Silvadene (silver sulfadiazine) was invented in the 1960s for burn care, and as far as I know, could be said to be the first commercial silver product on the market. Like other silvers, it is a broad-spectrum antimicrobial with no known resistance and is still used for wound care to this day. The problem with Silvadene is that it contains a large amount of silver that is rapidly"dumped" into the wound with each application. This silver is quickly depleted, and then there is no more coverage of silver as an antimicrobial in the wound bed until the next application. This is unlike more modern silver dressings that provide continuous silver coverage and antimicrobial effect. The high amount of silver dumped into the wound may be cytotoxic and could actually delay wound healing. Also, Silvadene creates what some have called a "pseudo-eschar"that comes about with continued application despite wound cleansing. This means the Silvadene is going on top of the previous layer of Silvadene and so on and so forth and not getting to the wound bed. It is contraindicated in pregnancy and in neonates, with concern for systemic absorption. With large wounds, it can even cause hematologic effects such as agranulocytosis and aplastic anemia and also sensitivities. Not even to mention the soupy mess it can make! Having said that, I do still use it occasionally in my practice. When do I use it? Usually when other options are really limited and for whatever reasons we are unable to get other dressings for patients. It has occasionally worked well in palliative wounds where healing maybe is no longer the goal. It is easy to get, relatively cheap, easy to teach patients to apply, and is usually covered by insurances.
Silvadene (silver sulfadiazine) was invented in the 1960s for burn care, and as far as I know, could be said to be the first commercial silver product on the market. Like other silvers, it is a broad-spectrum antimicrobial with no known resistance and is still used for wound care to this day. The problem with Silvadene is that it contains a large amount of silver that is rapidly"dumped" into the wound with each application. This silver is quickly depleted, and then there is no more coverage of silver as an antimicrobial in the wound bed until the next application. This is unlike more modern silver dressings that provide continuous silver coverage and antimicrobial effect. The high amount of silver dumped into the wound may be cytotoxic and could actually delay wound healing. Also, Silvadene creates what some have called a "pseudo-eschar"that comes about with continued application despite wound cleansing. This means the Silvadene is going on top of the previous layer of Silvadene and so on and so forth and not getting to the wound bed. It is contraindicated in pregnancy and in neonates, with concern for systemic absorption. With large wounds, it can even cause hematologic effects such as agranulocytosis and aplastic anemia and also sensitivities. Not even to mention the soupy mess it can make! Having said that, I do still use it occasionally in my practice. When do I use it? Usually when other options are really limited and for whatever reasons we are unable to get other dressings for patients. It has occasionally worked well in palliative wounds where healing maybe is no longer the goal. It is easy to get, relatively cheap, easy to teach patients to apply, and is usually covered by insurances.