Journal of Molecular Biomarkers and Clinical Trials

Hyaluronic Acid and Silver Sulfadiazine Combination: Evaluation in a Second Degree Burns Rat Model

*Jean Noël Gouze
Department Of Molecular Biomarkers, France

*Corresponding Author:
Jean Noël Gouze
Department Of Molecular Biomarkers, France

Published on: 2017-05-12


Objective: Assessing the benefit of a hyaluronic acid-silver sulfadiazine combination versus a silver sulfadiazine formulation in a rat model. Methods: A deep second degree burn was induced on the lower and upper back of 59 rats using a standardized severe burning procedure. The burn was daily dressed and responses to both treatments were assessed until complete wound closure. Macroscopic (inflammation, moisture environment, epithelization and retraction) and microscopic (dermis formation, blood vessels, collagen reorganization, early annexes) parameters were assessed.

Results: Hyaluronic acid silver sulfadiazine combination decreased and almost prevented apparition and persistence of exudate (13.6% ± 4.5 vs 81.4% ± 5.1 of treated wounds; 1.63 ± 0.26 vs 7.19 ± 0.63 days) and maceration events (18.6% ± 5.1 vs 98.3%± 1.7 of treated wounds; 2.36 ± 0.64 vs 12.76 ± 0.74 days). While no significant difference was found in terms of complete epithelization, the later appeared faster using hyaluronic acid silver sulfadiazine combination (25% of wound epithelization wasreached at 19.58 ± 0.48 vs 22.40 ± 0.65 days and 50 % of wound epithelization at 30.91 ± 0.94 vs 35.44 ± 1.41 days). Woundretraction was also achieved significantly faster when using hyaluronic acid silver sulfadiazine combination (25% was reached at 13.89 ± 1.19 vs 29.72 ± 1.28 days and 50% at 35.48 ± 1.08 vs 42.09 ± 0.92 days).

Conclusions: The hyaluronic acid silver sulfadiazine combination appears well indicated for the treatment of a deep second degree burn, probably by creating an optimal and favourable environment for an efficient wound healing process.


Second Degree Burn; Hyaluronic Acid; Silver Sulfadiazine


Thermal burn is one of the most common injury worldwide [1,2]. Severity is based on burn depth assessment that will then determine the appropriate treatment. Classification as first, second and third degree burn is closely depending on the severity of epidermis and dermis damage [3-5]. The major complication for second and third degree burn remains wound infections which are a significant source of morbidity and mortality [6,7]. A moisturizing ointment will be commonly used for a first degree burn while surgical treatment will be necessary for third degree burn [8]. Second degree burns represent 50-63% of burn admitted patients in emergency department [9,10] and are usually treated using topical antimicrobial [8,11,12]. Among them, the gold standard is a formulation containing 1% silver sulfadiazine (SSD). This treatment combines a high bactericidal activity and a low toxicity that facilitates wound healing [11,13]. However, SSD still remains controversial as a delay in wound healing is observed when compared to non-bactericidal dressings [14-17]