Friday, June 21, 2013

The use of SSD in burns

1. Cochrane review shows that is a paucity of high-quality evidence regarding the effect of different dressings on the healing of superficial and partial thickness burn injuries.

2. Although it is difficult to draw firm and confident conclusions about the effectiveness of specific dressings, the use of silver sulphadiazine (SSD) in dressings was consistently shown to be associated with poorer healing outcomes compared to other types of dressings such as the biosynthetic, silicon-coated and silver dressings.

3. On the other hand, hydrogel-treated burns had been shown to have better healing outcomes than those treated with usual care.

4. In fact, a systemic review done by a group of researchers from the pharmacy department of UM shows that the use of SSD is associated with significantly worse healing time compared to those without SSD.

5. Silver-containing solutions and compounds have enjoyed over a century of use as topical wound treatments because of the antimicrobial properties of silver.

6. Silver is injurious to bacteria in several ways including damaging the bacterial cell wall and membrane permeability, blocking enzyme and transport systems, and preventing transcription and cell division.

7. However, these agents, while they are bacteriostatic and/or bactericidal, they are often also injurious or cytotoxic to the host cells in the wound healing process; e.g. adversely affecting keratinocytes and fibroblasts functions.


Wasiak J, Cleland H, Campbell F, Spinks A. Dressings for superficial and partial thickness burns. Cochrane Database of Systematic Reviews 2013, Issue 3. Art. No.: CD002106. DOI: 10.1002/14651858.CD002106.pub4

Aziz, Z; Abu, SF; Chong, NJ (2012 May). A systematic review of silver-containing dressings and topical silver agents (used with dressings) for burn wounds. Burns 38 (3): 307–18.

Atiyeh BS, Costagliola M, Hayek SN, Dibo SA: Effect of silver on burn wound infection control and healing: Review of the literature.  Burns  2007; 33:139

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