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Silver sulfadiazine, sold under the brand Silvadene among others, is a topical antibiotic used in partial thickness and full thickness burns to prevent infection. [1] Tentative evidence has found other antibiotics to be more effective, and therefore it is no longer generally recommended for second-degree (partial-thickness) burns, but is still ...
'However, these conventional dressings tend to adhere to the wound surface (Thomas 1995) and their need for frequent changes traumatises newly epithelialised surfaces and delays healing. Silver sulphadiazine cream itself is also thought to delay wound healing due to a toxic effect on regenerating keratinocytes (Wasiak 2005)'
However systemic reviews in 2014, 2017 and 2018 concluded that more modern treatments, both with and without silver, show better results for wound healing and infection-prevention than silver sulfadiazine, [25] [26] [27] and therefore SSD is no longer generally recommended. [28] [29]
The wound-healing process is not only complex but fragile, and it is susceptible to interruption or failure leading to the formation of non-healing chronic wounds. Factors that contribute to non-healing chronic wounds are diabetes, venous or arterial disease, infection, and metabolic deficiencies of old age. [4]
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The end goal of wound management is closure of the wound which can be achieved by primary closure, delayed primary closure, or healing by secondary intention, each of which is discussed below. Pain control is a mainstay of wound management, as wound evaluation, wound cleansing, and dressing changes can be a painful process.
A week after the injury, the edges of the wound are pulled together by contraction. Contraction is an important part of the healing process when damage has been extensive, and involves shrinking in size of underlying contractile connective tissue, which brings the wound margins toward one another. [1]
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