Talk:Silver sulfadiazine

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whats up with that advertisement for "silverion"? that ought to be deleted... i did not find any purpose for the study on this cream it gave me no information

Sorry, whih adveretisement are you talking about? The article basically seems to say that the drug is no longer recommended. --ἀνυπόδητος (talk) 07:46, 23 February 2010 (UTC)

No longer recommended

Hi - This Wikipedia entry is really odd to me, because it says that this cream is no longer recommended, and yet my doctor recently recommended this cream to me, and futhermore upon my own application, I've found that it is very effective in reducing discomfort from burns, i.e. if I burn myself cooking, or even from sunburns. A good example that backs up my statements is the product on Amazon.com and it's reviews: http://www.amazon.com/Thermazene-Silver-Sulfadiazine-Cream-grams/dp/B0008KLQNM Interestingly enough, those reviews are for the product labeled for pets, but if you read the reviews, you'll see that all of the reviews are for human usage. People are using this product today, and doctors are prescribing it, so it seems to me that this article should at least reference the fact that there is a strong community of users, and if more research were done into other studies and recommendations by doctors, we might find that it is a recommended product that does have real benefits.--Jasonphos (talk) 11:16, 3 January 2011 (UTC)

Reading the article, I agree with you that it is a bit odd. Many creams against wounds increase healing time (corticoids, for one thing) and that doesn't seem to be a big problem as long as pain and infections are reduced. The real problem with silver sulfadiazine, as far as I see, is that it has a very high allergic potential and can cause rather severe rashes (especially if you are allergic to sulfonamides).

I am aware that it is still prescribed frequently, and it really has benefits as you experienced yourself, but the risk of allergic reactions is a problem. I also find it rather disturbing that this product can be bought at Amazon, without a prescription, and with only the (wrong) sentence "Cream should not be used in animals allergic to sulfur products" as a warning against allergies.

I'll try and expand the article a bit. --ἀνυπόδητος (talk) 17:13, 3 January 2011 (UTC)

This is flawed, it is regularly prescribed for burns. The review methodology was poor, this is documented in the review summary. However, the recomendation against usage by the review, are based on deep "burns which include nerve and muscle damage" in this scenario other alternatives are recomended. Therefore, the review does not recomend against it's usage (in all cases). — Preceding unsigned comment added by 24.63.120.110 (talk) 13:17, 3 July 2011 (UTC)

Hit Piece

This article is biased. I have seen this recommended in many cases, and used it myself in several, only one of which was an actual burn. Silver has been an excellent and safe microbial for thousands of years, and in every case I used it, I considered the healing miraculous. There is much more about Silver Sulfadiazine in the colloidal silver article than there is here. This article should be deleted and linked to that article, unless someone would write a real one. There is no silver allergy. It can cause dark deposits, but it takes a large amount. Antibiotic allergy is very common and documented, you will find no such documentation for silver allergy. Also, silver compounds have seemed to remain effective against resistant bacteria. This is an incredibly effective, widely used, totally safe medication, that is denigrated because it is cheap and effective. It is the commercial preperation of something you could make at home with some research(extensive, to the extent that you regard health and medication), a battery and a few dollars worth of silver. Many sources on the subject have a significant agenda. — Preceding unsigned comment added by MFPSFGFE (talk • contribs) 19:59, 30 May 2012 (UTC)

This article does need a lot of work. The first impression upon reading this is "I certainly don't want to use this!" but based on my knowledge, if I were burned, I would want this used in many cases. Doc USA 2012 (talk) 19:52, 3 August 2012 (UTC)

Hi, and thanks for your comment. The allergies to this drug are not reactions to silver but to sulfadiazine, which is an antibiotic from the group of sulfa drugs, which are well known to cause allergies, sometimes severe. I don't know whether the increase of healing times is a consequence of silver or of sulfadiazine. Many antimicrobials do increase healing times, so it might be either.

By the way: I don't know about other countries, but in Austria Flammazine has about the same prize as other commonly used antibiotic creams.

Hope this explains, ἀνυπόδητος (talk) 10:51, 31 May 2012 (UTC)

medical uses of silver

Medical uses of silver has additional information that could be moved here. The secondary and tertiary literature is mixed concerning SSD use in wound/burn dressings. I'll have to go back and check, but I believe that topically applied silver-containing products are not approved for OTC.Desoto10 (talk) 05:52, 20 January 2013 (UTC)

Whoever wrote this has an agenda

This makes no sense to me. A Dr. prescribed it for a severe burn my wife had at work, and the lack of blistering and the short healing time was amazing. I know a number of other people who also had it prescribed and they just rave over it. 67.210.53.245 (talk) 22:50, 24 July 2013 (UTC) Mike Waters

Did you look at the refs? Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:49, 24 July 2013 (UTC)

Change wording in the beginning

In the beginning of the article, it is said that 'Studies have found that silver sulfadiazine may increase healing times; and it is therefore not recommended by the authors of a Cochrane review.' This sounds very confusing; a cream isn't recommended because it works? After reading the linked Cochrane source, I found the following passage:

'However, these conventional dressings tend to adhere to the wound surface (Thomas 1995) and their need for frequent changes traumatises newly epithelialised surfaces and delays healing. Silver sulphadiazine cream itself is also thought to delay wound healing due to a toxic effect on regenerating keratinocytes (Wasiak 2005)'

I have no medical background whatsoever, so I don't feel confident rewriting the article myself - but the wording of the wikipedia introduction is very confusing right now. 83.101.70.58 (talk) 12:18, 15 March 2014 (UTC)

"increase healing times" means it takes longer to get better. This means it doesn't work and worse than that may be harmful. Doc James (talk · contribs · email) (if I write on your page reply on mine) 12:22, 15 March 2014 (UTC)

Wow, why such a hater?

Whoever wrote this article is a Silvadene hater. Is it because its white? Its so racist. Why does color always have to weigh in on the opinion of meds. Clearly a brown or yellow med wrote this. Compare this article to the article for Thalidomide. That article is a fair and balanced article written from a neutral position, even though the drug caused hundreds of birth defects in Europe. This article is not neutral and gives me bad gas in my stomach when I read it. It needs to be rewritten. My daughter burned her leg, and the top burn clinic in Nebraska, UNMC, uses silvadene. Just because the wound takes longer to heal, if that is true of silvadene, doesn't mean it shouldn't be used. Scar tissue forms faster than regular epithelial tissue, but is inferior. Vokster (talk) 18:29, 6 July 2014 (UTC)Vokster

Article needs to be rewritten

Article provides very little information and seems to be written as a hit piece to reduce usage. — Preceding unsigned comment added by 96.56.124.93 (talk) 03:10, 14 December 2014 (UTC)

irresponsibly written article

irresponsibly written

what looks like mutliple references/citations are actually traceable to "Cochrane" which is questionable as a well-vetted responsible peer-reviewed source to begin with

contributors are probably anti-vaccinators as well — Preceding unsigned comment added by 67.180.134.108 (talk) 21:54, 30 January 2015 (UTC)

Silver sulfadiazine misrepresented in this article and article needs serious editing to clarify article data that it pulls

Hello,

I have noticed that there are several sections in this article that have been completely overrun by someone just stating that silver sulfadiazine is something that should not be used in medicine and that it increases the time at which it takes someone to heal from their wounds, but the articles that are used to cite these findings do not have specified controls, they do not specify on what kind of wound they are treating (i.e. first, second, or third degree burn, pressure ulcer, skin tear, wound that involves complications) and they are inconsistent with related meta data on the whole of the Cochrane studies done in terms of treating various wounds with silver sulfadiazine. The articles that I have read usually state that there is no real measurable difference between the use of silver suladiazine and other forms of treatment for wound care when combined with a compression dressing. The findings of the whole of these studies basically comes to the conclusion that "An urgent need exists for further research studies that have sufficient sample sizes, adequate follow-up periods, appropriate comparators, detailed descriptions of interventions and relevant primary and secondary outcomes."

Because of all of this data leading from one way to the next and the vast majority of healthcare professionals still using silver sulfadiazide in their practice, I feel that there needs to be an additional section with all of this data from different studies that should be more closely monitored called Controversy.

I feel like this section should be more closely monitored by people with more access to these articles and not just the article abstracts since these can be misleading from the actual data that the study shows. I also feel that all of these studies, whether having positive or negative outcomes, should be looked at sceptically and should be seen for whether or not they have a defined type of wound they are checking, whether or not they are comparing silver sulfadiazide with other forms of treatment and what those other forms of treatment are, and whether or not their study screened for patients with varying complications to their wound or not, and if so what complications were present.

I also would like to edit the Medical Applications section to actually include the primary medical applications for silver sulfadiazine and not just the controversy that exists between its use and its efficacy based on these studies.

We have a couple of recent systematic reviews of high quality trials that show no benefit for silver in wound healing

This in Burn in 2012 https://www.ncbi.nlm.nih.gov/pubmed/22030441

And a 2008 Cochrane review.

What many practisioners do is based on tradition not evidence which may be the case here.

I have adjusted the wording to emphasize that the evidence is poor and worse outcomes are tentative at best.Doc James (talk · contribs · email) 16:47, 26 April 2015 (UTC)

The ref you link says "Evidence-supported interventions for acute wound healing include ... avoidance of silver sulfadiazine as a topical agent." Doc James (talk · contribs · email) 16:56, 26 April 2015 (UTC)

References

Just another unbiased opinion regarding the strong bias in this article

From what I can tell, this article on a commonly prescribed and well proven drug has been taken over by an editor with a biased agenda. This drug has been in use for many years and is commonly prescribed. Its efficacy and uses are myriad. This information is readily available everywhere online except Wikipedia. None of this information is in this article, which is not even subtly biased.

Hi! Please feel free to provide WP:MEDRS sources that support your view. Maybe I really am biased, but in Europe (where I live) this drug is pretty obsolete. --ἀνυπόδητος (talk) 15:08, 22 August 2016 (UTC)

For third degree burns that are going to require skin grafts anyway it is reasonable. For 1st and 2nd degree burns that are not going to need grafting (by far the large majority) it is not recommended as first line. The manufacturer did do some amazing marketing though when it was initially introduced. Doc James (talk · contribs · email) 16:01, 22 August 2016 (UTC)

Yes, I didn't think of 3rd degree. I'm not working in a hospital and don't usually see these... --ἀνυπόδητος (talk) 16:13, 22 August 2016 (UTC)

I was looking at this article a few weeks ago when someone I know mentioned being prescribed this after a car accident and I put it on my watchlist because I was struck by how definitive it was against this drug. I kind of forgot about it until it came up in my watchlist just now. I really don't know anything about this medication, but given the recent conversation, I also wonder if the tone, especially in the lead, should be tweaked to be more neutral. Thoughts? —PermStrump(talk) 22:27, 22 August 2016 (UTC)

FWIW... My first thought was to to look up if there might be some indication for this medication in special populations (specifically people with sickle cell), but the skin grafting thing might make sense for the case I was thinking of. I figured I'd mention the sickle cell thing in case Doc James or anyone else could speak to whether that was worth researching more. —PermStrump(talk) 22:32, 22 August 2016 (UTC)

In general the best avaliable evidence does not show benefit over safer treatments for burns. Doc James (talk · contribs · email) 22:37, 22 August 2016 (UTC)

Really as —PermStrump(talk) mentioned the issue is that this article, on the surface, appears to have an agenda against the drug it is meant to cover objectively. While I understand that it may not be the ideal treatment in all (or even many) cases, that is beside the point in the manner with which the article is written, and in the least the opening should describe the drug and its uses, with the information re benefits / lack thereof in the body under proper sections, as per editor's guidelines. --Jackbirdsong (talk) 05:11, 30 August 2016 (UTC)

I went ahead and moved the below line from the opening to the "Medical Uses" section of the article. Feel free to discuss if any objections. "Tentative evidence has found that other antibiotics are more effective than silver sulfadiazine, so it is not recommended by the authors of a Cochrane review when more effective options are available." --Jackbirdsong (talk) 05:16, 30 August 2016 (UTC)

Have restored partly to the lead. The lead should contain a summary of the body. Doc James (talk · contribs · email) 07:30, 30 August 2016 (UTC)

This is what I'm talking about. Please go to this list of related articles and compare their overall structure: https://en.wikipedia.org/wiki/List_of_antibiotics

They do not contain one-sided opinions on the drug's efficacy in the header. The lead is meant to describe the drug and its uses. If this was a medication that was no longer prescribed by physicians, or if it was universally accepted as archaic, then yes, the opinion in the lead would be more warranted. I can provide plenty of references to cite the fact that this medication is still in use. I'm going to move the opinion to the pertinent section, as mentioned above, in order to follow Wikipedia's guidelines. Also, it may be worth considering the fact that several different unrelated contributors have found this article to exhibit bias? Maybe a small change in the placement of content is warranted? --Jackbirdsong (talk) 21:31, 30 August 2016 (UTC)

Also, as requested, I'm going to leave some references that would potentially help to balance the perceived bias in this article. I'm not going to add them to the article itself at this point, but I'm going to leave them here for perusal:

In the use of silver compounds on burn patients, SSD was found to be effective in decreasing the bacteria below 105/gr tissue in all the ulcers treated in patients with infected chronic pressure ulcers.

Kucan JO, Robson MC, Heggers JP, et al. Comparison of silver sulfadiazine, povidone iodine and physiologic saline in the treatment of chronic pressure ulcers. J Am Geriatr Soc 1981;XXIX(5):232-5.

In a randomized trial with venous ulcers, SSD one-percent cream was proved to statistically reduce the ulcer size compared to the placebo.

Bishop JB, Phillips LG, Mustoe TA, et al. A prospective randomized evaluator-blinded trial of two potential wound healing agents for the treatment of venous stasis ulcers. J Vasc Surg 1992 Aug;16(2):251-7.

While in another study it was found to be well tolerated and effective on wound cleansing and granulation tissue formation.

Ouvry PA. [A trial of silver sulfadiazine in the local treatment of venous ulcer]. Phlebologie 1989 Nov-Dec;42(4):673-9.

--Jackbirdsong (talk) 21:48, 30 August 2016 (UTC)

A systematic review and meta analysis by Cochrane is perfectly fine in the lead.

We do not use old primary sources from 40 years ago. Doc James (talk · contribs · email) 09:14, 31 August 2016 (UTC)

I'm finding you lack of willingness to compromise on a very minor adjustment is making the situation difficult. Again, I'm not the first person to raise issue with the apparent bias in this article, and you seem to be the primary opposition to this. I'm going to ask for arbitration and we'll get some other people involved. Also, yes, "we" do use primary sources from 24 years ago when they provide reference to pertinent medical studies that still apply to contemporary drugs, and I can give you plenty of evidence from other articles to back this up. --Jackbirdsong (talk) 16:13, 31 August 2016 (UTC)

You can try a RfC.

We are not using 40 year old primary sources instead of a 2016 review in the journal Burns and the 2013 systematic review and meta analysis by Cochrane. Here at Wikipedia we support evidence based medicine.

It was requested at the top that you read WP:MEDRS. Please do so.

Removing the best avaliable medical information from the lead does not balance it. Doc James (talk · contribs · email) 01:02, 1 September 2016 (UTC)

The article now appears to demonstrate much more balance of tone in the lead. I'm glad you could find a way to compromise with others and find a solution to this discrepancy on such an important article. Thank you for your time. Jackbirdsong (talk) 04:47, 9 September 2016 (UTC)

Unclear language: Which trials?

In the "Medical Uses" section, it is not specified which trials are referred to in the sentence "A Cochrane review from 2013 found that most of the trials had methodological shortcomings and thus are of little use". Looking at the cited source, it appears that this sentence refers to trials "regarding the effect of different dressings on the healing of superficial and partial thickness burn injuries".

I suggest this information be incorporated into the article text as its current form is both confusing writing (referring to "the trials" without any prior mention of trials) and could lead to misinterpretation (such as the idea that the initial medical trials which established the safety and utility of silver sulfadiazine were of poor quality).--2601:18A:C781:55A2:2C8B:8C98:A05E:1283 (talk) 17:43, 5 July 2017 (UTC)

Medical uses

I find it strange that under the subsection 'Medical uses' the first thing that is said is 'other antibiotics [are found] to be more effective in the healing of superficial and partial thickness burn injuries'. While this may be true, it should not be the main focus of the 'medical uses' subsection, and should go either under a paragraph that actually describes the medical usage of silver sulfadiazine or should get its own section altogether. As of right now the article, which should be informative, instead reads (as earlier stated) as a mild hit-piece designed to dissuade readers from its use. Itsevanffs (talk) 14:48, 15 March 2023 (UTC)