A 2021 review described the clinical characteristics of burn wound colonization, infection, and sepsis, and provided best practices to decrease these complications. While burn wounds can be initially colonized by bacteria, typically skin flora, and over time by Gram-negative organisms, fungal organisms can colonize burn wounds as well. Factors associated with fungal colonization include loss of skin barrier, immunosuppression, and the use of topical antibacterial agents; common fungal organisms include Candida, Aspergillus, Fusarium, Mucor, and Rhizopus species, as they are ubiquitous in the environment. Specific to Fusarium species, risk factors include trauma caused by implantation of vegetable or soil matter and contact lens use. Specific to mold infections, management of Aspergillus infections includes aggressive wound debridement and closure with administration of voriconazole. Infections by other types of mold, such as Mucor, Rhizopus, and Fusarium, typically also involve aggressive debridement that may need amputation of the involved lumbs; additionally, voriconazole or liposomal amphotericin can be utilized, though the authors note the overall prognosis is not favorable. Unfortunately, the route of administration of these agents for mold infections was not specified and the use of topical irrigation was not discussed. 
A recent case report (Table 1) described the successful use of topical and systemic liposomal amphotericin, along with surgical debridement, for the treatment of cutaneous Fusarium burn infection. As this is the first report describing the use of liposomal amphotericin B topical irrigation solution, there is scant guidance for its use, although liposomal amphotericin B formulations have been utilized topically for other indications, including ophthalmic Fusarium spp. Infection and Aspergillus fumigatus empyema. The irrigation product was prepared using 5 mg of liposomal amphotericin B in one liter of steroid water, with a beyond-use date of 6 hours given limited stability data; the formulation provided a concentration of 5 mcg/mL amphotericin B, though the optimal concentration is unclear. Voriconazole was noted to be a potential alternative for cutaneous Fusarium infections. One case reported success in infection resolution with 1% voriconazole irrigation solution for Aspergillus growing from a thigh wound; the solution was prepared with 400 mg of lyophilized intravenous preparation of voriconazole with 40 mL of normal saline for irrigation. Another case reported clinical improvement with use of a 5% aqueous solution for Aspergillus growing from a hand wound; 200 mg of the intravenous voriconazole was mixed in 4 mL of sterile normal saline which was then mixed with 15 g of Aquaphor. As neither of these two cases reported burn infections, the clinical utility of topical voriconazole for this indication remains unclear.