What is the Safety and Efficacy of Biobrane Versus Silver Sulfadiazine in the Treatment of Low Body Surface Area Partial-thickness Burns?

OBJECTIVE: To determine how the synthetic skin substitute Biobrane® compares to silver sulfadiazine (SSD, Silvadene®) in the treatment of patients with low body surface area partial thickness burns. STUDY DESIGN: Systematic literature review of all English language articles of primary studies published between February 1990 and November 2004. DATA SOURCES: Randomized controlled trials comparing Biobrane with silver sulfadiazine were identified from MEDLINE, The Cochrane Central Registrar of Controlled Trials, and BioMed Central. OUTCOMES: Measured outcomes included: healing time, length of hospital stay, amount of pain, and development of treatment complications. RESULTS: Three trials comparing Biobrane to silver sulfadiazine found a significantly decreased amount of healing time in those subjects treated with Biobrane. Two of the three trials studied and found a significantly decreased length of hospital stay and a significantly decreased amount of pain in the Biobrane-treated subjects. Each of the three trials reported complications, which were not significant when comparing Biobrane to SSD. After combining the studies, calculations showed an overall decrease in the healing time, pain scores, and length of hospital stay. CONCLUSIONS: Evidence provided by these three trials suggests Biobrane is more effective than silver sulfadiazine at reducing healing time, length of hospital stay, and amount of pain in the treatment of partial-thickness thermal burn injuries. Although Biobrane does not have the anti-bacterial effects of silver sulfadiazine, the decreased number of dressing changes with Biobrane likely decreases pain and lessens the opportunity for wound exposure to infectious organisms or contaminants. Two of the three studies focused primarily on pediatric patients, however the results were similar throughout all age ranges. Wanner, Biobrane vs SSD, Pg 1