Modern
burn care techniques have reduced the risk of
infection of the acute
burn wound, resulting in more rapid healing and a lower incidence of graft loss. Secondary breakdown may still occur. The loss of epithelium in association with multifocal superficial
abscesses and ulceration has been termed
burns impetigo. This may result in considerable morbidity and require prolonged treatment. The events preceding development, the impact on the patient, and the ideal treatment appear unclear and poorly reported. In 5 years, between 2006 and 2011, 406 pediatric
burns were treated with skin grafts, with 7% developing
burns impetigo. Time to resolution ranged from 5 to 241 days: the mean time to complete healing was greatest with
conservative management (96 days), followed by antibacterial dressings (37 days), oral
antibiotics (36 days), topical
steroids (16 days), and oral
antibiotics in combination with topical
steroids (13.5 days).
Burns impetigo resulted in significant morbidity, requiring multiple visits to the treatment center and prolonged symptoms. Delay in diagnosis and treatment resulted in worse outcomes. Prompt consideration of
burns impetigo should occur when postgraft patients present with suggestive clinical signs and treatment with oral
antibiotics plus topical
steroids should be considered.