Peri-Operative Bacteraemia in Burn Patients. What Does it Mean?

Bacteraemias during burn wound manipulation are frequent, especially following burn wound excision. However, these bacteraemias seem not to have any clinical consequences, and their treatment is therefore controversial. Over a 20-month period 35 surgical debridement procedures were recorded prospectively in 18 burn patients. Blood culture samples were drawn before, during, and after surgical excision. Bacteraemias were found in ten out of the 35 patients (28%), and 16 of the 105 blood samples (15%) were positive. All three blood samples were positive in one case ("primary bacteraemia"), while others were "transient bacteraemia". Six positive blood cultures were considered to be "bacteraemias induced by wound manipulation" and seven "bacteraemias of unknown source". Bacteraemias of unknown source were not recorded at any time while "bacteraemias induced by wound manipulation" were recorded after day 5 post-burn. Patients with more than 40% TBSA had 4.3 times more bacteraemic risk than patients with less extensive TBSA. Blood pressure and white blood cell variations were observed in bacteraemic patients but without any clinical relevance. We conclude that bacteraemic rates were high and that there were two different patterns of bacteraemia- both transient and with no clinical relevance.