Silver sulfadiazine-cerium nitrate burn wound foam dressing stabilizes eschar by reducing local inflammation and controlling burn wound infections.

Abstract

Infections account for approximately 75% of burn-related fatalities. In severe cases, bacteria colonize wounds quickly and cause multi-organ failure. Therefore, severe burns necessitate immediate intervention to stabilize wounds, prevent or control infection and mitigate long term complications. Where surgical procedures are not immediately feasible, topical formulation such as Flammacerium® cream, which contains silver sulfadiazine (SSD) and cerium nitrate (CeN), act as an interim treatment to prevent or treat wound infection and stabilize burn wounds. In the civilian setting, application of Flammacerium® allows for the postponement of surgery until the patient is stable enough for the procedure or graft donor sites are available. In the military setting, topical antimicrobial treatments are often used; however, the weight and reapplication demand of cream-based treatments create significant logistical and practical challenges on the battlefield. Therefore, in this study, we have developed a lightweight foam-based burn wound dressing containing SSD (antimicrobial agent) and CeN (eschar-temporizing agent) that can manage severe burns, benefiting both civilian and military populations. SSD+CeN foam dressing showed sustained release of SSD and CeN in vitro and exhibited antimicrobial activity against common burn wound pathogens in vitro. The foam dressing showed similar effectiveness to Flammacerium® in reducing local inflammation and bacterial burden as well as controlling Pseudomonas aeruginosa infection using a rat model of deep partial-thickness burns. Finally, we demonstrated the prolonged effectiveness of SSD+CeN foam dressing against Pseudomonas infection. Our results suggest that SSD+CeN foam dressing could be used as an alternative platform to Flammacerium® for the management of the burn wounds.