Prevention of Burn Wound Infection / 병원감염관리

Burn patients are highly susceptible to infection because they are generally immunosuppressed and have open wound of avascular and necrotic tissue. The sources of burn wound infection are the health care workers, the environment and the patients themselves. Protection from cross-contamination, using effective antimicrobial agents, early escharectomy and closure of wound, proper antimicrobial prophylaxis, and frequent evaluation of burn wound are important for preventing burn wound infection.

Risk Factors and Prognostic Influences of Burn Wound Infection

PURPOSE: Among persons sustaining severe burns, burn wound infection may develop into devastating sepsis. The purpose of this study is to validate the risk factors for burn wound infection in order to increase the effectiveness of the early treament of those patients at high risk for burn wound infection. METHODS: We retrospectively evaluated 155 hospitalized burn patients with an affected burn area greater than 20% extent and who underwent wound culture because of clinically suspected wound infection from March 1997 to December 2000. RESULTS: When patient age, cause of burn, total burn surface area (TBSA), full thickness burn area (FTBA), anatomical distribution of burn, dehydration at admission treated as independent variables, TBSA and FTBA were seen to significantly influence the burn wound infection rate (p<0.05). When the length of hospital stay, interval from burn to skin graft, outcome of burn were taken as independent variables, the length of hospital stay and outcome of burn were significantly influenced by burn wound infection (p<0.05). CONCLUSION: The high risk group for wound infection comprises patients with extensive TBSA or FTBA and should be selected early to undergo intensive treatment as follows ; meticulous wound monitoring and aseptic maneuver, early eschar excision and early skin graft, adequate nutritional support, isolation against hospital-acquired infection, judicious antibiotic management based on antimicrobial susceptibility testing and control of emergent antibiotic-resistant bacteria.