Prevention of bacterial growth and local infection in burn wounds

Infection has been described as "the cardinal problem in the treatment of burns… [causing] conversion of 2° burns to 3° burns," 1 and as creating the "greatest threat to survival." 2 Fatal septicemia resulting from local infection can best be avoided by preventing development of the infection. Because of the avascular condition of the wound, control of infection generally requires topical antiseptic treatment. 3 In our pediatric surgical practice we have treated many burn patients and have used a variety of topical antiseptics with both the open and closed techniques, prior to developing a routine procedure acceptable to the two general hospitals in the area. On the basis of experience and clinical judgment, we now prefer povidone-iodine (Betadine Solution and Betadine Aerosol Spray) ∗ ∗Betadine Solution contains 10% povidone-iodine (yielding 1% available iodine) and Betadine Aerosol Spray contains 5% pocidone-iodine (yielding 0.5% available iodine), The Purdue Frederick Co., Yonkers, N.Y. with an open technique for the prevention of local infection. This paper examines a decade of accumulated data in an effort to evaluate objectively the validity of our clinical judgment.