Wound Care

Acute burn surgery covers the operative care of the burn wound from injury to closure — excision of nonviable tissue, decompression of compartments, and replacement of the missing skin envelope with autograft, allograft, dermal templates, or cell-based constructs. Early excision…

Enzymatic debridement uses topical proteolytic enzymes — bromelain (NexoBrid), collagenase (Santyl), anacaulase-bcdb — to selectively dissolve burn eschar while preserving viable dermis. The DETECT phase 3 RCT and Italian National Burn Database show faster eschar removal, less…

Biological and bioengineered skin substitutes — allograft, xenograft, amniotic membrane, acellular dermal matrices, biosynthetic composites, and cultured cellular products — answer the donor-site bottleneck. Selection runs by burn depth, TBSA, donor reserve, and whether the…

Mafenide acetate, cerium nitrate-silver sulfadiazine, povidone-iodine, and chlorhexidine are the main non-silver topical antimicrobials in burn care. Mafenide penetrates eschar for cartilage and infected deep burns; cerium nitrate-silver sulfadiazine stabilizes large eschars and…

Silver sulfadiazine, silver nitrate, and nanocrystalline silver dressings (Acticoat, Aquacel Ag, Mepilex Ag) are the dominant topical antimicrobials in burn wound care. The modern question is not whether to use silver, but which delivery system on which wound. Nanocrystalline…