Evaluating the Cost-effectiveness, Efficacy, Safety and Tolerance of Mepilex® Ag Versus Silvadene®

Not Applicable

Completed

Brief Summary: The primary objective is to compare the incremental costs (direct and indirect) and benefits (healing outcomes, quality of life) of using foam silver dressing (Mepilex® Ag) to a Silver sulfadiazine 1% cream (Silvadene®) from the perspective of the health care provider.

The secondary objectives are to investigate the safety, the tolerance and the performance on burn status including pain.

Detailed Description: In- and/or out-patients at ten centers in the United States were included in this investigation. Subjects included were 5 years of age and older who suffered from partial thickness burns. Every patient was followed for 3 weeks.

Recruitment & Eligibility

Inclusion Criteria

Patients with a second degree burn covering 5% to 20% BSA. TBSA covered with burn is allowed to be up to 25%, allowing a maximum of 10% to be third degree burn (only the Second degree burn should be treated)
Burn of thermal origin
Both gender with an age ≥ 5 years at randomization
Signed informed consent
Subjects who are younger than the legal consenting age must have a legally authorized representative

Exclusion Criteria

- Burns equal to or older than 36 hours
Burns of chemical and electrical origin
Clinically infected Burn (as judged by the investigator)
Treatment of the burn with an active agent before study entry, SSD is allowed up to 24 hours prior to randomization
Patients with necrotising leucocytic vasculitis or pyoderma gangrenosa.
Diagnosed underlying disease(s) (e.g. HIV/AIDS, cancer and severe anaemia) judged by the investigator to be a potential interference in the treatment.
Patients with insulin dependent diabetes mellitus
Patients treated with systemic glucocorticosteroids, except patients taking occasional doses or doses less than 10mg prednisolon/day or equivalent.
Use of immunosuppressive agents, radiation or chemotherapy within the past 30 days.
Known allergy/hypersensitivity to any of the components of the investigation products.
Patients with physical and/or mental conditions that are not expected to comply with the investigation.
Participation in other clinical investigation(s) within 1 month prior to start of the investigation
Pregnancy
Previously randomised to this investigation

Arm && Interventions

Group	Intervention	Description
Mepilex® Ag	Mepilex	Mepilex® Ag consists of a Safetac® soft silicone wound contact layer, a grey absorbent polyurethane foam pad containing a silver compound, activated carbon, and a vapour permeable waterproof film. Mepilex® Ag is an antimicrobial soft silicone foam dressing that absorbs exudate and maintains a moist wound environment. Mepilex® Ag contains silver sulphate that releases silver ions to inactivate a wide range of wound related pathogens (bacteria and fungi), shown in vitro. By reducing the number of microorganisms, Mepilex® Ag may also reduce odour.
Silvadene® Cream 1%	Silvadene	Silvadene® Cream 1% (silver sulfadiazine) is a topical antimicrobial drug indicated as an adjunct for the prevention and treatment of wound sepsis in patients with second-and third-degree burns.

Primary Outcome Measures

Name	Time	Method
Compare the Costs of Using the Interventions (Direct and Indirect)	August 2008-August 2009	The incremental cost-effectiveness ratio is calculated as the difference in total costs in each group divided by the difference in rate of full re-epithelialization (taken from the survival curve) at 20 days in each group (Δcosts/ Δeffects). Total costs were calculated based on the costs of primary and secondary dressings, silver sulphadiazine cream and estimated application, labor, supplies and pain medications. These costs were estimated from a representative sample of each population, across study facilities, using activity-based costing methods. The incremental cost-effectiveness ratio is interpreted as the price of additional health benefits. The ratio is supposed to be used by decision makers, in order for them to compare their willingness-to-pay for an additional health benefit with the pr

Secondary Outcome Measures

Name	Time	Method

Locations (10): The Burn Center, Washington Hospital Center
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Washington, District of Columbia, United States
Shands Burn Center, University of Florida
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Gainesville, Florida, United States
LA County Hospital & USC Medical Center
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Los Angeles, California, United States
Cornell Medical Center
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New York, New York, United States
Joseph Still Burn Center
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Augusta, Georgia, United States
UI Burn Treatment center
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Iowa City, Iowa, United States
Paul Silverstein Burn center
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Oklahoma City, Oklahoma, United States
Department of Surgery
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Seattle, Washington, United States
St Christopher's Hospital
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Philadelphia, Pennsylvania, United States
Southwestern Regional Burn Center, Parkland Hospital
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Dallas, Texas, United States