![]() Another reason against the use of antiseptics on open wounds is that they are not as effective against bacteria in vivo as they are in vitro, due to the presence of exudate, serum and blood, which seems to diminish their activity. 9- 10 However, cytotoxicity appears to be dependent on concentration. 7- 8 The strongest argument against the use of antiseptics on the lesions is that antiseptics have been found, mainly in vitro, to be cytotoxic for the cells essential to the wound healing process, such as fibroblasts, keratinocytes and leukocytes. However, the use of antiseptics as prophylactic anti-infectious agents for open wounds, such as lacerations, abrasions, burns and chronic ulcers, has been an area of intense debate for several years. The usefulness of antiseptics on intact skin is well established and widely accepted. Unlike antibiotics, which selectively act on a specific target, antiseptics have multiple targets and a broader spectrum of activities, including bacteria, fungi, viruses, protozoa, and even prions. 3- 6Īntiseptics are agents that destroy or inhibit the growth and development of microorganisms in living tissues. aureus (MRSA) is currently the most common pathogen in many burns, and Enterococcus spp., resistant to vancomycin, although not as common, is highly virulent. The bacterial organisms that are most frequently responsible for burns infection are Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli and Staphylococcus aureus. ![]() If therapeutic measures are inadequate or delayed, microbial invasion of tissues occurs, resulting in burn infection. 2Īfter approximately 5-7 days, burns are colonized by Grampositive bacteria, Gram-negative and yeasts derived from the gastrointestinal and respiratory tract of the host and/or exogenous microorganisms from the external environment or from the operators (“cross-infection”). The burnt surface is sterile immediately after injury, but is soon colonized by microorganisms: endogenous bacteria that survive the insult, such as Staphylococci located in the sweat glands and in hair follicles, colonize the wound surface within the first 48 hours unless topical antimicrobial agents are used. Infection is the main cause of death in severe burn trauma: the destruction of the cutaneous barrier and concomitant immune depression are key factors in the onset of infectious complications.
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