A ten-year retrospective study of sepsis in severely burned patients treated with or without silver sulfadiazinate.

Three groups of extensive burn patients of the surgical intensive care unit (ICU) have been compared: Group I: twenty patients, who were treated locally without silver sulfadiazinate (1968-1970); Group II: the twenty first patients topically treated with silver sulfadiazinate (1970-1972); Group III: twenty similarly treated patients, with silver sulfadiazinate, six years later (1976-1977). The groups are statistically comparable. All bacteriological samples were computerized; the chi-square method was used for statistical analysis of the data. The main conclusions are: (A) Silver sulfadiazinate treatment reduced Pseudomonas aeruginosa and Proteus sepsis. No change in Coliform bacilli sepsis was observed. After six years, a rise in Klebsiella sepsis and Candida sepsis was noted. (B) A quantitative estimate of infections in each group was made by measuring the percentage of positive samples, taking into account the five above-mentioned strains. In the beginning, silver sulfadiazinate reduced quantitative sepsis, but this benefit decreased after six years; the same evolution was demonstrated for positive blood bacteriology; severe septicaemia showed a parallel pattern.

Severe burn cases : a tentative analysis of the epidemiological, clinical and bacteriological data.

We have computerized the epidemiological, clinical and bacteriological data of 140 serious burn cases, hospitalized in our intensive care unit (I.C.U.). The most relevant conclusions are : Epidemiology : it is imperative to exert a prophylactic action against domestic burns through scalds and explosions. Clinic : the most frequent cause of death, during the phases of sept icemia, is cardiac failure. Lung burns significantly increase the mortality rate and they are impossible to codify in the classical systems of burn descriptions. Bacteriology : preventive antibiotic therapy determines, after three days, the strains which resist the usual antibiotics. An antibiotic loses some of its effect when used intensively in reanimation care. We express our concern with regard to the efficiency of antibiotic therapy in intensive care. We suggest to try and standardize data collection, so that multi-centre studies may help to increase the efficiency of their processing.