Comparison of Two Silver Dressings for Wound Management in Pediatric Burns

Author(s): 
Ingo Jester, MD; Ingo Böhn, MD; Thorsten Hannmann, MD; Karl-Ludwig Waag, PhD; Steffan Loff, PhD

Abstract: Purpose. Silver wound dressings are widely used in the treatment of burns. Dressings differ in material characteristics, various antimicrobial activities, and ease of use. The purpose of this study was to evaluate both dressing performance and amount of pain during the dressing changes of 2 silver dressings Urgotul SSD® (Laboratoires Urgo, Chenove, France), and Contreet Ag® (Coloplast, Minneapolis, MN) in children. Methods. A retrospective cohort study was performed with 2 groups of 20 burns treated with Urgotul SSD and Contreet Ag until the wounds were healed or grafted. Seventy dressing changes in the Contreet Ag group and 67 dressing changes in the Urgotul group were evaluated. Every dressing change was assessed regarding the dressing performance (exudate, adherence, bleeding, and dressing application/removal), and pain. Results. Pain was “absent or slight” in 61 (92%) dressing changes with Urgotul SSD, and in 60 (85%) of the dressing changes with Contreet Ag. Dressing application in the Urgotul group was more often “very easy” (n = 33; 49%) or “easy” (n = 32; 48%) than in the Contreet Ag group, “very easy” (n = 25; 35%), and “easy” (n = 42; 60%). Contreet Ag had a greater ability to absorb exudate (“very good” n = 60; 85%, and “good” n = 11; 15%) than Urgotul SSD (“very good” n = 34; 51%, and “good” n = 13; 19%). Conclusion. Urgotul SSD and Contreet Ag are comparable regarding pain during dressing change. The dressings differ in their ability to absorb exudate and ease of application. Both dressings provided nearly painless wound management, and therefore were highly accepted by the nurses and especially the children being treated.



Address correspondence to:
Ingo Jester, MD
Department of Paediatric Surgery
Birmingham Children’s Hospital
Steelhouse Lane
Birmingham B4 6NH
United Kingdom
Phone: 00 44 121 3338076
E-mail: Ingo.Jester@gmail.com












     For many years, silver sulfadiazine cream has been demonstrated as effective in the treatment of burn wounds and has been the standard of wound care in the authors’ hospital for a decade. More recently, many silver dressings have been developed for topical use in acute and chronic wound care.


     While the development of antibiotic resistance is an alarming concern in clinical practice, the advantage of silver is that it has minimal bacterial resistance.1 Therefore, many dressings with a broad range of components and material characteristics have been silver-coated and are available for therapeutic use. Acticoat™ (Smith & Nephew, Largo, FL) was one of the first silver-coated dressings on the market with a clinical indication for burn wounds. Most treatment experience for pediatric and even neonatal burns has been gained with Acticoat. 2–6

     Subsequently, the silver sulfadiazine impregnated hydrocolloid wound dressing, Urgotul® SSD (Laboratoires Urgo, Chenove, France), and the silver-coated foam, Contreet Ag® (Coloplast, Minneapolis, MN), became available on the market. Several in-vitro studies confirmed the effectiveness of these silver dressings against a broad range of Gram-negative and Gram-positive bacteria. 7–11

     Urgotul is a lipidocolloid dressing and is currently used for treating pediatric burns. 12,13 The polyester mesh is impregnated with carboxymethylcellulose, Vaseline, and silver sulfadiazine (3.75%). The wound dressing is antibacterial for 48 hours. Contreet Ag is a silver-coated polyurethane foam. The silver maintains antimicrobial activity for up to 7 days. 14,15

     Today, fortunately, mortality due to wound infection is low in children. Therefore, differences between dressings might be found only in the potential to improve comfort for children by reducing the frequency of dressing changes and their ease of use.

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