Prevention and treatment of burn wound infections: the role of topical antimicrobials

Introduction Skin-related infections are drivers of complications following severe burn, therefore a diverse armamentarium of topical antimicrobial agents have been developed. The last 30 years witnessed dramatic changes in surgical intervention and utilization of topical therapies. Areas Covered We explore well-known topical antimicrobial products used in burn care. First, we investigate how changes in the practice of burn surgery influenced choice of topical therapies used. Then, we examine antimicrobial creams and ointments commonly recognized due to their long use in burn care. Next, we dive into antimicrobial solutions commonly used as adjuncts to surgical intervention. Finally, we explore representative antimicrobial dressings, an ever-advancing roster of products in the next era in burn care. We describe how these new agents relate to already established tools in present-day burn care. Expert Opinion In the current day, though the wisdom of early excision and wound closure remains valid, efforts continue to minimize aggressive wound excision and disfiguring donor tissue collection while securing rapid wound closure. To this end, antimicrobial therapies are titrated to optimize operative outcomes and provide non-operative wound care when appropriate. Antimicrobial agents bridge the gap with the next generation of skin substitute and skin replacement therapies.