Healing of burn wounds by topical treatment: A randomized controlled comparison between silver sulfadiazine and nano-crystalline silver

Abstract

Background:Silver sulfadiazine (SSD) has been the standard topical antimicrobial for burn wounds for decades. Recently, nanometer-sized silver particles are available which have high surface to volume ratio and remain effective even at a very low concentration and minimizes the chance for tissue toxicity due to silver. Hence, we conducted a randomized controlled trial to compare the effectiveness of topical SSD and nano-crystalline silver (AgNP) hydrogel in burn wounds management.Materials and Methods:Study was conducted in the Burn Unit of IPGME&R & SSKM Hospital Calcutta, from January 2011 to August 2012. Patients with 2° burn injury were randomly allocated to SSD and AgNP treatment group. Clinical assessments of burn wound were done on every week till 4th week and on completion of treatment.Results:Data for evaluation were obtained for 54 patients on SSD (2° deep-dermal cases 27) and 52 (2° deep-dermal cases 31) on AgNP treatment. Healing status of 2° deep-dermal burns was more satisfactory for AgNP group than SSD treatment at 4 weeks. Among patients receiving AgNP, 80.6% showed at least 50% healing of 2° deep-dermal wounds compared to 48.1% on SSD at 4 weeks (P = 0.001). The figures for complete healing at 4 weeks were, respectively, 4% and 0% (P = 0.116).Conclusions:AgNP can be an effective and superior alternative to SSD for burn wounds, particularly 2° deep-dermal burns. Healing can be expected, in general, in 6 to 8 weeks time, depending upon the extent of body surface involvement.

Evaluation of genipin-crosslinked chitosan hydrogels as a potential carrier for silver sulfadiazine nanocrystals

“…AgSD has dual antibacterial effects. The free silver can react with both sulfhydryl groups of bacterial enzymes and DNA, and sulfadiazine can stop the synthesis of DNA by interrupting the production of folate [7]. However, the antibacterial effect of AgSD is badly limited by its poor aqueous solubility [8].…”

Nanotechnology-Driven Therapeutic Interventions in Wound Healing: Potential Uses and Applications

“…To circumvent this drawback, silver nanoparticles with high surface-to-volume ratio were synthesized which rendered these materials more efficient at low concentrations, thus resulting in reduced toxicity in comparison to traditional silver compounds. 69 It was demonstrated that pure silver nanoparticles were able to treat inflammation through cytokine modulation and induce wound healing with decreased scar formation. 35 Different shapes and sizes of silver nanostructures were also investigated and shown to achieve different degrees of antibacterial activity.…”

Topical Antibiotic Ointment Versus Silver-containing Foam Dressing for Second-degree Burns in Swine

“…[3][4][5] As a result, most studies that use SSD as the control or comparator are biased in favor of the new treatment and almost always demonstrate that the novel therapy is superior to SSD. 13,14 It is our belief that to demonstrate superiority or even noninferiority, any therapy studied should be compared to an optimal comparator or standard of care. Because advanced silver-based dressings or petrolatum-based topical antibiotic ointments are often used but have not been directly compared head to head, we designed the current study to determine which was more effective in a previously validated porcine partial-thickness burn model.…”