Is silver sulfadiazene the best dressing for burns?

A 2013 systematic review evaluated 30 randomized controlled trials (RCTs) (N=1,749) investigating wound dressings for healing of superficial and partial thickness burns in adults and children. Wound dressings were usually applied once or twice a day. Data were not pooled because of study heterogeneity and missing data. Overall, the included trials were rated as low quality because of issues with blinding, randomization, and allocation concealment. The primary outcome of healing time was defined as time to complete wound healing and reported in both mean and median number of days, depending on the individual trial. Hydrocolloid, silicon-coated nylon, biosynthetic, and silver impregnated dressings had faster healing times compared with silver sulfadiazene cream. However, when silver sulfadiazene cream was combined with a chlorhexidine-impregnated paraffin gauze dressing, no difference was noted in healing time compared with hydrocolloid dressings. Three trials (N=213) yielded conflicting results on healing time with fiber dressings compared with silver sulfadiazene.