The use of a new topical burn agent silver zinc sulfadiazine cream in the treatment of burn wounds preliminary report in 236 burned patients
Chuntrasakul, C.; Gaerunpong, V.; Chumsang, P.; Karnphermchit, P.; Soonthornsataya, B.
Siriraj Hospital Gazette 36(6): 378-388
A 1% silver zinc sulfadiazine cream was used for topical antisepsis on the wounds of 236 consecutive hospitalized burned patients with the extent varying 5% BSA (body surface area) to 100% BSA, average 30.73% BSA. Of these, 171 burned patients entered the hospital within 24 h of burning and 65 patients entered after 24 h. Ten severely burned patients died early of shock and smoke inhalation within the first 72 h. Of the remaining, 172 receieved topical silver zinc sulfadiazine throughout until the completion of wound healing or ready for skin grafting, 64 patients occasionally received mafylon for topical antisepsis in their course of the treatment and 89 patients required skin grafting. The overall mortality of 236 patients was 54 patients or 22.88%, 44 patients died after 72 h of burning. Patients of both groups (34) who entered within and after 24 h of burning died of septic complication (77.3%), the other deaths were due to coronary heart diseases, pneumonia and the endotracheal tube obstruction. Before the introduction of 1% silver zinc sulfadiazine, when 1% silver sulfadiazine was in use, the mortality in the burned patients with the use of silver sulfadiazine was slightly higher than the mortality in the present group; that 75.41 and 59.70%, respectively, in the patients with burned wounds > 40% BSA. The burned wound swab culture was performed in 216 patients, Staphylococcus aureus and Pseudomonas aeruginosa were the 2 most frequent predominating organisms. Silver zinc sulfdiazine cream is non-toxic, an effective topical agent, Siriraj self-made preparation, easy to use and less expensive, can be used not only for the burned wounds but also the other types of wounds, when topical antisepsis is necessary.