Certainly a degree of prophylactic antibacterial activity can be demonstrated for the chlorhexidine medicated material and also for Inadine, a non-adherent dressings coated with polyethylene glycol containing povidone iodine, though this latter material is slightly less efficient. There is also a case for using medicated dress- ings in the management of burns on patients who delayed seeking attention beyond the day of injury since a large number of these wounds are found to be heavily colonised at the time they first present for treatment. The lifestyle of the patient is an additional factor that can influence whether medication may be appropriate. Various creams can also be used to treat burns, often in combination with traditional dressings. In mobile patients however these have the disadvantage that as they are excel- lent lubricants, satisfactory securement of the dressing may be difficult to achieve especially in young children.
Creams are also expensive.
It makes little sense to vigorously rip off an ad- herent dressing since this may also remove much of the new epithelium. In addition, such a procedure may be very painful. There is also an attendant risk of leaving some of the dressings in situ. Occluded foreign bodies such as fi- bres or particles can lead to an inflammatory response and also exacerbate scarring. If more medication is thought desirable then a further sheet of tulle can be laid over the original.