Inpatient silver sulphadiazine versus outpatient nanocrystalline silver models of care for pediatric scald burns: a value analysis.
Open accessAbstract
BACKGROUND/OBJECTIVE: Scalds represent the most frequent pediatric burn injury. Inpatient nonsurgical wound management of small or medium-size burns (<20% total body surface area) represents a significant proportion of the cost of care, with nanocrystalline silver (NCS) and silver sulphadiazine (SSD) among the most commonly used dressings. Although several articles have described healing outcomes using these dressings, there are few concurrent economic analyses. To analyze overall health care value (outcomes/cost) in burns not requiring surgery, the authors compared management of scald burns with NCS versus SSD from both a quality perspective and using bottom-up microcosting to determine which dressing option optimizes health care value. METHODS: A value analysis was performed. Published studies investigating NCS and/or SSD in the treatment of pediatric burns over the past 25 years were analyzed. Healing time, hospital duration and frequency of dressings were chosen as quality metrics. A bottom-up microcosting analysis was performed to estimate costs associated with the two dressing options. RESULTS: Over the 25-year period, 356 studies investigated the use of SSD in burns, while 55 studies evaluated the use of NCS. Mean age and burn size were equivalent. Mean time to healing was 14.9 days for NCS and 17.2 days for SSD. The mean duration of hospital stay was 14.9 days for SSD and 5.9 days for NCS. Dressings were performed twice per week for NCS, and once or twice per day for SSD. The mean total cost per patient to the health care system was estimated to be $61,140 for SSD and $17,220 for NCS. CONCLUSION: Published outcomes of healing time are equivalent or slightly better using NCS over SSD for pediatric scalds. The financial model illustrated a potential significant cost saving with NCS, primarily as a result of an outpatient model of care. Overall health care value is optimized using NCS for pediatric scalds.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The operative records were reviewed to determine skin-to-skin surgical and anesthesia time; these data were extrapolated to determine a case cost using previously defined bottom-up microcosting results for our institution.
“The operative records were reviewed to determine skin-to-skin surgical and anesthesia time; these data were extrapolated to determine a case cost, using previously defined bottom-up microcosting results for our institution.13”
From Outcomes and Complications of the Mustardé Otoplasty: A “Good–Fast–Cheap” Technique for the Prominent Ear Deformity (2020) · cites this paper as [13]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Porter, M. E. (2010) · New England Journal of Medicine · doi:10.1056/nejmp1011024 · Cited by 5,084 · see citing works
Economics notes: Opportunity cost
Palmer, S., & Raftery, J. P. (1999) · BMJ · doi:10.1136/bmj.318.7197.1551 · Cited by 182 · see citing works
Ahn, C. S., & Maitz, P. (2012) · Burns · doi:10.1016/j.burns.2012.05.016 · Cited by 149 · see citing works
Priority Setting Toolkit: A Guide to the Use of Economics in Health Care Decision Making
Mitton, C., & Donaldson, C. (2004) · doi:10.25405/ncl.34086537 · Cited by 117 · see citing works
Fong, J., Wood, F. M., & Fowler, B. (2005) · Burns · doi:10.1016/j.burns.2004.12.009 · Cited by 116 · see citing works
Silverstein, P., Heimbach, D. M., Meites, H., Latenser, B. A., Mozingo, D. W., Mullins, F., Garner, W. L., Turkowski, J. R., Shupp, J. W., Glat, P. M., et al. (2011) · Journal of Burn Care & Research · doi:10.1097/bcr.0b013e318236fe31 · Cited by 99 · see citing works
A retrospective cohort study of Acticoat™ versus Silvazine™ in a paediatric population
Cuttle, L., Naidu, S., Mill, J., Hoskins, W., Das, K., & Kimble, R. M. (2007) · Burns · doi:10.1016/j.burns.2007.02.012 · Cited by 96 · see citing works
Ten-Year Epidemiological Study of Pediatric Burns in Canada
Spinks, A. B., Wasiak, J., Cleland, H. J., Beben, N., & Macpherson, A. (2008) · Journal of Burn Care & Research · doi:10.1097/bcr.0b013e3181776ed9 · Cited by 88 · see citing works
Burn care costing: The Welsh experience
Hemington-Gorse, S. J., Potokar, T. S., Drew, P. J., & Dickson, W. A. (2008) · Burns · doi:10.1016/j.burns.2008.08.012 · Cited by 64 · see citing works
Hospital Costs Associated With Pediatric Burn Injury
Klein, M. B., Hollingworth, W., Rivara, F. P., Kramer, C. B., Askay, S. W., Heimbach, D. M., & Gibran, N. S. (2008) · Journal of Burn Care & Research · doi:10.1097/bcr.0b013e31817db951 · Cited by 54 · see citing works
Determination of VA Health Care Costs
Barnett, P. G. (2003) · Medical Care Research and Review · doi:10.1177/1077558703256483 · Cited by 50 · see citing works
Peters, D. A., & Verchere, C. G. (2006) · Journal of Burn Care & Research · doi:10.1097/01.bcr.0000200891.56590.3b · Cited by 36 · see citing works
Self-citationMeasuring the cost of care for children with acute burn injury
Carey, K., Kazis, L. E., Lee, A. F., Liang, M. H., Li, N.-C., Hinson, M. I., Lydon, M. K., Bauk, H., Shapiro, G. D., & Tompkins, R. G. (2012) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/ta.0b013e318265c88a · Cited by 27 · see citing works
Cox, S. G., Cullingworth, L., & Rode, H. (2011) · PubMed · Cited by 24 · see citing works
A Microcosting Approach for Isolated, Unilateral Cleft Lip Care in the First Year of Life
Abbott, M. M., & Meara, J. G. (2011) · Plastic & Reconstructive Surgery · doi:10.1097/prs.0b013e3181f95af3 · Cited by 22 · see citing works
Strand, O., Miguel, L. S., Rowan, S., & Sahlqvist, A. (2010) · PubMed Central · Cited by 13 · see citing works
Bass, M. J., & Phillips, L. G. (2008) · Journal of Craniofacial Surgery · doi:10.1097/scs.0b013e318175b58c · Cited by 11 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Heyneman, A., Hoeksema, H., Vandekerckhove, D., Pirayesh, A., & Monstrey, S. (2016) · Burns · doi:10.1016/j.burns.2016.03.029 · Cited by 123 · see citing works
Topical antimicrobial agents for pediatric burns
Cartotto, R. C. (2017) · Burns & Trauma · doi:10.1186/s41038-017-0096-6 · Cited by 66 · see citing works
Balsa, I. M., & Culp, W. T. N. (2015) · Veterinary Clinics of North America Small Animal Practice · doi:10.1016/j.cvsm.2015.04.009 · Cited by 62 · see citing works
Boroditsky, M. L., Van Slyke, A. C., & Arneja, J. S. (2020) · Plastic and Reconstructive Surgery - Global Open · doi:10.1097/gox.0000000000003103 · Cited by 30 · see citing works
Self-citationDo Adolescents with Gynecomastia Require Routine Evaluation by Endocrinology?
Malhotra, A. K., Amed, S., Bucevska, M., Bush, K. L., & Arneja, J. S. (2018) · Plastic & Reconstructive Surgery · doi:10.1097/prs.0000000000004465 · Cited by 22 · see citing works
Self-citationMRI compatibility of silver based wound dressings
Bailey, J. K., Sammet, S., Overocker, J., Craft-Coffman, B., Acevedo, C. M., Cowan, M. E., & Powell, H. M. (2018) · Burns · doi:10.1016/j.burns.2018.05.017 · Cited by 13 · see citing works
Pediatric Hand Fracture Outcomes: How Often Do We Need to Operate?
Wei, S., Forbes, D., Hartley, R. L., Salhi, S., Fraulin, F. O. G., Harrop, A. R., & Arneja, J. S. (2022) · Plastic Surgery · doi:10.1177/22925503221085076 · Cited by 9 · see citing works
Self-citationEpidemiological evaluation paediatric burn injuries via an outpatient database in Eastern Ontario
Garland, K., Nahiddi, N., Trull, B., & Malic, C. (2018) · Burns Open · doi:10.1016/j.burnso.2018.06.004 · Cited by 7 · see citing works
Self-citationCarr, M., Skarlicki, M., Palm, S., Bucevska, M., Bone, J. N., Gosain, A. K., & Arneja, J. S. (2021) · The Cleft Palate-Craniofacial Journal · doi:10.1177/10556656211021738 · Cited by 6 · see citing works
Self-citationChen, Z., Wu, C., Zeng, L., Li, X., Gan, Q., & Wang, H. (2026) · Journal of Clinical Nursing · doi:10.1111/jocn.70300 · Cited by 5 · see citing works
The Economics of Burn Injuries Among Children Aged 0 to 4 Years in British Columbia
Beaulieu, É., Zheng, A., Rajabali, F., MacDougall, F. J., & Pike, I. (2020) · Journal of Burn Care & Research · doi:10.1093/jbcr/iraa189 · Cited by 5 · see citing works
Initiating silver recycling efforts: Quantifying Ag from used burn dressings
Courtemanche, R. J. M., Taylor, N., & Courtemanche, D. J. (2015) · Environmental Technology & Innovation · doi:10.1016/j.eti.2015.04.003 · Cited by 4 · see citing works
Construction of a Silver Nanoparticle Complex and its Application in Cancer Treatment
Li, W. F., Ma, H. H., Dong, P. Y., Liang, C. L., Li, L., & Zhang, X. F. (2022) · Journal of biomimetics, biomaterials and biomedical engineering · doi:10.4028/p-s8bc3p · Cited by 1 · see citing works
Outpatient Management of Burns
Goldberg, D., & Harrington, D. T. (2016) · Springer eBooks · doi:10.1007/978-3-319-29161-1_12
- Authors
- Malic, C., Verchere, C., & Arneja, J. S.
- Affiliations
- University of British Columbia (CA)
- Corresponding author
- Arneja, Jugpal S
- Venue
- Plastic Surgery
- Publisher
- SAGE Publications
- Published
- 2014-06
- Volume
- 22
- Issue
- 2
- Pages
- 99-102
- ISSN
- 1195-2199 (ISSN-L)
- 2292-5503
- 2292-5511
- PMC
- PMC4116324
- OpenAlex
- W2403632547
- Cited by
- 14
- References
- 17
- Citations by year
- 2026: 1 · 2022: 2 · 2021: 1 · 2020: 2 · 2018: 3 · 2017: 1 · 2016: 2 · 2015: 2
- FWCI
- 1.26
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Plastic Surgery (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Burn Injury Management and Outcomes
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Medicine › Rehabilitation › Wound Healing and Treatments
- Keywords
- silver sulfadiazine, nanocrystalline silver, burn wound dressing, micro-costing, health care value, cost reduction, healing time, length of hospital stay
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
