title: Topical petrolatum gel alone versus topical silver sulfadiazine with standard gauze dressings for the treatment of superficial partial thickness burns in adults: a randomized controlled trial.
abstract: BACKGROUND
  Non-extensive superficial partial thickness burns constitute a major proportion of burns. Conventional treatment involves regular changing of absorptive dressings including the application of a topical antimicrobial, commonly silver sulfadiazine. A systematic review has found insufficient evidence to support or refute such antimicrobial prophylaxis. Another review compared silver sulfadiazine dressings with other occlusive and non-antimicrobial dressings and found insufficient evidence to guide practice. Other research has suggested that dressings with petrolatum gel are as effective as silver sulfadiazine.
  
  
  METHODS
  Single-center, randomized, controlled parallel group trial comparing conventional silver sulfadiazine dressings with treatment with petrolatum gel alone. Consenting adults 18-45 years old with superficial partial thickness burns≤10% total body surface area seen within 24h of the injury were randomized to daily dressing either with petrolatum gel without top dressings or conventional silver sulfadiazine treatment with gauze dressings. Primary outcomes were blinded assessment of time to complete re-epithelialization, wound infection or allergic contact dermatitis. Secondary outcomes included assessment of ease, time and pain of dressing changes.
  
  
  RESULTS
  26 patients were randomized to petrolatum and 24 to silver sulfadiazine dressings. Follow up data available for 19 in each group. Mean time to re-epithelialization was 6.2 days (SD 2.8) in the petrolatum group and 7.8 days (SD 2.1) in the silver sulfadiazine group (p=0.050). No wound infection or dermatitis was observed in either group. Scores for adherence to wound, ease of dressing removal and time required to change dressings were significantly better in the petrolatum treatment arm (p<0.01).
  
  
  CONCLUSIONS
  Petrolatum gel without top dressings may be at least as effective as silver sulfadiazine gauze dressings with regard to time to re-epithelialization, and incidence of infection and allergic contact dermatitis. Petrolatum gel appears to be an effective, affordable and widely available alternative in the treatment of minor superficial partial thickness burns in adults.
authors.affiliation: Division of Plastic Surgery, Department of Surgery, Philippine General Hospital, University of the Philippines, Manila, Philippines. Electronic address: gsgenuino@gmail.com.
authors.forename: Glenn Angelo S
authors.initials: GA
authors.lastname: Genuino
authors.affiliation: Division of Plastic Surgery, Department of Surgery, Philippine General Hospital, University of the Philippines, Manila, Philippines. Electronic address: rina_baluyut@yahoo.com.
authors.forename: Kathrina Victoria
authors.initials: KV
authors.lastname: Baluyut-Angeles
authors.affiliation: Division of Plastic Surgery, Department of Surgery, Philippine General Hospital, University of the Philippines, Manila, Philippines. Electronic address: dreespiritu@gmail.com.
authors.forename: Andre Paolo T
authors.initials: AP
authors.lastname: Espiritu
authors.affiliation: Department of Surgery, Philippine General Hospital, University of the Philippines, Manila, Philippines. Electronic address: melalapitan@gmail.com.
authors.forename: Marie Carmela M
authors.initials: MC
authors.lastname: Lapitan
authors.affiliation: Department of Surgery, Philippine General Hospital, University of the Philippines, Manila, Philippines; Division of Primary Care, National University of Ireland, Galway, Ireland. Electronic address: briansbuckley@gmail.com.
authors.forename: Brian S
authors.initials: BS
authors.lastname: Buckley
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D001458:Bandages; D002056:Burns / Q000188:drug therapy*; D004643:Emollients / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D010577:Petrolatum / Q000627:therapeutic use*; D062326:Re-Epithelialization; D012837:Silver Sulfadiazine / Q000627:therapeutic use*; D016037:Single-Blind Method; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000891:Anti-Infective Agents, Local; D004643:Emollients; D010577:Petrolatum; D012837:Silver Sulfadiazine
keywords: Dressings; Partial thickness burns; Petrolatum; Silver sulfadiazine