Invasive infection, usually arising from the burn wound itself, remains the primary danger to the seriously burned man (Table). The offending organism is most often Pseudomonas aeruginosa, although the frequency of and mortality from such sepsis has recently been reduced by effective surface antibacterial agents.1,2
The onset of Pseudomonas burn sepsis is often insidious, perhaps even more so when the patient is treated with 0.5% aqueous silver nitrate. The organism is notoriously resistant to tolerable anti-bacterial agents, whether administered locally or systemically. Delayed diagnosis and the low therapeutic index of presently available antibiotics are very likely responsible for the high mortality associated with Pseudomonas burn wound sepsis. However, dilute solutions of silver nitrate, when optimally applied, uniformly control the bacteria at the site of invasion, the burn wound itself. Furthermore, every strain isolated from our patients has remained sensitive in vitro to 0.5% aqueous silver nitrate. The delay in