Patel Priti P, Vasquez Sylvia A, Granick Mark S, Rhee Samuel T
Division of Plastic Surgery, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, New Jersey, USA.
J Craniofac Surg. 2008 Jul;19(4):913-22. doi: 10.1097/SCS.0b013e318175b516.
Burn trauma continues to injure an estimated 1 million children each year in the United States alone, with many more injuries suffered worldwide. Several decades ago, advances in acute burn wound management, including development of topical antimicrobials, dramatically improved outcomes in pediatric burn injuries. However, infection remains the leading cause of burn wound mortality. With increasing antibiotic resistance in many medical centers, precise selection of topical antimicrobial therapy has grown in importance for pediatric burn management. Effective choice and application of topical antimicrobials require correct classification of burn wounds, appropriate understanding of the process of burn wound sepsis, and accurate identification of pathogens for individual patients as well as for their surrounding environment. This article examines the current and evolving role of topical antimicrobials in pediatric burn wound management. Burn wound classification, the biologic process of burn wound sepsis, wound cultures with pathogen profiling, and evaluations of commonly used topical antimicrobials are reviewed. Newer biologically active occlusive (bio-occlusive) and hybrid products are examined in the context of topical antimicrobial therapy and their increasing role in pediatric burn wound management.
仅在美国，每年就有大约100万儿童遭受烧伤创伤，全球烧伤受伤的儿童更多。几十年前，急性烧伤创面处理技术取得了进展，包括局部抗菌药物的研发，显著改善了小儿烧伤的治疗效果。然而，感染仍然是烧伤创面死亡的主要原因。随着许多医疗中心抗生素耐药性的增加，精准选择局部抗菌治疗对于小儿烧伤管理变得越来越重要。有效选择和应用局部抗菌药物需要正确分类烧伤创面，恰当理解烧伤创面脓毒症的过程，以及准确识别个体患者及其周围环境中的病原体。本文探讨了局部抗菌药物在小儿烧伤创面管理中当前的和不断演变的作用。对烧伤创面分类、烧伤创面脓毒症的生物学过程、病原体分析的创面培养以及常用局部抗菌药物的评估进行了综述。在局部抗菌治疗的背景下，研究了新型生物活性封闭性（生物封闭性）和混合产品及其在小儿烧伤创面管理中日益重要的作用。
