Comparative Analysis of Cost-effectiveness of Silver Dressing in Burns

Comparative Analysis of Cost-effectiveness of Silver Dressing in Burns

The evidence is insufficient to determine whether the types of dressings containing silver differ in time / proportion for complete wound healing and pain. We will analyze the cost-effectiveness of these dressings in outpatients, considering the service provided by the Brazilian National Public Health System.

Randomized, single-center, single-blinded, controlled clinical trial. Adult patients (age between 18 and 65 years), regardless of sex, with second degree burns treated in outpatient regimen will be randomized (1:1) into two groups: 1% silver sulfadiazine and nanocrystalline silver.

Primary outcome:

- Proportion of lesions completely epithelialized within 15 days.

Secondary outcomes:

• Time in days for complete epithelialization of the burned areas;
• Number of dressing changes;
• Level of pain associated with the application and removal of the dressings;
• Direct medical and non-medical costs;
• Need for surgery;
• Incidence of infection;
• Presence of local adverse reactions.

Inclusion Criteria:

• Adults aged between 18 and 65 years;
• Regardless of sex and ethnicity;
• Presenting second degree burns (partial thickness involving the epidermis and part of the dermis, with at least the preservation of some dermal appendages from of which the wound can eventually be epithelialized spontaneously) (ARTZ; MONCRIEF; PRITT, 1980) under an outpatient regimen, without the need for surgical debridement of devitalized tissue and skin grafts informed in the initial clinical diagnosis.

Exclusion Criteria:

• Patients with diabetes;
• Pregnant women;
• Patients with intellectual disabilities;
• Patients with burns to the face or on the palmar face of the hands or on the plantar face of the feet, as the need for specific treatment was felt to prevent functional sequelae;
• Patients who have already started treatment in other institutions;
• Those whose burns had happened 5 or more days before their entrance in the hospital;
• Those incapable of signing the informed consent form or who have declined to participate.