Antibacterial and Wound Healing Activity of 2% Formulation of 2-Medpy-3-CN on Infected Burn Wounded Animal Model

@#Introduction: Humans have learned to recognize and process plants into medicinal forms through centuries. Burns can spread to other tissues, especially when infected with bacteria such as Methicillin-Resistant Staphylococcus aureus (MRSA). The study aimed to assess the in vivo antibacterial and wound healing activity of 2% formulation of 2-Medpy-3-CN on infected burn wounded animal model. Methods: In vitro antibacterial activity of the Alsti was done by broth dilution and disc diffusion methods. Alsti 2% ointment was prepared for the infected burn wound treatment. A total of 18 rats are grouped into A, B, C, and D, the first three groups (A-C) were injured thermally, and Group D was used as healthy controls. The three test Groups were exposed to MRSA ATCC 43300 at 105 CFU/mL. Group A was treated with 2% Alsti, Group B with Silver sulfadiazine 1% (SSD), and Group C was untreated. Wounds healing was assessed by the healed area and microscopic identification of hematoxylin and eosin (H&E)-stained skin tissue. Results: Wound healing progresses with application of Alsti 2% ointment as observed through wound diameter and histopathological changes of the skin. Wound diameter decreases with treatments, while the contrary was observed in the non-treated group. Microscopic observation of the stained skin showed that epidermal development, and collagen formation progress with treatment days. Untreated wounds showed marked inflammation, progressive ulceration, and necrosis. Conclusion: Alsti 2% formulation showed antibacterial and wound healing activities, hence, can be used as alternative in burn wound infections.

Development and Characterization of a Hydrogel Containing Silver Sulfadiazine for Antimicrobial Topical Applications. Part II: Stability, Cytotoxicity and Silver Release Patterns

Abstract Hydrogels are interesting for use in the treatment of topical wounds due to their virtually zero toxicity, and capacity for extended release of pharmaceuticals. Silver sulfadiazine (SSDZ) is the drug of choice in the treatment of skin burns. The aim of the study was to determine cytotoxicity, antimicrobial activity and stability of a PVA hydrogel with integrated silver sulfadiazine. SSDZ-hydrogels were prepared using 10% (w/w) PVA (either 89% or 99% hydrolyzed) and 1% (w/w) silver sulfadiazine. Cellular viability was assessed via MTS assays, antimicrobial activity via disk-diffusion and accelerated stability tests were carried out with analysis at 0, 30, 60, 90 and 180 days of storage at 40 ± 2 °C and a relative humidity of 75 ± 5%. The parameters evaluated included organoleptic characteristics, moisture, swelling ability, mechanical strength, FTIR, XRD, TGA and DSC, and silver release patterns via XRD and potentiometry. Cell viability tests indicated some cytotoxicity, although within acceptable levels. After 90 days of storage, SSDZ hydrogel samples exhibited a brown coloration, probably due to the formation of Ag or Ag2O nanoparticles. The SSDZ-loaded hydrogels suffered visual and physical changes; however, these changes did not compromise its use as occlusive wound dressings or its antimicrobial properties.

Utilidad del apósito liofilizado de piel de cerdo en el manejo de cicatrización de úlcera de pie diabético / Usefulness of lyophilized pig skin dressings in wound healing as treatment for diabetic foot ulcer

Resumen Objetivo: Mostrar la utilidad del apósito liofilizado de piel de cerdo comparado con el manejo conservador con sulfadiazina de plata en el proceso de cicatrización de la úlcera de pie diabético. Materiales y Método: Estudio cuasiexperimental en pacientes con diagnóstico de pie diabético, se establecieron 2 grupos de estudio utilizando una relación 2:1, el grupo de exposición (10 pacientes) tratado con apósito liofilizado de piel de cerdo y el grupo de control (5 pacientes) manejado con sulfadiazina de plata. La utilidad se midió con la cicatrización en semanas de tratamiento. El análisis estadístico incluyó prueba de t, prueba de z, regresión logística simple y cálculo de la probabilidad del evento. Resultados: El tiempo de cicatrización fue más corto en el grupo manejado con apósito liofilizado de piel de cerdo (10,20 semanas) que en el grupo con manejo a base de sulfadiazina de plata (13,8 semanas). A las 9 semanas de iniciado el tratamiento, la mitad de las pacientes con apósito de piel de cerdo ya habían cicatrizado comparado con la cicatrización en el grupo manejado con sulfadiazina de plata (20%). La probabilidad de cicatrización a las 11 semanas en paciente manejados con sulfadiazina de plata es 20% y con apósito liofilizado de piel de cerdo 80%. Conclusión: El apósito liofilizado de piel de cerdo tuvo mejores resultados en el estudio, comparado con el manejo estándar con sulfadiazina de plata. Es necesario realizar un estudio aleatorizado para determinar la efectividad de este material como herramienta terapéutica.

Aim: To demonstrate the usefulness of lyophilized pig skin dressings versus usual management with silver sulfadiazine in wound healing treatment for diabetic foot ulcers. Materials and Method: In this quasi-experimental study, we included patients diagnosed with diabetic foot. We established two groups with a distribution (2:1), the exposure group treated with lyophilized pig skin dressings (10 patients) and the control group (5 patients), the standard of care with silver sulfadiazine. Usefulness was measured with wound healing in treatment weeks. Statistical analysis included t-test, z-test, simple logistic regression, and calculation of probability of an event. Results: Wound healing time was shorter in the group treated with lyophilized pig skin dressing (10.20 weeks) than in the group treated with silver sulfadiazine (13.8 weeks). At 9 weeks after treatment started, 50% of patients treated with lyophilized pig skin dressings had complete wound healing compared with the patients in the group managed with silver sulfadiazine. (20%). The probability of wound healing been completed at 11 weeks in a patient managed with silver sulfadiazine is 20%, compared to lyophilized pig skin dressings is 80%. Conclusion: Lyophilized pig skin dressings had better outcomes than silver sulfadiazine in wound healing treatment for diabetic foot ulcers inside the study. Is mandatory develop another study with a randomized design to determinate the effectiveness as a therapeutic alternative.

Wound healing activity of Allium cepaL. bulbs in a second-degree burn wound model in Holtzman rats / Actividad cicatrizante de los bulbos de Allium cepa L. en un modelo de quemadura de segundo grado en ratas Holtzman

Background: The bulb of Allium cepa Linnaeus (onion) is used in traditional medicine as an antidiabetic, antioxidant, antihypertensive, anti-inflammatory, and antihyperlipidemic, among others. The lack of information or little knowledge about the effects of Allium cepa L. on skin lesions, specifically burn wounds, arouses interest in studying its effects on these skin disorders. Objective: This study assessed the wound healing activity of Allium cepa L. on second-degree burns induced in Holtzman rats. Method: Thirty-two albino rats were randomly distributed into four groups of 8 rats each, including the Healthy group, the Control group, the Experimental group (Alliumcepa L.), and the Standard group (1% silver sulfadiazine). Burn wounds were induced, and topical treatments were performed daily for 21 days. The reduction of the burned body area (mm2) was determined during the experimental time. Albino rats were sacrificed with an excess of surgical anesthesia to obtain tissue samples for histopathological analysis. Results: Standard and experimental groups significantly reduced burned body area (p<0.01) compared to the control group. Histopathological studies showed hyperemic chorion in the Control group, fibroblasts, and collagen in the Standard group, and dermis composed of a reticular stratum of fibroblasts, collagen, and few blood vessels in the Experimental group. Conclusion: Allium cepa L. revealed wound-healing activity on burns induced in Holtzman rats and reduced the damage produced by burns

Antecedentes: El bulbo de Alliumcepa L. (cebolla) se utiliza en medicina tradicional como antidiabético, antioxidante, antihipertensivo, antiinflamatorio, anti hiperlipidémico entre otros. La falta de información o muy poco conocimiento acerca de los efectos de Allium. cepa L. en lesiones cutáneas, específicamente en las heridas por quemaduras, despierta el interés por estudiar sus efectos en estas afectaciones cutáneas. Objetivo: El objetivo de este estudio fue evaluar la actividad cicatrizante de Allium. cepa L. en quemaduras de segundo grado inducidas en ratas Holtzman. Método: Se utilizaron treinta y dos ratas albinas distribuidas al azar en cuatro grupos de ocho ratas cada uno, incluyendo el Grupo sano, el Grupo Control, el Grupo Experimental (Allium cepa L.) y el Grupo Estándar (Sulfadiazina de plata al 1%). Se indujo la herida por quemadura, y los tratamientos tópicos se realizaron diariamente durante 21 días. La reducción del área corporal quemada (mm2) se determinó durante el tiempo de experimentación, luego los animales fueron sacrificados con exceso de anestesia quirúrgica para obtener las muestras de tejidos para el estudio histopatológico. Resultados: Los grupos estándar y experimental mostraron reducción significativa en el área corporal quemada (p<0,01) comparadas al grupo control. El estudio histopatológico evidenció corion hiperémico en el grupo control; fibroblastos y colágeno en el grupo estándar y dermis integrada por un estrato reticular de fibroblastos, colágeno y pocos vasos sanguíneos en el grupo experimental. Conclusión: Alliumcepa L. reveló actividad cicatrizante en quemaduras inducidas en ratas Holtzman, y disminuyó el daño producido por las quemaduras

Optimization of determination method for silver sulfadiazine cream and its stability under extreme conditions / 药学实践杂志

Objective To optimize the method of assay for silver sulfadiazine, and to investigate its stability in high temperature, humidity and salt environment. Methods Agilent ZORBAX SB-C18 column was used in HPLC for the determination of silver sulfadiazine with acetonitrile and 0.1% phosphoric acid as mobile phase.The flowing rate was 1.0 ml/min and column temperature was 30℃. Salt spray test chamber was used to simulate the high temperature, humidity and salt environment. The silver sulfadiazine content was assayed at 0, 2, 4, 6, 8, 10, 12 weeks. Results The calibration curve was linear within the range of 4.00～20.00 μg/ml (r=0.9999). The average recovery was 101.47% (RSD=2.33%). The content of silver sulfadiazine cream began to decrease significantly after 4 weeks. Conclusion This method is convenient, accurate and reliable. It can be used for the content determination of silver sulfadiazine in the cream.The results showed that the silver sulfadiazine cream was unstable in the environment of high temperature, humidity and salt. Therefore, environmental impact should be fully considered in transportation, storage and application. For the long-distance navigation mission, protective measures should be taken for its packaging or replace it with more stable products.

Effectiveness of chlorhexidine/silver sulfadiazine catheters in the prevention of catheter-related bloodstream infections: A traditional meta analysis / 解放军医学杂志

[Abstract] Objective To evaluate the effectiveness of chlorhexidine/silver sulfadiazine catheters vs. conventional standard catheters in the prevention of catheter-related bloodstream infections with bundles. Methods We searched the Cochrane Library, Embase, Medline, CINAHL and Web of Science databases from construction to March 2019 for randomized controlled trials to compare the use of chlorhexidine/silver sulfadiazine catheters and conventional standard catheters. Cochrane bias risk assessment tool was used to evaluate the included research, and the effective data was extracted. The set risk ratio (RR) was calculated with 95% confidence interval (CI), and the rate of CRBSI per 1000 catheter-days and bacterial colonization rate were measured. The primary outcome was CRBSI thousand day rate and the secondary outcome was bacterial colonization rate. The meta analysis was performed by R3.4.1 software. Results Seventeen trials included 4892 patients who received chlorhexidine/sulfadiazine silver coated catheters and conventional standard catheters were included. Compared with conventional standard catheters, chlorhexidine/ silver sulfadiazine catheters were associated with a lower incidence of catheter colonization (RR=0.55, 95%CI: 0.45-0.68, P=0.02). In addition, the the difference of the rate of CRBSI per 1000 catheter-days was not significant (RR=0.70, 95%CI: 0.48-1.02, P=0.32). Conclusion Compared with conventional standard catheters, the use of chlorhexidine/silver sulfadiazine-catheters with bundles can further reduce the incidence of catheter colonization, but does not reduce the rate of CRBSI per 1000 catheter-days.

Tissue healing efficacy in burn patients treated with 1% silver sulfadiazine versus other treatments: a systematic review and meta-analysis of randomized controlled trials

Abstract This study aims to evaluate tissue healing efficacy in burn patients treated with 1% silver sulfadiazine versus other treatments. This is a systematic literature review and meta-analysis of randomized clinical trials performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) and PICO strategy, registered in the International Prospective Register of Systematic Reviews (PROSPERO) under the number CRD42017081057. The review found 71 studies in MEDLINE/Pubmed, 1 in Clinical Trials, 19 in the Cochrane Library, and 4 in LILACS in five manual searches. Of these, 81 studies were pre-selected. After independent analysis by two reviewers, only 11 studies met the inclusion criteria for the review. All studies (n = 11) using alternative treatments to silver sulfadiazine were shown to be superior in the mean time for complete wound healing, with statistically significant differences between experimental and control groups (p <0.00001); mean difference (- 4.26), 95% CI [- 5.96, - 2.56].

Comparison of Collage Dressing with Sulfadiazine Dressing in Management of Partial-thickness Burns

Introduction: Collagen is an endogenous substance, which forms an important structural component in connective tissue andis of special importance in the skin. The importance of collagen in healing has been appreciated for many years for the simplereason that the end result of wound healing is always a scar which is composed of collagenous fibers.Aims: This prospective randomized controlled study was designed to compare the effectiveness of collagen dressing and silversulfadiazine dressing in partial-thickness burns.Materials and Methods: This study was conducted at Government Royapettah Hospital, Chennai. A total of 60 patients withpartial-thickness burn wounds were included in this study, and they are divided into two groups. Group 1 consisted of 30 patientsin whom collagen dressing was done. Group 2 consisted of 30 patients in whom silver sulfadiazine dressing was done. Thevariables analyzed were pain score, infection rate, the rate of healing of the wound, resultant scar, and patient compliance.Patients with partial-thickness burns involving <40% of the total body surface area and wounds not older than 24 h are inclusioncriteria in the study, whereas patients with full-thickness burns, burns involving >40% of the total body surface area, woundsolder than 24 h, and facial burns are the exclusion criteria for this study.Results: The average pain score in the range of 0–10 was 7.10 in the silver sulfadiazine group and 2.87 in the collagen group.Infection was present in 40% of the patients in the silver sulfadiazine group, whereas it was only 13.3% in the collagen group. Insilver sulfadiazine group, healing was achieved on an average of 17.77 days, whereas in the collagen group, it took 11.80 days.Conclusion: Collagen sheet promotes early healing, decreases the need for analgesics, and reduces the incidence of associatedcomplications such as infection. The morbidity of the patients is reduced as the resultant scar is better in the majority of thepatients using collagen. Due to the simple application and good tolerance of the membrane, collagen can be advocated as atemporary biological dressing material in partial-thickness burns.

Comparative study of wound healing effect of topical Acacia catechu extract and silver sulfadiazine on excisional wound model in guinea pigs

Background: Impaired and aberrant wound healing imposes a huge financial burden and places an enormous drain in health care resources in the developed world and an insurmountable problem in the developing countries too. In this study, authors have compared the wound healing effect of topical application of Acacia catechu extract with silver sulfadiazine in excisional wound model in guinea pigs.Methods: Twelve guinea pigs were randomly divided into two groups (n=6). The wound healing was observed in excision model. The standard group is treated with silver sulfadiazine (group 1) and the test group with Acacia catechu extract (group 2). The mean wound size expressed in mm2 and the mean percentage of the wound healed was measured on day 0, 4, 8, 12, 16 and 19. Biopsy was done on day 21 for histopathological examination (HPE).Results: Statistical analysis was done by using unpaired t test for between the groups comparison and by using paired t test for within the group comparison. The mean percentage of the wound healed with-in the groups was found to be statistically highly significant (p value <0.001) and in between the groups was found to be statistically non-significant (p value >0.05). A comparable increase in collagen content and granulation tissue was found on HPE in both the groups on day 21.Conclusions: Wound healing effect of the Acacia catechu extract is equal to and comparable with that of silver sulfadiazine.

Loxoscelismo escrotal / Scrotal loxoscelism

Loxoscelismo es el cuadro clínico originado por la mordedura de araña del género Loxosceles. Es considerado un accidente que ocurre con mayor frecuencia en las noches, debido al hábito nocturno de la araña y buena adaptación a los ambientes domésticos, preferentemente en espacios oscuros y secos. Clínicamente presenta dos escenarios, cutáneo (83,3 %) y visceral o sistémico (16 %), con una variación del cuadro cutáneo denominado loxoscelismo predominantemente edematoso. El objetivo es informar un caso inusual de loxoscelismo escrotal. El diagnóstico se realizó mediante las características clínicas y epidemiológicas del accidente. En conclusión, el loxoscelismo escrotal es una entidad muy infrecuente, el manejo del paciente influye mucho en su evolución y progresión; el tratamiento exhaustivo con sulfadiazina 2 veces al día y antibióticos intravenosos, muestra resultados muy favorables.

Loxoscelism is a condition produced by the bite of spiders from the genus Loxosceles. It is considered to be an accident that occurs mostly in the night, due to the spider's nocturnal habits and good adaptation to domestic environments, preferably dark, dry spaces. It presents in two clinical scenarios: cutaneous (83.3 %) and visceral or systemic (16 %), with a variation in the cutaneous manifestation known as predominantly edematous loxoscelism. The objective of the study was to report an unusual case of scrotal loxoscelism. Diagnosis was based on the clinical and epidemiological characteristics of the accident. It is concluded that scrotal loxoscelism is a very infrequent condition. Management of the patient greatly influences its evolution and progress. Exhaustive treatment with sulfadiazine twice daily and intravenous antibiotics yields very favorable results.

Comparación de dos técnicas de curación en pacientes quemados pediátricos / Comparison of two healing techniques in pediatric burned patients

Introducción: Existen varias curaciones para quemaduras. La sulfadiazina de plata se ha usado por años pero las membranas microporosas son cada vez más preferidas. Objetivos: Comparar la eficiencia de las membrana microporosa (Telfa Clear®) versus sulfadiazina de plata (Platsul®) en menores de 15 años hospitalizados por quemadura. Pacientes y Métodos: Estudio de cohorte retrospectivo de 87 pacientes, dividido en 2 grupos comparables en extensión y profundidad de la quemadura, edad y sexo. Durante enero a diciembre 2007 se curaron 52 pacientes con Platsul® y desde enero a octubre 2008 se curaron 35 con Telfa Clear®. Se evalúa tiempos y extensión de reepitelización, porcentaje de injertos, costos, días de hospitalización, número de curaciones, complicaciones, almacenamiento-estabilidad y costos. Estadística no paramétrica para el análisis univariado y regresión logística multivariado en Stata 11.2. Resultados: Los pacientes curados con Platsul® se injertaron más tardíamente y presentan más curaciones. Platsul® es peor evaluado por su almacenamiento-estabilidad y mayores costos. No hay diferencia en la incidencia de infección. Conclusiones: Ambas Técnicas son eficientes en permitir reepitelización, pero Platsul® puede demorar el injerto. La Telfa Clear® es mejor evaluado por el equipo de salud en cuanto a almacenamiento y estabilidad. El menor costo de Telfa Clear® es una ventaja.

Introduction: There are several dressings for burns. Silver sulfadiazine has been used for years but microporous membranes are increasingly preferred. Objectives: To compare the efficiency of microporous membrane (Telfa Clear®) versus silver sulfadiazine (Platsul®) in children younger than 15 years old hospitalized for burns. Patients and Methodology: Retrospective cohort study of 87 patients, divided into 2 comparable groups in extent and depth of the burn, age and sex. During January to December 2007, in 52 patients Platsul® were use and in 35 patients Telfa Clear® were use from January to October 2008. The time and extent of re-epithelialization, percentage of grafts, costs, length of stay, number of dressing change, complications, storage-stability and costs are evaluated. Non-parametric statistics were used for univariate analysis and logistic regression for multivariate analysis en Stata 11.2. Results: Platsul® was associate to a later graft and had a greater number of dressing changes. Platsul® is worst rated for its storage-stability and higher costs. No difference in infection rate was observed. Conclusions: Both techniques are efficient in allowing re-epithelialization, but burns treated with Platsul® were grafted later than when Telfa Clear® was used. Telfa Clear® is best evaluated by the health team in terms of storage and stability. The cost of Telfa Clear® is presented as an advantage.

Effect of mannatide combined with silver sulfadiazine on the burn wounds / 中国基层医药

Objective To observe the effect of mannatide combined with silver sulfadiazine for burn wound. Methods A total of 128 cases with burn wound in the People's Hospital of Yangquan Suburb were selected in the research and randomly divided into two groups according to the digital table ,with 64 cases in each group.The control group was given mannatide treatment ,the observation group was treated with mannatide combined with silver sulfadia-zine.The burn wound appearance ,burn wound healing and the incidence of adverse reactions were compared between the two groups.Results The improve rate of wound,wound exudate rate,decrustation rate in the observation group were 82.81%,18.75%,62.50%,respectively,which were higher than those in the control group (50%,46.88%, 31.25%,χ2＝14.71,11.48,12.55,all P＜0.01).The immediate pain relief rate ,infection rate,incidence rate of scar formation and wound healing time in the observation group were 90.63%,3.13%,12.50%,(16.85 ±1.63)d, respectively,which were significantly better than those in the control group [62.50%,14.06%,28.13%,(23.64 ± 2.16)d],there were statistically significant differences between the two groups (χ2＝14.11,4.87,4.83,t＝20.07, all P＜0.05).The incidence rate of adverse reactions in the observation group was 3.13%,which was significantly lower than 14.06%in the control group (χ2＝4.87,P＜0.05).Conclusion Mannatide combined with silver sulfa-diazine is safe and effective in the treatment of burn wound.It can improve burn wound appearance and shorten wound healing time,which is suitable for use in clinical practice.

Queimaduras e suas cicatrizes / Management of burns and resulting scars

As queimaduras ainda são r esponsáveis por grande parte dos ferimentos e óbitos decorrentes de causas externas no Brasil, bem como por grande número de afastamento do trabalho e sequelas funcionais e estéticas, principalmente na população masculina. A avaliação das queimaduras deve levar em consideração o grau de profundidade, localização, acometimento de vias aéreas e agente causal. Nos casos com indicação de tratamento ambulatorial, o antimicrobiano tópico de escolha ainda é a sulfadiazina de prata a 1%, após lavagem adequada das lesões, além da profilaxia do tétano. A prevenção de cicatrizes hipertróficas e queloides é muito importante para evitar limitações de movimento e de convívio social.

Burns are still the cause of a great portion of injuries and deaths triggered by external factors in Brazil. Also, it is intensely linked to absenteeism, and functional and aesthetic sequelae, especially in the male population. The assessment of burns should take into account their depth and location, involvement of the upper airways and causative agent. In cases where the treatment is carried out in an outpatient setting, after adequate washing of the lesions, 1% silver sulfadiazine cream is still the topical antimicrobial of choice, in addition to tetanus prophylaxis. Aimed at avoiding possible limitations of motion and social interaction, the prevention of hypertrophic scars and keloids is very important.

Curativos de prata iônica como substitutos da sulfadiazina para feridas de queimaduras profundas: relato de caso / Ionic silver dressings as substitute for sulfadiazine for deep burn wounds: case report / Apósitos de plata iónica como sustitutos de sulfadiazina en las heridas por quemaduras profundas: reporte de caso

OBJETIVO: Este artigo tem por objetivo relatar as possíveis vantagens de curativos na forma de lâminas impregnadas com prata iônica (Atrauman®, Mepilex border Ag®, Mepilex-Ag® e Silvercel não aderente®) como agentes tópicos substitutos do creme de sulfadiazina de prata 1% nas queimaduras profundas. RELATO DOS CASOS: Foram tratados 31 pacientes. O Atrauman-Ag® foi empregado em 15 pacientes, o Mepilex border Ag® em três, Mepilex-Ag® em quatro e o Silvercel não aderente® em nove pacientes. Do total, relatamos a utilização destes novos curativos em dois pacientes do estudo com diagnóstico inicial de queimadura profunda. Em nenhum caso foram observados sinais de infecção nas feridas, apesar das trocas de curativos terem sido realizadas entre 4 a 7 dias, mesmo nas queimaduras de espessura total. O conforto propiciado por estes curativos foi evidente, minimizando o estresse e dor e as feridas de espessura parcial se apresentaram com sinais evidentes de rápida epitelização. CONCLUSÃO: Neste estudo preliminar, notamos que todos pacientes se beneficiaram de modo significativo do uso de curativos modernos com lâminas impregnadas por prata iônica quando comparados ao curativo convencional de sulfadiazina. Além da proteção contra infecção, mesmo nas queimaduras de espessura total, eles oferecem a enorme vantagem de as trocas serem espaçadas entre 4 a 7 dias, quando comparados à sulfadiazina, que exige a troca diária dos curativos, minimizando dor e desconforto aos pacientes e também o estresse da equipe de saúde envolvida nos Centros de Tratamento de Queimados.(AU)

OBJECTIVES: This article aims to evaluate the efficacy, and possible advantages of dressings in the form of ionic silver impregnated sheets (Atrauman Ag®, Mepilex Border Ag®, Mepilex - Ag® and Silvercel non - adherent®) as a local substitute agents for the cream of silver sulfadiazine-1% on deep burns. CASE REPORTS: 31 patients were treated. Atrauman-Ag® was used in 15 patients, Mepilex Border Ag® in three, Mepilex-Ag® in four and Silvercel non-adherent® in nine patients. Of the total, we report the use of these new dressings in two patients. In no case were signs of wound infection, even though dressing changes were performed between 4 and 7 days, also in total thickness burns. The comfort provided by these dressings was evident, minimizing stress and pain and partial thickness wounds presented with clear signs of rapid epithelization. CONCLUSION: In this preliminary study, we noticed that all patients benefited significantly from the use of new dressings with ionic silver impregnated sheets when compared to the conventional dressing of sulfadiazine cream. In addition to protection against infection, even in full-thickness burns, they offer the significant advantage that the changes of dressings are spaced between 4 and 7 days. Compared to sulfadiazine, which requires the daily exchange of dressings, they minimize pain and discomfort to patients, and also the stress to the health team involved in the treatment of the Burn Treatment Centers.(AU)

Objetivos: Este artículo tiene como objetivo evaluar la eficacia preliminar y los beneficios potenciales de la curación en forma de láminas impregnadas con plata iónica (Atrauman®, Mepilex Border Ag®, Mepilex-Ag® y Silvercel no aderente®) como sustitutos de crema de sulfadiazina de plata al 1% en quemaduras profundas. Casos Clínicos: Se han tratado 31 pacientes. El Atrauman-Ag® se utilizó en 15 pacientes, Mepilex Border Ag® en tres, Mepilex Ag® en cuatro y Silvercel no adherente® en nueve pacientes. Del total, se presenta la utilización de estos nuevos apósitos en dos pacientes. En ningún caso se observaron signos de infección en las heridas, a pesar de los cambios de apósito se llevaron a cabo entre los 4 y 7 días, incluso en quemaduras de espesor total. La comodidad ofrecida por éstos curación era evidente, lo que minimiza el estrés y el dolor y las heridas de espesor parcial se presentan con signos claros de una rápida epitelización. Conclusión: En este estudio preliminar, se observó que todos los pacientes se beneficiaron significativamente del uso de apósitos impregnados con plata iónica en comparación con sulfadiazina. Además de la protección contra la infección, incluso en quemaduras de espesor total, ofrecen la gran ventaja de las cambios están separadas de 4 a 7 días en comparación con sulfadiazina, que requiere el cambio diario de vendajes, minimizando dolor y malestar a los pacientes, e también el estrés del personal de salud de los centros de tratamiento de Queimados.(AU)

Preparation and property of gelatin hydrogel loaded with AgSD-nanocrystal / 国际药学研究杂志

Objective To prepare a silver sulfadiazine(AgSD)-nanocrystal loaded hydrogel with gelatin as the main raw mate-rial,genipin as crosslinker,and test its physicochemical property and drug release characteristics. Methods AgSD-nanocrystal was prepared by ball milling,the particle size and polydispersity index were determined,the solubility was studied by an ultra perfor-mance liquid chromatography(UPLC)method and the microstructure was observed with transmission electron microscope(TEM);drug loaded gelatin hydrogel in different crosslinking degrees were prepared,the dissolution rate was studied in the same way as AgSD-nanocrystal and the possible dissolution mechanism was analyzed by fitting curves;the microstructure was observed by scanning elec-tron microscope(SEM). After 6 weeks,with the same method,all the above mentioned properties of drug loaded hydrogel and AgSD-nanocrystal suspension were determined repeatedly,and at the same time their stability was tested. Results After nanocrystalliza-tion,the polydispersity index of AgSD was 0.211,the mean particle size was about 267.8 nm,the dissolution rate greatly increased within 6 hours compared with that of AgSD bulk powder. There was a negative correlation between dissolution rate and crosslinking de-gree,and the nanoparticle gel's curve was higher than that of the bulk. In terms of stability,AgSD-nanocrystal in hydrogel was almost in the original state in SEM,while those in suspention had an increasing particle size and decreasing dissolution rate. Conclusion The stability and dissolution of the new drug loaded hydrogel are good,and its data can be used as reference for relevant study.

Gelatin hydrogel loaded with silver sulfadiazine nanocrystal:in vitro anti-bacterial activities and in vivo wound healing enhancing properties / 国际药学研究杂志

Objective To prepare a gelatin hydrogel crosslinked by genipin and loaded with silver sulfadiazine(AgSD) nanoparticles,and test its in vitro anti-bacterial activities and in vivo wound healing enhancing properties. Methods The suspension of AgSD nanoparticles and coarse powder,hydrogels loaded with AgSD nanoparticles and coarse powder were prepared,respectively, and blank gels were used as control. The diameters of inhibition zone of sensitive bacteria were measured;The biocompatibility to L929 cells was studied by MTT method and relative growth rates of the cells were determined. The minimum inhibitory concentration (MIC)and minimum bactericidal concentration(MBC)of 3 sensitive bacteria were tested;DeepⅡdegree scald co-aureus infection mice model was established and the healing index of treatment by drug-loaded hydrogel dressing was calculated within 3 weeks. The collagen deposition was studied after sirius red staining and pathological manifestations were observed after HE staining. Results Compared with AgSD coarse powder,the antibacterial property of AgSD nanoparticles obviously improved in inhibition zone and MIC, MBC experiments. Better biocompatibility and antibacterial property were revealed for AgSD nanoparticles gel group compared with AgSD cream group in MTT assay and inhibition zone studies;Healing index increased significantly since the second week in AgSD nanoparticles gel group compared with staph group,AgSD cream group and AgSD coarse powder gel group in wound-healing experi-ment(P<0.05). Compared with those control groups,nanocrystal gel group had more content of typeⅠcollagen and total collagen, and higher pathology scores(P<0.05). Conclusion AgSD nanocrystal loaded gelatin hydrogel has good antibacterial activity in vitro and high quality healing enhancing property in vivo.

Study on Quality Standard for Shengji Ointment / 中国药师

Objective:To improve the quality standard for Shengji ointment. Methods:A TLC method was used to identify Resina draconis and Olibanum. An HPLC method was used to determine the content of silver sulfadiazine. The detection wavelength was set at 254 nm. The determination was performed on a Wondasil C18 column(250 mm × 4. 6 mm, 5 μm) with the mobile phase consisting of acetonitrile-0. 1% phosphoric acid(8: 92). The injection volume was 5 μl. Results:The TLC spots were clear, specific and repro-ducible. A good linear relationship was obtained between the peak areas and the concentrations of sulfadiazine within the range of 40. 97-1024. 18 μg·ml-1(r=0. 9999). The average recovery was 100. 17% (RSD=0. 64%,n=6). Conclusion: The methods are easy-operated, specific, reproducible and accurate, which can be used for the quality control of the preparation.

Effect of honey dressing and silver sulfadiazine dressing for wound healing in burn patients:A Meta-analysis / 中国实用护理杂志

Objective To compare the effects of honey dressing and silver sulfadiazine dressing for wound healing in burn patients by Meta-analysis.Methods All the randomized controlled trials were collected by searching many kinds of databases in or out of the country to compare honey dressing with silver sulfadiazine dressing for wound healing in burn patients.Review Manager 5.2 was used to analyze the effects.Results Six randomized controlled trials (RCT) were included.Honey dressing was much better than silver sulfadiazine dressing for burn wounds,while there were no significant differences in positive rate of wound swab culture and healing days.Conclusions It can be proved that honey dressing has an advantage over silver sulfadiazine dressing in the wound healing days within 21 and final outcome.Whether honey dressing is superior to silver sulfadiazine dressing in antibacterial effects and healing days remains to be studied with adequate,powerful,high quality randomized controlled trials.

Pharmacodynamics of sulfadiazine silver-dyclonine composite film for the treatment of superficial II degree burn / 中国药学杂志

OBJECTIVE: To explore the pharmacodynamics of silver sulfadiazine-dyclonine composite film for the treatment of superficial TJ degree burn in rats. METHODS: Thirty SD rats were randomly divided into normal saline group, silver sulfadiazine film group and silver sulfadiazine-dyclonine composite film group(n = 10 in each group). The hair removal area of rats was scalded in 85°C water bath for 15s, producing superficial II degree burn model. The heart rates before and after the medication, changes of pain threshold, wound healing and cure rate were observed. RESULTS: Silver sulfadiazine-dyclonine composite film had little influence on the heart rate in the early period, however, the heart rate decreased slightly soon afterwards. Silver sulfadiazine-dyclonine composite film increased the pain threshold significantly. Compared to silver sulfadiazine film, silver sulfadiazine-dyclonine composite film had a little advantage on the average time for wound healing which were (19.5 ± 1.02) d for the composite film and (21 ± 1.18) d for the other one. On the 20th day, the cure rate of silver sulfadiazine-dyclonine composite film was 90%. CONCLUSION: Silver sulfadiazine-dyclonine composite film also has skin burn repair action as silver sulfadiazine film, and it has analgesis effect and can promote wound healing.

A comparative study of the effects of topical application of Aloe vera, thyroid hormone and silver sulfadiazine on skin wounds in Wistar rats / 한국실험동물학회지

Many research studies report the healing effects of Aloe Vera, thyroid hormone cream and silver sulfadiazine. However, the effects of these therapeutic agents are not well understood and have not been compared in one study. This study aimed at investigating the effects of topical application of an Aloe vera gel, a thyroid hormone cream and a silver sulfadiazine cream on the healing of skin wounds surgically induced in Wistar rats for determining the treatment of choice. In a randomized controlled trial, twelve male rats, aged 120 days and with a mean weight of 250 to 300 g, were divided randomly into 5 groups based on drug treatments: Aloe vera gel (AV), thyroid hormone cream (TC), silver sulfadiazine 1% (S), vehicle (V) and control. To evaluate the efficacy of each treatment technique, a biomechanical approach was used to assess tensile stress after 14 days of treatment. Tensile stress was significantly improved in the Aloe vera gel group as compared with the other four groups (P< or =0.05). While the other treatment options resulted in better healing than the control group, this difference was not significant. We conclude that Aloe vera topical application accelerated the healing process more than thyroid hormone, silver sulfadiazine and vehicle in surgically induced incisions in rats.