TY  - BOOK
AU  - Deldar, Romina
AU  - Moffatt, Lauren T
AU  - Shupp, Jeffrey W
TI  - Cerium Nitrate Treatment in the Management of Burns
SN  - 2162-1918
PY  - 2021///
KW  - IN PROCESS -- NOT YET INDEXED
KW  - MedStar Health Research Institute
KW  - MedStar Washington Hospital Center
KW  - Firefighters' Burn and Surgical Research Laboratory
KW  - MedStar General Surgery Residency
KW  - Surgery/Burn Services
KW  - Journal Article
N2  - CRITICAL ISSUES: CN+SSD cream is not approved by the FDA, and its efficacy in clinical trials has been challenging to demonstrate. One reason is that CN changes the eschar visibly, introducing unavoidable bias. Also, the market and patient population is small and burn wound presentation is highly variable; FUTURE DIRECTIONS: For use in settings where the once- or twice-daily CN+SSD cream dressing changes are least feasible (low-income, military, and mass casualty settings), it may be possible to develop a solid dressing containing cerium and silver that requires infrequent dressing changes. For future clinical studies, the trial design most suited to comparing silver-containing dressings with and without cerium may be paired difference of matched intra-patient wounds; SIGNIFICANCE: The standard of care for deep burn wounds is eschar excision and autologous skin grafting within the first post-burn days. However, when this is not practical due to medical reasons, unavailable surgical facilities, or lack of donor sites or other coverage, surgeons have used topical cerium nitrate (CN) in a cream with silver sulfadiazine (SSD) for over four decades to convert the eschar into a pliable and protective crust that facilitates the postponement or staging of eschar excision and grafting. CN+SSD treatment is reported to reduce dressing changes, improve patient comfort, and reduce bacterial burden, with unaffected epithelialization and few complications. Recent Advances: CN aqueous solution applied topically alone or with solid silver dressings in animal models has mitigated wound injury progression, wound microbial burden, and systemic immune dysfunction
UR  - https://dx.doi.org/10.1089/wound.2020.1330
ER  -