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American Family Physician Jan 2012Most burn injuries can be managed on an outpatient basis by primary care physicians. Prevention efforts can significantly lower the incidence of burns, especially in... (Review)
Review
Most burn injuries can be managed on an outpatient basis by primary care physicians. Prevention efforts can significantly lower the incidence of burns, especially in children. Burns should be managed in the same manner as any other trauma, including a primary and secondary survey. Superficial burns can be treated with topical application of lotions, honey, aloe vera, or antibiotic ointment. Partial-thickness burns should be treated with a topical antimicrobial agent or an absorptive occlusive dressing to help reduce pain, promote healing, and prevent wound desiccation. Topical silver sulfadiazine is the standard treatment; however, newer occlusive dressings can provide faster healing and are often more cost-effective. Physicians must reevaluate patients frequently after a burn injury and be aware of the indications for referral to a burn specialist.
Topics: Administration, Topical; Ambulatory Care; Anti-Bacterial Agents; Burns; Humans; Incidence; Occlusive Dressings; Outpatients; Silver Sulfadiazine; Treatment Outcome; United States
PubMed: 22230304
DOI: No ID Found -
Advances in Clinical and Experimental... 2013The most prevalent topical treatment for partial thickness burns is silver sulfadiazine 1% (SSD). Recent studies have shown that the healing of partial thickness burns... (Comparative Study)
Comparative Study
BACKGROUND
The most prevalent topical treatment for partial thickness burns is silver sulfadiazine 1% (SSD). Recent studies have shown that the healing of partial thickness burns is delayed with the use of SSD. One of the potential burn dressings is sucralfate.
OBJECTIVES
With this study the authors have aimed to analyze comparatively the effects of sucralfate and SSD on second degree burn wounds in rats.
MATERIAL AND METHODS
Forty-eight male rats were divided into three equal groups. A burn model was constituted on the back of all rats. The burned areas in the first, second and third groups were covered daily with sucralfate, SSD and cold cream (control), respectively. At the end of the 7th, 14th, 21st and 28th day, the rats were anesthetized and the burned skin tissue samples were collected for histopathological examination.
RESULTS
At the end of the study, the epidermis and horny layer was completely formed in the SSD and sucralfate group; however the appendix of skin was just formed in the sucralfate group. Also the percentage of wound healing was calculated at 76%, 91% and 100% respectively in the control, silver sulfadiazine and sucralfate groups.
CONCLUSIONS
Sucralfate is known to have multiple beneficial effects on wound healing. Using topical sucralfate accelerates the burn wound healing process in comparison with both the control and SSD groups and can be used as an adjunctive or alternative agent in the future.
Topics: Administration, Cutaneous; Animals; Anti-Infective Agents, Local; Burns; Disease Models, Animal; Male; Rats; Rats, Wistar; Silver Sulfadiazine; Skin; Skin Cream; Sucralfate; Time Factors; Wound Healing
PubMed: 23986207
DOI: No ID Found -
Medicina (Kaunas, Lithuania) Jun 2022Background and Objectives: Wound healing is commonly associated with critical bacterial colonization or bacterial infection, which induces prolonged inflammation,...
Background and Objectives: Wound healing is commonly associated with critical bacterial colonization or bacterial infection, which induces prolonged inflammation, resulting in delayed re-epithelialization. An appropriate wound dressing requires a humid environment, which also functions as a barrier against bacterial contamination and will accelerate a regenerative response of the wound. Silver sulfadiazine (SSD) is used to prevent wound infection. Hyaluronic acid (HA) is an extracellular matrix component involved in tissue regeneration. This retrospective study was conducted to evaluate the effectiveness of cream and gauze pads based on hyaluronic acid at low molecular weight (200 kDa) and silver sulfadiazine 1% in the wound healing process. In addition, we examined SSD action on biofilms in vitro and on animal wounds, obtaining positive outcomes therefrom. Materials and Methods: We selected 80 patients with complicated chronic wounds of different etiologies, including diabetes mellitus (10), post-traumatic ulcers (45), burns (15), and superficial abrasion (10). Results: After 8 weeks, ulcer size was decreased in 95 ± 2% of the treated patients; a significant reduction in the inflammatory process was observed from day 14 onwards (p < 0.01 vs. baseline), considering improvement of the surrounding skin and reduction of the bacterial load. The SSD treatment decreased bacterial colony proliferation, both in planktonic state and in biofilm, in a dose-dependent manner on the wound but inhibited the development of tissue granulation at the highest dose (800 μg/wound). Conclusions: In conclusion, the combined action of SSD and HA is clinically effective in improving wound healing.
Topics: Animals; Biofilms; Humans; Hyaluronic Acid; Retrospective Studies; Silver Sulfadiazine; Wound Healing
PubMed: 35744098
DOI: 10.3390/medicina58060835 -
Molecules (Basel, Switzerland) Apr 2022Cerium and its derivatives have been used as remedies for wounds since the early 20th century. Cerium nitrate has attracted most attention in the treatment of deep... (Review)
Review
Cerium and its derivatives have been used as remedies for wounds since the early 20th century. Cerium nitrate has attracted most attention in the treatment of deep burns, followed later by reports of its antimicrobial properties. Its ability to mimic and replace calcium is presumed to be a major mechanism of its beneficial action. However, despite some encouraging results, the overall data are somewhat confusing with seemingly the same compounds yielding opposing results. Despite this, cerium nitrate is currently used in wound treatment in combination with silver sulfadiazine as Flammacérium. Cerium oxide, especially in nanoparticle form (Nanoceria), has lately captured much interest due to its antibacterial properties mediated via oxidative stress, leading to an increase of published reports. The properties of Nanoceria depend on the synthesis method, their shape and size. Recently, the green synthesis route has gained a lot of interest as an alternative environmentally friendly method, resulting in production of effective antimicrobial and antifungal nanoparticles. Unfortunately, as is the case with antibiotics, emerging bacterial resistance against cerium-derived nanoparticles is a growing concern, especially in the case of bacterial biofilm. However, diverse strategies resulting from better understanding of the biology of cerium are promising. The aim of this paper is to present the progress to date in the use of cerium compounds as antimicrobials in clinical applications (in particular wound healing) and to provide an overview of the mechanisms of action of cerium at both the cellular and molecular level.
Topics: Anti-Bacterial Agents; Anti-Infective Agents, Local; Bacterial Infections; Burns; Cerium; Humans; Nanoparticles; Wound Healing
PubMed: 35566026
DOI: 10.3390/molecules27092678 -
American Journal of Veterinary Research Apr 2018OBJECTIVE To assess effects of photobiomodulation, silver sulfadiazine, and a topical antimicrobial product for the treatment of experimentally induced full-thickness...
Gross and histologic evaluation of effects of photobiomodulation, silver sulfadiazine, and a topical antimicrobial product on experimentally induced full-thickness skin wounds in green iguanas (Iguana iguana).
OBJECTIVE To assess effects of photobiomodulation, silver sulfadiazine, and a topical antimicrobial product for the treatment of experimentally induced full-thickness skin wounds in green iguanas (Iguana iguana). ANIMALS 16 healthy subadult green iguanas. PROCEDURES Iguanas were anesthetized, and three 5-mm cutaneous biopsy specimens were obtained from each iguana (day 0). Iguanas were randomly assigned to 2 treatment groups, each of which had a control treatment. Wounds in the topical treatment group received silver sulfadiazine, a topical antimicrobial product, or no treatment. Wounds in the laser treatment group received treatment with a class 4 laser at 5 or 10 J/cm or no treatment. Wound measurements were obtained daily for 14 days. Iguanas were euthanized, and treatment sites were evaluated microscopically to detect ulceration, bacterial contamination, reepithelialization, necrosis, inflammation, fibrosis, and collagen maturity. RESULTS On day 14, wounds treated with a laser at 10 J/cm were significantly smaller than those treated with silver sulfadiazine, but there were no other significant differences among treatments. Histologically, there were no significant differences in ulceration, bacterial infection, reepithelialization, necrosis, inflammation, fibrosis, and collagen maturity among treatments. CONCLUSIONS AND CLINICAL RELEVANCE Photobiomodulation at 10 J/cm appeared to be a safe treatment that was tolerated well by green iguanas, but it did not result in substantial improvement in histologic evidence of wound healing, compared with results for other treatments or no treatment.
Topics: Administration, Topical; Animals; Anti-Infective Agents; Bacterial Infections; Iguanas; Low-Level Light Therapy; Silver Sulfadiazine; Wound Healing
PubMed: 29583044
DOI: 10.2460/ajvr.79.4.465 -
Wounds : a Compendium of Clinical... Aug 2019Cutaneous burns challenge global health care systems with high patient morbidity and mortality rates.1 One recent study of adults admitted for 2 to 60 days to a US burn...
Cutaneous burns challenge global health care systems with high patient morbidity and mortality rates.1 One recent study of adults admitted for 2 to 60 days to a US burn center reported that more than 7.9% of burn patients experienced at least 1 hospital-acquired infection (HAI), extending the hospital length of stay and increasing the likelihood of complications and death.2 Of these HAIs, most (35.8%) were skin and soft tissue infections, followed by respiratory (24.4%), bloodstream (18.1%), and urinary tract (17.8%) infections. A burn covering more than 5% of total body surface area (TBSA) multiplied HAI risk by 3, with higher risk as the burned TBSA increased. Other factors increasing HAI risk included inhalation injury, flame burn, patient age (≥ 60 years), and comorbidities (ie, diabetes, heart failure, myocardial infarction, renal disease, or peripheral arterial disease).2 Topical 1% silver sulfadiazine cream (SSD), introduced into burn care in the mid 20th century by Dr. Charles Fox, improved global burned patient survival rates and outcomes by reducing the likelihood of burn-related infection.3 Research in later decades explored other topical treatments capable of reducing the incidence of burn-related infections. This month's Evidence Corner describes 2 recent reviews comparing the effects of topical antiseptics4 or honey5 with SSD on burn wound healing and infections.
PubMed: 31356177
DOI: No ID Found -
Journal of Burn Care & Research :... May 2022Wound infections and sepsis are significant causes of morbidity after burn injury and can be alleviated by early excision and grafting. In situations that preclude early...
Wound infections and sepsis are significant causes of morbidity after burn injury and can be alleviated by early excision and grafting. In situations that preclude early surgery, topical agents allow for a safer delay. Cerium nitrate compounded with silver sulfadiazine (Ce-SSD) is a burn cream that provides broad antibacterial activity, forms a temporary barrier, and promotes re-epithelialization. Methemoglobinemia is a rare, but oft-cited, systemic complication of Ce-SSD. In this retrospective review, 157 patients treated with Ce-SSD between July 2014 and July 2018 were identified, and the monitoring protocol for methemoglobinemia during Ce-SSD treatment was evaluated. The median age was 59 years (interquartile range [IQR], 47-70.5 years), with TBSA of 8.5% (IQR, 3-27), adjusted Baux score of 76 (IQR, 59-94), and inhalation injury present in 9.9% of patients. Primary endpoints included incidence of symptomatic and asymptomatic methemoglobinemia. Of the 9.6% (n = 15) of patients with methemoglobinemia, 73.3% (n = 11) had maximum methemoglobin levels ≥72 hours from the time of the first application. One patient developed clinically significant methemoglobinemia. Patients with TBSA ≥20% were more likely to develop methemoglobinemia (odds ratio 9.318, 95% confidence interval 2.078-65.73, P = .0078); however, neither Ce-SSD doses nor days of exposure were significant predictors. Ce-SSD application to temporize burn wounds until excision and grafting is safe, effective, and, in asymptomatic patients with TBSA <20%, can be used without serial blood gas monitoring. Vigilant monitoring for symptoms should be performed in patients with TBSA ≥20%, but routine blood gases are not necessary.
Topics: Aged; Anti-Infective Agents, Local; Burn Units; Burns; Cerium; Humans; Methemoglobinemia; Middle Aged; Silver Sulfadiazine
PubMed: 34543402
DOI: 10.1093/jbcr/irab180 -
World Journal of Plastic Surgery Sep 2017Burn is the most devastating condition in emergency medicine leading to chronic disabilities. This study aimed to compare the effect of , silver sulfadiazine and alpha...
BACKGROUND
Burn is the most devastating condition in emergency medicine leading to chronic disabilities. This study aimed to compare the effect of , silver sulfadiazine and alpha ointments on healing of burn wounds in rat.
METHODS
Ninety-five rats were divided into 5 groups. Group 1 just underwent burn injury, and groups 2-5 received alpha ointment, silver sulfadiazine (SSD), gel base and extract, respectively. A hot plate was used for induction of a standard 3 degree burn wound. Burn wounds were macroscopically and microscopically evaluated on days 7, 14 and 21 after burn induction.
RESULTS
A decrease in the number of inflammatory cells was noted when and SSD were applied while the most inflammatory response was seen after administration of alpha ointment. The number of macrophages alone decreased after burn injury, while the frequency was the most when and alpha ointment were applied. Re-epithelialization, angiogenesis and formation of granulation tissue were the best in relation to and alpha ointment while, the worst results belonged to burn injury group and SSD regarding granulation tissue formation. Considering histological assessment, the best results were observed for scoring of inflammation, re-epithelialization, angiogenesis, formation of granulation tissue and number of macrophage when and alpha ointment were used after burn injury.
CONCLUSION
It can be concluded that topical application of as a non-toxic, inexpensive and easy to produce herbal can lead to a rapid epithelialization and wound healing and these findings can be added to the literature on burn wound healing.
PubMed: 29218280
DOI: No ID Found -
World Journal of Critical Care Medicine May 2016Central venous catheters are commonly used in critically ill patients. Such catheterization may entail mechanical and infectious complications. The interest in... (Review)
Review
Central venous catheters are commonly used in critically ill patients. Such catheterization may entail mechanical and infectious complications. The interest in catheter-related infection lies in the morbidity, mortality and costs that it involved. Numerous contributions have been made in the prevention of catheter-related infection and the current review focuses on the possible current role of antimicrobial impregnated catheters to reduce catheter-related bloodstream infections (CRBSI). There is evidence that the use of chlorhexidine-silver sulfadiazine (CHSS), rifampicin-minocycline, or rifampicin-miconazol impregnated catheters reduce the incidence of CRBSI and costs. In addition, there are some clinical circumstances associated with higher risk of CRBSI, such as the venous catheter access and the presence of tracheostomy. Current guidelines for the prevention of CRBSI recommended the use of a CHSS or rifampicin-minocycline impregnated catheter in patients whose catheter is expected to remain in place > 5 d and if the CRBSI rate has not decreased after implementation of a comprehensive strategy to reduce it.
PubMed: 27152256
DOI: 10.5492/wjccm.v5.i2.137 -
Gels (Basel, Switzerland) Apr 2023Response surface methodology (RSM) was applied to optimise a temperature-responsive hydrogel formulation synthesised via the direct incorporation of biocellulose, which...
Response surface methodology (RSM) was applied to optimise a temperature-responsive hydrogel formulation synthesised via the direct incorporation of biocellulose, which was extracted from oil palm empty fruit bunches (OPEFB) using the PF127 method. The optimised temperature-responsive hydrogel formulation was found to contain 3.000 /% biocellulose percentage and 19.047 /% PF127 percentage. The optimised temperature-responsive hydrogel provided excellent LCST near to the human body surface temperature, with high mechanical strength, drug release duration, and inhibition zone diameter against Moreover, in vitro cytotoxicity testing against human epidermal keratinocyte (HaCaT) cells was conducted to evaluate the toxicity of the optimised formula. It was found that silver sulfadiazine (SSD)-loaded temperature-responsive hydrogel can be used as a safe replacement for the commercial SSD cream with no toxic effect on HaCaT cells. Last, but not least, in vivo (animal) dermal testing-both dermal sensitization and animal irritation-were conducted to evaluate the safety and biocompatibility of the optimised formula. No sensitization effects were detected on the skin applied with SSD-loaded temperature-responsive hydrogel indicating no irritant response for topical application. Therefore, the temperature-responsive hydrogel produced from OPEFB is ready for the next stage of commercialisation.
PubMed: 37102941
DOI: 10.3390/gels9040329