Antibiotic Resistance –
How can we manage infection in burn wounds?

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Mortality in burns has declined over the past few decades, this is largely due to improved treatments, such as; early excision and grafting of the burn wounds, continuous feeding to treat significant nutritional deficiencies and advancements in critical care. However, despite improvements in treatment, infection remains the leading cause of morbidity and mortality in burn patients. Loss of the protective skin barrier as the first line of defence and defects appearing in the patients’ immune system make the burn injured patient an ideal medium for bacterial growth.

The emergence of highly drug-resistant bacteria in burn patients represents an alarming development with invasive bloodstream infections of particular concern (Kumarsammy et al 2010). Antimicrobial resistance among a wide variety of human bacterial and fungal fungal burn wound pathogens, particularly nosocomial isolates, limits the available therapeutic options for effective treatment of the burn wound infection.

Resistance is not new, the World Health Organisation (WHO) has stated that antimicrobial resistance (AMR) has become a global crisis (WHO 2015). The role of Antimicrobial Stewardship (AMS) is now more important than ever, but largely up to now this has been aimed at antibiotics rather than the wider antimicrobial dressings available. There is now evidence that pathogens are developing resistance to traditionally used antimicrobials.

This presentation will look at the effect of AMR on burn wound management and discuss options available to manage burn wound infections

References:

Kumarsammy, K.K., Toleman, M.M., Walsh, T.R., Bagaria, J., Buttm f. et al (2010) Emergence of new antibiotic resistance mechanism in India, Pakistan and the UK.: a molecular, biological and epidemiological study. Lancet, Infectious Diseases. 10: 597-601

WHO (2015) Global action plan on antimicrobial resistance. World Health Organisation, Switzerland.

Get to know Jacky Edwards

• Currently work as a Consultant Nurse (Burns) at Wythenshawe Hospital, (MFT) since 2010, She is the only Consultant Nurse in Burns in the UK.
•  Have worked in burns since 1988 and committed to improving the patient pathway, quality improvement and service development as well as education of the workforce
•  Member of the Major Trauma and Burns Clinical Reference Group (CRG) where she represent nurses and the RCN. During this time, she has chaired the development of the Burns Annex for Mass Casualties, developed outcomes and quality dashboards and am currently developing education for burns major incidents and the Rehabilitation Prescription.
• CRG representative on the National Burns Operational Network Delivery Group (NBDONG) and contribute to wider issues in burn care.
• Until recently she was the lead for the Surgical Wound Workstream for the National Wound Care Strategy Programme (NWCSP) and published the Surgical Wound Care recommendations
• Programme Lead for the Manchester Burns Course is currently being revalidated by the University of Manchester. She has previously been a lecturer at University of Manchester and been honorary lecturer at Manchester Metropolitan University, Edge Hill University and University of Chester
•  In 2012 she was Nursing Times Nurse of the Year for the development of the Burns Outreach Service which is now replicated across many burn services  
• She is  passionate about wound care and ensuring we are using effective treatments for both acute and chronic burn wounds.