Anti-Infection Therapy for Systemic Treatment
with BRT with MEBT/MEBO
There are two pathogenic types of postburn
infections,
one is a natural pathogenesis; the other is a subsequent infection
postburn.
The natural
pathogenesis
is similar, in some aspects but considerably different to the "primary
infection" reported by typical surgical burn treatments. The former
still consists of subclinical infections, which means that the
possibility of postburn infection is a natural reaction of
burns.
The subsequent infection demonstrated the same
syndrome
as reported from surgical burn treatments, and consists of postburn
infection caused by all exogenous sources and factors. The principles
of anti-infection treatment are as follows:
1. The principle of routine treatment
Generally, all burn patients with TBSA > 30 % (TBSA > 10
% in
children) must be treated with systemic anti-infection routinely
whether infection occurs or not.
The principle is: to apply one or more powerful
broad-spectrum antibiotics as early as possible after injury until the
5th to 7th day for massive deep II degree burns and the 7th to 10th day
for massive III degree burns via intramuscular injection or intravenous
drips.
The more extensive the TBSA and depth of wounds,
the
more powerful antibiotics and broader spectrum antimicrobials are
required.
After 7 days for deep II degree or 10 days for
deep III
degree burns, promptly discontinue applying all antibiotics regardless
of what the patients' condition may be.
2. Heteropathy anti-infection treatment
(1)
Principles : In
order to prevent and treat subsequent infections including infections
that occurred after routine treatments, the heteropathy "anti-infection
treatment" should be applied. However, it is initially very important
to eliminate any factors that may cause subsequent infections, which is
a key point to diagnosing infections during the treatment of
burns.
The pathogenic course of burns is further
complicated by
inflammation and infection. Patients with fever and increased heart
rates, etc., should be diagnosed with extreme caution and care in terms
of handling infection and systemic treatments with antibiotics.
After postburn routine treatment, the burned body
needs
to regulate itself so that internal organs can recover and the would
repair can be initiated. Thus, thoughtful and timely measured
applications of antibiotics must be followed along with avoiding any
interference with the body's normal functions.
(2)
Indications : Infection happened when three clinical
manifestations occur simultaneously, i.e.
A. body
temperature >39.5℃or < 36.0℃;
B. heart rate >140/min;
C. appearance of toxic granules in neutrophils leukocytes.
Timely and careful monitoring is required.
(3) Strategy :
One layer dose of one or more powerful broad-spectrum antibiotics
without renal damage should be applied.
It can be used once again, and then stopped if the
toxic
granules in neutrophils disappear. The patients should be re-examined
to eliminate any factors of subsequent infections, and treated with
other antibiotics if the indications of infection are not improved or
even exacerbated.
Inefficacy of using antibiotics is commonly due to
the
presence of systemic infection and the fact that the focus area, which
is the primary center where the infection is localized just under the
wound, may be located too far from the concentration of the
administered antibiotics.
So inefficacy or foci of infection may be noticed
at the
localized "focus" area where antibiotic concentrations are not so
strong or effective. Patients suffering from general asthenia should
take fresh blood infusions to regulate their internal balance.
Abuse
of antibiotics without indications of infection is strictly forbidden!
Bacterial infections interfere with the discharge of necrotic tissues
and maintenance of a moist physiological environment.
In "Burn Regenerative Therapy", an unsuitable
environment for bacterial growth is provided by several components in
MEBO together with the moist physiological environment of the
wound.
In this environment, pathogenic bacterial
aggregation is promoted, invasion is prevented, and toxin production is
inhibited.
This controls bacterial infection without
blocking skin regeneration.
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