BURNS (N NAMIAS, SECTION EDITOR) The Current State of Topical Burn Treatments: a Review Danielle LaSalle Hashmi 1,2 & Linwood Haith Jr. 1 # Springer Nature Switzerland AG 2019 Abstract Purpose of Review The purpose of this review is to discuss commonly used dressings for burn treatments, including short-acting topicals and long-acting silver dressings. Recent Findings Recent literature supports the use of long-acting silver dressings over traditional daily use topical treatments. Longer acting topical dressings result in less frequent dressing changes, less pain, and greater ease of use, but have similar results in wound healing and infection prevention. Summary There are many topical agents on the market for use on burn wounds. Short-acting topicals can be divided into 3 generalized classes: antiseptics, antimicrobials, and enzymatic debridement agents. Longer acting applied dressings include silver-bonded nylon and fiber (Silverlon ® Argentum, Clarendon Hills, IL); multilayer rayon, polyester silver- coated mesh polyethylene (Acticoat™ Smith & Nephew London, UK); silver sodium carboxymethylcellulose (Aquacel ® Ag, ConvaTec, Greensboro, NC); silver-containing soft silicone foam (Mepilex ® Ag; Mölnlycke Health Care, Gothenburg); soft silicone silver (Mepitel Ag ® Mölnlycke Health Care, Gothenburg). Tradition and surgeon preference are major influences on frequency of use. While recent literature supports using long-acting silver-based dressings over short-acting topicals, more research, particularly randomized controlled trials, is needed to provide evidence-based recommendations regarding their use. Keywords Burn topicals . Silver burn dressing . Silver sulfadiazine . Mepilex Ag . Aquacel Ag . Acticoat . Mepitel Ag Introduction From its origins, humanity has had a persistent and compel- ling urge to apply all types of materials to burn wounds. John A. Moncrief, third president of the American Burn Association, described how early Egyptians used oily strips of linen, Chinese in the fifth and sixth centuries utilized tea leaves, and old Jewish cultures of the Middle East used ink, and the devastating period of topical tissue poisons such as picric acid, carbolic acid, and tannic acid among others through the mid-twentieth century [1]. There are many topical agents on the market for use on burn wounds. They include both short-acting topicals, with a 24-h or less action of duration, and long-acting topicals. The short-acting topicals can be divided into 3 generalized classes: antiseptics, antimicrobials, and enzymatic debridement agents. The difference between antiseptics and antibacterial agents is that the antiseptics are non-selectively toxic to all biologic matter and may have significant toxic manifestations. Antimicrobial agents have significantly less cytotoxic effect and more specific antibacterial, antifungal, and antiviral activ- ity. Enzymatic topicals act to debride wounds. Although this discussion will focus on topical short-acting and long-acting antimicrobials, a brief synopsis of antiseptics and enzymatic agents will more fully acquaint the reader to topical agents used in burn care. Short-Acting Topicals The most common antiseptics in burn care include emul- sifiers, peroxygens, oxidizers, halides, and organic acids. The most typical emulsifying agents in burn care are soaps, surfactants, and biguanides. This article is part of the Topical Collection on Burns * Danielle LaSalle Hashmi Danielle.hashmi@gmail.com 1 Nathan Speare Regional Burn Treatment Center, Crozer Chester Medical Center, 1 Medical Center Blvd, Chester, PA 19013, USA 2 Phoenixville, USA Current Trauma Reports https://doi.org/10.1007/s40719-019-00170-w