Precise diagnosis of infection in burn wound biopsy specimens. Combination of histologic technique, acridine orange staining, and culture.

This study developed a rapid manual histologic technique on burn wound biopsy specimens for an early diagnosis of infection. A total of 86 biopsy specimens were processed using this rapid manual method, acridine orange fluorescent staining for the detection of microorganisms, and a quantitative culture for the identification and counting of bacteria in adjacent homogenized biopsy specimens. Use of these three techniques has shown their complementarity for the evaluation of sepsis in burn wound patients. The histologic study allowed a classification of the depth of bacterial involvement 4 hours after specimen collection, whereas the acridine orange fluorescent staining was useful for quantitative evaluation of infection in the same delay. Thus a rapid therapeutic decision can be made while waiting for the results of quantitative culture and sensitivity tests, which require 24 to 48 hours. We propose routine monitoring of burned patients consisting of these three tests performed simultaneously on each biopsy specimen.