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Topical Mafenide Hydrochloride Aqueous Spray in Initial Management of Massive Contaminated Wounds with Devitalized Tissue

Published online by Cambridge University Press:  28 June 2012

Janice A. Mendelson
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Abstract

Since at least WWII, some open, contaminated wounds involving massive soft tissue injury and vascular damage have resulted in “irreversible shock,” despite prompt rescue, hemorrhage control, and blood and fluid replacement, without signs of clinical infection.

In animal studies, survival time was related statistically to the dosage of Clostridium perfringens in multicontaminated explosive wounds. Survival time was lengthened by the application of some topical antibacterial agents, but actual recovery was achieved only with topical mafenide hydrochloride solution aqueous spray, which resulted in negative clostridium. perfringens cultures. Although not related statistically to survival time, the mafenide hydrochloride spray also controlled the Pseudomonas aeruginosa in these wounds.

Mafenide hydrochloride had the American trade name of Sulfamylon from about 1942 until 1998, when another pharmaceutical company patented Sulfamylon as the trade name for mafenide acetate, a weaker antibacterial agent. However, mafenide hydrochloride still is available from chemical companies.

Mafenide hydrochloride solution spray has been used successfully in treatment of patients with severe by contaminated wounds and deep burns, and its use in initial care should be revisited.

Keywords

clostridium perfrimgensdeep burnsdevitalized tissueirreversible shockmafenide hydrochlorideMarfanilpseudomonas aeruginosaSulfamylonwound managementwoundscontaminated
Type
Comprehensive Review
Information
Prehospital and Disaster Medicine , Volume 16 , Issue 3 , September 2001 , pp. 172 - 174
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2001

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