Pathogenesis
Initially, the burn wound is a sterile environment. However, colonization occurs rapidly and it is dependent on depth. Deeper burns are more likely to become colonized rapidly. Sequentially, common organisms isolated from burns include:
- 6-48 hours: Gram positive cocci eg Staphylococcus aureus
- 48 hours-1 week:
- Gram negative organisms eg Proteus, Klebsiella
- anaerobic organisms eg Escherichia coli
Once the burn is colonized, then invasive infection is a possible sequel that can be limited by:
- reducing the count of organisms
- minimizing the number of types of organism within the wound
The most likely sources of contamination are:
- fluids impinging on wound
- cutaneous contact with unburnt skin eg the patient touching the wound
- enteric fluids
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