Silver sulfadiazine (Silvadene, SSD, SSD AF, Thermazene) is a topical antimicrobial ointment for burn injuries that’s effective on gram-positive bacteria, gram-negative bacteria, and some yeasts.1  It soothes, may prevent infection, and keeps burn injuries from drying out.

   And our regional burn center rarely uses it.

Silver sulfadiazine can be used for burn injuries in the right patient, but burn centers normally handle deeper or large surface area moderate-to-severe burns that may require grafting or other burn coverings.  When a patient may need this degree of care, silver sulfadiazine may not be as helpful.  It can form a layer that inhibits graft material from bonding properly over the wound.  In some cases, the ointment must be scrubbed off of the fresh burn injury — an uncomfortable process and not helping the patient’s healing process.  In deep or large area burns, there may also be a risk of systemic absorption of free sulfadiazine.1

For minor burn injuries that do not require the services of a burn trauma center, silver sulfadiazine is an option.  For the more serious cases, please don’t use any ointment, salves, or medications on the injury before transport to a burn center.  Less is more in this case.


1   Silvadene – silver sulfadiazine cream 1%. Pfizer Laboratories, Inc. Last revised: September 2016. Web site: Accessed February 6, 2021.


The Stop the Bleed campaign ( was started several years ago as a collaborative effort between several national organizations to help educate the public in basic bleeding control.  UMC’s Trauma & Burn Services and UMC EMS partnered up to teach basic bleeding control to schools and communities within our region, with over 17,000 students and adults taught in 2019.

A large arterial bleed can cause death within 3 minutes if not stopped.  Unless first responders are just down the road, we might not make it in time.  This makes our community members the “first 1st responders” and are key to saving these lives.

When do you use pressure or pack a wound?  When should you go straight to a tourniquet?  First of all, make sure you’re safe and won’t become a victim yourself.  Apply direct pressure over ANY bleeding wound as your first step.  If the injury is on an arm or leg and is bleeding profusely (usually spurting blood), apply a tourniquet as soon as it reaches you.  Direct pressure will help slow the bleeding until it arrives or you get help to make one. If in doubt on whether the profuse bleeding is arterial or venous, just apply the tourniquet a couple of inches above the wound while avoiding elbows, knees, and other joints.  A tourniquet does not mean they’ll lose that limb, but it can save a life!

If the injury is around the armpit or groin where a tourniquet can’t reach, pack the wound by stuffing gauze or any sizeable strip of clean cloth deep into the wound.  Get serious in packing — the pressure exerted by the packed cloth or gauze is key to stopping the bleed.  

If the injury in at the core of the body (chest, back, abdomen), do not pack the wound!  There’s a lot of hollow space surrounding organs and you may cause more harm than good.  Just apply firm, direct pressure and make sure EMS knows this person is a priority — the patient needs a surgeon.

Tourniquets and wound packing is painful.  Don’t think you’ve done anything wrong — you’re doing it right!  A few minutes of pain is a lot better than losing a life! 

A quick-reference poster from the Stop the Bleed campaign is show below.  You can also download a higher-resolution PDF for printing at your school or workplace:Link to a printable copy (directly from