After analyzing 24 RCTs, the authors concluded that dressings with and without silver showed better outcomes than SSD with respect to time to wound healing. 7 The outcomes that were assessed included time to wound healing and rate of infection. examined the efficacy of SSD versus silver-containing and non-silver-containing dressings. In a 2018 systematic review and meta-analysis, Nímia et al. The authors concluded that the comparator treatments were statistically superior to SSD with respect to the mean time for complete wound healing. 6 The authors analyzed 11 randomized controlled trials (RCTs) and identified wound-healing time as the primary outcome. evaluated the efficacy of SSD versus numerous other treatments when used for wound healing in burn patients. The comparative interventions included aloe vera, bacitracin, collagenase, honey, petrolatum, as well as various other preparations/dressings.Ī 2019 systematic review and meta-analysis by Maciel et al. Although our search yielded a total of 24 articles, this review focuses on the 5 meta-analyses and systematic reviews wherein the emphasis was on the comparison of SSD with other interventions in the management of burns. In order to obtain the highest level of evidence, our search was limited to meta-analyses and systematic reviews. To assess whether clinical evidence supports the use of SSD in the management of burns, we performed a search of PubMed using the terms “silver sulfadiazine” and “burns”. The average wholesale price for a 50 g jar of SSD cream is approximately $15.00 and the wholesale acquisition cost is approximately $12.00. 3 Although SSD is available as a prescription medication marketed under the brand names Silvadene and Thermazene, it is available generically, as well. The product is contraindicated in patients with severe hypersensitivity reactions following application, pregnant women at or close to term, premature infants, and in infants during the first 2 months of life. 3 Silver sulfadiazine is considered to be safe, however, dermatologic, gastrointestinal, hematologic, hepatic, neurologic, and renal effects have been reported with its use. It is bactericidal for many gram-negative and gram-positive bacteria and also has activity against yeast. Silver sulfadiazine, which combines silver ions with a sulfonamide moiety, has broad antimicrobial activity. The aim of this article is to provide the reader with an assessment of SSD’s utility for managing burns. 4 Despite SSD’s popularity, compelling evidence to support its use in the management of burns is lacking. 3 Anecdotally, though, SSD may have become the agent of choice for all types of burns, including minor burns. 1 One antimicrobial agent commonly used in the management of burns is silver sulfadiazine (SSD). Formulated as a 1% topical cream, SSD is FDA-approved as an adjunct for the prevention and treatment of wound sepsis in patients with second- and third-degree burns. 2 Depending on the burn severity, appropriate management may involve initial resuscitation and stabilization, pain management, and wound care, which often involves the use of antimicrobial agents. 1 Overall, the goals of treatment are to control pain, remove dead tissue, prevent infection, reduce scarring, and regain function. According to the American Burn Association, about 450,000 serious burn injuries occur in the United States every year that require medical attention.
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