Comparative efficacy and economic impact of sequential triple therapy versus nano-silver dressings in delayed-presentation low-temperature burns: A retrospective cohort study.

Abstract

To compare the comprehensive efficacy of a triple therapy combining silver sulfadiazine cream, recombinant human epidermal growth factor (rhEGF), and Compound Huangbai Liquid (Combined Group) versus a nano-silver dressing regimen (Traditional Group) for small-area (<1% TBSA), low-temperature burns that progressed to deep burns due to delayed presentation. A retrospective cohort study was conducted, enrolling 309 patients admitted between January 2023 and December 2024 who were diagnosed with deep second- to third-degree burns following delayed presentation after initial neglect of blisters. The Combined Group (n = 165) received the triple therapy, and the Traditional Group (n = 144) received the nano-silver dressing regimen. Wound healing time, frequency of dressing changes, VAS pain score, wound infection rate, and economic burden were evaluated. The wound healing time in the Combined Group was significantly shorter than in the Traditional Group (28 ± 4 days vs. 41 ± 5 days, P < 0.001), with fewer dressing changes (14 ± 3 times vs. 21 ± 4 times, P < 0.001). The pain scores were significantly lower in the Combined Group from the second dressing change onward (P < 0.05). There was no statistical difference in wound infection rates between the two groups (2.4% vs. 3.5%, P > 0.05). Further precise accounting showed that both the total cost and out-of-pocket expenses for patients in the Combined Group were significantly lower than those in the Traditional Group (Total cost: 1508 ± 360 CNY vs. 3735 ± 480 CNY; Out-of-pocket: 302 ± 72 CNY vs. 1904 ± 96 CNY, P < 0.001). For small-area, low-temperature deep burns that have worsened due to delayed presentation, the combined regimen demonstrates significant superiority over the traditional regimen in accelerating healing, reducing pain, and, most notably, drastically lowering the economic burden on patients through synergistic drug actions. It represents an ideal choice for addressing this clinical challenge.