Tissue deposition of silver following topical use of silver sulphadiazine in extensive burns

Wang, Xuewei; Wang, N.Z.; Zhang, O.Z.; Zapata-Sirvent, Ramon L.; Davies, J.W.L.

doi:10.1016/0305-4179(85)90070-1

Cited by 43 publications

(21 citation statements)

References 10 publications

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“…Despite the universal use of silver-containing compounds for burn care, Wang et al note that 'surprisingly, few studies have reported the discolouration and argyria-like appearance in scars, skin and mucus membranes' after the topical application of silver dressings [90]. Most of these reports involve the use of silver nitrate or silver sulfadiazine [17,[90][91][92], however some studies have documented the potential for nanocrystalline silver dressings (Acticoat TM ) to cause skin staining. Using a porcine deep-partial thickness burn model, Wang et al reported that a number of wounds treated with nanocrystalline silver had 'a slate-gray appearance', and that brown-black pigment was documented within the burn scars [90].…”

Section: Adverse Effectsmentioning

confidence: 98%

“…Silver nitrate has been utilized as a topical burn treatment since 1965 and silver sulfadiazine has been a mainstay of burn care since 1968 [13][14][15]. As much as 10% of silver sulfadiazine may be absorbed through partial thickness burns that have good vascularity [2,16] with blood silver levels of >300 mg/L measured [2,[16][17][18]. The absorption of silver is greatest during the inflammation and cell proliferation phases of wound healing [6,19,20].…”

Section: Biochemistry and Physiologymentioning

confidence: 99%

See 1 more Smart Citation

Silver in medicine: The basic science

Marx

Barillo²

2014

Burns

128

102

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Section: Adverse Effectsmentioning

confidence: 98%

Section: Biochemistry and Physiologymentioning

confidence: 99%

Silver in medicine: The basic science

Marx

Barillo²

2014

Burns

128

102

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“…8 With respect to the safety profile, leukopenia has been described to occur when the material is used on, and absorbed through, large burn surfaces. 8 -11 Other side effects that are known to occur are hypersensitivity, allergic reactions, 8,12 discoloration of the wound bed, 8,13 microorganism resistance, 8,12 and pain during application and removal of the material. Infrequently occurring events include skin necrosis, erythema multiforme, burning sensation, rashes, and interstitial nephritis.…”

mentioning

confidence: 98%

An Open, Parallel, Randomized, Comparative, Multicenter Study to Evaluate the Cost-Effectiveness, Performance, Tolerance, and Safety of a Silver-Containing Soft Silicone Foam Dressing (Intervention) vs Silver Sulfadiazine Cream

Silverstein¹,

Heimbach

Meites³

et al. 2011

Journal of Burn Care & Research

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An open, parallel, randomized, comparative, multicenter study was implemented to evaluate the cost-effectiveness, performance, tolerance, and safety of a silver-containing soft silicone foam dressing (Mepilex Ag) vs silver sulfadiazine cream (control) in the treatment of partial-thickness thermal burns. Individuals aged 5 years and older with partial-thickness thermal burns (2.5-20% BSA) were randomized into two groups and treated with the trial products for 21 days or until healed, whichever occurred first. Data were obtained and analyzed on cost (direct and indirect), healing rates, pain, comfort, ease of product use, and adverse events. A total of 101 subjects were recruited. There were no significant differences in burn area profiles within the groups. The cost of dressing-related analgesia was lower in the intervention group (P = .03) as was the cost of background analgesia (P = .07). The mean total cost of treatment was $309 vs $513 in the control (P < .001). The average cost-effectiveness per treatment regime was $381 lower in the intervention product, producing an incremental cost-effectiveness ratio of $1688 in favor of the soft silicone foam dressing. Mean healing rates were 71.7 vs 60.8% at final visit, and the number of dressing changes were 2.2 vs 12.4 in the treatment and control groups, respectively. Subjects reported significantly less pain at application (P = .02) and during wear (P = .048) of the Mepilex Ag dressing in the acute stages of wound healing. Clinicians reported the intervention dressing was significantly easier to use (P = .03) and flexible (P = .04). Both treatments were well tolerated; however, the total incidence of adverse events was higher in the control group. The silver-containing soft silicone foam dressing was as effective in the treatment of patients as the standard care (silver sulfadiazine). In addition, the group of patients treated with the soft silicone foam dressing demonstrated decreased pain and lower costs associated with treatment.

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“…20 Absorption increases with the increase of wound area, depth, and quantity of exudates and becomes significant through wounds involving more than 5% of the total body surface area. For example, patients with extensive burns have experienced silver deposition in tissue after the use of topical silver sulfadiazine, 28 and argyria-like symptoms were reported in a 17-year-old boy with 30% body surface area …”

Section: Controlled Clinical Studies Of Safety And/or Efficacy Of Topmentioning

confidence: 98%

Are Silver Products Safe and Effective for Chronic Wound Management?

Bolton

2006

Journal of Wound, Ostomy and Continence Nursing

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Tissue deposition of silver following topical use of silver sulphadiazine in extensive burns

Cited by 43 publications

References 10 publications

Silver in medicine: The basic science

Silver in medicine: The basic science

An Open, Parallel, Randomized, Comparative, Multicenter Study to Evaluate the Cost-Effectiveness, Performance, Tolerance, and Safety of a Silver-Containing Soft Silicone Foam Dressing (Intervention) vs Silver Sulfadiazine Cream

Are Silver Products Safe and Effective for Chronic Wound Management?

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