Silver sulfadiazine

If there's patients that, uh, have a little bit of wound dehiscence superiorly, um, I usually watch it.

I will prescribe them Silvadene, which is a really nice, gentle, broad-spectrum antimicrobial cream.

Um, and I think, you know, I've been doing this for about seven years.

I've taken two patients back to the operating room for wound, for wound revisions, and, uh, I believe that they were due to failure of a running barbed suture.

And the second thing?

Second, if the known trigger is a sulfa drug, you must never apply silver-- sulfadiazine, Silvadene as your topical antimicrobial.

Right.

Silvadene contains a highly reactive sulfur group.

If you apply it, you are literally slathering the patient in the exact chemical that caused their skin to fall off in the first place.

You’ll massively exacerbate the systemic reaction.

It provides excellent, sustained, broad-spectrum antimicrobial coverage through the slow release of silver ions, and crucially, it's highly biocompatible.

It does not impair split thickness, graft take, and it actively promotes epithelialization and wound healing.