Nanocrystalline Silver Dressings Research Articles

SYNTHESIS AND ANTIBACTERIAL ACTIVITY OF SILVER NANOPARTICLES: SYSTEMATIC REVIEW

Silver is exploited for the benefit of mankind from past centuries. Silver has been proved to be much more powerful when compared to other metallic nanoparticles, not only bactericidal properties but it is also effective against eukaryotic microorganisms and viruses. Creation of Ag Nanoparticles has increased the silver efficacy many folds due to their physical and chemical properties, especially the surface area to volume ratio is most important imparting the antibacterial activity over various microorganisms. To lessen bacterial infections in incurable wounds nanocrystalline silver dressings, creams, gels are formulated. However, several problems are associated with the use. Silver nanoparticle toxicity is a major threat associated with their use and the inhibition of beneficiary microorganisms due to lack of specificity of silver nanoparticles is environmentalist’s concern. To reduce the threats associated, there should be a careful assessment of the silver nanoparticles release into the environment and should be regulated. It has to be noted that novel methods to produce silver nanoparticles which reduce the toxicity and other associated threats has to be developed in the future to exploit the vast capabilities of the silver nanoparticles for the benefit of mankind. As technology advancement is always in demand with changing environmental conditions, the present review will focus on the synthesis and antibacterial properties of silver nanoparticles along with its environmental impact. Key Words: Silver nanoparticles ∙ Antibacterial Activity ∙ Microorganisms ∙ Environmental Impact

Film dressings from Thai mango seed kernel extracts versus nanocrystalline silver dressings in antibacterial properties.

Introduction: The extract from the Mango Seed Kernel (MSK) has been documented to exhibit antibacterial activity against Gram-positive and Gram-negative bacteria, including Staphylococcus aureus and Pseudomonas aeruginosa. This suggests that biomaterials containing MSK extract could be a viable alternative to conventional wound treatments, such as nanocrystalline silver dressings. Despite this potential, there is a notable gap in the literature regarding comparing the antibacterial effectiveness of MSK film dressings with nanocrystalline silver dressings. This study aimed to develop film dressings containing MSK extract and evaluate their antibacterial properties compared to nanocrystalline silver dressings. Additionally, the study aimed to assess other vital physical properties of these dressings critical for effective wound care. Materials and methods: We prepared MSK film dressings from two cultivars of mango from Thailand, 'Chokanan' and 'Namdokmai'. The inhibition-zone method was employed to determine the antibacterial property. The morphology and chemical characterization of the prepared MSK film dressings were examined with scanning electron microscopy (SEM) and Fourier-Transform Infrared Spectroscopy (FTIR), respectively. The absorption of pseudo-wound exudate and water vapor transmission rate (WVTR) of film dressings were evaluated. Results: The results showed that 40% of MSKC film dressing had the highest inhibition zone (20.00 ± 0.00mm against S. aureus and 17.00 ± 1.00mm against P. aeruginosa) and 20%, 30%, and 40% of MSKC and MSKN film dressings had inhibition zones similar to nanocrystalline silver dressing for both S. aureus and P. aeruginosa (p > 0.05). In addition, all concentrations of the MSK film dressings had low absorption capacity, and Chokanan MSK (MSKC) film dressings had a higher WVTR than Namdokmai MSK (MSKN) film dressings. Conclusion: 20%, 30%, and 40% of MSK film dressing is nearly as effective as nanocrystalline silver dressing. Therefore, it has the potential to be an alternative antibacterial dressing and is suitable for wounds with low exudate levels.

Treatment of infection and inflammation associated with COVID-19, multi-drug resistant pneumonia and fungal sinusitis by nebulizing a nanosilver solution

Solutions containing Ag0 nanoclusters, Ag+1, and higher oxidation state silver, generated from nanocrystalline silver dressings, were anti-inflammatory against porcine skin inflammation. The dressings have clinically-demonstrated broad-spectrum antimicrobial activity, suggesting application of nanosilver solutions in treating pulmonary infection.Nanosilver solutions were tested for antimicrobial efficacy; against HSV-1 and SARS-CoV-2; and nebulized in rats with acute pneumonia. Patients with pneumonia (ventilated), fungal sinusitis, burns plus COVID-19, and two non-hospitalized patients with COVID-19 received nebulized nanosilver solution.Nanosilver solutions demonstrated pH-dependent antimicrobial efficacy; reduced infection and inflammation without evidence of lung toxicity in the rat model; and inactivated HSV-1 and SARS-CoV-2. Pneumonia patients had rapidly reduced pulmonary symptoms, recovering pre-illness respiratory function. Fungal sinusitis-related inflammation decreased immediately with infection clearance within 21 days. Non-hospitalized patients with COVID-19 experienced rapid symptom remission.Nanosilver solutions, due to anti-inflammatory, antiviral, and antimicrobial activity, may be effective for treating respiratory inflammation and infections caused by viruses and/or microbes.

Impact of negative pressure wound therapy and nanocrystalline silver dressings on the quality of life of patients with chronic non-healing ulcers: a preliminary study

Therapeutic measures should be primarily directed to promote healing, but also to improve or at least to maintain HRQoL. This prospective randomized pilot study was conducted to assess the impact on HRQoL of negative pressure wound therapy (NPWT) combined with nanocrystalline silver dressings in outpatients with chronic nonhealing ulcers. A total of 17 patients were included in the study, 10 of which were treated with the combined method and 7 with NPWT only. Patients were followed for 6 weeks. The 36-item short-form (SF-36) questionnaire was administered to at baseline and at the end of treatment. Patients included in the study had multiple concomitant pathological conditions and a mean age of 70 years. Significant changes in different domains of the SF-36 questionnaire, including physical functioning, role limitations (physical), vitality, mental health, social functioning, bodily pain, and general health, before and after treatment were not found. The mean (standard deviation, SD) score of social functioning was 53.1 (31.8) before treatment and 66.3 (23.6) after treatment (P = 0.09). The application of NPWT with nanocrystalline silver dressings or NPWT alone for 6 weeks was effective in wound healing promotion. The impact on HRQoL was non-significant except for somewhat better benefits in the social domain in patients treated with NPWT and silver dressings. The present preliminary data could be the basis for the design of future, more robust clinical studies.

Assessment of wound healing using Nano-crystalline silver membrane placed following periodontal flap surgery

Background: Nanomaterials are widely explored in Periodontics, as well as controlled drug release in forms of hollow spheres, core-shell, nanotubes and other active components. The present study was conducted to assess wound healing using Nano-crystalline silver membrane placed following periodontal flap surgery. Materials & Methods: 60 patients diagnosed with chronic periodontitis of both genders were divided into 2 groups of 30 each. Group I received a nano-crystalline silver dressing and group II received non-eugenol dressing. Flap surgery in each patient was carried out. Parameters such as wound healing index, microbiological analysis and vascular endothelial growth factor (VEGF) were recorded at the 7th and 14th day postoperatively. Results: Patients in group I received a nano-crystalline silver dressing and in group II, non-eugenol dressing. Group I had 14 males and 16 females and group II had 12 males and 18 females. The mean healing index on 7th day was 3.75 and 2.28 in group I and II and 4.12 and 3.14 in in group I and II on 14th day respectively. The difference was significant (P< 0.05). CFU/ml (X106) pre- operatively and post- operatively was 3.4 and 1.6 and 1.5 and 1.8 in group I and II respectively.

A Fatal Case of Febrile Ulceronecrotic Mucha-Habermann Disease in a 10-Year-Old Boy.

A Fatal Case of Febrile Ulceronecrotic Mucha-Habermann Disease in a 10-Year-Old Boy.

Efficacy and costs of nanocrystalline silver dressings versus 1% silver sulfadiazine dressings to treat burns in adults in the outpatient setting: A randomized clinical trial

BackgroundNanocrystalline silver dressings can reduce the number of changes, facilitating burn wound management. However, the evidence regarding their efficacy and cost-consequences compared to well-established treatments, such as 1% silver sulfadiazine, is still scarce. ObjectiveTo determine the efficacy, safety, and costs of nanocrystalline silver dressings compared to 1% silver sulfadiazine dressings to treat adult patients with burns. Study design and settingRandomized, single-center, single-blind trial conducted at a referral hospital in São Paulo, Brazil. Methods100 adult patients were randomized 1:1 to nanocrystalline silver (n = 50) or 1% silver sulfadiazine (n = 50). The primary outcome was the proportion of participants with complete re-epithelization at day 15 after randomization. Secondary outcomes included the number of dressing changes, direct medical costs (in international dollars, I$), pain intensity, the incidence of infections, number of patients undergoing surgery, and adverse events. ResultsOn day 15, the proportion of patients who reached the primary outcome did not differ significantly between participants treated with nanocrystalline silver dressings (24 [48%]) and those treated with 1% silver sulfadiazine dressings (26 [52%]); risk difference of −4.0 percentage points (95% confidence interval [CI], −17 to 9; P = 0.56). The number of patients undergoing surgical intervention was similar between groups (6% vs. 6%), and no local or serious adverse events were reported. The mean (standard deviation, SD) number of dressing changes in the nanocrystalline silver group was 4.1 (2.3), and the corresponding estimate in the 1% silver sulfadiazine group was 9.6 (6.7); mean difference of −5.56 (95% CI), −7.57 to −3.55, P < 0.001). Treatment with nanocrystalline silver dressing incurred significant cost reductions in medical materials, human resources, and administrative labor. However, the mean total cost with nanocrystalline silver dressing was higher compared to 1% silver sulfadiazine dressings: I$496.37 (445.90) vs. I$274.73 (182.76); mean difference = 221.63 (95% CI, 89.04 to 354.23, P = 0.001). The main driver of higher mean total costs among nanocrystalline silver-treated participants was the purchase cost of the dressings, representing 79.3% of the total cost in the nanocrystalline silver group but only 15.2% in the 1% silver sulfadiazine group. ConclusionWe found no evidence of a difference between nanocrystalline silver and 1% silver sulfadiazine dressings regarding efficacy and safety outcomes. Nanocrystalline silver dressings were associated with an increase in the total costs, but they could result in important savings for an institution (less changes of dressings, reducing human resources burden), especially if acquisition costs can be decreased. Additional cost-effectiveness studies are warranted. Trial registration numberNCT02108535

A retrospective review of the use of a nanocrystalline silver dressing in the management of open chronic wounds in the community.

As part of an infection management protocol, antimicrobial dressings offer an appropriate, cost‐effective choice for the management of localised bioburden in chronic wounds. The choice of antimicrobial can impact significantly not only on the treatment outcomes and cost but also on the safety and well‐being of the patient. This retrospective study investigates these outcomes comparing health care records of 2572 patients with open chronic wounds, who were treated either with an Integrated Care Wound Bundle (ICB) including nanocrystalline silver (NCS) dressings (n = 330) or without NCS dressings and not on a ICB (n = 2242) in the community from March 2016 to March 2018. Wounds treated in the NCS dressing treatment bundle had a mean healing time of 10.46 weeks, vs 25.49 weeks for the non‐ICB treated wounds. In addition, the average interval time between dressing changes was in favour of the NCS dressing treatment bundle (3.98 vs 1.87 days), contributing to a substantial reduction in mean treatment labour costs ($1251 vs $6488). The use of a NCS dressing demonstrated improved efficacy and cost effectiveness of labour required for chronic wound management; highlighting the importance of choosing an effective antimicrobial dressing as part of an infection management protocol.

Effect of nano-crystalline silver membrane on early wound healing after periodontal surgery: A comparative randomized study.

Background:Periodontal dressings are used for wound protection and patient comfort. Nano-silver particles have the ability to promote wound healing through anti-inflammatory properties. Hence, the present study aims to evaluate early wound healing parameters following periodontal surgery using nano-crystalline silver membrane as periodontal dressing.Materials and Methods:Forty-two systemically healthy patients diagnosed with chronic periodontitis indicated for periodontal flap surgery were enrolled for the present study. Post surgery, the patients were randomly allocated to either a nano-crystalline silver dressing (Acticoat™) group (test group) or only the noneugenol dressing group (control group). Plaque index (PI) and wound healing index were recorded at the 7th- and 14th-day postsurgery. The microbiological analysis and vascular endothelial growth factor (VEGF) levels were evaluated at baseline and 7th-day postsurgery.Results:The healing index was significantly higher in the test group as compared to the control group at days 7 and 14 (P < 0.001; P < 0.001). The colony-forming units/ml count of bacteria were significantly reduced postsurgery in the test group (P = 0.019). VEGF levels increased significantly 7th-day postsurgery in the test group (P = 0.001). There was no statistically significant difference in the PI on the 7th-day postsurgery between the two groups (P = 0.173).Conclusion:The results of the study revealed that silver can be used as a potent periodontal dressing ingredient that can decrease the microbial colonization beneath the pack and promote faster healing postsurgery due to its antimicrobial activity.

Clinical evidence based nano crystalline silver dressing rationality, efficacy and strategy in extensive burn patients survival

Extensive burns of more than 50% have high mortality and those over 90% have almost nil survival rate. All resuscitative measures fail as patient gets infected leading to burn wound sepsis causing septicemia and leading to mortality as the end clinical result. So we need clinically evidenced and rationally based burn dressing strategy to increase extensive burn patient survival. This is random retrospective selection of five patients in each two groups from second degree burn patients of more than 50 percent treated by collagen in one group and other by Nanocrystalline Silver dressings and observed for clinical evidence of patients survival keeping all resuscitative and treatment modalities as standard treatment protocol in all cases. The nano crystalline silver dressing is cost effective, rational and evidence based strategy. It is easy to use, has powerful anti bacterial effect, decreased frequency of dressing changes, shortened time of wound cleaning and painless dressing. It helps make the wound sterile for further treatment within a week. It is a great weapon in the hand of Burn Surgeon for rapid and better recovery of patients. This nano crystalline sustained release silver dressings are best suited to take care of burn wounds of more than 50%. Bacteriophages treatment is reserved for multiple drug resistant bacteria and had good recovery.

51 Negative Pressure Wound Therapy for Small-to-medium-sized Paediatric Thermal Burns: A Randomized Controlled Trial (SONATA in C)

Abstract Introduction In the setting of burns, negative pressure wound therapy (NPWT) has been widely adopted as a means of wound bed preparation prior to skin grafting and graft immobilization. Its role in the treatment of acute burns has been less well-studied, although there is limited evidence to suggest that it might facilitate physiological healing. This study aimed to assess its efficacy in the management of acute burns in children with small-to-medium-sized thermal injuries. Methods In this single-center, two-arm, parallel, randomized, controlled clinical trial, we assigned patients under 17 years of age with acute thermal burns covering &amp;lt; 5% of their total body surface area to either an active control (nanocrystalline silver dressings) or an experimental treatment combining standard dressings with NPWT. Patients were excluded if their burn occurred &amp;gt;7 days prior to presentation, affected the face, or was deemed by clinicians to be trivial. The primary outcome was time to re-epithelialization. Secondary outcomes included scarring, grafting, pain, ease of management, and adverse events. Results A total of 114 children underwent randomization. The median time to re-epithelialization was 8 days (interquartile range (IQR) 7–10) for the NPWT group and 10 days (IQR 8–12.25) for the control group (hazard ratio, 1.515; 95% confidence interval (CI) 1.003 to 2.289; P=0.048). Children administered NPWT within 48 hours of their injury (n=16) re-epithelialized in a median of 7 days (IQR 5–8; HR, 2.129; 95% CI 1.155 to 3.922; P=0.015). The proportion of children referred to scar management was 8.7% for the experimental group and 25.9% for the control group (odds ratio, 0.27; 95% CI 0.08 to 0.90; P=0.032). There were no significant differences in grafting (2.2% vs. 7.4%; odds ratio, 0.28; 95% CI 0.03 to 2.58; P=0.260), pain during dressing changes (P=0.946), or at-home pain between dressing changes (P=0.592). NPWT was associated with a greater treatment burden (P&amp;lt; 0.001) and incidence of adverse events, which included minor blistering and wound maceration. Conclusions In children with small-to-medium-sized thermal burns, NPWT accelerated re-epithelialization and decreased the need for long-term scar management. Applicability of Research to Practice This study found NPWT to be a promising adjunct to standard care in the treatment of pediatric thermal burns. (Clinical Trials Registry number, ACTRN12618000256279.)

Evaluation of Nano-Crystalline Silver Dressings in Superficial Partial Thickness Burns

Evaluation of Nano-Crystalline Silver Dressings in Superficial Partial Thickness Burns

Antiseptics for burns.

Antiseptics for burns.

A systematic review and meta-analysis of clinical outcomes associated with nanocrystalline silver use compared to alternative silver delivery systems in the management of superficial and deep partial thickness burns

ObjectiveThe purpose of this systematic review and meta-analysis was to assess the clinical effectiveness of nanocrystalline silver compared to alternative silver delivery systems (silver sulphadiazine [SSD] and silver nitrate) in adults and children with superficial and deep partial thickness burns. MethodsPubMed, EMBASE, Cochrane and other databases were searched to identify relevant randomised controlled trials and observational studies. ResultsEight studies that assessed both nanocrystalline silver and SSD and one study that compared nanocrystalline silver vs. silver nitrate were identified. Nanocrystalline silver compared to SSD/silver nitrate was associated with a statistically significant reduction in infections (odds ratio [OR] 0.21, 95% CI 0.07–0.62, p=0.005), length of stay in hospital (mean difference −4.74 (95% CI −5.79 to −3.69, p=0.00001) and surgical procedures (OR 0.40, 95% CI 0.28–0.56, p=0.00001). Three studies that reported on pain had lower pain scores with nanocrystalline silver use than with SSD/silver nitrate; a high level of heterogeneity precluded pooling estimates. ConclusionThis comprehensive systematic review and meta-analysis of the available evidence suggest that the use of nanocrystalline silver dressings results in shorter length of stay in hospital, less pain, fewer surgical procedures and reduced infection rates compared to silver sulphadiazine/silver nitrate.

A Pilot Randomized, Controlled Study of Nanocrystalline Silver, Manuka Honey, and Conventional Dressing in Healing Diabetic Foot Ulcer.

Nanocrystalline silver (nAg) and Manuka honey (MH) dressing have increasing popularity for treating diabetic foot ulcer (DFU). This study was an open-label randomized controlled trial with three parallel groups' design in examining the preliminary effectiveness of nAg against MH and conventional dressing in healing DFU in terms of ulcer healing, ulcer infection, and inflammation. 31 participants (11 in the nAg group, 10 in the MH group, and 10 in the convention group) diagnosed with type 2 diabetes were enrolled. Wound cleaning, debridement, and topical dressing application were performed according to the group allocation in each visit at weeks 1, 2, 3, 4, 6, 8, 10, and 12. The results found that the proportions of complete ulcer healing were 81.8%, 50%, and 40% in the nAg, MH, and conventional groups, respectively. The ulcer size reduction rate was potentially higher in the nAg group (97.45%) than the MH group (86.21%) and the conventional group (75.17%). In bacteriology, nAg showed a greater rate of microorganism reduction although it was not significant. To conclude, nAg alginate was potentially superior to MH and conventional dressing in healing diabetic foot ulcer in terms of ulcer size reduction rate.

Nanocrystalline silver dressings significantly influence bioimpedance spectroscopy measurements of fluid volumes in burns patients

Bioimpedance spectroscopy (BIS) is a tool utilized in health care to investigate body composition and fluid distribution. Limited research has addressed the clinical use of BIS in burns. This study aimed to examine the effects of silver dressings on BIS measurements in burns patients. BIS measurements were collected during two dressing conditions: no dressing (ND), and; Acticoat™ dressing (AD). Wilcoxon sign-ranks tests determined if there were any significant differences in BIS measures between the dressing conditions. Multilevel mixed-effects linear regressions examined the effect of %TBSA and body mass on BIS variables across the dressing conditions. The mean age of the patients (n=31) was 34.90 years; with a median TBSA of 15%. There was a significant increase in extracellular fluid (ECF) (p<0.001), intracellular fluid (ICF) (p<0.001) and total body water (TBW) (p<0.001) when AD was in place. There were significant interactions between dressing condition, %TBSA and body mass, whereby the difference in ECF, ICF and TBW between the ND and AD conditions were increased as %TBSA and body mass increased. Algorithms were developed subsequently to adjust BIS outputs for use when AD is in place. Clinician's may continue to use BIS in real-time using the predictive algorithms established during this study.

Negative pressure and nanocrystalline silver dressings for nonhealing ulcer: A randomized pilot study.

Chronic wounds have a high prevalence and wound care, treatment, and prevention consume large quantities of resources. Chronic wounds are a growing challenge for clinicians. A prospective randomized pilot study was conducted to assess the effectiveness in terms of reduction in area and safety of the combined use of negative-pressure wound therapy and nanocrystalline silver dressings as compared to negative pressure wound therapy (NPWT) alone in the management of outpatients with chronic wounds. A total of 17 patients were included in the study, 10 were treated with the combined method and 7 with NPWT. Patients were followed for 6 weeks, with a final assessment at 3 months. Clinical improvement, microbiologic data, and toxicity of silver were evaluated. The antibacterial effects of ionic silver together with the development of granulation tissue promoted by NPWT reduced significantly the median extension of the wound between weeks 3 and 6 of treatment. The combination with silver also reduced bacterial colonization with Pseudomonas aeruginosa and the bacterial load on the surface of the wound. The silver levels correlated positively with the extension of the wound, although in none of the patients' toxic levels were reached. The combination of NPWT with nanocrystalline silver dressings was safe and as effective as NPWT alone.

Effect of light on physicochemical and biological properties of nanocrystalline silver dressings

The purpose of this study was to characterize the interactive effects of light and aging on physicochemical properties and antimicrobial activity of nanocrystalline silver wound dressings Acticoat that might find their way into the environment.

Role of nanocrystalline silver dressings in the management of toxic epidermal necrolysis (TEN) and TEN/Stevens-Johnson syndrome overlap.

Toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS) are severe mucocutaneous eruptions. There is currently no defined optimal approach to wound care. The objective of this study was to evaluate silver dressings in the wound-care management of TEN and SJS/TEN syndrome overlap with a retrospective case review of nine patients with TEN and SJS/TEN overlap presenting to our institution. Nanocrystalline silver dressings appear to be useful in the rapid commencement of healing in these patients. TEN and SJS/TEN overlap are rare conditions. This contributed to a relatively small number of cases included in the study. The ease of application, antimicrobial properties and low frequency of change make nanocrystalline silver dressings ideal in TEN/SJS.

Comparative study of the efficacy of nanocrystalline silver dressing and silver sulfadiazine applied on burns in hospitalized patients

Objective: To evaluate the efficacy of dressing based on silver as nanocrystalline silver and silver sulfadiazine in patients with burns and clinical signs of infection, in the healing process, seeking a favorable outcome of local therapy. Methods: A prospective and exploratory study, carried out with patients with burns with a quantitative approach by the method of clinical investigation. The study population comprised 30 patients, burn victims, aged between 03 and 40 years old. The patients had between 04% to 27% of Body Surface Burned (SCQ), with the majority of second degree burns. Topical therapy was performed in 30 patients with exudating wounds, while 15 patients received injections of silver sulfadiazine and 15 nanocrystalline silver. Results: Patients who used nanocrystalline silver showed significant improvement of the lesions in addition to decreased exudation and early epitheliazation after the second day of healing, while those who had used silver sulfadiazine began to show improvement from the fourth day of healing. Conclusions: The results with nanocrystalline silver showed a reduced incidence of exudate in comparison with the dressing made with silver sulfadiazine.