Silver Sulfadiazine and Boric Acid are Effective in Protecting the Stasis Zone from Secondary Ischemia

A burn wound is characterized by hyperemia on the outer layer, stasis in the middle zone, and coagulation zones in the innermost region due to thermal damage to the skin. It is crucial to provide prompt and adequate treatment to prevent further damage. The depth of the burn increases as ischemic indicators become more distinct in the stasis zone when the burn is not adequately treated, despite the absence of ischemic signs in the stasis zone at the initial stages of the wound. This study aims to assess the impact of silver sulfadiazine, boric acid, low-molecular-weight heparin, and glyceryl trinitrate on wound healing in the stasis zone. The study involved 4 intervention groups, each consisting of 6 rats, and a sham group. After 7 days of daily topical application of the active substances, the animals were sacrificed, and wound healing in the stasis zones was evaluated through macroscopic, histological, and immunohistochemical analysis. These findings demonstrate the effectiveness of these treatments in promoting wound healing. The results demonstrated that the boric acid and silver sulfadiazine groups exhibited the highest levels of wound healing, both macroscopically and histologically. Immunohistochemistry revealed significant differences, with the silver sulfadiazine group demonstrating superior results in MMP9 staining and the boric acid group in VEGF staining (P < .05). These findings suggest that boric acid and silver sulfadiazine effectively prevent ischemia in the stasis zone. Boric acid, in particular, appears to have significant potential as a wound-healing agent due to its anti-inflammatory properties.