In 2000 and 2002, the Royal Perth Hospital (RPH) Burn Unit, Western Australia, conducted two 'before and after' patient care audits comparing the effectiveness and cost of Silvazine™ (silver sulphadiazine and chlorhexidine digluconate cream) and Acticoat™, a new dressing product for in-patient treatment of early burn wounds. The main outcome variables were: burn wound cellulitis, antibiotic use and cost of treatment. Two patient care audits and a comparative sample were used. The two regimes audited were, 'standard treatment' of twice daily showers or washes with 4% chlorhexidine soap and Silvazine™ cream as a topical dressing (2000, n = 51), compared with the 'new treatment' of daily showers of the burn wound with 4% chlorhexidine soap and the application of an Acticoat™ dressing (2002, n = 19). In 2002, costs were also examined using a sample of matched pairs (n = 8) of current and previous patients. The main findings were: when using Acticoat™ the incidence of infection and antibiotic use fell from 55% (28/51) and 57% (29/51) in 2000 to 10.5% (2/19) and 5.2% (1/19) in 2002. The total costs (excluding antibiotics, staffing and surgery) for those treated with Silvazine™ were US$ 109,357 and those treated with Acticoat™ were US$ 78,907, demonstrating a saving of US$ 30,450 with the new treatment. The average length of stay (LOS) in hospital was 17.25 days for the Silvazine™ group and 12.5 days for the Acticoat™ group - a difference of 4.75 days. These audits demonstrate that Acticoat™ results in a reduced incidence of burn wound cellulitis, antibiotic use and overall cost compared to Silvazine™ in the treatment of early burn wounds.