Application of the Nanocrystalline Silver in Treatment of Burn Wounds in Children

Abstract

Infection is one of the most frequent and major complications in patients with burn injuries and is the main cause for prolonged in-hospital stay and death in cases of wide-spread burns despite marked progress in the development of treatments methods for these patients. Burn infections get complicated by the development of multi-resistant organisms. The colonization and infection of these wounds are a dual clinical problem. On one hand, a slowing of the healing process is possible based on a damaged immune system and inadequate perfusion to the wound. On the other hand, the infected wound may be a potential source of spreading of antibiotic-resistant microorganisms. The infected wound is a cause for pain and discomfort for patients, as well as life-threatening septic conditions. Thus, the treatment cost and the medical care increase, respectively. The topical treatment of the wound is an integral part of the general treatment of the burns. The topical treatment agents should posses some important characteristics such as a broad spectrum of antibacterial activity, low resistance level, decreased vapour loss, dehydration prevention, limited adverse effects, pain control, ease of use and limited toxic risk. Due to the wide variety of suitable agents, the choice of the agent depends on the assessment of the wound. The most important considerations for the choice of a burn wound dressing are the level of its antiseptic effect, the influence of its bioactive abilities on the epithelization and its abilities for management of the wound infection. The perfect dressing for children should provide optimal protection, reparation and minimization of pain and burn sequelae. Over the last 30 years, the knowledge of the mechanism of wound healing has made incredible progress as a result of intensive technological and clinical research. The new technologies have focused on the development of antiseptic products releasing the antiseptic agent slowly and steadily, which allows a lower and more efficient concentration. The widespread antiseptic agents containing silver have a long history of usage and a wide spectrum of activity (Klasen, 2000; Landsdown, 2006; Fong & Wood, 2006). Silver dressings are the most commonly and frequently used in burn wound treatment. The perfect silver dressing should contain such silver concentration which creates a free (or limited) side antibacterial effect. The silver nitrate solution is not applied any more due to its toxic effect, change of ionic balance and low penetration in depth. The silver sulphadiazine SSD (Flammazine, Dermazin, Silvadene, Silverdin®, etc.) is the most frequently used agent for topical treatment of children with burns. SSD has a powerful antibacterial effect against a broad spectrum of Gram-positive and Gram-negative bacteria, and especially MRSA and