Incidence of bacteremia after burn wound manipulation in the early postburn period

David W. Mozingo, Albert T. McManus, Seung H. Kim, Basil A Pruitt

Research output: Contribution to journalArticle

74 Citations (Scopus)

Abstract

Background: Transient bacteremia associated with burn wound manipulation is considered a frequent occurrence and is commonly cited as an indication for perioperative antibiotic prophylaxis in burn patients. Methods: In a prospective clinical setting, blood cultures (BC) were obtained from 19 burn patients at the following intervals: 30 minutes before wound cleansing (WC) or wound excision (WE), 30 minutes after the start of WC or WE, hourly until procedure completion, and I hour after completion. Burn wound biopsy for histologic grading and microbial culture was performed after the first BC. Results: Twenty-two WC and 20 WE episodes were evaluated by 67 and 76 BC sets, respectively. Patients had a mean age of 42.8 years and mean burn size of 50% of the body surface area. Three WC episodes (13.6%) and four WE procedures (20.0%) were associated with postprocedure bacteremia. Two patients had both preprocedure and postprocedure bacteremia later attributed to nonburn wound infections. Excluding these cases, the bacteremia rate was 12.5% (9.5% from WC and 15% from WE). Wound biopsy culture and histologic analysis did not predict the occurrence of bacteremia. Conclusion: Current therapy is associated with a lesser incidence of burn wound manipulation- induced bacteremia than reported in prior series. The discordance between wound biopsy and BC results, the absence of positive histology, and the similarity of bacteremia occurrence rates with WC and WE confirm the effectiveness of current techniques of microbial control in burn wounds and question the need for perioperative antibiotic therapy in patients with burns involving less than 40% of the total body surface during the first 10 postburn days.

Original languageEnglish (US)
Pages (from-to)1006-1011
Number of pages6
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume42
Issue number6
DOIs
StatePublished - Jun 1997
Externally publishedYes

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Bacteremia
Incidence
Wounds and Injuries
Biopsy
Antibiotic Prophylaxis
Body Surface Area
Wound Infection
Burns

ASJC Scopus subject areas

  • Surgery

Cite this

Incidence of bacteremia after burn wound manipulation in the early postburn period. / Mozingo, David W.; McManus, Albert T.; Kim, Seung H.; Pruitt, Basil A.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 42, No. 6, 06.1997, p. 1006-1011.

Research output: Contribution to journalArticle

Mozingo, David W. ; McManus, Albert T. ; Kim, Seung H. ; Pruitt, Basil A. / Incidence of bacteremia after burn wound manipulation in the early postburn period. In: Journal of Trauma - Injury, Infection and Critical Care. 1997 ; Vol. 42, No. 6. pp. 1006-1011.
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abstract = "Background: Transient bacteremia associated with burn wound manipulation is considered a frequent occurrence and is commonly cited as an indication for perioperative antibiotic prophylaxis in burn patients. Methods: In a prospective clinical setting, blood cultures (BC) were obtained from 19 burn patients at the following intervals: 30 minutes before wound cleansing (WC) or wound excision (WE), 30 minutes after the start of WC or WE, hourly until procedure completion, and I hour after completion. Burn wound biopsy for histologic grading and microbial culture was performed after the first BC. Results: Twenty-two WC and 20 WE episodes were evaluated by 67 and 76 BC sets, respectively. Patients had a mean age of 42.8 years and mean burn size of 50{\%} of the body surface area. Three WC episodes (13.6{\%}) and four WE procedures (20.0{\%}) were associated with postprocedure bacteremia. Two patients had both preprocedure and postprocedure bacteremia later attributed to nonburn wound infections. Excluding these cases, the bacteremia rate was 12.5{\%} (9.5{\%} from WC and 15{\%} from WE). Wound biopsy culture and histologic analysis did not predict the occurrence of bacteremia. Conclusion: Current therapy is associated with a lesser incidence of burn wound manipulation- induced bacteremia than reported in prior series. The discordance between wound biopsy and BC results, the absence of positive histology, and the similarity of bacteremia occurrence rates with WC and WE confirm the effectiveness of current techniques of microbial control in burn wounds and question the need for perioperative antibiotic therapy in patients with burns involving less than 40{\%} of the total body surface during the first 10 postburn days.",
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