pressures ≥ than 25 mmHg should prompt consideration of aggressive
intervention as elevated abdominal pressures can quickly lead to mortality if not
promptly addressed. Two modailities that have been described to treat ACS is
paracentesis or decompressive laparotomy. Mortality rates have been reported
to be in the 50-60 percent range.
V. Wound Care
Appropriate wound care is generally determined by thoroughly assessing
the burn depth and size. Superficial partial thickness burns can be treated with
daily dressing changes with topical antimicrobial agents or application of
petroleum gauze to facilitate rapid reepithelialization. These burns will usually
heal within three weeks of injury without the need of surgical intervention.
Several topical antimicrobial agents are available for the management of these
burns. The most commonly used are silver sulfadiazine (Silvadene), mafenide
acetate (Sulfamylon) and bacritracin/neomycin/ polymyxin B. Silvadene is
known to have activity against a variety of organisms such as S. aureus, E.
Coli, Klebsiella species, P. aeruginosa, Proteus species and C. albicans. Some
of the reported side effects of its use are maculopapular rash, evident in 5% of
patients and transient leukopenia, evident several days after initiating therapy,
occurring in 5-15% of treated patients. This transient leukopenia has not led to
an increase incidence of infection in these patients. Sulfamylon has
antimicrobial activity against gram positive species, including Clostridium, and
gram negatives organisms. However, it has limited activity against some