One technique for evaluating a burn wound infection is to biopsy and examine tissue from wound microscopically. This can help separate superficial colonization from tissue invasion.
Type of bacterial growth in a burn wound:
(1) colonization (not invading viable tissue)
(2) invasion
Localization of Micro-Organisms Colonizing Wound
Stage
on wound surface
superficial (IA)
within the eschar
penetration (IB)
in the subeschar space
proliferation (IC)
Localization of Micro-Organisms Invading Wound
Stage
in viable tissue just adjacent to the subeschar space
microinvasion (IIA)
widespread or multi-focal invasion deep into viable subcutaneous tissue
generalized (IIB)
invasion of small blood vessels and/or lymphatics
microvascular (IIC)
The higher the stage, the greater the risk of serious infection.
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