Abstracts 71

Hershey S. D. and Curse1 E. (1982) Hyperosmola- Deitch E. A., Gelder F. and McDonald J. C. (1982) lity caused by percutaneously absorbed glycerin in a Prognostic significance of abnormal neutrophil burned patient. J. Truuma 22,250. chemotaxis after thermal injury. J. Trauma 22, 199.

Low dose prophvlactic penicillin Routine administration of low doses of penicillin for prophylaxis does not protect burned patients against cellulitis and bum wound sepsis nor promote selection of antibiotic-resistant bacteria. In a study of 51 patients with bums covering between 1 and 9 1 per cent of the body surface area, 25 of whom received a S-day course of penicillin prophylactically, the antibiotic treated group showed cellulitis in 11 patients and 2 had burn wound sepsis, whereas in the patients receiv- ing placebo there were 7 cases of cellulitis and 3 cases of burn wound sepsis. No patient in either group developed gentamicin-resistant gram-negative organ- isms, although the gastrointestinal tract of 2 patients in the penicillin group showed new colonization by yeasts.

Durtschi M. B., Orgin G., Counts G. W. et al. (1982) A prospective study of prophylactic penicillin in acutely burned hospitalized patients. J. Truama 22, I I.

Reducing mortality rates From 1739 children admitted with bums 1 I5 reached autopsy. The overall mortality rate decreased from 14 per cent in 1966 to 2.8 per cent in 1980. In all, 74.8 per cent of the deaths were associated with sepsis, and pulmonary lesions were the most frequent fatal com- plication (75.6 per cent). The bum wound was the major source of sepsis (62.7 per cent). The fatalities decreased from an average annual mortalitv rate of 11.5 per cent in 1966-1975 to an average of 2.8 per cent in the oeriod 1976-1980 after adootion of a new standard flujd resuscitation procedure, tangential exci- sion and intensive treatment of bum wound sepsis. After introducing routine antacid treatment and a milk diet the percentage of stomach ulcers found at autopsy decreased from 2.0 per cent to 0.8 per cent, and duode- nal ulcers from 3.5 per cent to 0.5 per cent.

Linares H. A. (1982) A report of 115 consecutive autopsies in burned children 1966-1980. Burns 8, 263.

Neutrophil chemotaxis Neutrophil chemotaxis was studied in samples taken from 23 patients with burns covering about one-third of the body surface and from 23 normal individuals. The measurements were made under agarose to allow both the chemotactic generating ability of the patients’ serum and the chemotactic capability of the neutro- phils to be determined. Compared with the control findings, 83 per cent of the patients had significantly decreased chemotaxis towards the end of the first week after burning. This defect appeared to be unrelated to the presence of a chemotactic factor inactivator and there was no statistically significant correlation between the development ofabnormal chemotaxis and sepsis or mortality.

ANIMAL STUDIES Muscle glucose uptake and amino acid release Glucose uptake and amino acid release by soleus muscle from burned and unburned regions of the body were compared in the presence or absence of ketone bodies. In the absence of ketones, burned limb muscles took up on average more glucose and released more alanine, more glutamate and more glutamine than control. The unburned limb muscles of burned ani- mals usually did not differ from controls. Acetoacetate depressed glucose uptake in all groups of muscles by a comparable absolute amount, and alanine release was slightly depressed in all muscle groups. B- hydroxybutyrate produced depressions in glucose uptake and alanine release. Neither ketone had any appreciable effect on glutamate or glutamine release by any muscle group.

Turinsky J. and Shangraw R. E. (198 1) Augmented glucose uptake and amino acid release by muscle underlying the burn wound and their moderation by ketone bodies. Exp. Mol. Pathol. 35, 338.

Pathogenic Proteus mirabilis Rats with a non-fatal scald covering 30 per cent of the body surface are highly susceptible to lethal surface infection with Proteus mirubilis. Dose-response studies showed that the lethal inoculation dose (50 per cent) was less than I O3 organisms per cm2. Bacteriolo- gical examination of moribund animals showed them to be bacteraemic and to have wound biopsy counts exceeding lOh organisms per gramme of tissue. Bac- terial motility is a virulence factor in this surface infection since substrains selected for loss of subsurface spreading in soft agar lost virulence.

McManus A. T., McLeod C. G. and Mason A. D. (1982) Experimental Proteus mirabilis burn surface infection. Arch. Surg. 117, 187.

LABORATORY STUDIES Failure of silver adsorption Electron microscopic examination of biopsies taken from burned tissue and the surrounding healing tissue has been used to assess the adsorption and distribution of silver derived from topically applied silver sulpha- diazine. In only one of the eight patients studied were silver deposits found in the cytoplasm of both the epi- dermal cells and the sweat glands following treatment for 2 I days.

Akahane T. and Tsukada S. (1982) Electron- microscopic observation on silver deposition in burn wounds treated with silver sulphadiazine cream. Burn> 8, 271.