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Warnings given on silver sulphadiazine creams in burn treatment

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Nurses should reconsider the use of silver sulphadiazine (SSD) cream to treat superficial or partial thickness burns, Cochrane researchers have suggested.

SSD creams, such as Flamazine, provide broad-spectrum antimicrobial activity and have been widely used in clinical practice for years to minimise the risk of burns becoming infected.

But a Cochrane review of 26 clinical trials – comparing SSD cream with a range of different wound dressings – found the cream could actually delay wound healing.

Trials showed that a number of different dressing types, including polyurethane films, hydrocolloid gels and biosynthetic dressings can be more effective for treatment of moderate burns than SSD or standard chlorhexidine-impregnated gauze dressings. As well as reducing healing times some alternative dressings also reduced pain associated with burns.

There is a wealth of evidence supporting the use of antimicrobial silver-based products and the number of these available has increased significantly recently.

But tissue viability experts have raised concerns about the overuse of such products and the long-term effects of silver exposure on the body.

Sylvie Hampton, a tissue viability nurse for over 10 years who works as a consultant for Tissue Viability Consultancy Services, said nurses should exercise caution when using any silver-based product.

‘We know silver has an antimicrobial effect and it is particularly effective in treating pseudomonas. But silver dressings are being used indiscriminately and people are dumping huge amounts of silver into wounds,’ she said.

‘Not only is this a huge cost to the NHS but also none of the dressings on the market have been closely analysed, so we have no idea what the long-term side-effects of using these products will be. Nurses should be selective in their use of silver and only use it for short periods of time on appropriate wounds,’ she added.

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