A Comparison of Cost-Effectiveness of Silver Nanocrystal Dressing with Silver Sulfadiazine in Burn Wound Healing: A Systematic Review

Burn is one of the costliest and most harmful damages. Burn wounds, even if they are non-lethal, can have the worst physical, psychological, social, and economic effects. Silver sulfadiazine ointment is the gold standard for wound management burns. However, different studies have shown different results in comparing the use of silver sulfadiazine ointment with new dressings containing silver nanoparticles. The purpose of this study was to compare the-cost effectiveness of silver nanocrystal dressing with silver sulfadiazine in burn wound healing.

This research was based on the Health Technology Assessment Plan approved by the National Health Research Institute of Iran. Using the systematic review method, the PubMed, Scopus, Proquest, Google Scholar, Cochrane, Up To Date, Iranmedex, and Scientific Information Database (SID) databases were used to compare the effectiveness and cost of silver nanocrystal with silver sulfadiazine ointment. Considering the diversity of studies in terms of methodology and the limitation of studies appropriate to the research question, since there was no possibility of meta-analysis, narrative review was used to analyze the results of the studies during the years1990 to 2017.

In the initial search of the databases, 213 articles were found; of which, 60 articles were deleted due to duplication, and 153 studies were selected After reviewing the titles and abstracts,122 studies were excluded. Out of 31 full-text articles, 13 articles were finally included in the study. The results of analysis showed that wound infection, healing time, pain, need to skin grafts, and duration of hospitalization were less than that for silver nanocrystals compared to sulfadiazine. Moreover, the cost of treatment for silver nanocrystals was lower than that of silver sulfadiazine.

Treatment with silver nanocrystals is more effective and less costly than silver sulfadiazine. Given to the limited number of the articles in line with the objectives of the study, it is necessary to perform further studies before finalizing any decision regarding the cost-effectiveness and making suggestions to replace the dressing.