3/17/2024 0 Comments Silvadene cream 20 year old![]() A 2014 study suggested that for minor superficial partial thickness burns, applying a layer of petroleum jelly may be just as good. Mind you: though silver is a long standing traditional treatment for burn wounds, its use is not strongly evidence supported. It is considered a better choice for Gram negative bacteria and fungal colonization, but this is rarely an issue for the acute burn wound. It has overall poorer tissue penetration. Chemically it is much like silvadene, but before adding the sulfa-based component. Silver nitrate 0.5% solution is another alternative for the sulfa-allergic patient. As it penetrates deeper, it is usually the recommended antibiotic for burns over cartilaginous areas such as the nose and ears. Other things to note about this drug– it penetrates an eschar better, but is more painful to apply (to partial thickness burns). Note that even though the trade name contains the word “sulfa”, mafenide acetate is actually not a sulfa-based medication. Sulfamylon is a reasonable alternative for the sulfa-allergic patient. Remember, it’s a sulfa-based drug, so you would want to avoid it in a patient with known sulfa allergy. You can apply it will a tongue blade to a sterile 4×4 to create an occlusive dressing, or apply it directly to the wound surface. Silver sulfadiazine (Silvadene) is easy to apply, relatively inexpensive, and readily available most patients will tell you it actually feels pretty soothing to their wounds. ![]() Topical silver is the conventional antimicrobial used for burn wound dressings. It is believed that silver ions inhibit DNA synthesis by bacteria, thus preventing antimicrobial growth. Traditionally, the treatment of outpatient burn wounds involves application of a silver-based solution. I’ll summarize with a review of the most important evidence regarding use of these dressings, and finally my recommendations. This blog post will focus on the different options for dressing these wounds. There are many types of antimicrobials out there, and many ways to apply them. Thus, it’s widely accepted to apply topical antimicrobials to try and keep those colony counts down. These bacteria can lead to infection of the wound, which is one of the most dangerous causes of burn morbidity. Initially skin flora like Staph epidermidis invade the wound, but then bugs like Pseudomonas, Enterobacter, and E. While burn wounds begin more or less sterile, these wounds will rapidly become colonized with bacteria. Note the erythema and blistering of the left dorsum of the hand, which was more severely affected. Superficial partial thickness burns of the hands, caused by hot oil while cooking. Superficial partial thickness burns of the palms of both hands, sustained with hot oil while cooking. You feel he is otherwise stable for outpatient management. You arrange urgent follow up with a burn surgeon, as per American Burn Association Referral/Transfer guidelines. Using the rule of palms and confirming with a burn app you estimate a 4% TBSA burn. ![]() Blistering is beginning to appear, suggesting these are superficial partial thickness burn wounds. The wounds are sensate, erythematous, and blanching in all areas. 1,2 The scarceness of information in the literature describing this possible drug-induced reaction prompted our report.A 30 year old male chef sustains burns of both hands after hot oil spilled on him at work. It is a relatively common occurrence with an incidence of 3% to 5%. Leukopenia associated with sulfadiazine silver is one hematologic reaction that has only recently been recognized. More serious in nature is the possibility that the hematologic side effects of the sulfonamides in general could be expected with sufficient systemic absorption of sulfadiazine silver. Rash (which responds to antihistamine therapy), fever, tachycardia, and leukocytosis occur infrequently. Its relative freedom from appreciable side effects such as electrolyte and acid-base disturbances, staining, and pain on application has contributed to its popularity. This bactericidal agent acts on the cell membranes and cell walls of a variety of Gram-positive and Gram-negative bacteria as well as on yeast. SULFADIAZINE silver 1% cream has been available in the United States since 1973 for the topical treatment of burns. ![]()
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