Fuller F W, Engler P E
Department of Surgery, Saint Barnabas Medical Center, Livingston, New Jersey.
J Burn Care Rehabil. 1988 Nov-Dec;9(6):606-9. doi: 10.1097/00004630-198811000-00006.
The cause of early postburn leukopenia (EPBL) is unknown. The evidence suggests that treating burn wounds with 1% silver sulfadiazine cream (SSD) is contributory, but that other factors exist, possibly including burn stress. Differences of opinion exist as to whether SSD applications to the wounds of non-septic burn patients should be discontinued if EPBL develops. A survey of opinion in 101 North American burn treatment facilities and a review of the literature show a strengthening of the perception that EPBL, whether caused by SSD or not, holds little risk for the burn patient. The majority of burn patients are now being assigned to treatment strategies in which the onset of EPBL requires discontinuance of SSD only at WBC counts lower than 2,000/cu mm or not at all. This is significantly lower (p less than .02) than the mean of the values recorded in the literature. There is now substantial experience with continuing the SSD therapy in this setting regardless of the WBC count. No complications are reported therefrom.
烧伤后早期白细胞减少症（EPBL）的病因尚不清楚。有证据表明，用1%磺胺嘧啶银乳膏（SSD）治疗烧伤创面是一个促成因素，但其他因素也存在，可能包括烧伤应激。对于非感染性烧伤患者出现EPBL时是否应停止在伤口使用SSD，存在不同意见。对101家北美烧伤治疗机构的意见调查以及文献综述表明，人们越来越认为，无论EPBL是否由SSD引起，对烧伤患者的风险都很小。现在，大多数烧伤患者被采用的治疗策略是，只有当白细胞计数低于2000/立方毫米时才停止使用SSD，或者根本不停止使用。这明显低于（p小于0.02）文献中记录的平均值。现在有大量经验表明，在这种情况下，无论白细胞计数如何，都可继续使用SSD治疗。未报告由此产生的并发症。
