[Asepsis and antisepsis in the treatment of burn patients (author's transl)]. 1977

P R Zellner, and E Metzger

Among the main aspects to be considered when treating burns, the problem of infection control remains unsolved. Considerable financial resources are needed to prevent the transmission of organisms. To justify such investments in buildings and antiseptic measures, an extensive epidemiological hospital study was carried out from 1970 to 1974, involving 930 patients, and more than 25,000 wound biopsies as well as 10,000 contact cultures and environmental swabs. Bacteria from the environment of severly burned patients were counted every week. Serotyping was used for a specialized study of Pseudomonas aeruginosa. In 200 patients wound organisms were counted. The most important organisms were: Streptococcaceae (pyogenic streptococci, less frequently faecal and salivary streptococci). Pseudomonadaceae, Enterobacteriaceae, and Micrococcaceae (especially Micrococcus aureus). Povidon iodine, gentamicin and silver sulfadiazine were used for local disinfection. Antibiotics used were gentamicin, carbenicillin and polymyxin. Whereas from 1970 to 1972 P. aeruginosa was the predominant organism found in wounds, other gram-positive organisms increased from 1972 on. Wounds were colonized mainly in the course of the first two weeks of treatment. Special studies regarding P. aeruginosa revealed a predominance of serotypes 5 and 13 between 1970 and 1973, whereas types brought into the hospital were dominant from 1973 on. An analysis of furniture and equipment, water faucets and drains showed that Pseudomonas strains found in the water did not coincide with those found in wounds. Therefore, a contamination from this source seems unlikely. Strains found on furniture and equipment, however, also appeared in the wound flora. When the therapeutic routine was changed (to prevent patients passing through common treatment areas such as bathrooms and dressing areas) hospital organisms 5 and 13 could be eliminated almost completely. Thus, it is possible to achieve a considerable reduction in the rate of cross-infection among patients by, for instance, excluding common treatment areas from the therapy programme. Nevertheless, in the majority of cases wounds will still be colonized, in particular by bacteria that were already in the anal region or on the skin before the patient was injured. For this reason, the elimination of such organisms by topical bactericidal agents constitutes an an important factor in efforts to reduce the rate of septicaemic complications. In view of the persisting high mortality due to generalized infections this therapeutic aspect must also be exploited thoroughly in the future. Although in comparative studies of topical therapy using povidon iodine, silver sulfadiazine and gentamicin, organisms did appear in the course of the first two weeks; in the case of the PVP-I the colonization never reached 10(5) organisms per cm2, i.e. the danger threshold for generalized sepsis. There was no evidence of a correlation between number of organisms and depth of burns.

UI MeSH Term Description Entries
D010347 Patient Care Planning Usually a written medical and nursing care program designed for a particular patient. Nursing Care Plans,Goals of Care,Plans, Nursing Care,Care Goal,Care Goals,Care Plan, Nursing,Care Planning, Patient,Care Plans, Nursing,Nursing Care Plan,Plan, Nursing Care,Planning, Patient Care
D002056 Burns Injuries to tissues caused by contact with heat, steam, chemicals (BURNS, CHEMICAL), electricity (BURNS, ELECTRIC), or the like. Burn
D003428 Cross Infection Any infection which a patient contracts in a health-care institution. Hospital Infections,Nosocomial Infections,Health Care Associated Infection,Health Care Associated Infections,Healthcare Associated Infections,Infection, Cross,Infections, Hospital,Infections, Nosocomial,Cross Infections,Healthcare Associated Infection,Hospital Infection,Infection, Healthcare Associated,Infection, Hospital,Infection, Nosocomial,Infections, Cross,Infections, Healthcare Associated,Nosocomial Infection
D004352 Drug Resistance, Microbial The ability of microorganisms, especially bacteria, to resist or to become tolerant to chemotherapeutic agents, antimicrobial agents, or antibiotics. This resistance may be acquired through gene mutation or foreign DNA in transmissible plasmids (R FACTORS). Antibiotic Resistance,Antibiotic Resistance, Microbial,Antimicrobial Resistance, Drug,Antimicrobial Drug Resistance,Antimicrobial Drug Resistances,Antimicrobial Resistances, Drug,Drug Antimicrobial Resistance,Drug Antimicrobial Resistances,Drug Resistances, Microbial,Resistance, Antibiotic,Resistance, Drug Antimicrobial,Resistances, Drug Antimicrobial
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000900 Anti-Bacterial Agents Substances that inhibit the growth or reproduction of BACTERIA. Anti-Bacterial Agent,Anti-Bacterial Compound,Anti-Mycobacterial Agent,Antibacterial Agent,Antibiotics,Antimycobacterial Agent,Bacteriocidal Agent,Bacteriocide,Anti-Bacterial Compounds,Anti-Mycobacterial Agents,Antibacterial Agents,Antibiotic,Antimycobacterial Agents,Bacteriocidal Agents,Bacteriocides,Agent, Anti-Bacterial,Agent, Anti-Mycobacterial,Agent, Antibacterial,Agent, Antimycobacterial,Agent, Bacteriocidal,Agents, Anti-Bacterial,Agents, Anti-Mycobacterial,Agents, Antibacterial,Agents, Antimycobacterial,Agents, Bacteriocidal,Anti Bacterial Agent,Anti Bacterial Agents,Anti Bacterial Compound,Anti Bacterial Compounds,Anti Mycobacterial Agent,Anti Mycobacterial Agents,Compound, Anti-Bacterial,Compounds, Anti-Bacterial
D000985 Antisepsis The destruction of germs causing disease.
D001207 Asepsis The prevention of access by infecting organisms to the locus of potential infection.
D014946 Wound Infection Invasion of a wound by pathogenic microorganisms. Infection, Wound,Infections, Wound,Wound Infections

Related Publications

P R Zellner, and E Metzger
February 1978, Unfallheilkunde,
P R Zellner, and E Metzger
October 1949, Ciba-Zeitschrift,
P R Zellner, and E Metzger
April 1956, The Surgical clinics of North America,
P R Zellner, and E Metzger
January 2000, Vestnik Rossiiskoi akademii meditsinskikh nauk,
P R Zellner, and E Metzger
January 1915, Texas medical journal (Austin, Tex.),
P R Zellner, and E Metzger
December 1947, Nursing mirror and midwives journal,
P R Zellner, and E Metzger
October 1886, The Chicago medical journal and examiner,
P R Zellner, and E Metzger
March 1952, Meditsinskaia sestra,
P R Zellner, and E Metzger
January 1982, Vestnik khirurgii imeni I. I. Grekova,
P R Zellner, and E Metzger
January 1978, Odontostomatologia E Implantoprotesi,
Copied contents to your clipboard!