Large Surface Area Burns

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See full Zimbabwe STG for complete management of large surface area burns. 

Give anti-tetanus booster: 

Medicine	Adult Dose	Frequency
tetanus toxoid im	0.5ml	one dose only

Antibiotics are required only when/if wound is contaminated. Gram positive organisms (notably B-haemolytic streptococcus) predominate early on (first 5 days): 

	Medicine	Dose	Frequency	Duration
	benzylpenicillin iv	2.5MU	every 6 hours	change to oral*
then	*amoxicillin po	500mg	6 hourly	review

Change regimen if indicated by culture and sensitivity tests. Gram negative organisms are usually implicated later on, and a more appropriate blind therapy before results are obtained is: 

	Medicine	Dose	Frequency	Duration
	benzylpenicillin iv	2.5MU	6 hourly	review
and	gentamicin iv	80mg	8 hourly	review based on culture and sensitivity