Staphylococci species and has minimal antifungal coverage. Unlike, Silvadene,
mafenide acetate has excellent eschar coverage. However, because it is a
potent carbonic anhydrase inhibitor, it can cause hyperchloremic metabolic
acidosis with continuous use. This systemic toxicity as well as the pain it elicits
on application has limited its use. Mafenide can penetrate cartilage.
Deeper partial thickness burns are unlikely to heal in less than 3 weeks
without becoming hypertrophic and pruritic. Patients with deep partial or full
thickness burns benefit from early excision and grafting usually defined as 1- 7
days after injury. Early excision decreases the risk of local infection and
subsequent systemic inflammation as well as decreasing the resting energy
expenditure. Following a thermal insult, the affected skin becomes colonized
with Gram positive organisms gradually followed by gram negative organisms.
However, the mere presence of these organisms does not define an invasive
burn wound infection. A quantitative culture yielding > 10^5 bacteria per gram of
affected tissue and the histological verification of bacterial invasion into viable
tissue constitute a localized burn wound infection. The decision to perform a
split versus full thickness skin graft is mostly influenced by the size, depth and
location of the burn. Split thickness skin grafts (STSG) function well in patients
with moderate to large affected areas. The donor sites reepithelialize in ten to
fourteen days allowing it to be used for additional grafting, if needed. However,
STSG tend to contract significantly more than full-thickness skin grafts (FTSG)