An open study comparing topical silver sulfadiazine and topical silver sulfadiazine–cerium nitrate in the treatment of moderate and severe burns

Abstract

Sixty patients with moderate and severe burns were randomly assigned to receive topical silver sulfadiazine (SSD) alone ( n=30) or SSD combined with cerium nitrate (SSD–CN) ( n=30). There were four deaths in the SSD group and one in the SSD–CN group; more patients with higher risk severity survived in the SSD–CN group. Wound infection did not differ significantly between the groups. The rate of re-epithelialization of partial thickness burns was faster by 8 days in the SSD–CN group. The relatively dry shell-like eschar of the SSD–CN-treated burn allowed planned excisions with immediate autologous grafting and the tissue beneath was ready to accept grafting 11 days earlier than in the SSD group ( p=0.03). This resulted in a significantly shorter hospital stay for those in the SSD–CN group than in the SSD group (23.3 vs. 30.7 days; p=0.03) with consequent cost savings. A higher incidence of transient stinging pain was reported with application of SSD–CN, but this was effectively managed with analgesics where necessary. The results of this study confirm the greater efficacy of SSD–CN in the treatment of burns patients.