Following a motor vehicle accident, a 28-year-old man was admitted to the hospital burn unit. He had sustained third-degree burns on his left h and left proximal forearm. Intravenous colloid solution was administered, and wound dressings were changed twice daily (A).
Gopi Rana-Mukkavilli, MD of New York City reports that the patient became febrile (temperature, 39.2°C [102.5°F]) 2 days after admission. Blood cultures revealed Pseudomonas aeruginosa. Because of the high risk of infection and septicemia from third-degree burns, these wounds must be carefully and scrupulously tended.
Intravenous ceftazidime and gentamicin were given. The wound was debrided (B); silver sulfadiazine ointment was applied to prevent reinfection. After 2 weeks of antibiotic therapy and frequent dressing changes, a skin graft was placed on the debrided wound. The patient was subsequently discharged from the hospital without further complications.