Treatment

Established burn wound infection requires careful management. Features suggestive of the diagnosis include:

• increasing pain or discomfort from the burn
• new pyrexia
• spreading cellulitis or lymphangitis from the periphery of the burn
• increasing discharge
• malodorous smell emanating from wound
• rising White cell count or metabolic acidosis

Management entails close liaison with microbiology. Any discharged should be swabbed and sent for culture and sensitivity. Pyrexia should prompt blood cultures. In the presence of tracking infection, a broad spectrum systemic antibiotic should be considered. Topical application of mafenide of aqueous chlorhexidine to the burn has been used to provide antibiosis.

If there are significant amounts of devitalised tissue, surgical debridement may be required.

Consideration should be given to factors affecting the patient's ability to fight infection, for example the optimization of nutrition.