Pearls & Oy-sters: Bismuth neurotoxicity from use of topical bismuth dressing for burns

Bismuth-containing ointment has been used for the dressing of wounds since World War I.¹ A popular option for burns and skin grafts, bismuth iodoform paraffin paste (BIPP) is a sterile gauze impregnated with 2 active ingredients: bismuth subnitrate and iodoform.² Because it does not get infected with chronic use in deep wounds, it is often left in situ for weeks.² BIPP is also used in maxillofacial and neurologic surgeries, where case reports have noted a rare adverse effect of toxic encephalopathy.³ However, the literature on toxic encephalopathy caused by BIPP used for burn wounds is sparse.

from Neurology recent issues https://ift.tt/2FPtCw7