PURPOSE: Patients suffering from burns are at increased risk of infection, particularly those of the burn wound and urinary tract. These patients are often obligated to stool in the bed, increasing the likelihood that their wounds and urinary catheters will become contaminated with pathogens from the fecal stream. There is little published research on techniques of gastrointestinal (GI) waste management. The purpose of this study was to examine the clinical utility and economic impact of introducing a bowel management system (BMS). METHODS: The study was conducted as a Before/After trial in our burn unit. Patients receiving the BMS (n=38) were matched with Control patients (n=38) on gender, age („b 5 Years), total body surface area (TBSA) burned, length of hospital stay, length of mechanical ventilation, and the burn location. Urinary tract infections (UTIs) and skin/soft tissue infections (SSTIs) were diagnosed using the National Nosocomial Infection Surveillance (NNIS). Unscheduled dressing changes, and the resources consumed therein, were based on staff interviews and a review of charts. Costs associated with infections were estimated using published literature. RESULTS: Significantly fewer patients developed both UTI and SSTI. Respectively, 15.8% (6/38) versus 47.4% (18/38) of patients developed UTI in the BMS and control groups (p<0.05) while SSTI was detected in 13.1% (5/38) of BMS patients and 26.3% (10/38) of the control group patients (p<0.05). Assuming each patient had one unscheduled dressing change per day for half of their stay, the average costs were $1390.00 and $5497.00 in the BMS and control groups respectively. For the BMS to lose this dominance, the infection rates would have to be equal, and the cost of an unscheduled dressing change less than $6.10. CONCLUSIONS: A proactive bowel management program using the BMS was effective in preventing both UTIs and SSTIs and cost substantially less than the standard reactive practice.