Nishant Merchant1,2,3, Karen Smith1,2,3, Marc G Jeschke1,2,3. 1. 1 Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre , Toronto, Ontario, Canada . 2. 2 Department of Surgery, Division of Plastic Surgery, Department of Immunology, University of Toronto , Ontario, Canada . 3. 3 TECC Program Sunnybrook Health Sciences Centre, University of Toronto , Toronto, Ontario, Canada .
Abstract
BACKGROUND: Modern day burn care continues to wage an uphill battle against an enemy that evolves faster than we can develop weapons. Bacteria (bioburden) are everywhere and can infiltrate anywhere within our susceptible population of burn patients. This is why prevention of infection is key to improving their survival and outcome. PURPOSE: To reduce the incidence of infection in the burn patient population. MATERIALS: Review of pertinent recent literature regarding infection prevention and control in the intensive care unit setting. RESULTS: We propose that bioburden is one of the central elements in the infectious cycle that is ever-present in burn units. The mechanism of bacterial entry into the unit and subsequent transmission and infection are delineated. Recommendations for mitigating this risk are provided to guide future clinicians in their care of burn patients. CONCLUSIONS: The treatment of infection and sepsis against highly adaptable bacteria is often insurmountable by ill patients. In this process, bioburden needs to be corralled to have any success. Thus, preventing organisms from entering the unit and transferring onto other patients, and eliminating the bacteria dwelling in the unit are all necessary actions in this battle. Ultimately, maintaining a culture that is constantly wary of this risk only can achieve this goal.
BACKGROUND: Modern day burn care continues to wage an uphill battle against an enemy that evolves faster than we can develop weapons. Bacteria (bioburden) are everywhere and can infiltrate anywhere within our susceptible population of burn patients. This is why prevention of infection is key to improving their survival and outcome. PURPOSE: To reduce the incidence of infection in the burn patient population. MATERIALS: Review of pertinent recent literature regarding infection prevention and control in the intensive care unit setting. RESULTS: We propose that bioburden is one of the central elements in the infectious cycle that is ever-present in burn units. The mechanism of bacterial entry into the unit and subsequent transmission and infection are delineated. Recommendations for mitigating this risk are provided to guide future clinicians in their care of burn patients. CONCLUSIONS: The treatment of infection and sepsis against highly adaptable bacteria is often insurmountable by ill patients. In this process, bioburden needs to be corralled to have any success. Thus, preventing organisms from entering the unit and transferring onto other patients, and eliminating the bacteria dwelling in the unit are all necessary actions in this battle. Ultimately, maintaining a culture that is constantly wary of this risk only can achieve this goal.
Authors: Bijie Hu; Lili Tao; Victor D Rosenthal; Kun Liu; Yang Yun; Yao Suo; Xiandong Gao; Ruisheng Li; Danxia Su; Hungmei Wang; Chunxia Hao; Wei Pan; Catherine L Saunders Journal: Am J Infect Control Date: 2012-10-05 Impact factor: 2.918
Authors: Elaine R Cohen; Joe Feinglass; Jeffrey H Barsuk; Cynthia Barnard; Anna O'Donnell; William C McGaghie; Diane B Wayne Journal: Simul Healthc Date: 2010-04 Impact factor: 1.929
Authors: Joan M Weber; Robert L Sheridan; Shawn Fagan; Colleen M Ryan; Mark S Pasternack; Ronald G Tompkins Journal: J Burn Care Res Date: 2012 Jul-Aug Impact factor: 1.845
Authors: Laura J Moore; Stephen L Jones; Laura A Kreiner; Bruce McKinley; Joseph F Sucher; S Rob Todd; Krista L Turner; Alicia Valdivia; Frederick A Moore Journal: J Trauma Date: 2009-06
Authors: L E Pirii; A W Friedrich; J W A Rossen; W Vogels; G I J M Beerthuizen; M K Nieuwenhuis; A M D Kooistra-Smid; E Bathoorn Journal: Eur J Clin Microbiol Infect Dis Date: 2017-10-23 Impact factor: 3.267