WOUND MANAGEMENT IN BURN CENTERS IN EUROPE

Infection remains a common cause of death in burned patients. A recent survey of UK burns units showed a range of opinion on the timing of b urn wound excision and the use of therapeutic and prophylactic antibio tics. The same questionnaire was sent to other European burns units to assess their practice. Answers were obtained from 96 of the 164 units contacted. A written policy on antibiotic treatment was used by 35 (3 6%) units, imipenem being the single most popular antibiotic, but cour ses often lasted more than 10 days. Excisions were covered routinely b y prophylactic antibiotics in 44 (45%) units, and 10 of these covered all procedures where the wound was manipulated. All units took surface swab cultures, and 26 (27%) took punch biopsies of the wounds. Silver sulphadiazine was used in 66 (69%) of the units while others preferre d sulfamylon, povidone iodine or flamacerium. In 40 hospitals (42%) re porting proven cases of toxic shock syndrome, the median number was on ly six cases in two years. Nineteen (20%) excised burns within 48 hour s of admission. The use of very broad spectrum antibiotics for prolong ed courses was the most marked difference from the UK.