Interventions:
The intervention and comparator were clearly stated. The authors justified their choice of comparator, stating that silver sulphadiazine was the most common form of topical antimicrobial agent in use. They did not discuss any other relevant alternatives.
Effectiveness/benefits:
Appropriate measures of effectiveness were used, but it was not clear exactly when pain was measured. The effectiveness results were clearly reported. In the trial, patients appear to have been appropriately randomised to each group. The authors did not report if patients were blinded to treatment. If not, there is the possibility of assessment bias.
Costs:
The authors appear to have adopted a hospital perspective. The evaluation of the costs in the trial was limited; the objective does not appear to have been to conduct a full cost-effectiveness analysis. It was unclear exactly how the costs were measured, and only the short-term costs of each of the dressings was included. It was not clear that the average use and cost of resources was compared between the two options. It is likely that there were differences between the two groups in their use of items, such as pain relief medications, in-patient care, and long-term follow-up consultations. If these differed between the two groups, they should have been measured to accurately assess the costs of each treatment. The price year was not reported.
Analysis and results:
The results were clearly reported. The dosing requirements for each of the treatments was unclear, so it was difficult to interpret the costs that were reported. An incremental analysis of the costs (indicating the additional cost of the intervention over the comparator) was not conducted. Due to the limitations of the cost analysis, it is unlikely that the costs can be generalised to other hospital settings. Only a limited assessment of uncertainty around the results was conducted.
Concluding remarks:
The assessment of efficacy was well conducted, but the scope of the cost analysis was limited. The authors' conclusions on effectiveness appear to be appropriate, but their conclusions on cost-effectiveness should be treated with caution.