Back ground: Burns are one of the major public health problems in the world. Burn injuries have caused a significant increase in mortality rate, infections, pain, pruritus and burning sensation as the most common burn complications. Meanwhile, the use of effective topical antibiotics with less need of multiple dressing with equal or higher effectiveness compare to conventional dressings can reduce drug resistance and treatment costs and provide more convenience for medical staff and patients. The aim of this study was to compare the effectiveness of 1%silver sulfadiazine cream and silver nano spray in terms of time length of hospitalization, wound size, rate of positive wound culture, severity of pain, burning sensation and itching in patients with grade 2 and 3 heat burns below 20%. Methods: This trial clinical controlled(case-control) triple blind study was performed by simple random sampling method for 12 months on 66 patients with grade 2 and 3 heat burn under 20%, admitted in burn ward of Imam Reza Hospital in Birjand. The instruments used were:10-point pain scale score, visual analog scale score, Betsen Jensen checklist and burn wound culture. Burn wounds dressing in a group were treated with 1% silver sulfadiazine cream daily and in another group with nano-silver spray once every 3 days. Wounds were measured for size on arrival and 7th day with Betsen Jensen checklist assessment and were checked for positive wound culture in firs,3th and 6th days. The patients were evaluated for time length of hospitalization and severity of pain, burning and itching sensation every other day. Paired t-test, chi-square and ANONA with repeated measurement and SPSS software ver.18 were used to analyze the data. p < 0.05 considered as significant Results: Our research showed that there was no significant difference in rate of positive wound culture (p = 1), (t = 0), mean wound size (p = 0.1), mean time length of hospitalization (p = 0.22) and mean score of: pain severity (p = 0.69), burning sensation (p = 0.95) and itching (p = 0.56) were detected between 1% silver sulfadiazine cream and nano silver spray (p < 0.05). Conclusion: In this research, our hypothesis of being difference between 1% silver sulfadiazine cream and nano-silver spray in rate of hospitalization length time, wound culture, size of burn wound and the severity of pain, burning sensation and itching rejected and the practical effectiveness of two drugs was equal. due to facility usage of nano-silver spray and also lower cost, it can be a good alternative to silver sulfadiazine cream. Trial registration: This study was the result of research with ethics code IR.BUMS.REC.1399.089
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