Comparison of Silver-Content Hydrofiber Dressing Material and Silver Sulphadiazine in Geriatric Burn Patients

Abstract

Background: Elderly burn patients often experience delayed wound healing and increased morbidity due to age-related physiological changes. Effective pain management and accelerated healing are crucial in this population. Objective: To compare the efficacy of silver-containing hydrofiber dressing (Aquacel® Ag) and 1% silver sulfadiazine (GSD) in the management of superficial partial-thickness burns in geriatric patients. Methods: This retrospective study included 73 patients over 60 years of age treated for scalding burns between 2009 and 2011. Patients were divided into two groups: Group I received Aquacel® Ag, and Group II received 1% GSD. Pain scores, dressing frequency, epithelialization time, and itching duration were recorded and analyzed using t-tests and chi-square tests. Results: Group I required fewer dressing changes and reported significantly lower pain scores and analgesic needs compared to Group II (p<0.001). Epithelialization occurred earlier in Group I, and itching duration was shorter (p<0.001). Fewer hospital visits were needed in the Aquacel® Ag group, improving patient compliance and comfort. Conclusion: Aquacel® Ag appears to be more effective than GSD in geriatric burn patients in terms of pain reduction, fewer dressing changes, and faster healing. These advantages may improve outpatient management and reduce morbidity in elderly patients with burn injuries.

Keywords

• Burn injuries
• Geriatric patients
• Silver sulfadiazine
• Aquacel Ag
• Hydrofiber dressing
• Wound healing
• Pain management

Geriatrik Yanık Hastalarında Gümüş İçerikli Hidrofiber Pansuman Materyali ile Gümüş Sülfadiazin Karşılaştırması

Öz

Giriş: Yaşlı yanık hastalarında, yaşa bağlı fizyolojik değişiklikler nedeniyle yara iyileşmesi sıklıkla gecikir ve morbidite artışı görülür. Bu hasta grubunda etkili ağrı yönetimi ve hızlandırılmış yara iyileşmesi büyük önem taşımaktadır. Amaç: Bu çalışmanın amacı, geriatrik hastalarda yüzeyel kısmi kalınlıktaki (superficial partial-thickness) yanıkların tedavisinde gümüş içeren hidrofiber pansuman (Aquacel® Ag) ile %1 gümüş sülfadiazinin (GSD) etkinliğini karşılaştırmaktır. Yöntemler: Bu retrospektif çalışmaya, 2009–2011 yılları arasında haşlanma yanığı nedeniyle tedavi edilen ve 60 yaş üzeri 73 hasta dahil edilmiştir. Hastalar iki gruba ayrılmıştır: Grup I'e Aquacel® Ag uygulanırken, Grup II'ye %1 GSD uygulanmıştır. Ağrı skorları, pansuman sayısı, epitelizasyon süresi ve kaşıntı süresi kaydedilmiş ve t-testi ile ki-kare testleri kullanılarak analiz edilmiştir. Bulgular: Grup I, Grup II'ye kıyasla daha az pansuman gereksinimi göstermiş, anlamlı derecede daha düşük ağrı skoru ve analjezik ihtiyacı bildirmiştir (p<0.001). Epitelizasyon Grup I’de daha erken gerçekleşmiş ve kaşıntı süresi daha kısa bulunmuştur (p<0.001). Aquacel® Ag grubunda daha az hastane ziyareti gerekmiş, bu da hasta uyumu ve konforunu artırmıştır. Sonuç: Aquacel® Ag, geriatrik yanık hastalarında ağrı azaltımı, daha az pansuman gereksinimi ve daha hızlı iyileşme açısından GSD’ye göre daha etkili görünmektedir. Bu avantajlar, ayaktan tedavi sürecini iyileştirebilir ve yaşlı hastalarda yanık morbiditesini azaltabilir.

Anahtar Kelimeler

• Yanık yaralanmaları
• Geriatrik hastalar
• Gümüş sülfadiazin
• Aquacel Ag
• Hidrofiber pansuman
• Yara iyileşmesi
• Ağrı yönetimi

Kaynakça

1. 1. Romanowski KS, Sen S. Wound healing in older adults with severe burns: clinical treatment considerations and challenges. Burns Open. 2022;6(2):57–64. [Crossref]
2. 2. Secanho MS, Rajesh A, Menezes Neto BF, Maciel ABPDO, Chequim MM, Rocha C, et al. Epidemiology of burn-related morbidity and mortality in patients over 80 years of age. J Burn Care Res. 2022;43(5):1042–7. [Crossref]
3. 3. Savetamal A. Infection in elderly burn patients: what do we know? Surg Infect (Larchmt). 2021;22(1):65–8. [Crossref]
4. 4. Firchal EW, Sjoberg F, Fredrikson M, Pompermaier L, Elmasry M, Steinvall I. Long-term survival among elderly after burns compared with national mean remaining life expectancy. Burns. 2021;47(6):1252–8. [Crossref]
5. 5. Kankam HK, Lee KC, Sardeli AV, Dretzke J, Lord JM, Moiemen N. Acute burn injuries associated with long-term mortality: a systematic review and meta-analysis. Burns. 2022;48(8):1783–93. [Crossref]
6. 6. Mulatu D, Zewdie A, Zemede B, Terefe B, Liyew B. Outcome of burn injury and associated factors among patients visited at Addis Ababa Burn, Emergency and Trauma Hospital: a two-year hospital-based cross-sectional study. BMC Emerg Med. 2022;22(1):199. [Crossref]
7. 7. Abazari M, Ghaffari A, Rashidzadeh H, Badeleh SM, Maleki Y. A systematic review on classification, identification, and healing process of burn wound healing. Int J Low Extrem Wounds. 2022;21(1):18–30. [Crossref]
8. 8. Khalid KA, Nawi AFM, Zulkifli N, Barkat MA, Hadi H. Aging and wound healing of the skin: a review of clinical and pathophysiological hallmarks. Life (Basel). 2022;12(12):2142. [Crossref]

9. 9. Alam W, Hasson J, Reed M. Clinical approach to chronic wound management in older adults. J Am Geriatr Soc. 2021;69(8):2327–34. [Crossref]
10. 10. Farzan R, Firooz M, Ghorbani Vajargah P, Mollaei A, Takasi P, Tolouei M, et al. Effects of aromatherapy with Rosa damascena and lavender on pain and anxiety of burn patients: a systematic review and meta-analysis. Int Wound J. 2023;20(6):2459–72. [Crossref]
11. 11. Lan X, Tan Z, Zhou T, Huang Z, Huang Z, Wang C, et al. Use of virtual reality in burn rehabilitation: a systematic review and meta-analysis. Arch Phys Med Rehabil. 2023;104(3):502–13. [Crossref]
12. 12. Ennab RM, Aljabali AA, Charbe NB, Barhoum A, Alqudah A, Tambuwala MM. Nanocelluloses in wound healing applications. In: Handbook of Nanocelluloses: Classification, Properties, Fabrication, and Emerging Applications. Cham: Springer International Publishing; 2022. p. 1–28. [Crossref]
13. 13. Mudgal M, Dharmarajan TS. Dermatological manifestations in endocrine disorders. In: Norman R, Dharmarajan TS, editors. Geriatric Dermatology. Cham: Springer; 2025. p. 1–35. [Crossref]
14. 14. Rajhathy EM, Vander Meer J, Valenzano T, Laing LE, Woo KY, Beeckman D, et al. Wound irrigation versus swabbing technique for cleansing non-infected chronic wounds: a systematic review of differences in bleeding, pain, infection, exudate, and necrotic tissue. J Tissue Viability. 2023;32(1):136–43. [Crossref]
15. 15. Charlesworth P, Klaassen MF. Chapple’s principles of wound care and healing: the physiological challenge. Cham: Springer Nature; 2024. [Crossref]
16. 16. Reza B, Soheil N, Ehsan B, Kourosh S, Reza F. Efficacy of photo biomodulation therapy for pain relief and soft tissue wound healing after dental implant surgery: a double-blind randomized clinical trial. J Photochem Photobiol B. 2021;8:100062. [Crossref]
17. 17. Caruso DM, Foster KN, Blome-Eberwein SA, et al. Randomized clinical study of hydrofiber dressing with silver or silver sulfadiazine in the management of partial-thickness burns. J Burn Care Res. 2006;27(3):298–309. [Crossref]
18. 18. Muangman P, Pundee C, Opasanon S, et al. A prospective, randomized trial of silver-containing hydrofiber dressing versus 1% silver sulfadiazine for the treatment of partial thickness burns. Int Wound J. 2010;7(4):271–6. [Crossref]
19. 19. Arviansyah A, Puling IMDR, Ibrahim FZ, Alvionita NM, Augustine F, Wilyanto SE, et al. Effectiveness and safety of Aquacel Ag in burn injury management: a systematic review and meta-analysis of randomized controlled trials. Teikyo Med J. 2023;46(9):8203–10. [Crossref]
20. 20. Joergensen B, Blaise S, Svensson AS. A randomised, open-label, parallel-group, multicentre, comparative study to compare the efficacy and safety of Exufiber® with Aquacel® Extra™ dressings in exuding venous and mixed aetiology leg ulcers. Int Wound J. 2022;19:223–8. [Crossref]