EFFICACY OF BUROWS SOLUTION IN THE TREATMENT OF GRAM-NEGATIVE BURN WOUND CONTAMINATION

Bacterial contamination or infection of burn wounds may result in seco ndary loss of autograft, delayed re-epithelialization of open wounds, or decreased healing of subsequent autografts. Burow's solution (alumi num acetate) has been used for treatment of external otitis and cutane ous diseases and is felt to act primarily as an astringent creating a hostile environment for bacteria. We studied 31 burn patients treated with topical Burow's solution since 1991. Treatment was instituted whe n wounds developed a mucopurulent exudate with evidence of graft loss or delay in expected healing. Burow's solution was begun an average of 17 days following admission (range = 8 to 43 days) and used an averag e of 9.8 days (range = 2 to 25 days). Thirty patients had undergone pr evious excision and skin grafting. Twenty-nine patients (94 percent) h ad multiple organisms on wound culture including a variety of gram neg ative and gram positive bacteria. All wounds showed a decrease in exud ate within 48 hours, with abatement of epithelial loss if previously p resent. Nineteen patients underwent subsequent skin grafting with good to excellent take in 16 (85 percent). Eleven patients were switched t o barrier dressings and had secondary healing without surgery. No clin ical morbidity or toxicity attributable to Burow's solution was noted. Use of topical Burow's solution in select burn patients with contamin ated open wounds is associated with decreased exudate and promotion of final wound closure.