Abstract

Silver sulfadiazine (SSD) has long served as the gold standard topical agent for burn wound infection control. Despite its broad-spectrum antimicrobial action, conventional SSD therapy has limitations such as poor solubility, delayed healing, and cytotoxicity. This review article discusses the evolution of SSD from traditional creams to sophisticated nanostructured formulations, including nanolotions, nanogels, and nanofibers, offering enhanced therapeutic efficacy, reduced toxicity, and improved healing outcomes. Recent advances, including ethosomal systems, lipid nanoparticles, and hybrid bioactive dressings, are also discussed in addition to nano-SSD’s pharmacological and clinical performance.

• 1.   World Health Organization. Burns: Key facts [Internet]. Geneva: WHO; 2021
• 2.   Ladhani HA, Yowler CJ, Claridge JA. Burn wound colonization, infection, and sepsis. Surg Infect (Larchmt). 2021;22(1):44–8.
• 3.   Heyneman A, Hoeksema H, Vandekerckhove D, Pirayesh A, Monstrey S. The role of silver sulphadiazine in the conservative treatment of partial thickness burn wounds: A systematic review. Burns. 2016;42(7):1377–86.
• 4.   Abul Barkat H, Barkat MA, Ali R, Hadi H, Kasmuri AR. Old wine in new bottles: Silver sulfadiazine nanotherapeutics for burn wound management. Int J Low Extrem Wounds. 2023;1–13.
• 5.   Edwards-Jones V, Foster HA. Effects of silver sulphadiazine on the production of exoproteins by Staphylococcus aureus. J Med Microbiol.
• 6.   Wright JB, Lam K, Hansen DL, Burrell RE. Efficacy of topical silver against fungal burn wound pathogens. Am J Infect Control. 1999;27(4):344–50.
• 7.   Venkataraman M, Nagarsenker M. Silver sulfadiazine nanosystems for burn therapy. AAPS PharmSciTech. 2013;14(1):254–64.
• 8.   Kulick MI, Wong R, Okarma TB, Falces E, Berkowitz RL. Prospective study of side effects associated with the use of silver sulfadiazine in severely burned patients. Ann Plast Surg. 1985;14(5):407–19.
• 9.   Maitre S, Jaber K, Perrot JL, Guy C, Cambazard F. Increased serum and urinary levels of silver during treatment with topical silver
• 10.   Edwards-Jones V, Foster HA. The effects of topical antimicrobial agents on the production of toxic shock syndrome toxin–1. J Med Microbiol. 1994;41(6):408–13.
• 11.   Mooney EK, Lippitt C, Friedman J. Silver dressings. Plast Reconstr Surg. 2006;117(2): 666–9.
• 12.   Fatima S, Ahmad S, Siddiqui MA, Rizwanullah M, Mir SR, Akhter S, et al. Enhanced antimicrobial activity of silver sulfadiazine cosmetotherapeutic nanolotion for burn infections. Cosmetics. 2022;9(4):93.
• 13.   Barkat MA, Harshita, Ahmad I, et al. Nanosuspension-based aloe vera gel of silver sulfadiazine with improved wound healing activity. AAPS PharmSciTech. 2017;18(8): 3274–85.
• 14.   Liu Y, et al. Thermoresponsive hydrogel as a carrier for silver sulfadiazine nanosuspensions in burn wound healing. Nanomedicine.
• 15.   Patel R, Thakur R, Mahajan A, et al. DNase-I supplemented silver sulfadiazine solid lipid nanoparticles for enhanced wound healing. Int
• 16.   Razavi S, Partoazar A, Takzaree N, et al. Silver sulfadiazine nanoethogel for burn healing: Characterization and investigation of its in vivo effects. Nanomedicine (Lond). 2018;13(11):1319–31.
• 17.   Morsi NM, Aboelwafa AA, Dawoud MH. Development and evaluation of silver sulfadiazine-loaded cubosomes for topical treatment of burn wounds. Int J Nanomedicine. 2019;14:2613–27.
• 18.   Singh D, Singh M, Singh S, et al. Polycaprolactone nanofibers for controlled delivery of silver sulfadiazine to burn wounds. Mater Sci Eng C. 2017;81:119–27..
• 19.   Taglietti A, Diaz Fernandez YA, Amato E, et al. Antibacterial activity of silver nanoparticles coli: Insights into the mechanism of action. Langmuir. 2012;28(46):15735–42. against Staphylococcus aureus and Escherichia coli: Insights into the mechanism of action. Langmuir. 2012;28(46):15735–42..
• 20.   Bragg PD, Rainnie DG. The effect of silver ions on the respiratory chain of Escherichia coli. Can J Microbiol. 1974;20(6):883–9.
• 21.   Thurman RB, Gerba CP. The molecular mechanisms of copper and silver ion disinfection of bacteria and viruses. Crit Rev Environ Control. 1989;18(4):295–315.
• 22.   Fox CL Jr, Modak SM. Mechanism of silver sulfadiazine action on burn wound infections. Antimicrob Agents Chemother. 1974;5(6): 582–8.
• 23.   Gupta A, Maynes M, Silver S. Effects of halides on plasmid-mediated silver resistance in Escherichia coli. Appl Environ Microbiol. 1998;64(12):5042–5.
• 24.   Pourhajibagher M, Bahador A. Curcuminloaded silver sulfadiazine nanoliposomes for enhanced antibacterial activity against Acinetobacter baumannii in burn wound infections. Photodiagnosis Photodyn Ther. 2018;22:98–104.
• 25.   Ito K, Saito A, Fujie T, et al. Sustainable antimicrobial effect of silver sulfadiazine loaded nanosheets on infection in a mouse model of partial thickness burn injury. Acta Biomater. 2015;24:87–95.
• 26.   Wen Z, Wang Y, Hu Y, et al. Impregnation of silver sulfadiazine into bacterial cellulose for antimicrobial and biocompatible wound dressing. Biomed Mater. 2012;7(6):065006.

Data Sharing Statement

Funding