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Silver sulfadiazine impairs wound healing in mice.


Silver sulfadiazine appeared to disrupt cytokine activity, suppress macrophage recruitment, and inhibit collagen deposition and re-epithelialization in mice with full-thickness burns, according to the results of a study involving 102 mice.

"Our data suggest a mechanism by which SSD [silver sulfadiazine] impairs wound healing. Treatment with SSD alters the cytokine milieu resulting in aberrant recruitment and activation of macrophages. Histological analysis revealed decreased macrophage recruitment and impaired collagen deposition and re-epithelialization," wrote coauthors Jamie Rosen and Angelo Landriscina and their associates at the Albert Einstein College of Medicine, New York. "Further investigations are necessary," they added.

SSD is a broad-spectrum antimicrobial used widely for treating second- and third-degree burns. Despite its popularity, some past studies have found it inferior to other wound treatments.

To explore why, the investigators created two full-thickness thermal burns each on the backs of 102 mice and treated 46 of the mice with 50 mcL of 1% SSD cream per wound/ day. The other mice served as untreated controls (J. Invest. Dermatol. 2015 [doi: 10.1038/jid.2015.21])

Photographs and computerized wound measurements showed that by day 3, the SSD group had greater wound expansion than did the control group (49.7%, compared with 23.8%; P < .0002), the researchers reported.

Furthermore, the SSD group had only 16.3% wound closure by day 10, compared with 42.1% for controls (P < .005). Cytokine assays showed that the SSD group also had lower expression of IL-1 and IL-1ra, while histologic studies revealed fewer macrophages and less collagen deposition and re-epithelialization.

"We hypothesize that SSD alters gene expression of IL-1 family genes, resulting in impaired downstream cytokine production and ultimately delayed wound healing," concluded the authors.

But because data in mice do not always translate to humans, more studies would be needed to confirm the mechanism.


Key clinical point: Silver sulfadiazine may impair wound healing.

Major finding: By day 10, mice treated with silver sulfadiazine had only 16.2% wound closure, compared with 42.1% for untreated controls (P < .005).

Data source: Histologic, clinical, and cytokine evaluations of 102 mice with full-thickness burns.

Disclosures: The investigators reported no funding sources and declared no relevant financial disclosures.

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Author:Karon, Amy
Publication:Dermatology News
Date:Mar 1, 2015
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