Comparative Evaluation of a DACC-Coated Hydrophobic Dressing versus Silver Sulfadiazine in the Management of Chemical Burns: A Pilot Comparative Study from a Single Center in Pakistan

Introduction. Low- and middle-income countries (LMICs) bear a disproportionate burden of burn injuries, which continue to be a major worldwide health concern. A distinct class of burn injuries known as chemical burns is distinguished by the possibility of profound skin degradation and progressive tissue damage. Although delayed epithelialization and cytotoxic effects on regenerating tissue have been concerns, silver sulfadiazine (SSD) has long been regarded as the standard topical antibacterial therapy in burn care. In order to bind germs without releasing active antimicrobial drugs and perhaps maintain tissue viability, Sorbact® bacteriostatic dressings use hydrophobic interaction technology. The purpose of this pilot comparative study was to evaluate the clinical results of 1% SSD and Sorbact® dressings for patients with partial-thickness chemical burns in a context with limited resources. Methods. This single-center pilot comparative study was conducted at the Burn Care Centre, Pakistan Institute of Medical Sciences (PIMS), Islamabad. Sixty adult patients who presented within 6 hours of sustaining partial-thickness chemical burns involving ≤30% total body surface area (TBSA) were randomized in a 1:1 ratio in a institutional clinical trial software to receive either Sorbact® dressings or 1% SSD. All patients received standardized supportive management as per institutional protocol including intravenous analgesia, fluid resuscitation, and systemic antibiotics (Piperacillin–Tazobactam) as per institutional protocol. The primary outcome was time to complete epithelialization of the wound. Secondary outcomes included hospital stay duration, need for split-thickness skin grafting (STSG) and dressing frequency. Results. The study included 60 patients (63.3% female) with a mean TBSA of 23.3%, most commonly involving the trunk (n=22) and face (n=16), with comparable baseline characteristics between groups. Mean time to complete epithelialization was significantly shorter in the Sorbact® group. Hospital stay duration was reduced in the Sorbact® group, and fewer patients required STSG. No systemic infections were documented in either group. Discussion. In this pilot single-center study, Sorbact® dressings demonstrated favorable clinical outcomes compared with 1% SSD in partial-thickness chemical burns. Given the unique nature of study and limited sample size, large multicenter trials are required to confirm these findings and evaluate cost-effectiveness in LMIC settings.