Table 1.
Summarized recommendations on topical antimicrobials with burn-wound infection prevention as an outcome
| Title, (PMID if available) | Quality assessment % (Mean appraisal score) % | Summary | ||||||
|---|---|---|---|---|---|---|---|---|
| Recommendations on topical antimicrobial agents to prevent burn-wound infection | ||||||||
| Burn wound depth (thickness) | Minor/ Major | Outpatient/ Inpatient | Clinical scenario | Addresses: AB, AS, ACD* | Recommended agents | Alternatives | ||
|
Wound, pressure ulcer and burn guidelines – 6: Guidelines for the management of burns, second edition
40
(PMID: 32343002) |
83.33 (75.79) | Partial | Major | Inpatient | Initial treatment | AB | Not specified. | Not specified. |
| Partial | Major | Inpatient | Not specified. | ACD | Silver-containing Hydrofiber (1A) | "Silver alginate and silver-containing polyurethane foam/soft silicone. (2A)" | ||
|
Guidelines for Burn Care Under Austere Conditions- Surgical and Nonsurgical Wound Management
39
(PMID: 27355660) |
58.33 (60.07) | Full | Major | Inpatient | Austere conditions, scarce supply, and delayed excision. | AB | Mafenide acetate 11% cream | Silver sulfadiazine as a sole agent, silver-containing dressings, aqueous 10% mafenide acetate solution, Dakin's solution, cerium-based products, honey. |
| Full | Major | Inpatient | AS | Silver sulfadiazine | ||||
| Full and Partial | Minor | Outpatient | Austere conditions | AS, AB | Silver sulfadiazine cream and Mafenide acetate, Silver impregnated dressings | Bacitracin, Polysporin®, and Neosporin® | ||
| Not specified | Minor | Outpatient | Austere conditions, facial burns | AB | Bacitracin, Polysporin®, and Neosporin® | Not specified. | ||
| European Practice Guidelines for Burn Care 38 | 75 (70.98) | Not specified | Not specified | Inpatient | Not specified. General recommendation. | ACD | Dressings containing nanocrystalline silver. | Not specified. |
| Behandlung thermischer Verletzungen des Erwachsenen (33) | 66.66 (69.39) | Superficial partial | Not specified | Inpatient | Not specified. | ACD | Silver-containing dressings. | Non-specified antimicrobial ointments, medicinal honey. |
| Partial (Unclear depth) | Not specified | Inpatient | Temporally unable to tell burn-wound depth. | ACD | Antiseptic dressings (Non-specific) | Not specified. | ||
| Best practice recommendations for the prevention and management of burns. In: Foundations of Best Practice for Skin and Wound Management. (32) | 66.66 (61.31) | Not specified | Not specified | Not specified | Not specified. General recommendation. | AS and AB | Honey, PMHB, Gentian Violet/Methylene Blue, Silver sulfadiazine (SSD) 1% cream, Mafenide acetate cream 11% or solution 5% | Not specified. |
| Not specified | Minor burns | Not specified | Not specified. | ACD | PVP-I dressings (Knitted viscose fabric impregnated with polyethylene glycose containing 1% povidone-iodine) | Not specified. | ||
| Deep-partial and full | Not specified | Inpatient | Burns awaiting surgery | ACD | Silver-containing dressings | Not specified. | ||
| Prise en charge du brûlé grave à la phase aiguë chez l’adulte et l’enfant (36) | 83.33 (80.90) | Full and Partial | Major | Inpatient | Emergency room. The patient cannot be transferred to a Burns Treatment Center within hours of the accident | ACD, AB, AS | Silver or antiseptic-containing dressings (Chlorhexidine, Povidone Iodine) | Not specified. |
| Clinical Guidelines: Diagnosis and Treatment Manual. Chapter 10: Medical and Minor surgical procedures, Burns. (31) | 16.66 (26.19) | Full and Partial | Major | Inpatient | Curative care at the dispensary and primary hospital in health care exclusion settings. | AS | Silver sulfadiazine | Not specified. |
| Not specified | Minor | Outpatient | AS | Silver sulfadiazine | ||||
| Clinical Guidelines: Burn Patient Management (30) | 66.66 (61.31) | Partial | Not specified | Not specified | Not specified. | ACD | Ionic silver dressings | Not specified. |
| Not specified | Not specified | Not specified. | ACD | Chlorhexidine impregnated paraffin gauze, Mesh gauze impregnated with 3% Xeroform® (Bismuth tribomophophenate) | ||||
| Full and Partial | Not specified | Not specified | Not specified. | ACD | Nanocrystalline silver dressings | |||
| Full and Partial | Major | Inpatient | Burn units | AS | Silver sulfadiazine 1% + Cerium nitrate 2.2% | |||
|
ISBI Practice Guidelines for Burn Care. (37) (PMID: 27542292) |
100 (91.17) | Superficial-partial | Not specified | Not specified | Fresh burns expected to heal spontaneously. | ACD | Iodine and silver-containing dressings. | Not specified. |
| Superficial-partial | Not specified | Not specified | Resource-limited settings with no available modern dressings to cover de-roofed or snipped blisters. | NSTA | Not specified. | Not specified. | ||
| Full and deep-partial | Not specified | Inpatient | Burn wounds awaiting excision. Closed technique. | NSTA | Not specified. | Not specified. | ||
| Full and deep-partial | Not specified | Inpatient | Burn wounds treated with open (after eschar removal) and semi-open techniques in resource-limited settings | NSTA | Not specified. | Not specified. | ||
|
ISBI Practice Guidelines for Burn Care, Part 2 (35) (PMID: 30343831) |
100 (91.17) | Not specified | Not specified | Not specified | In general, for most burn wounds, weigh the risk of delayed wound healing | NSTA | Not specified | Not specified |
| Full and deep-partial | Major | Inpatient | Especially applies to burn wounds prior to surgical debridement | AS, ACD | Silver-based topical agents and dressings. | Not specified | ||
| Superficial-partial thickness | Minor | Outpatient | More superficial burns expected to heal on their own, treated as outpatients. | ACD | Silver-containing dressings (Hydrofiber and activated charcoal dressings) | Not specified | ||
| Full and deep-partial | Minor and major | Inpatient | Deep burns of the ear. Deep burns. | AB | Mafenide acetate 11% cream + *topical nystatin | Mafenide acetate 5% aqueous solution | ||
| Full | Major | Inpatient | It may have a role in for deeper burn wounds (that are not expected to heal spontaneously) prior to surgical excision. | AS | Dakin's solution (0.5% buffered NaOCl) | Not specified | ||
| Superficial-partial | Not specified | Not specified | Resource-limited settings with no available topical antimicrobial ointments or creams | AS | Honey | Not specified | ||
| Full | Major | Inpatient | Early surgical excision and wound closure cannot be performed | AS | Cerium nitrate (2.2% CN with 1% SSD) | Not specified | ||
|
Guideline and treatment algorithm for burn injuries (34) (PMID: 25904267) |
41.66 (51.03) | Superficial-partial | Minor | Outpatient | Minor burns | ACD | Nitrofurazone 0.2% pomade | Not specified |
| Full | Major | Inpatient | Eschar and large burns | ACD | 1% silver sulfadiazine (SSD) | Mupirocin, Nitrofurazone | ||
*Abbreviations: AB= Antibiotics, AS= Antiseptics, ACD= Antimicrobial-containing dressings, NSTA= Not specified topical antimicrobials