An experimental and clinical evaluation of a tulle gras dressing medicated with silver sulphadiazine

doi:10.1016/0305-4179(77)90009-2

Burns

Volume 3, Issue 3, March 1977, Pages 186-193

https://doi.org/10.1016/0305-4179(77)90009-2 Get rights and content

Abstract

A tulle gras dressing medicated with I per cent silver sulphadiazine was shown to reduce significantly the incidence of Staphylococcus aureus in experimental burns made on guinea-pigs. It was shown that the local toxicity of silver sulphadiazine was comparable to that of many common antibiotics; the medicated dressing apparently did not interfere with wound healing.

In a controlled clinical trial the effects of a non-medicated tulle gras dressing were compared with a tulle gras dressing containing silver sulphadiazine. The use of silver sulphadiazine reduced the incidence of S. aureus and Gram-negative bacilli in burns treated in an outpatient department. A high proportion of antibiotic-resistant staphylococci were isolated from patients in the trial; the value of alternative therapies in this situation is discussed.

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Cited by (13)

Silver sulphadiazine and the healing of partial thickness burns: a prospective clinical trial
1989, British Journal of Plastic Surgery
A clinical trial was devised to determine whether the healing of partial thickness burns was retarded by the use of silver sulphadiazine cream (SSD) compared with simple, non-bacteriocidal dressings.
Biopsy-confirmed partial thickness burns of at least 2% confluent area were dressed according to a strict protocol to compare the rate of epithelialisation of the control dressing, tulle gras, with that obtained with the use of silver sulphadiazine.
The same comparative dressing regimen was carried out on a series of split thickness graft donor sites. Twenty such donor sites and fifteen burn areas were admitted to the trial.
The mean time to healing of SSD-treated burn areas was longer than that for tulle gras; the difference when analysed by pairedt-test was statistically significant (p < 0.05).
There was very little difference in the compared healing rates of the donor sites, which implies that SSD does not retard epithelialisation of dermal depth injuries but rather that the delayed healing is a unique response of the partial thickness burn wound to the presence of SSD. A review of the relevant literature is included in the discussion.
Plasticized polyvinyl chloride film as a primary burns dressing: a microbiological study
1988, Burns
Twenty-four patients were studied after the application of plasticized polyvinyl chloride (PVC) film as a temporary burns dressing. The burns were assessed as being partial thickness (nine patients) and full thickness (15 patients) in depth and involving 2 per cent to 35 per cent of the body surface area. Microbiological cultures were performed on the exudate beneath the plasticized PVC film and then at each dressing change until the burn was healed. Bacterial isolates showed no unexpected organisms and there was no predominant organism to suggest contamination from the plasticized PVC film. Indeed, bacteria were only rarely isolated from the initial exudate (three of 37 burn wounds), and subsequent bacterial cultures did not differ from those normally found in burn wounds.
In addition, incorporation of the plasticized PVC film into nutrient broth and agar with Staph. aureus and Ps. aeruginosa did not influence the recovery of these organisms, indicating that plasticized PVC film does not exert any antibacterial effect.
The preclinical evaluation of the water vapour transmission rate through burn wound dressings
1987, Biomaterials
The control of evaporative water loss, following bum injury, is of major importance to the overall condition of the patient, whether this control is by natural eschar or by a dressing. It is therefore important to preclinically determine the water vapour transmission rate of these dressings, firstly to make comparisons between different materials and secondly to screen prototype materials, under controlled conditions. A preclinical (in vitro) technique is described and the results are given for several commercially available dressings which encompass foam, film and hydrogel material categories.
Burn wound dressings-a review
1987, Burns
Cutaneous tissue repair: Practical implications of current knowledge. II
1985, Journal of the American Academy of Dermatology
This article reviews the scientific basis for the certain factors that delay wound repair in the clinical setting. A brief history of wound healing is given, followed by a discussion of endogenous local factors (bacterial infection, hypoxia, foreign body, and desiccation) and endogenous systemic factors (nutritional deficiencies, aging, coagulation disorders, and the Ehlers-Danlos syndromes) associated with poor wound repair. Also reviewed are the mechanisms by which exogenously administered agents (glucocorticoids, antineoplastic agents, and anticoagulants) may delay healing. Commonly used topical antimicrobials, their spectrum of activity, and evidence of effects on wound healing are examined. Finally, properties of commercially available wound coverings and wound care in the future are discussed.
Surgical dressings
1985, Journal of Hospital Infection

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Burns

Abstract

References (20)

search of an acceptable burn classification

Br. J. Plast. Surg.

Alternative forms of local treatment for burns

Lancet

Silver sulfadiazine-a new topical therapy for pseudomonas in burns

Arch. Surg.

Melolin trial

Nursing Mirror

Changes in the drug resistance of Staphylococcus aureus in a non-hospital population during a 20 year period

J. Clin. Pathol.

The tangential excision of burns: an experimental study using an animal model

Injury

Out-patient burns: a prospective study

J. Trauma

Diagnosis of depth of burning

Br. J. Surg.

The comparative toxicity of antibiotics to skin

Br. J. Pharmacol.

Cited by (13)

Silver sulphadiazine and the healing of partial thickness burns: a prospective clinical trial

Plasticized polyvinyl chloride film as a primary burns dressing: a microbiological study

The preclinical evaluation of the water vapour transmission rate through burn wound dressings

Burn wound dressings-a review

Cutaneous tissue repair: Practical implications of current knowledge. II

Surgical dressings