Comparative evaluation of povidone-iodine aerosol foam solution and silver sulphadiazine cream as prophylactic topical antibacterial agents for treatment of the burn wound

Abstract

Nine patients with fresh burns were treated with povidone-iodine aerosol foam solution and matched with 9 patients with fresh burns of similar extent and distribution treated with silver sulphadiazine cream. Severe pain at the time of application of povidoneiodine was a constant complaint. The wounds of 7 patients treated with povidone-iodine had been colonized by bacteria by day 11 post burn, whereas the wounds of only 2 patients treated with silver sulpha-diazine had been colonized at the corresponding time. Gram-negative organisms appeared more frequently, earlier and in higher concentrations in the povidoneiodine treated patients ( Pseudomonas aeruginosa, 4 patients), whereas Staphylococcus aureus was more frequent with silver sulphadiazine (4 patients). Five of the povidone-iodine treated patients had developed burn wound sepsis by day 11 post burn, whereas no silver sulphadiazine treated patient developed burn wound sepsis. For this reason, further evaluation of povidone-iodine foam as a prophylactic topical antibacterial for burns was abandoned.