• Prophylaxis and treatment of infection in burn wounds • As an adjunct to short-term treatment of infection in : • Leg ulcers • Pressure sores • As an adjunct to prophylaxis of infection in: • Skin graft donor sites • Extensive abrasions • Conservative management of finger-tip injuries

Direction for use Burns: The burn wound should be cleaned and Silverzine applied over-all the affected areas to a depth of 3-5 mm. This application is best achieved with a sterile gloved hand and/or sterile spatula. Where necessary, the cream should be re-applied to any are from which it has been removed by patient activity. In burn, Silverzine should be re-applied at least every 24 hours, or more frequently if the volume of exudates is large. Hand burns: Silverzine can be applied to the burn and the whole hand enclosed in as clean plastic bag or glove which is then closed at the wrist. The patient should be encouraged to move the hand and fingers. The dressing should be changed when an excessive amount of exudates has accumulated in the bag. Leg ulcer/pressure sores: The cavity of ulcer should be filled with Silverzine to a depth of at least 3-5 mm. As Silverzine can cause maceration of normal skin on prolonged contact, care should be taker to prevent spread onto non-ulcerated areas. Application of Silverzine should be followed by an absorbent pad or gauze dressing, with further application of pressure bandaging as appropriate for the ulcer. The dressings should normally be changed daily but for wounds which are less exudative, less frequent changes (every 48 hours) may be acceptable. Cleansings and debriding should be performed before application of Silverzine. Silverzine in not recommended for use in leg or pressure ulcer that are very exudative. Finger-tip injuries: Haemostasis of the injury should be achieved prior to the application of a 3-5 mm layer of Silverzine. A conventional finger dressing may be used. Alternatively the fingers of a plastic or surgical glove can be used and fixed in place with waterproof adhesive tape. Dressings should be changed every 2-3 days. Contraindication: It is contraindicated in-patients who are hypersensitive to it or any of the other ingredients in the preparation. It should not be used on pregnant women approaching or at term, on premature infants, or on newborn infants during the first 2 months of life. Side Effect: Several cases of transient leukopenia have been reported in-patients receiving Silver Sulfadiazine therapy. Other infrequently occurring events include skin necrosis, erythema multiform, skin discoloration, burning sensation, rashes, and interstitial nephritis. Precautions: If hepatic and renal functions become impaired and elimination of drug decreases, accumulation may occur and discontinuation of Silverzine should be weighed against the therapeutic benefit being achieved. In considering the use of topical proteolytic enzymes in conjunction with Silverzine, the possibility should be noted that silver may inactivate such enzyme. In the treatment of burn wounds involving extensive areas of the body, the serum sulfa concentration. Renal function should be careful mentioned. The urine should be checked for sulfa crystals. Use in Pregnancy and Lactation: Teratogenic Effects: Pregnancy Category B. This drug should be used during pregnancy only if clearly justified, especially in pregnant women approaching or at term. Nursing Mothers: It is not known whether Silver Sulfadiazine is excreted in human milk. A decision should be made, whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.