Amniotic membrane dressing vs conventional topical antibiotic dressing hospitalized brun patients

Different natural and synthetic materials were used for temporary burn wound coverage; however, they are associated with disadvantages including high price which prohibit their widespread use, especially in developing countries. Among all, human amniotic membrane is the only easily available and cost free coverage. Its effects on burn wounds have been studied in this survey. One-hundred and twenty four patients with 20-50% second and third degree burns and without any other disease were randomly assigned into two groups. The first 61 patients [control group] underwent traditional method of dressing with silver sulfadiazine and gauze which were changed twice a day. The remaining 63 patients underwent dressing with human amniotic membrane [amnion group], being changed every 3-4 days. Patients in the control group had significantly lower albumin and needed more albumin infusion [231.80 +/- 234 gr. versus 111.51 +/- 143.82 gr.], received more blood transfusion [1.75 +/- 2.52 bags versus 0.65 +/- 1.18 bags], had significantly more intense pain and so received more narcotics than amnion group [7.97 +/- 12.85 doses versus 3.84 +/- 7.56]. Wound infection was higher in the control group [65.66% versus 46.91%] and so was the incidence of sepsis [24.62% versus 6.10%]. There was 8.53% mortality in the control group versus 0% in the amnion group. All of the above-mentioned differences were statistically significant. Amniotic membrane dressing in deep and more extensive burns leads to better homeostatic, immunologic and local results and because of its low price, its use is strongly recommended

Therapeutic effects of honey versus silver sulphadiazine in the management of burn injuries

To determine the therapeutic effects of honey versus silver sulphadiazine 1% in the management of burn injuries, in our set up. A quasi-experimental study. Burns emergency unit, department of Plastic Surgery Liaquat University Hospital, Hyderabad - Sindh form January 2002 to December 2003. Eighty patients having age range of 4 to 62 years with burn involving 10% to 40% body surface area were studied. Patients presenting with chemical or electric burn, and those with full thickness burn were excluded. Majority of cases was males. Patients were divided in two groups. One group received treatment with honey while other received silver sulphadiazine. Honey used was natural and unprocessed. Patients treated with honey showed rapid wound healing with no apparent local or systemic side effects. Mean duration of healing in honey treated group was 15.3 days. While in other group, mean was 20 days. Patients treated with honey did not develop growth of any pathogenic organism. However, 32[80%] patients treated with silver sulphadiazine showed growth of different pathogenic organisms necessitating the use of systemic antibiotic therapy accordingly. In honey group, only 3[7.5%] patients developed contracture as compared to 7[17.5%] patients treated with silver sulphadiazine. After complete healing, itching/pruritus was complained by 13[32.5%] patients treated with silver sulphadiazine while only 2[5%] patients complained so treated with honey. The burn wounds are healed rapidly by using honey with minimum scarring and pigmentation as compared to silver sulphadiazine. Use of honey in these patients can be cost effective in terms of treatment and hospital stay. However, to develop more confidence with the use of honey in burn wound management, more studies with larger sample size are needed

Sulfadiazina de prata e outros fármacos utilizados no tratamento de queimados / Silver sulfadiazine and other drugs used in burns treatment

O uso de antibactérianos tópicos tem papel decisivo no controle de infecçoes em queimaduras.A presente revisao discute vantagens e desvantagens dos fármacos disponíveis para o tratamento de queimados:nitrato de prata,iodopovidona, mafenida,acido acetico,nitrofurazona,hipoclorito de sodio,clorexidina,gentamicina,sulfadiazida de prata.Para esse último,atualmente o mais utilizado no tratamento tópico sao apresentados dados relativos ao estectro de açao,farmacocinética,reaçoes adversas e precauçoes no emprego terapêutico.