Comparing the efficacy of topical sucralfate versus silver sulfadiazine in management of burns

Abstract

Background:

Second-degree superficial burns constitute a substantial proportion of burn injuries and require effective topical therapy to promote wound healing, prevent infection, reduce pain, and improve functional and cosmetic outcomes. Although silver sulfadiazine (SSD) has traditionally been considered the standard topical agent, concerns regarding delayed epithelialization have prompted evaluation of alternative agents such as topical sucralfate.

Aim:

To compare the efficacy of topical sucralfate and silver sulfadiazine in the management of second-degree superficial burns.

Materials and Methods:

This prospective comparative clinical study was conducted in the Department of General Surgery over a period of 18 months. Sixty patients with second-degree superficial burns involving ≤40% total body surface area were enrolled and randomly allocated into two equal groups: Group A received topical sucralfate and Group B received 1% silver sulfadiazine. Patients were assessed for time to granulation tissue formation, time to complete wound healing, wound infection, pain score, duration of hospital stay, and scar quality. Statistical analysis was performed using the independent t-test and Chi-square test, with a p-value of <0.05 considered statistically significant.

Results:

The mean age of the study population was 43.8 ± 11.2 years, with females accounting for 56.7% of cases. Granulation tissue appeared significantly earlier in the sucralfate group compared with the SSD group (5.07 ± 0.78 vs. 8.17 ± 0.75 days; p<0.001). Complete wound healing occurred faster with sucralfate (12.20 ± 0.81 vs. 15.00 ± 0.91 days; p<0.001). Patients treated with sucralfate had significantly lower pain scores (2.63 ± 0.49 vs. 4.43 ± 0.50; p<0.001) and shorter hospital stay (8.03 ± 0.89 vs. 11.03 ± 0.81 days; p<0.001). Although wound infection rates were lower in the sucralfate group (16.7% vs. 26.7%), the difference was not statistically significant (p=0.531). Scar quality was significantly superior in the sucralfate group, with all patients demonstrating excellent or good outcomes (p<0.001).

Conclusion:

Topical sucralfate was found to be superior to silver sulfadiazine in the management of second-degree superficial burns. It significantly accelerated wound healing, reduced pain, shortened hospitalization, and improved scar quality while providing comparable infection control. Topical sucralfate may therefore be considered an effective and safe alternative to conventional silver sulfadiazine in superficial partial-thickness burns.