TY - JOUR
T1 - Effectiveness of cerium nitrate-silver sulfadiazine in the treatment of facial burns
T2 - a multicenter, randomized, controlled trial
AU - Facial Burns Group
AU - Oen, Irma M M H
AU - van Baar, Margriet E
AU - Middelkoop, Esther
AU - Nieuwenhuis, Marianne K
PY - 2012/8/1
Y1 - 2012/8/1
N2 - BACKGROUND: The face is a very frequent site of burn injuries. This multicenter, randomized, controlled trial thus investigates the effectiveness of cerium nitrate-silver sulfadiazine in the treatment of facial burns compared with silver sulfadiazine.METHODS: Adult patients with acute facial burns admitted to Dutch burn centers were randomized to treatment with either cerium nitrate-silver sulfadiazine or silver sulfadiazine. Primary outcome was need for surgery and time to wound healing. Aesthetic and functional outcome was assessed at 3, 6, and 12 months after burn.RESULTS: From March of 2006 until January of 2009, 179 patients were randomized and 154 could be included. The two groups of patients (cerium nitrate-silver sulfadiazine group, n=78; silver sulfadiazine group, n=76), were comparable regarding sex, age, percentage total body surface area burned, and cause. During admission, four patients died, leaving 77 and 73 patients for primary analyses, respectively. Surgery was required in 13 (16.9 percent) compared with 15 patients (20.5 percent) (p=0.57; odds ratio, 0.8; 95 percent CI, 0.3 to 1.8), respectively. Median time to wound healing was 11.0 days in the cerium nitrate-silver sulfadiazine group (interquartile range, 7.0 to 15.0) and 9.0 days for silver sulfadiazine group (interquartile range, 5.0 to 15.75) (p=0.17). There were no significant differences in functional and aesthetic outcome.CONCLUSIONS: No differences were found in effectiveness of both treatments. The vast majority of facial burns do not require surgery, and treatment with cerium nitrate-silver sulfadiazine and silver sulfadiazine leads to satisfactory outcome, both aesthetically and functionally.
AB - BACKGROUND: The face is a very frequent site of burn injuries. This multicenter, randomized, controlled trial thus investigates the effectiveness of cerium nitrate-silver sulfadiazine in the treatment of facial burns compared with silver sulfadiazine.METHODS: Adult patients with acute facial burns admitted to Dutch burn centers were randomized to treatment with either cerium nitrate-silver sulfadiazine or silver sulfadiazine. Primary outcome was need for surgery and time to wound healing. Aesthetic and functional outcome was assessed at 3, 6, and 12 months after burn.RESULTS: From March of 2006 until January of 2009, 179 patients were randomized and 154 could be included. The two groups of patients (cerium nitrate-silver sulfadiazine group, n=78; silver sulfadiazine group, n=76), were comparable regarding sex, age, percentage total body surface area burned, and cause. During admission, four patients died, leaving 77 and 73 patients for primary analyses, respectively. Surgery was required in 13 (16.9 percent) compared with 15 patients (20.5 percent) (p=0.57; odds ratio, 0.8; 95 percent CI, 0.3 to 1.8), respectively. Median time to wound healing was 11.0 days in the cerium nitrate-silver sulfadiazine group (interquartile range, 7.0 to 15.0) and 9.0 days for silver sulfadiazine group (interquartile range, 5.0 to 15.75) (p=0.17). There were no significant differences in functional and aesthetic outcome.CONCLUSIONS: No differences were found in effectiveness of both treatments. The vast majority of facial burns do not require surgery, and treatment with cerium nitrate-silver sulfadiazine and silver sulfadiazine leads to satisfactory outcome, both aesthetically and functionally.
KW - adult
KW - anti-infective agents
KW - burns/drug therapy
KW - cerium/therapeutic use
KW - drug combinations
KW - facial injuries/drug therapy
KW - female
KW - follow-up studies
KW - humans
KW - Kaplan-Meier Estimate
KW - length of stay
KW - logistic models
KW - male
KW - middle aged
KW - prospective studies
KW - silver sulfadiazine/therapeutic use
KW - treatment outcome
KW - Wound Healing
KW - statistics & numerical data
KW - volwassene
KW - brandwonden
KW - infectiewerende middelen
KW - geneesmiddelentherapie
KW - therapeutisch gebruik
KW - combinatie van geneesmiddelen
KW - aangezichtsblessures
KW - vrouwelijk
KW - vervolgstudies
KW - mensen
KW - duur van opname
KW - statistieken
KW - numerieke data
KW - logistieke modellen
KW - middelbare leeftijd
KW - mannelijk
KW - prospective studies
KW - behandelingsresultaat
U2 - 10.1097/prs.0b013e3182589d63
DO - 10.1097/prs.0b013e3182589d63
M3 - Article
C2 - 22842424
SN - 0032-1052
VL - 130
SP - 274
EP - 283
JO - Plastic and Reconstructive Surgery
JF - Plastic and Reconstructive Surgery
IS - 2
ER -