Other reviews of the evidence have also concluded, "[the] quality of the trials was limited". Cochrane has raised concerns about delays in time to wound healing when SSD is used. In addition to concerns regarding delayed wound healing, silver sulfadiazine is associated with sloughing of the wound surface that makes reassessment of wound depth difficult, and requires daily reapplication. For this reason, application of silver sulfadiazine is not recommended for most burns due to altered wound appearance and the frequency of required dressing changes. Adverse effects
A noninfection-related clear fluid may form on the wounds surface. Burning and painful sensations are not uncommon, but are only temporary. Application to large areas or to severe burns may lead to systemic absorption and lead to adverse effects similar to those of other sulfonamides. About 0.1 to 1.0% of people show hypersensitivity reactions such as rashes or erythema multiforme. This reaction is known from other sulfonamides including antibacterials, thiazide diuretics, and sulfonylurea antidiabetics; but data on the likelihood of cross-allergies are inconsistent. Incorporation of the silver ions can lead to local argyria (discoloration of the skin), especially if the treated area is exposed to ultraviolet light. Generalised argyria with silver accumulation in kidneys, liver, and retina has only been found in association with excessive long-term use, or repeated use on severe and heavily inflamed burns. Possible consequences of generalised argyria include interstitial nephritis and anemia.
The prevalence of pre-school age children who are blind due to vitamin A deficiency is lower than expected from incidence of new cases only because childhood vitamin A deficiency significantly increases all-cause mortality. See also
Keratoconjunctivitis
Keratoconjunctivitis sicca
Keratomalacia, also caused by vitamin A deficiency. References
Further reading
Jellife DB. "Xerophthalmia: A World-wide Drive for Prevention." Journal of Tropical Pediatrics 1980; 26: ii-iii. 4 November 2009. == External links ==