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Topical Antimicrobials in Burn Care

Part 1—Topical Antiseptics

Cambiaso-Daniel, Janos MD*†; Boukovalas, Stafanos MD; Bitz, Genevieve H. BS§; Branski, Ludwik K. MD, MMS*†; Herndon, David N. MD, FACS, MCCM*‡; Culnan, Derek M. MD§

doi: 10.1097/SAP.0000000000001297
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Burn wounds disrupt the body's primary defense against invasion and colonization by microorganisms. Topical antimicrobials are one component in burn wound care. These agents suppress microbial growth to advantage skin cells and wound healing. Topical antimicrobials can be divided into 2 superclasses: antiseptics and antibiotics. We review the 4 main classes of topical antiseptics (emulsifiers, acids, oxidizers, and heavy metals) and antiseptic-impregnated dressings in current clinical use and address the mechanisms, as well as the advantages and disadvantages of each antiseptic for burn wound management.

From the *Department of Surgery, University of Texas Medical Branch, and Shriners Hospitals for Children, Galveston, TX; †Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Austria; ‡Division of Plastic Surgery, University of Texas Medical Branch, Galveston, TX; and §JMS Burn and Reconstructive Center, Merit Health Central Hospital, Jackson, MS.

Received September 5, 2017, and accepted for publication, after revision October 16, 2017.

Conflicts of interest and sources of funding: This study was supported by the National Institute of General Medical Sciences of the National Institutes of Health (award numbers P50GM060338, R01GM056687, and T32GM8256) and Shriners Hospitals for Children (grants SHC 84080, SHC 80100, SHC 71008).

The contents of this manuscript are solely the responsibility of the authors and do not necessarily represent the official views of the National Institute of General Medical Sciences or the Shriners Hospitals for Children.

Reprints: Derek M. Culnan, MD, JMS Burn and Reconstructive Center at Merit Health Central Hospital, 1850 Chadwick Dr, Ste 1427 Jackson, MS 39204. E-mail: derek.culnan@burncenters.com.

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