Development of topical chemotherapy in the management of burns

Abstract

Several chemotherapeutic agents have recently been introduced as sudden and revolutionary discoveries. Review of the literature reveals that Ehrlich first developed the concept of chemotherapy in 1904. Several chemotherapeutic agents were synthesized by the German dye industry in the early 1920's. Investigations in the bacteriostatic activity of these agents culminated in a Nobel Prize for Domagk in 1938. These chemotherapeutic agents were used topically by the German Army during World War II. During the latter part of the war, clinical investigations with topical chemotherapeutic agents in the management of burn wound sepsis were being performed in England. However, newly developed potent antibiotics soon pushed the topical chemotherapeutic agents into the background. Almost twenty years passed before interest in topical chemotherapeutic agents was renewed. The potent parenterally administered antibiotics were only partially effective in the large devascularized wounds. Topical nontoxic stable formulations of the old chemotherapeutic agents were tested in vitro and in vivo and were found to be effective in suppressing invasive sepsis in the burn wound.