Infection in the burn wound continues to be a major unsolved problem, although improved know-ledge of fluid and electrolyte balance, protein metabolism and the control of sepsis in burn have been obtained during the past few decades. The prolonged survival time of the patient with major burns, emergent antibiotic-resistant bacteria and sensitization of an appreciable segment of patients to the bactericidal drugs, the destruction of the remarkably protective epithelial barrier, and the associated impairment of the natural antibacterial defence systems are the major factor to promote the overwhelming infection in burns.
During the past 3 year and 3 month period from April, 1966 to June, 1969, 177 cases of burn were treated at Surgical Department of Pusan National University Hospital and Pusan Children Charity Hospital and summarized as follow:
1) Males were affected more often than females, the incidence being 111 and 66 cases respectively.
2) Among 177 cases of burned patients, 73 patients were under 20% of burn and 31 patients over 51%. The majority cases were second and third degree burns combined.
3) Location of the involved part: head, face and neck 97 cases, upper extremity 83 cases, upper trunk 60 cases, lower trunk 69 cases, lower extremity 109 cases. The lower extremity was most frequently involved.
4) The organisms in the fresh burn wound of 54 cases revealed staphylococcus aureus 55%, staphylococcus 16%, E. coli 19%, and pseudomonas species 10%. The staphylococcus was the most dominant among contaminants in these fresh burn wounds.
5) Among the bacteria cultured from the burn wounds during first, second and third postburn week, staphylococcus aureus was 62% in the first week, but it decreased progressively in incidence. E. coli was 43 % in the first week and increased thereafter. Pseudomonas species continued to increase.
6) The staphylococcus aureus affected more than E. coli or pseudomonas in the wound of upper half of the body surface, but it approximated to the indicence of E. coli in the lower half.
7) In 12 cases of blood culture, 2 cases revealed staphylococcus aureus and the remainder were negative.
8) With the result of the antibiotic-sensitivity test erythromycin and chloramphenicol were most sensitive in the first and third postburn week. In the second postburn week erythromycin kanamycin and necomycin were most effective.
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