![]() Iwasaki et al reported elevated serum silver levels and rapid deterioration of mental status in a burn patient with end Thus amount of cream used, positively correlated with urinary silver excretion. Boosalis et al noted modestly elevated serum silver levels and markedlyĮlevated urinary silver excretion in 23 patients with second- and third-degree burns treated with SSD cream. Renal insufficiency accelerates silver accumulation. The sulfadiazine portion is eliminated quickly, whereas the silver Silver sulfadiazine is eliminated via renal excretion. It is thought that this transient leucopenia portends little risk for the patient. Leucopenia is commonly reported during the first two to three days of therapy with SSD cream but generally resolves spontaneously Hepatic, renal, and neurological toxicity may ensue. Silver also deposits in the labial mucosa, gingiva, cornea, and internal organs. ![]() Prolonged use of SSD cream may lead to argyria. Risk of systemic absorption and toxicity. Prolonged and excessive use of SSD cream in the treatment of extensive and chronic blistering disorders likely confers significant The association of SSD cream use and silver toxicity is well-demonstrated in the literature with reference to burn patients. Used commonly to treat bullous disorders, such as pemphigus vulgaris, epidermolysis bullosa, and toxic epidermal necrolysis. Silver sulfadiazine (SSD) cream, known for its antibacterial effects when used as a dressing for extensive burn wounds, is When prescribing protracted wound care with SSD for blistering disorders. Hence we recommend that clinicians exercise caution In burn patients may be applicable to patients with bullous diseases. Renal insufficiency accelerates silver accumulation and thus toxicity.ĭata on silver toxicity in patients with primary blistering disorders is scarce however the literature regarding silver toxicity Toxicity has been well documented in burn patients. The beneficial antibacterial effect of SSD use is not without risk, as silver ![]() Management of erosions in bullous disorders. Silver sulfadiazine (SSD) cream, most known for its use in the treatment of extensive burn wounds, is commonly used in the The drug should not be withdrawn from the therapeutic regimen while there remains the possibility of infection except if a significant adverse reaction occurs.Silver sulfadiazine therapy in widespread bullous disorders: Potential for toxicityĮmily M Mintz, Dornechia E George, Sylvia Hsu Dermatology Online Journal 14 (3): 19 Department of Dermatology, Baylor College of Medicine, Houston, TX, USA Abstract Treatment with SILVADENE Cream 1% should be continued until satisfactory healing has occurred, or until the burn site is ready for grafting. However, if individual patient requirements make dressings necessary, they may be used. Administration may be accomplished in minimal time because dressings are not required. Whenever necessary, the cream should be reapplied to any areas from which it has been removed by patient activity. The cream should be applied once to twice daily to a thickness of approximately 1/16 inch. The burn areas should be covered with SILVADENE Cream 1% at all times. ![]() The burn wounds are then cleansed and debrided, and SILVADENE Cream 1% (silver sulfadiazine) is applied under sterile conditions. Prompt institution of appropriate regimens for care of the burned patient is of prime importance and includes the control of shock and pain.
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