Simple, effective and affordable approach for the treatment of burns infections.

OBJECTIVE: The aim of the present study was to develop a simple and effective treatment modality using citric acid as a sole antimicrobial agent to control infections in burns patients not responding to conventional treatment. METHODS: Forty-six cases with 5-60% superficial to deep burns in a study group and 20 cases with 10-70% superficial to deep burns in a control group were investigated for culture and susceptibility. The isolates in study group were further tested for susceptibility to citric acid. Three percent citric acid gel was applied to burns wounds in study group; however, the control group received conventional antibiotic therapy and local wound care. RESULTS: In the control group, Pseudomonas aeruginosa (44.44%) and Staphylococcus aureus (33.33%) were found to be the commonest bacterial isolates and, amikacin and ciprofloxacin (40.74%) were found to be most effective antibacterial agents. In study group, P. aeruginosa (30.48%) and S. aureus (23.17%) were found to be the commonest bacterial isolates. Ceftazidime (52.43%), ciprofloxacin (47.56%) and amikacin (46.34%) were found to be most effective antibacterial agents. Application of citric acid to burn wounds resulted in complete healing in 40 (86.95%) cases in 7-25 applications (P value 0.145); however, in a control group conventional antibiotic therapy and local wound care resulted in complete healing in nine (45%) patients only. CONCLUSIONS: Citric acid treatment was found effective in the control of burns infections as compared to conventional therapy. Complete healing in 86.95% cases as compared to 45% in a control group indicates that citric acid is nontoxic, economical and quite effective in the management of burns infections.

A simple and effective approach for the treatment of diabetic foot ulcers with different Wagner grades.

Diabetic foot infections are the major cause of morbidity. Infection is the common sequel of diabetic foot ulceration that leads to delayed wound healing. These infections are difficult to control. If not addressed well in time, they may lead to amputation of foot. An attempt has been made to develop simple and effective treatment modality by using citric acid as a sole antimicrobial agent to control diabetic foot infections not responding to conventional treatment. Hundred and fifteen cases of diabetic foot ulcers of different Wagner grades infected with a variety of bacteria were investigated for culture and susceptibility, and susceptibility to citric acid. Citric acid gel was applied to ulcer to determine its efficacy in the management of diabetic foot ulcers with different Wagner grades. Citric acid gel was found effective in the control of foot infections; especially in Wagner grades I and II, the success rate was found to be more than 94%. In Wagner grade III also, it was found effective in complete healing of ulcers without deep osteomyelitis. Citric acid treatment is effective in the control of diabetic foot infections and in successful management of diabetic foot ulcers with Wagner grades I and II, and even with Wagner grade III, without deep osteomyelitis.