. | This topic last updated: Nov 17, 2017.
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