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Topical Mafenide Hydrochloride Aqueous Spray in Initial Management of Massive Contaminated Wounds with Devitalized Tissue

Published online by Cambridge University Press:  28 June 2012

Janice A. Mendelson
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Abstract

Since at least WWII, some open, contaminated wounds involving massive soft tissue injury and vascular damage have resulted in “irreversible shock,” despite prompt rescue, hemorrhage control, and blood and fluid replacement, without signs of clinical infection.

In animal studies, survival time was related statistically to the dosage of Clostridium perfringens in multicontaminated explosive wounds. Survival time was lengthened by the application of some topical antibacterial agents, but actual recovery was achieved only with topical mafenide hydrochloride solution aqueous spray, which resulted in negative clostridium. perfringens cultures. Although not related statistically to survival time, the mafenide hydrochloride spray also controlled the Pseudomonas aeruginosa in these wounds.

Mafenide hydrochloride had the American trade name of Sulfamylon from about 1942 until 1998, when another pharmaceutical company patented Sulfamylon as the trade name for mafenide acetate, a weaker antibacterial agent. However, mafenide hydrochloride still is available from chemical companies.

Mafenide hydrochloride solution spray has been used successfully in treatment of patients with severe by contaminated wounds and deep burns, and its use in initial care should be revisited.

Keywords

clostridium perfrimgensdeep burnsdevitalized tissueirreversible shockmafenide hydrochlorideMarfanilpseudomonas aeruginosaSulfamylonwound managementwoundscontaminated
Type
Comprehensive Review
Information
Prehospital and Disaster Medicine , Volume 16 , Issue 3 , September 2001 , pp. 172 - 174
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2001

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References

1. Ochner, EWA Jr, Jacob, SW, Mansberger, AR Jr: A new preparation for the study of experimental shock from massive wounds. Surgery 1958;43:703–707.Google Scholar
2. Ziperman, HH: The management of large bowel injuries in the Korean campaign. U.S. Armed Forces Med. J 1956;7:85–91.Google ScholarPubMed
3. Lindsey, D, Wise, HM Jr, Knecht, AT et al. : The role of Clostridia in mortality following an experimental wound in the goat. Surgery 1959;45(4):602–611.Google Scholar
4. Mendelson, JA: Topical therapy as an expedient treatment of massive open wounds: Experimental study. Surgery 1960;48:1035–1047.Google ScholarPubMed
5. Mendelson, JA, Lindsey, D: Sulfamylon (mafenide) and penicillin as expedient treatment of experimental massive open wounds with C. perfringens infection. J Trauma 1962;2:239–261.CrossRefGoogle ScholarPubMed
6. Sherman, RT: Treatment of vesicant and thermal burns. Annual Summary Report (Final) 31 March 1965–31 May 1966, Univ of Tennessee. AD-48451 National Technical Information Service, Springfield, VA.Google Scholar
7. Meleny, FL: A statistical analysis of a study of the prevention of infection in soft part wounds, compound fractures, and burns with special reference to the sulfonamides. Surg Gyn Obstet 1945;80:263–296.Google Scholar
8. Lyons, C: An investigation of the role of chemotherapy in wound management in the Mediterranean theater. Ann Surg 1946;123:902–924.CrossRefGoogle ScholarPubMed
9. Northey, EH: The Sulfonamides and Allied Compounds. New York, NY: Reinhold; 1948: pp 252-253, 557–558.Google Scholar
10. Siebenmann, CO, Plummer, H: Chemotherapy and antitoxin therapy of experimental C. welchii infection in mice. J Pharmacol Exper Therap 1945;83:71–84.Google Scholar
11. Mendelson, JA: The management of burns under conditions of limited resources using topical aqueous Sulfamylon (mafenide) hydrochloride spray. J Burn Care Rehabil 1997;18:238–244.CrossRefGoogle ScholarPubMed
12. Lindberg, RB, Moncrief, JA, Brame, RE et al. : A comparison of Sulfamylon hydrochloride and Sulfamylon acetate in control of experimental burn wound infections. Sec. 40. Annual Research Report. US Army Surgical Research Unit, 1966.Google Scholar
13. Mendelson, JA, Pratt, JH, Amato, JJ et al. : Mafenide hydrochloride and mafenide acetate in spray and ointment forms as topical therapy of C. perfringens contaminated massive wounds: Experimental study. J Trauma 1970;10:1132–1149.CrossRefGoogle ScholarPubMed
14. Hartles, RL, Williams, RT: The metabolism of sulphonamides, 4. The relation of the metabolic fate of ambamide (Marfanil) and V335 to their lack of systemic antibacterial activity. Biochem J 1947;41:206–212.CrossRefGoogle Scholar
15. Mendelson, JA: The Management of Burns under Conditions of Limited Resources (videotape). Maverick Video Productions, San Antonio, TX: 1970.Google Scholar
16. Physicians' Desk Reference, 55th ed. Montvale, NJ: Medical Economics, 2001, 947–948.Google Scholar
17. Jones, JM (ed): Physicians' Desk Reference to Pharmaceutical Specialties and Biologicals. Rutherford NJ: Medical Economics, 1950, p 525.Google Scholar