A silver coated dressing reduces the incidence of early burn wound cellulitis and associated costs of inpatient treatment: Comparative patient care audits

In 2000 and 2002, the Royal Perth Hospital (RPH) Burn Unit, Western Australia, conducted two ‘before and after’ patient care audits comparing the effectiveness and cost of Silvazine™ (silver sulphadiazine and chlorhexidine digluconate cream) and Acticoat™, a new dressing product for in-patient treatment of early burn wounds. The main outcome variables were: burn wound cellulitis, antibiotic use and cost of treatment. Two patient care audits and a comparative sample were used. The two regimes audited were, ‘standard treatment’ of twice daily showers or washes with 4% chlorhexidine soap and Silvazine™ cream as a topical dressing (2000, n = 51), compared with the ‘new treatment’ of daily showers of the burn wound with 4% chlorhexidine soap and the application of an Acticoat™ dressing (2002, n = 19). In 2002, costs were also examined using a sample of matched pairs (n = 8) of current and previous patients. The main findings were: when using Acticoat™ the incidence of infection and antibiotic use fell from 55% (28/51) and 57% (29/51) in 2000 to 10.5% (2/19) and 5.2% (1/19) in 2002. The total costs (excluding antibiotics, staffing and surgery) for those treated with Silvazine™ were US$ 109,357 and those treated with Acticoat™ were US$ 78,907, demonstrating a saving of US$ 30,450 with the new treatment. The average length of stay (LOS) in hospital was 17.25 days for the Silvazine™ group and 12.5 days for the Acticoat™ group—a difference of 4.75 days. These audits demonstrate that Acticoat™ results in a reduced incidence of burn wound cellulitis, antibiotic use and overall cost compared to Silvazine™ in the treatment of early burn wounds.