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Wound healing
Wound infection
Animal studies

Wound healing in second-degree burns in rats treated with silver sulfadiazine: a systematic review and meta-analysis

01 April 2022
Research

Abstract

Objective:

This study aims to assess the wound healing efficacy in second-degree burns in rats treated with 1% silver sulfadiazine (SSD)—a sulfonamide antibiotic.

Method:

This is a systematic literature review and meta-analysis performed according to the PICO (Population, Intervention, Comparison and Outcomes) strategy.

Results:

The review found 100 studies in PubMed, Web of Science and other search engines. Of these, 70 studies were pre-selected after removing duplicates. After independent analysis by two reviewers, only seven studies met the inclusion criteria for meta-analysis. All studies except one showed faster wound closure by the application of silver sulfadiazine ointment. Using a random effects model, healing was faster in SSD-treated groups when compared to the control group on day 21, with a statistically significant mean difference of –2.72 days (95% confidence interval: –4.99, –0.45) between treatment and control groups (p<0.01).

Conclusion:

The results of this meta-analysis revealed that SSD aided in faster healing of second-degree burns.

Wound care places an enormous burden on healthcare resources worldwide. Despite strides in technological innovations of a wide range of options for treating wounds, hard-to-heal wounds continue to pose a challenge to physicians across the globe. Hence, enormous efforts are needed to improve our scientific understanding of the wound healing process to develop new approaches for treatment.1

Treatment of burn wounds aims to control infection and aid in rapid neovascularisation at the wound site. The final aim of burn management and therapy is wound healing and re-epithelialisation as early as possible in order to prevent infection and to reduce functional and aesthetic after-effects.2,3

Wound dressings have been fabricated in various forms using different types of materials, for example fibre mats and hydrogels, and in addition may contain additives such as drugs and drug-like molecules that target the different phases of wound healing, with the aim of eventually reducing the healing time. Many antiseptic agents, such as honey,4 silver5 and povidone-iodine6 have been used for treating burns. Silver has reemerged as a viable treatment option for infections encountered in burns, open wounds and hard-to-heal ulcers. For decades, routine management of burn wounds has centred on a standard 1% cream formulation containing silver complexed to a lipid-soluble polypropylene glycol base, along with the sulfadiazine molecule. Silver sulfadiazine (SSD), a sulfonamide class of antibiotic, exhibits its bactericidal property as soon as it encounters the bacterial cell wall of a wide range of Gram-positive and Gram-negative microorganisms, thus enhancing the rate of healing.7,8,9

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meta-analysis
second-degree burn
silver sulfadiazine
systematic review
wound
wound care
wound healing