Bacterial infection of wounds is responsible for most mortality and for much of the morbidity of extensive thermal injuries. Although only the indigenous biota of the skin are initially recoverable from most major burn wounds, dense colonization of the wounds by pathogenic gram-negative bacteria and by Staphylococcus aureus will occur within as little as 16 hours unless effective wound bacteriostasis is begun promptly. Proliferation of bacteria can occur so rapidly that after 24 hours each gram of eschar contains 100 million bacteria. Nearly three years ago, at the Hartford Burn Unit in St. Louis, Moyer and his associates introduced the use of thick gauze dressings kept wet with 0.5% solution of silver nitrate. This dressing was designed primarily to provide continuous bacteriostasis on major burn wounds; it has proved reliable and effective and is now used in many clinics.
In the September issue of the Archives of Surgery1 the