Treatment of second degree burns: nitrofurazone, povidone-iodine, and silver sulfadiazine

Nitrofurazone (N), povidone-iodine (P), and silver sulfadiazine (S) were compared in the emergency department outpatient treatment of 84 patients suffering second degree burns over less than 15% (adults) or 5% (children) of their total body surface area. Indices of healing were percent of healing, degree of dryness, crust separation, eschar separation, tissue granulation, and wound pain. Statistical analysis indicates that healing in N-treated patients was superior to that in S-treated patients: tissue granulation began sooner, crusts separated more rapidly, wounds were dryer, and the amount of healing at two weeks was greater. Results in P-treated patients were equivalent to those in N-treated when cases with complications were excluded from analysis. Among patients with less serious burns, N-treated patients suffered less pain than S-treated, but there was no significant difference in pain between N and P or between P and S. In patients with more serious second-degree burns there was more pain with P than with N, but neither P nor N differed significantly from S in this regard.