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Silverol should be applied in a layer approximately 3-5 mm thick with a sterile, gloved hand or spatula, to completely cover the burn area. Ordinarily, blisters are not opened, but loose tissue is generally removed prior to application.
After application of Silverol, the wound should either be left exposed or covered with a fine mesh gauze and an elastic mesh bandage.
The exposure method is preferable in some patients (such as children) and for certain parts of the body (face, genitalia, etc.). When the wound is exposed, Silverol should be reapplied at about 12-hour intervals, or more frequently if the medication is rubbed off on the bedding. When dressings are used, they should be changed daily or on alternate days. Use of dressings serves to press the medication firmly against the wound, helps keep the area moist, reduces evaporative water loss and prevents drying/caking of the medication.
Silverol dressings can usually be left in place for about 48 hours during the first
2 weeks post burn. Subsequently, necrotic tissue undergoes proteolytic decomposition, producing considerable exudate which dilutes the drug and necessitates more frequent dressing changes. When feasible, patients should be bathed daily as an aid in debridement. A whirlpool bath is particularly helpful, but patients may be bathed in bed or in a shower.
With Silverol treatment, there will generally be an absence of infection, and
examination of the wound will reveal soft pliable eschars. These will separate
gradually, leaving a clear granulating surface. In partial-thickness burns, the generating epithelium often appears in about 2 weeks, and burns initially classified as fullthickness injuries often heal within 5 weeks without grafting.
In leg ulcers, Silverol should be applied followed by an absorbent gauze dressing and a support bandage, e.g. 10 cm elastic bandage. Care should be taken not to spread Silverol on to non-ulcerated skin, and it should not be used on every wet ulcer. The dressing should be changed at least 3 times a week, and desloughing and cleansing should be carried out at the same time.
Any Silverol remaining at the end of treatment should be discarded.
Treatment with Silverol should be continued until satisfactory healing has occurred, or until the burn site is ready for grafting. The drug should not be withdrawn from the therapeutic regimen while the possibility of infection remains, unless a significant side effect occurs.
Antimicrobial preparation for local treatment of bums, infected pressure sores and leg ulcers.
Known hypersensitivity to silver sulfadiazine or to any other ingredient of the
Because sulfonamide therapy is known to increase the possibility of kernicterus,
Silverol should not be used on pregnant women approaching or at term, on premature infants, or on newborn infants during the first 2 months of life.
Hypersensitivity to silver sulfadiazine, glucose-6-phosphate-dehydrogenase deficiency. Extensive burn areas of the body, monitor serum sulfa concentrations, renal function, urine should be checked for sulfa crystals. If hepatic or renal function become impaired.
Rash, pruritus or burning sensation, adverse reactions attributable to sulfonamides may occur.
Silverol/Proteolytic Enzymes: In considering the use of topical proteolytic enzymes in conjunction with silver sulfadiazine, it should be noted that there is a possibility that the silver may inactivate such enzymes.
Silverol/Oral Hypoglycemic Agents/Phenytoin: In patients with large area burns where serum sulfadiazine levels may approach therapeutic levels, the action of oral hypoglycemic agents and phenytoin may be potentiated, and it is recommended that blood levels be monitored.
Silverol/Cimetidine: In patients with large area burns, it has been reported that coadministration of cimetidine may increase the incidence of leucopenia.