From the Guidelines
Silver sulfadiazine cream is not recommended for second-degree burns due to its association with increased burn wound infection and longer hospital stays compared to other dressings or skin substitutes, as shown in a review of 36 RCTs 1. When treating second-degree burns, it is essential to prioritize methods that promote healing, prevent infection, and minimize scarring.
- The use of silver sulfadiazine has been associated with a statistically significant increase in burn wound infection and longer length of hospital stay compared to dressings or skin substitutes 1.
- Instead, petrolatum, honey, or aloe may be considered for improving healing time in patients with partial-thickness burns, as suggested by the 2024 American Heart Association and American Red Cross guidelines for first aid 1.
- It is crucial to clean the burn area gently with mild soap and water, and cover it with a sterile non-stick dressing to promote a clean environment for healing.
- Severe or extensive burns, including those larger than 3 inches, or burns on the face, hands, feet, genitals, or major joints, require immediate medical attention, as they may necessitate specialized care, such as intravenous fluid resuscitation, surgery, or treatment in a burn center 1.
From the FDA Drug Label
Silver sulfadiazine cream, USP 1% is a topical antimicrobial drug indicated as an adjunct for the prevention and treatment of wound sepsis in patients with second and third degree burns.
- Silver sulfadiazine cream is indicated for the prevention and treatment of wound sepsis in patients with second degree burns.
- The cream can be used as an adjunct for the treatment of second degree burns.
- Key words: silver sulfadiazine, second degree burns, wound sepsis 2
From the Research
Silver Cream for Second Degree Burns
- Silver sulfadiazine is an effective agent with low toxicity and few side effects for topical use in burns, including second degree burns 3
- It may be used in a variety of other conditions than burns, and its deposition in tissues and absorption of sulfadiazine are both minimal 3
- A study compared nitrofurazone, povidone-iodine, and silver sulfadiazine in the treatment of second degree burns, and found that healing in nitrofurazone-treated patients was superior to that in silver sulfadiazine-treated patients 4
- The study also found that among patients with less serious burns, nitrofurazone-treated patients suffered less pain than silver sulfadiazine-treated patients, but there was no significant difference in pain between povidone-iodine and silver sulfadiazine 4
- Topical antiseptics, including silver sulfadiazine, can penetrate eschar of burn patients and retain their effectiveness after penetration 5
- Other topical treatments for burns, such as silver nitrate, mafenide acetate, and povidone-iodine, have also been discussed in the literature 6