Silver Dressings Research Articles

Clinical efficacy and safety of a silver ion-releasing foam dressing on hard-to-heal wounds: a meta-analysis.

Delayed or stalled healing in open wounds can result from persisting chronic inflammation related to infection and/or persistent bacterial colonisation and biofilm. Treatment of hard-to-heal wounds focuses on debridement and exudate management, but also on infection prevention and control. Silver dressings have been evaluated in randomised clinical trials (RCTs); this meta-analysis evaluated the efficacy and safety of a silver ion-releasing foam dressing (Biatain Ag; Coloplast A/S, Denmark) to treat hard-to-heal wounds. Literature databases (PubMed and Cochrane Library) were searched for studies on silver ion-releasing foam dressings in the treatment of hard-to-heal wounds. Individual patient data from four RCTs were obtained and included in the meta-analysis. Findings showed that treatment with the silver ion-releasing foam dressing was associated with a significantly higher relative reduction in wound area after four (least squares-mean difference (LS-MD): -12.55%, 95% confidence interval (CI): (-15.95, -9.16); p<0.01) and six weeks of treatment (LS-MD: -11.94%, 95%CI: (-17.21, -6.68); p<0.01) compared with controls. Significant benefits were also observed for time to disappearance of odour (hazard ratio: 1.61, 95%CI: (1.31, 1.98); p<0.01), relative reduction of exudate (LS-MD: -5.15, 95%CI: (-7.36, -2.94); p<0.01), proportion of patients with periwound erythema (relative risk (RR): 0.81, 95%CI: (0.69; 0.94); p<0.01), and less pain at dressing removal (LS-MD: -0.35, 95%CI: (-0.63, -0.06); p=0.02). No differences regarding safety outcomes were identified. This meta-analysis has demonstrated beneficial outcomes and a good tolerability profile for silver ion-releasing foam dressings in the treatment of moderate-to-highly exuding wounds with delayed healing compared with control dressings.

Commercial Silver-Based Dressings: In Vitro and Clinical Studies in Treatment of Chronic and Burn Wounds.

Chronic wounds are a major health problem because of delayed healing, causing hardships for the patient. The infection present in these wounds plays a role in delayed wound healing. Silver wound dressings have been used for decades, beginning in the 1960s with silver sulfadiazine for infection prevention for burn wounds. Since that time, there has been a large number of commercial silver dressings that have obtained FDA clearance. In this review, we examine the literature involving in vitro and in vivo (both animal and human clinical) studies with commercial silver dressings and attempt to glean the important characteristics of these dressings in treating infected wounds. The primary presentation of the literature is in the form of detailed tables. The narrative part of the review focuses on the different types of silver dressings, including the supporting matrix, the release characteristics of the silver into the surroundings, and their toxicity. Though there are many clinical studies of chronic and burn wounds using silver dressings that we discuss, it is difficult to compare the performances of the dressings directly because of the differences in the study protocols. We conclude that silver dressings can assist in wound healing, although it is difficult to provide general treatment guidelines. From a wound dressing point of view, future studies will need to focus on new delivery systems for silver, as well as the type of matrix in which the silver is deposited. Clearly, adding other actives to enhance the antimicrobial activity, including the disruption of mature biofilms is of interest. From a clinical point of view, the focus needs to be on the wound healing characteristics, and thus randomized control trials will provide more confidence in the results. The application of different wound dressings for specific wounds needs to be clarified, along with the application protocols. It is most likely that no single silver-based dressing can be used for all wounds.

Use of Silver Dressing on Diabetic Ulcers During Infection: Case Report

Aims: This study aimed to describe the results of applying silver dressing on diabetic ulcers during infection in patients with infected wounds on digiti one pedis dextra. Methods: This research uses a descriptive design, namely a case study with a nursing approach consisting of assessment, analysis of problem formulation, formulation of nursing diagnosis, intervention, implementation, evaluation, and nursing documentation. The subject of this case study is Mrs. A with diabetic ulcers on Digi 1 pedis extra with infection. Case management was carried out for three days on April 17-19, 2024. Data was collected through anamnesis, wound assessment, supporting examination, and literature study. Wound assessment was performed using the Meggitt-Wagner instrument for assessing wound severity and the SINBAD (Site, Ischemia, Neuropathy, Bacterial infection, Area ulcer, and Depth) system for improving foot ulcer management according to their severity and predicting major adverse foot events. Results: After three days of treatment using silver dressing, the wound condition shows that the infection has been resolved, and the wound has improved significantly from a grade 2 diabetic ulcer with abscess using the Meggitt-Wagner instrument and a SINBAD score of 3 (less severe ulcer) to a grade 2 diabetic ulcer without abscess and a SINBAD score of 2 (less severe ulcer). Conclusion: Wound care using silver dressing significantly accelerates the resolution of infections and supports the overall healing process

Safety of silver dressings in infants; a systematic scoping review.

Silver-based dressings are used to reduce infection risk and optimise conditions for wound healing. They are widely used in the management of burns and other complex wounds. However, reports of elevated serum silver and concern over systemic toxicity, has meant that their use in young children has been questioned. The aim of the current study was to map the literature relating to use of silver-based dressings in children under 1 year of age. A systematic scoping review was conducted according to methodology described by the Joanna Briggs Institute. Sources were identified from major medical databases as well as the grey literature. Inclusion criteria were the use of silver-based dressing in children under 1 year of age. Outcomes of interest were complications or adverse events attributed to silver-based dressings and elevated serum silver levels. Five-hundred and ninety-nine sources were identified through the search strategy, with 110 included for review. Complications were described in 31 sources, with the most frequent being wound infection. No cases of argyria, kernitcterus or methemaglobinaemia were reported. Six sources documented elevated serum silver levels in infants but none reported adverse events related to this. On the basis of current evidence, we suggest reserving silver dressings in infants under one for wounds that are at high risk of infection. Wound area and duration of treatment should be considered when assessing risk of systemic absorption of silver.. Standardised data-collection and recording of complications and adverse events is recommended to better inform future clinical decision making.

Effectiveness of silver and iodine dressings on wound healing: a systematic review and meta-analysis

ObjectiveTo evaluate the effects of silver and iodine dressings on healing time, healing rate, exudate amount, pain and anti-infective efficacy.DesignSystematic review and meta-analysis.Data sourcesDatabases including PubMed, Cochrane Library, Embase, Web...

Clinical nursing application of nano-silver dressing on radiation injury chronic infected wound

ObjectiveTo explore the clinical nursing application of nano-silver dressing in the nursing of radiation injury chronic infected wound. MethodsIn this study, 52 patients who met the standard of chronic infected wounds were randomly divided into two groups for nursing intervention, namely the experimental group using nano silver dressing and the control group using medical gauze, with 26 patients in each group. Age, body mass index, blood glucose and wound area were recorded in both groups before nursing intervention. The blood C-reactive protein value, white blood cell count and pain score were recorded on the intervention day, the intervention 7 d and the intervention 14 d. The therapeutic effect, dressing change times and wound healing time of each group after intervention were analyzed. ResultsOn the 7 d and 14 d after using nano silver dressing, the C-reactive protein value, white blood cell count and pain score of patients, as well as the therapeutic effect, dressing times and wound healing time were better than those without using nano silver dressing. ConclusionNano-silver dressing can accelerate the healing of radiation injury chronic infected wound, and can achieve significant therapeutic effect in clinical treatment.

The use of antimicrobial dressings for the management of diabetic foot ulcers: A survey of podiatrists in Aotearoa New Zealand.

Diabetic foot ulcers (DFUs) are commonly contaminated with pathogenic organisms and precede most diabetes-related amputations. Antimicrobial dressings are used in the treatment of DFUs; however, recent guidelines do not support their use. There are no data describing the experience of antimicrobial dressing use among podiatrists in Aotearoa New Zealand (AoNZ). This study aimed to (i) determine which antimicrobial dressings podiatrists in AoNZ use for the management of diabetic foot ulcers; and (ii) determine what factors influence AoNZ podiatrists' use of antimicrobial dressing when managing DFUs. An anonymous cross-sectional web-based survey was undertaken. Participants were AoNZ registered podiatrists who managed DFUs in their practice. The survey included questions relating to personal and professional demographic characteristics and DFU management and dressing practices. Descriptive statistics were computed to address the research aims. Responses from 43 AoNZ podiatrists were included. Participants reported both cadexomer iodine and silver dressings were the most common antimicrobial dressings used, with honey dressings being the least frequently used. The most influential factors in choosing antimicrobial dressings when managing DFUs were the presence of current infection, ulcer exudate and ability to prevent future infection. The least influential factors in choosing antimicrobial dressings when managing DFUs were patient preferences, cost of dressings and comfort of dressing/pain on removal. AoNZ podiatrists managing DFUs primarily use antimicrobial dressings containing cadexomer iodine or silver as active ingredients, while lower-cost options, such as honey and povidone iodine are less often used. Current recommendations highlight the lack of evidence to support positive outcomes from any particular antimicrobial dressing over another and advocate that exudate control, comfort and cost be prioritised in decision-making. As cost has been an increasing burden to our healthcare funding, clinicians and organisations may consider this before purchasing and stocking expensive dressings.

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

Microneedles for Enhanced Bacterial Pathogen Inactivation and Accelerated Wound Healing

AbstractBacterial wound infections are a significant socioeconomic concern in the modern healthcare industry owing to increased morbidity, prolonged hospital stay, and mortality. Bacterial infectious agents that colonize the wound bed develop biofilms, acting as a physical barrier that prevents the effective penetration of topical antimicrobials. Further, bacteria in such infectious wounds express a wide range of virulence factors promoting intercellular transmigration and host cell invasion complicating the treatment regimen. To address this need, a water‐dissolvable poly‐vinyl pyrrolidine (PVP), calcium peroxide (CPO) infused microneedle structure (denoted as PVP/CPO MN) for effective transdermal delivery of antimicrobial payload deep into the tissues is developed. Fluid exudate from the wound bed dissolves the PVP/CPO MN enabling the release of CPO deep into the infected wound bed. A slow catalytic decomposition of CPO results in the sustained release of reactive oxygen species (ROS) deep within the infected wound inhibiting the inter‐ and intracellular pathogens. Here, a systematic study of microneedle fabrication and sterilization after complete packaging is conducted to ensure scalability and safe applicability while maintaining mechanical and antibacterial properties. In vitro, antibacterial efficacy of the microneedles is validated against two common wound pathogens, Pseudomonas aeruginosa (P. aeruginosa) and Staphylococcus aureus (S. aureus). Moreover, the PVP/CPO MN exhibited significant efficacy in eradicating both extracellular and intracellular bacterial populations within an in vivo porcine wound model. Additionally, the microneedle technology facilitated a faster wound healing, with ≈30% increase compared to control and a 15% improvement over conventional silver dressing.

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.

Modified in-vitro AATCC-100 procedure to measure viable bacteria from wound dressings.

Chronic wounds are reoccurring healthcare problems in the United States and cost up to $50 billion annually. Improper wound care results in complications such as wound debridement, surgical amputation, and increased morbidity/ mortality due to opportunistic infections. To eliminate wound infections, many antimicrobial dressings are developed and submitted to FDA for evaluation. AATCC-100 is a standard method widely used to evaluate cloth wound dressings. This method, requires enrichment, followed by culturing to measure the concentration of culturable organisms; a caveat to this method could result in neglected viable but nonculturable (VBNC) bacteria and overestimate the antimicrobial properties of wound dressings. Therefore, the objectives of this study were to assess this accepted protocol with quantitative real-time polymerase chain reaction (qRT-PCR), to measure time dependent antimicrobial efficacy of wound dressing, and to examine for potential viable bacteria but non-culturable as compared with traditional plating methods. The test organisms included opportunistic pathogens: Pseudomonas aeruginosa (ATCC 15692) and Staphylococcus aureus (ATCC 43300). To mimic a wound dressing environment, samples of commercially available wound dressings (McKesson Inc.) with silver ion (positive control) and dressings without silver ion (positive control) were assessed under sterile conditions. All samples were examined by the original protocol (the extended AATCC-100 method) and qRT-PCR. The expression of specific housekeeping genes was measured (proC for P. aeruginosa and 16s rRNA for S. aureus). Based on these tests, log reduction of experimental conditions was compared to identify time dependent and precise antimicrobial properties from wound dressing samples. These results showed antimicrobial properties of wound dressings diminished as incubation days are increased for both methods from day 1 PCR result of 4.31 ± 0.54 and day 1 plating result of 6.31 ± 3.04 to day 3 PCR result of 1.22 ± 0.97 and day 3 plating result of 5.89 ± 2.41. These results show that data from qRT-PCR generally produced lower standard deviation than that of culture methods, hence shown to be more precise. Complementary parallel analysis of samples using both methods better characterized antimicrobial properties of the tested samples.

Effect of silver colloid dressing over conventional dressings in diabetic foot ulcer: A prospective study.

Topical silver treatments and silver dressings are increasingly being utilized for the local treatment of wounds; nevertheless, the evidence for their usefulness is unclear. The aim of this study was to investigate the impact of conventional dressings and silver colloid dressing on diabetic foot ulcers (DFU) with and without compression therapy. This prospective, double-blind experiment included 50 patients with non-ischemic DFUs, split into two groups of 25 patients each. The study was conducted for a period of six months. The primary endpoint was to evaluate the entire epithelialization (total healing) of all ulcers on the study leg. The ulcer area significantly decreased in the colloidal silver group (67.77 ± 17.82%) compared to the conventional saline group (21.70 ± 23.52%). When compared to the conventional group, the colloidal silver group required considerably fewer days to reach the endpoint (23.15 ± 8.15 days vs. 48.35 ± 18.07 days), and by day 14, ulcer area reduction (from 100%) was greater (48% in the silver group vs. 89.69% in the conventional group). In managing DFUs, unstructured hydrogel wound dressings using silver colloids based on ionic silver are more effective than regular saline dressings since they heal wounds more quickly in fewer days while also drastically reducing ulcer areas over time.

Cytotoxicity and concentration of silver ions released from dressings in the treatment of infected wounds: a systematic review.

Silver-releasing dressings are used in the treatment of infected wounds. Despite their widespread use, neither the amount of silver released nor the potential in vivo toxicity is known. The aim of this study was to evaluate the cytotoxic effects and the amount of silver released from commercially available dressings with infected wounds. The review was conducted according to the PRISMA statement. The Web of Science, PubMed, Embase, Scopus, and CINAHL databases were searched for studies from 2002 through December 2022. The criteria were as follows: population (human patients with infected wounds); intervention (commercial dressings with clinical silver authorized for use in humans); and outcomes (concentrations of silver ions released into tissues and plasma). Any study based on silver-free dressings, experimental dressings, or dressings not for clinical use in humans should be excluded. According to the type of study, systematic reviews, experimental, quasi-experimental, and observational studies in English, Spanish, or Portuguese were considered. The quality of the selected studies was assessed using the JBI critical appraisal tools. Studies that assessed at least 65% of the included items were included. Data were extracted independently by two reviewers. 740 articles were found and five were finally selected (all of them quasi-experimental). Heterogeneity was found in terms of study design, application of silver dressings, and methods of assessment, which limited the comparability between studies. In vivo comparative studies of clinical dressings for control of infection lack a standardized methodology that allows observation of all the variables of silver performance at local and systemic levels, as well as evaluation of its cytotoxicity. It cannot be concluded whether the assessed concentrations of released silver in commercial dressings for the topical treatment of infected wounds are cytotoxic to skin cells. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022351041, PROSPERO [CRD42022351041].

Development, characterization, and evaluation of a simple polymicrobial colony biofilm model for testing of antimicrobial wound dressings.

Simple biofilm models are the first step to testing of any antimicrobial and wound dressing; therefore, the aim of this study was to develop and validate a simple polymicrobial colony biofilm wound model comprised of Pseudomonas aeruginosa, Staphylococcus aureus, and Candida albicans on RPMI-1640 agar. The model was then used to evaluate the topical disinfectant chlorohexidine and four commercially available wound dressings using the polymicrobial model. The model used was as a starting point to mimic debridement in clinical care of wounds and the effectiveness of wound dressings evaluated afterwards. Planktonic assessment using AATCC100-2004 demonstrated that all antimicrobial wound dressings reduced the planktonic microbial burden below the limit of detection; however, when challenged with polymicrobial colony biofilms, silver wound dressings showed limited effectiveness (1-2 log CFU reductions). In contrast, a single iodine releasing wound dressing showed potent antibiofilm activity reducing all species CFUs below the limit of detection (>6-10 log) depending on the species. A disrupted biofilm model challenge was performed to represent the debridement of a wound and wound silver-based wound dressings were found to be marginally more effective than in whole colony biofilm challenges while the iodine containing wound dressing reduced microbial recovery below the limit of detection. In this model, silver dressings were ineffective versus the whole colony biofilms but showed some recovery of activity versus the disrupted colony biofilm. The iodine wound dressing reduced the viability of all species below the level of detection. This suggests that mode of action of wound dressing should be considered for the type of biofilm challenge as should the clinical use, e.g. debridement.

Biomimetic aligned nanofibrous dressings containing cell-selective polymer enhance diabetic wound regeneration

Diabetic ulcers remain a significant challenge in wound care due to loss of epithelial cell migration. Aligned nanofibrous scaffolds mimicking the skin's extracellular matrix (ECM) are promising candidates for diabetic wound healing. In this study, a composition of poly(ε-caprolactone), gelatin, and dopamine-containing varying amounts of ε-polylysine (ε-PL) was electrospun to prepare aligned nanofiber wound dressings (ANFDs). We then investigated the morphological, physicochemical, mechanical, and biological properties of fabricated ANDFs. The presence of ε-PL confers bactericidal properties while promoting epithelial and fibroblast adhesion, proliferation, and migration, confirming its cell selectivity. The clinical importance of the ANFDs was then demonstrated in a mice model of full-thickness diabetic wounds. The results confirm that ANFD treatment resulted in a higher rate of wound closure in the linear range of wound closure than wounds treated with silver dressings. Taken together, these results suggest the potential of antimicrobial ANFDs for the treatment of diabetic wounds.

Enhanced healing of wounds that responded poorly to silver dressing by copper wound dressings: Prospective single arm treatment study.

Dressings containing silver ions are an accepted and common option for wound treatment. However, some wounds fail to heal at the desired rate despite optimal management. The aim of the study was to examine the effect of copper dressings in noninfected wounds. The study included 20 patients aged 18-85 years with 2-30 cm2 noninfected wounds treated for 17-41 days with silver wound dressings that failed to reduce by >50% the wound size, who were then treated with copper dressings. Ten patients were diabetics, 10 suffered from hypertension, and six suffered from peripheral vascular disease (PVD). Two patients suffered from two wounds. Most were amputation wounds below the knee. Five patients dropped out from the study due to complications not related to the wound. The mean period of silver and copper dressings treatment was 25.6 and 29.6 days, respectively (p = 0.25; t test). None of the wounds became infected. Comparing a period of 25 days, during the copper dressings treatment, the mean wound area reduction was ~2.4 times higher than during the silver dressing treatment, 87.35 ± 22.4% versus 37.02 ± 25.11% (mean ± SD; p < 0.001; paired t test), respectively. The average decline during the silver and copper treatments were 1.2% and 2.14% per day (p = 0.002; multiple regression analysis), respectively. The enhanced wound healing process observed with the copper dressings may be explained by the integral role of copper throughout all physiological skin repair processes. Silver in contrast has no physiological role in wound healing. The results of our study confirm case reports showing enhanced wound healing of hard-to-heal wounds with copper dressings, both of infected and noninfected wounds. Taken together, the results of the current study support the hypothesis that the application of copper dressings in situ for noninfected wounds results in the stimulation of the wound healing processes, as opposed to silver dressings.

Green Synthesis of Silver Nanoparticle Using Aqueous Leaf Extract of Barleria noctiflora and its Bioactive Efficacy

For millennia, silver has been known to have powerful antibacterial effects. Topical silver dressings are now commonly used to treat infections in burns, open wounds, and persistent ulcers. Because pathogenic organisms evolve on a daily basis as a result of mutation and antibiotic resistance, the manufacture and investigation of nanoparticles for use in antibacterial garments, burn ointments, and medical device coatings is an important industrial topic of nanoscience. This is the first study on the synthesis of silver nanoparticles from leaf extract of the medicinal plant Barleria noctiflora. Through the use of FT-IR, UV-visible spectrum analysis, XRD analysis, SEM EDAX, and antimicrobial potential, the bioreduced nanoparticles were discovered and verified. The greatest absorption peak in the UV-visible spectrum examination was seen at 480 nm for the silver nanoparticles. Twelve distinct peaks were identified in the FTIR spectra of biogenic AgNPs, located at 3127.21, 1624.74, 1400.35, 1155.96, 1021.11, 906.70, 825.31, 718.73, 669.69, 538.93, 457.21, and 417.49 cm-1. Peaks at 2θ values of 10.545, 19.000, 21.137, 22.033, 23.370, 26.691, 31.507, and 33.747, corresponding heights of 23.40, 235.26, 750.78, 357.58, 335.93, 171.19, 186.87, and 115.38cts, respectively, indicated by XRD analysis that the silver particles generated in our experiments were nanocrystals. The silver nanoparticles were tested with "d" spacing values of 8.38940, 4.67087, 4.20328, 4.03422, 3.80651, 3.33986, 2.83949, and 2.65601. SEM spectral analysis revealed oval AgNPs with a size range of 20 m. Metallic nanoparticles generated from Barleria noctiflora were tested for antibacterial activity against gram-positive and gram-negative pathogens such as E. Coli, Staphylococcus aureus, and the fungi Aspergillus niger and Candida albicans using the disc diffusion method. Surprisingly, metallic Ag nanoparticles had strong inhibitory zones against the selected illnesses.

Larval therapy vs conventional silver dressings for full-thickness burns: a randomized controlled trial

BackgroundThis is the first clinical trial to investigate the effectiveness of maggot debridement therapy (MDT) for full-thickness burn injuries in comparison to conventional silver dressings.MethodsThirty-one cases with full-thickness (grade III based on ICD-10 classifications version 2019) burns were assigned into larval therapy (15 cases) and conventional treatment (16 cases) groups. Participants in the MDT group have received loose larvae on days 0, 2, 4, and 6, while controls received a conventional regimen comprised of sharp debridement, silver sulfadiazine, antibiotic therapy, and offloading every day. The primary and secondary outcomes were defined as the time to debridement (from admission to skin autograft) and time to healing (from admission to complete healing post-skin autograft). Patients in two groups were also compared in terms of necrosis resolution, granulation, and granulation/necrosis (g/n) ratio during study time periods.ResultsParticipants who received larvae had significantly decreased necrosis on days 2 (p = 0.028) and 4 (p = 0.023) compared to those who received control treatment. Significant differences (p < 0.001) were also observed for granulation between the two groups in favor of MDT and the fold changes of g/n in the larvae group were 5, 15, and 13 times higher than that for the conventional regimen on days 2, 4, and 6 of treatment, respectively. Strikingly, a subgroup analysis of high necrotic burns (necrosis > 50%) revealed a significant improvement (p < 0.001) for MDT compared to the control treatment. There were also significant differences (p < 0.001) for the time to debridement and time to healing between the two groups. However, bacterial contamination did not show significant changes between the two treatment regimens.ConclusionsOur findings revealed that MDT has a favorable superiority over conventional regimen for the treatment of grade-III burns, and thus further clinical trials with larger sample size are warranted to confirm these results.

Copper-based dressing: Efficacy in a wound infection of ex vivo human skin

This study aimed to evaluate the wound healing and antibacterial effects of two experimental copper dressings compared to a commercial silver dressing. Burn wounds were created in the ex vivo human skin biopsies, then were infected by Staphylococcus aureus. Tissues were treated with copper dressings, silver dressing, or a dressing without any antibacterial component. An infected wound tissue without treatment was considered as the control group. Three days after treatments, tissues were analyzed by bacterial count and histology staining, while their media was used to assess the expression of cytokines and chemokines. Histology staining confirmed the presence of second-degree burn wounds and colonization of bacteria in the surface and superficial layer of tissues. The results demonstrated a higher antibacterial effect, improved epithelium formation, and decreased wound area in one of the copper dressings compared to other dressings. Markers associated with infection control increased in both the copper and silver-treated groups. The cytokine profiling analysis revealed increased expression of markers related to angiogenesis and anti-inflammatory responses and decreased pro-inflammatory cytokine responses in the infected wound treated with one of the copper dressings. Our results confirmed the efficacy of the experimental copper dressing in reducing bacteria and promoting wound healing.

Antimicrobial Activity of Silver-Containing Surgical Dressings in an In vitro Direct Inoculation Simulated Wound Fluid Model Against a Range of Gram-Positive and Gram-Negative Bacteria.

Background: Surgical site infections can lead to serious complications and present a huge economic burden. Established wound infections can be difficult to eradicate so preventative measures, including antimicrobial dressings, are advantageous. Materials and Methods: The antimicrobial activity of an ionic silver, ethylenediaminetetraacetic acid (EDTA) and benzethonium chloride-containing (ISEB) surgical cover dressing (SCD) was compared with two other silver-containing SCDs (silver sulfate and ionic silver carboxymethylcellulose [CMC]) and a non-silver-containing CMC SCD control using an in vitro model. The dressings were tested against a range of gram-positive and gram-negative bacteria found in wound environments, including antibiotic resistant strains, using a direct inoculation simulated wound fluid (SWF) model. Dressings were fully hydrated with SWF and inoculated with a final concentration of 1 × 106 colony forming units (CFU) per 10 microliter of the challenge organisms. Dressings were incubated at 35°C ± 3°C for up to seven days; total viable counts (TVCs) were performed to determine bacterial bioburden. Results: All challenge organism levels remained high for the CMC SCD control and silver sulfate SCD throughout the test period. A greater than 95% reduction in TVCs was observed by four hours for all challenge organisms for the ISEB SCD, with non-detectable levels (<70 CFU per dressing) reached within 24 hours and sustained throughout the test period. Antimicrobial activity was less rapid with ionic silver CMC SCD, with 9 of 11 challenge organisms reaching undetectable levels within 6 to 72 hours. Conclusions: A more rapid antimicrobial activity was observed for the ISEB SCD compared with other dressings tested within this in vitro model.