Silver Foam Dressings Research Articles

Comparing the outcomes between silver sulfadiazine (SSD) versus sustained-release silver foam in treatment of partial thickness burn patients

Objective: To compare the outcomes between silver sulfadiazine (SSD) versus sustained-release silver foam in treatment of partial thickness burn patients.
 Study design: Randomized controlled trial.
 Place and Duration: Department of Burn/Plastic surgery, Nishtar Medical University/Hospital, Multan in Six months from 27-11-2021 to 27-05-2022.
 Methodology; All patients of second degree partial thickness burns (n=164) were divided in equally in two groups through draw method, 82 patients in each, group (A) treated with silver sulfadiazine and group (B) with sustained-release silver foam dressing. Baseline data and outcome i.e., pain, wound healing and hospital stay were recorded on predesigned proforma
 Results: In Group I, there were 15.0% patients who had wound healed and 25.0% patients had wound healed in Group II. The mean VAS score at 5, 10, 15 and 20 day of Group II was less than the Group II (p<0.001). whereas, the wound healing in both the groups were almost equal at 5, 10, 15 and 20 day, and the differences were statistically insignificant, (p>0.050).
 Conclusion; utilization of sustained-release silver dressing exhibits notable advantages in the wound healing process, including accelerated recovery rates, reduced pain levels, and consequently, earlier hospital discharge, when compared to silver sulfadiazine (SSD) dressings in treatment of partial thickness burn patients.

Effectiveness of four topical treatment methods in a rat model of superficial partial-thickness burn injury: the advantages of combining zinc-hyaluronan gel with silver foam dressing

BackgroundThere are several options available for conservative treatment of partial-thickness burns, however, reliable, affordable, and easily obtainable animal testing models are hard to find for the comparison of the different treatment methods. We aimed at developing a preclinical testing model and at comparing four treatment methods for superficial partial-thickness burns. MethodsBurn injury was induced in 90 adult male Wistar rats by placing the 130°C hot tip of a commercially obtainable soldering device for 30 s on the clipped skin of the interscapular region at a steady pressure. Skin histology was studied on days 5, 10, and 22 after the induction of the burn injury, on which days, respectively, the ratio of the not epithelialized wound (%), the extent of re-epithelialization (score), and the scar thickness (µm) were assessed. We compared 4 groups: silver-sulfadiazine cream, zinc-hyaluronan gel, silver foam dressing, and the combination of zinc-hyaluronan gel with a silver foam dressing. ResultsOn day 5, the induction of superficial partial-thickness burn injury was confirmed histologically in the rats. The zinc-hyaluronan gel and the combination treatment resulted in a markedly smaller ratio of the non-epithelialized area (29 ± 10% and 28 ± 13%, respectively) than silver-sulfadiazine cream (69 ± 4%; p < 0.01). On day 10, the extent of re-epithelialization was the lowest (∼0.2) in the silver-sulfadiazine cream group, while the other 3 treatments performed significantly better. The combination treatment lead to the maximal score of 2 in all rats, which was higher than in the other 3 treatment groups. On day 22, the scar thickness was the smallest in the combination treatment group (560 ± 42 µm), which was significantly less than in the silver-sulfadiazine cream group (712 ± 38 µm; p < 0.05). ConclusionsWe designed and histologically confirmed a reproducible method for induction of superficial partial-thickness burns in rats for preclinical testing. In our model, the combination of zinc-hyaluronan gel with silver foam dressing was more effective than either of its components alone or than silver-sulfadiazine cream.

A COMPARATIVE STUDY OF ULCER HEALING WITH SILVER FIX FOAM DRESSING AND REGULAR BETADINE DRESSING

BACKGROUND An ulcer is not a serious health problem for the patient but a major health concern due to discomfort, pain, loss of workdays, and treatment cost. Several treatment modalities are available in treating ulcers based on their aetiology. In most ulcer management, povidone-iodine has been used for a very long duration with good results. On the other hand, silver, an antibacterial and anti-inammatory agent, is a newer treatment modality. In this study, we wanted to evaluate and compareAims and Objectives the healing of an ulcer in patients treated with silver x foam and betadine with regard to the progress of healing and duration, and rate of healing in both methods. This was a comparative study conducted after obtaining approval from the ethical committeeMATERIALS AND METHODS of Rangaraya Medical College and Government General Hospital, Kakinada, in the Department of General Surgery, over two years from June 2018 to May 2020 among patients suffering from non-healing ulcer who attended the general surgery outpatient department of Government General Hospital, Kakinada. The advantage of silver foam dressings is that they can be changed every 4th or 5th day when comparedRESULTS to betadine, which requires daily or alternate day dressings. Silver foam dressings show better control of infection and rate ofCONCLUSION healing when compared to povidone-iodine in the management of all patients with ulcers.

Paediatric Partial-Thickness Burn Therapy: A Meta-Analysis and Systematic Review of Randomised Controlled Trials.

Background: Paediatric second-degree burn injuries are a significant source of medical challenges to the population that may cause severe, lifelong complications. Currently, there are dozens of therapeutic modalities and we aimed to summarise their reported outcomes and determine their effectiveness, compared to the widely used silver sulphadiazine (SSD). Methods: We conducted the meta-analysis and systematic review of randomised controlled trials (RCTs), which investigated the performance of dressings in acute paediatric partial-thickness burns. The evaluated endpoints were time until wound closure, grafting and infection rate, number of dressing changes and length of hospitalisation. Results: Twenty-nine RCTs were included in the qualitative and 25 in the quantitative synthesis, but only three trials compared SSD directly to the same intervention (Biobrane). Data analysis showed a tendency for faster healing times and a reduced complication rate linked to biosynthetic, silver foam and amnion membrane dressings. A substantial difference was found between the number of dressing changes associated with less pain, narcosis and treatment duration. Conclusions: Considerable between-study heterogeneity was caused by the unequal depth subcategory ratio and surface area of the injuries; therefore, no significant difference was found in the main outcomes. Further research is necessary to establish the most effective treatment for these burns.

592 Strategy for Improving Wound Care Compliance in the Outpatient Setting by using Take-home Visual Aids

IntroductionWound care compliance is a critical component in the success of treating burns in the outpatient setting. Patients and caregivers are educated with demonstration and written materials which have demonstrated a 24-hour retention rate of 30% and 10% respectively. This can leave the patient at higher risk for infection, increased pain from suboptimal dressings, and feelings of frustration. Research has shown that visual learners make up 65% of the population, with auditory learners at 30%, and tactile learners at 5%. We assessed that a combination of demonstration and visual aids could better assist different learning styles and improve wound care compliance. Our study goal was to assess the efficacy of the visual aids component through new patient encounters in the emergency department and outpatient setting using a six-question survey at subsequent encounters.MethodsThe study design is a prospective analysis with comparison to historical controls. Visual aids were designed by the burn physician assistants with assistance at an ABA-verified burn center. We created four double-sided cards made out of a water-resistant synthetic paper, with one for each of our most used dressings. The content of the cards included one of the following: bacitracin/fine mesh gauze with bismuth tribromophenate, bacitracin with low-adherent acetate gauze, silver nylon dressings, and silver foam dressings. Each card contains moulage wounds, step-by-step, and corresponding written instructions at a 4th grade education reading level. These visual aids were given to patients being discharged from the emergency department, or to new patients in the burn clinic. A six-question survey was administered at one week follow-up encounters with a scale of 1-10 (one being least helpful, and ten being the most helpful) assessing patients understanding of burn wound care and compliance. Compliance rates were abstracted from historical controls with similar burn wound severity.ResultsLimited data is available at the time of submission as the study is currently in-progress and anticipated to be completed by March 2021. We will be using descriptive statistics and comparative analysis to evaluate the results.ConclusionsPatients initial feedback has been overall positive with a corresponding compliance rate that is successful. Our patients verbalized their approval, with multiple patients stating that they plan to keep the wound care card for any burn injuries that might occur in the future. Additional research is needed to examine the impact of combined demonstration, tactile, and auditory learning aids. In addition, we plan to further expand our engagement effort to include similar wound care cards for pediatric patients as well as language alternative cards to meet our surrounding community's needs.

Surgical debridement, maggot therapy, negative pressure wound therapy, and silver foam dressing revive hope for patients with diabetic foot ulcer: A case report.

Introduction and importanceDiabetic foot ulcers (DFUs), as one of the most debilitating complications of diabetes, can lead to amputation. Treatment and management of d DFUs are among the most critical challenges for the patients and their families.Case presentationThe present case report is of a 63-year-old man with a 5-year history of uncontrolled type 2 diabetes who has had DFU for the past three years on three sites of the left external ankle in the form of two deep circular ulcers with sizes of 6 × 4 cm and 6 × 8 cm, the sole as a superficial ulcer with a size of 6 × 3 cm, and the left heel as a deep skin groove. Moreover, the left hallux was completely gangrenous. The patient's ulcers were infected with Staphylococcus aureus and multidrug-resistant Pseudomonas aeruginosa. The patient was transferred to our wound management team. DFU was treated and managed using a combination of surgical debridement, maggot therapy, the Negative Pressure Wound Therapy (NPWT), and silver foam dressing. After three months and ten days, the patient's ulcers completely healed, and he was discharged from our service with the excellent and stable condition.Clinical discussionDFUs are caused by various pathological mechanisms, the monotherapy strategy would lead to a very low level of recovery. Therefore, DFU management requires multimodal care and interdisciplinary treatment.ConclusionBased on the present case report study's clinical results, wound-care teams can use the combination therapy applied in this case report to treat refractory DFU.

Comparative study of Collagen vs. Silver foam dressing in second degree superficial burns: An institutional study

Aim: To compare the efficacy of collagen dressing with that of Silver foam in the management of Second Degree superficial burns. Material and methods: A prospective study was done at our Department of burns and plastic surgery from a period January 2016 to December 2016. Patients with less than 40% second degree superficial burns who consented were included in the study. Collagen dressing was done on one hand or leg and on other hand or leg we did silver foam dressing. Wound epithelisation, exudates of wound, patient tolerance to pain while change of dressing and requirement of Split thickness skin graft in non healed wound were noted and analysed using ‘Pearson Chi-Square test’ . Results: A total of 30 patients were included in our study. 16 were males and 14 were females.21 out of 30 patients in whom collagen was applied had complete epithelisation in 10 days whereas 19 out of 30 patients in whom silver foam dressing was done had epithelisation in 10 days. 26 out of 30 patients in whom collagen was applied had complete epithelisation in 14 days whereas 24 out of 30 patients in whom silver foam dressing was done had epithelisation in 14 days. There was no statistically significant difference in the completeness of healing of wounds in 2 weeks. 4 patients treated with collagen dressing and 6 patients having silver foam application required split thickness skin grafting. Pain was significantly less statistically on application of silver foam dressing compared to collagen treated wounds. Conclusions: Collagen dressing does not offer significant better results over Silver foam dressings in terms of completeness of healing of burns. Pain tolerance is better in silver foam dressing. Silver foam dressing works better in exudative wounds.

Superiority of silver-foam over porcine xenograft dressings for treatment of scalds in children: A prospective randomised controlled trial

AimOur aim was to compare two different regimens for the treatment of children with partial-thickness scalds. These were treated with either a porcine xenograft (EZderm®, Mölnlycke Health Care, Gothenburg, Sweden) or a silver-foam dressing (Mepilex® Ag, Mölnlycke Health Care, Gothenburg, Sweden). MethodsWe organised a prospective randomised clinical trial that included 58 children admitted between May 2015 and May 2018 with partial-thickness scalds to The Burn Centre in Linkoping, Sweden. The primary outcome was time to healing. Secondary outcomes were pain, need for operation, wound infection, duration of hospital stay, changes of dressings, and time taken. ResultsThe patients treated with silver-foam dressing had a significantly shorter healing time. The median time to 97% healing for this group was 9 (7–23) days compared to 15 (9–29) days in the porcine xenograft group (p = 0.004). The median time to complete healing for the silver-foam group was 15 (9–29) days and for the porcine xenograft group 20.5 (11–42) days (p = 0.010). Pain, wound infection, duration of hospital stay, and the proportion of operations were similar between the groups. Number of dressing changes and time for dressing changes were lower in the silver-foam dressing group (p = 0.03 for both variables). ConclusionsWe compared two different treatments for children with partial-thickness scalds, and the data indicate that wound healing was faster, fewer dressing changes were needed, and dressing times were shorter in the silver-foam group.

Biobrane dressing for paediatric burns in Singapore: a retrospective review.

The ideal burn dressing for children should aim to alleviate pain, decrease length of hospital stay and minimise complications such as conversion and infection. The current literature is still inconclusive with regard to the gold standard burn dressing for the paediatric population. We retrospectively reviewed children with superficial partial thickness burns admitted to our paediatric burns unit from January 2014 to April 2015. A total of 30 patients were included in our study, of whom 13 had Biobrane® dressing. The remaining 17 patients were treated with conventional silver foam dressing (i.e. Biatain® Ag) and served as matched controls. Long-term follow-up scar evaluation was carried out at an average interval of two years after injury. In the Biobrane group, the length of hospital stay was significantly shorter (Biobrane vs. silver foam: 4.76 ± 2.64 days vs. 8.88 ± 5.09 days; p = 0.01) and the infection rate was significantly lower (Biobrane vs. silver foam: 0% vs. 35.3%; p = 0.02). The Biobrane group had no hypergranulation or wound infection and did not require skin grafting. Long-term follow-up scar evaluation did not reveal any statistical difference between the patient groups at the two-year interval. Paediatric patients with partial thickness burns treated with Biobrane dressing had shorter hospital stay and lower incidence of infection compared to those treated with conventional silver foam dressing. Biobrane and silver foam dressings did not demonstrate any significant difference in terms of long-term scar outcomes over an average follow-up duration of two years.

Silver sulfadiazine versus sustained-release silver dressings in the treatment of burns: A surprising result

Introduction: In recent times, there has been an increased use of dressings containing silver. Although there are many studies showing the impact of sustained-release silver foam dressings on microbial assay, there is a scarcity of studies on clinical and economical parameters. This study highlights the comparison between sustained-release silver dressings and 1% silver sulfadiazine (SSD) with respect to patient comfort, its impact on wound healing, and cost estimation in patients with burns. Materials and Methods: This prospective observational study was conducted from 1st August 2015 to 31st December 2015. Patients with second-degree burns (scald and flame burns) covering 20–60% of the total body surface area and belonging to the age group from 18 to 60 years were selected. The patients were divided into the following groups on alternate basis: Group 1–dressing with 1% SSD; Group 2–dressing with sustained-release silver dressings. The following variables were used: pain during change of dressing using visual analogue scale (VAS) score, the percentage of wound healing on the 5th, 10th, 15th, and 20th days on the anterior and posterior trunk using graphs, duration of hospital stay, cost calculation accounting for dressings and hospital expenses. Results: Statistical analysis showed an advantage of sustained-release silver foam dressing over SSD with respect to reduced pain on the basis of VAS score on the 5th, 10th, 15th, and 20th days (7.47, 6.27, 3.8, and 3.87 in Group 1 vs. 4.4, 3.13, 2.53, and 1.93 in Group 2) with P Conclusion: Comparative study shows that sustained-release silver foam dressing has faster wound healing, lesser pain with earlier hospital discharge than SSD, and lesser expenses when total hospital burden was accounted.

Treatment of Recalcitrant Chronic GVHD Ulcers with Combined Silver Collagen Matrix and Silver Foam Dressings

Treatment of Recalcitrant Chronic GVHD Ulcers with Combined Silver Collagen Matrix and Silver Foam Dressings

Treatment of recalcitrant chronic GVHD ulcers using combined silver collagen matrix and silver foam dressings may impact antibiotic resistance and hospitalizations in patients with chronic GVHD

Treatment of recalcitrant chronic GVHD ulcers using combined silver collagen matrix and silver foam dressings may impact antibiotic resistance and hospitalizations in patients with chronic GVHD

A Review on Antimicrobial Silver Absorbent Wound Dressings Applied to Exuding Wounds

Exuding often occurs in the inflammatory stage both for acute wounds and chronic wounds. Absorbent wound dressings are specially developed and used in exuding wounds. In order to reduce bacteria and risk of infection, many absorbent dressings are impregnated with silver ions or particles which are the most widely used substance to obtain antimicrobial effects and therefore this review focuses on the antimicrobial absorbent dressings treated with silver ions or silver particles. The methods of dispersing silver in dressings include coating or spraying silver-containing solution on the wound dressing surface, padding the wetted dressing with pressure, embedding silver nanoparticles in non-woven fibers. When silver dressings absorb exudate from wounds, the antimicrobial silver will be activated and then breaks down the bacterial cell wall to kill the bacterium. Silver foam dressings and silver alginate dressings are the most popular antimicrobial absorbent dressings, which have been developed and produced by many health care companies.

English

OBJECTIVE: To compare the healing of wounds with silver foam and povidone dressing materials. MATERIAL & METHOD: This was a prospective comparative clinical trial. Seventy patients with infected wounds were evaluated. Silver foam and povidone iodine dressings were applied in thirty five each patients, and the patients were followed as per post-application treatment protocol until wound healed or preparing for graft. Wound assessed every 4th day. Assessment included clinical examination, bacteriological analysis, histopathological findings. RESULTS: Total duration of treatment in silver foam dressing and povidone iodine dressing in 1-50cm 2 are 34.67 days and 40.81 days and in 51-100cm 2 are 48.22 days and 57.20 days. On assessment of reduction of surface area and slough every 4 th day in both group, it was found that silver foam was significantly better that control group In 1-50cm2 mean percentage of reduction in size on 28th day in silver foam is 76.45% as compared to povidone iodine is 57.29% (P< 0.001). In 51-100cm2 mean percentage of reduction in size on 28th day, in silver foam is 53.06% as compared to povidone iodine is 28.63% (P<0.001). Mean time taken for reduction of exudate in silver foam dressing and povidone iodine was respectively 11.6 days and 18.91 days (P<0.0001) and mean time taken to resolution of odor in silver foam dressing and povidone iodine dressing was respectively 4.80 days 6.54 days (P=0.0924). CONCLUSION: This study provides evidence that use of silver foam in infected wounds in which healing process is impaired due to bacterial colonization is more efficacious that povidone iodine dressing. It suggests that antibacterial activity of silver foam is very efficient and that it has excellent exudate management, both of which lead to rapid initiation, maintenance and completion of healing process.

Adapting a Vacuum Assisted Closure dressing to challenging wounds: negative pressure treatment for perineal necrotizing fasciitis with rectal prolapse in a newborn affected by acute myeloid leukaemia

We report the case of a newborn with acute myeloid leukaemia, who developed perineal necrotizing fasciitis due to Pseudomonas Aeruginosa, after twenty days of life. Following surgical debridement, she was effectively treated with topical negative pressure therapy (V.A.C.(R) device) with silver foam dressings, this achieved complete closure in thirteen days. Negative pressure therapy should be considered when conventional wound care fails to achieve complete wound closure, even in neonates.

Topical Silver for Infected Wounds

Abstract Reference/Citation: Vermeulen H, van Hattem JM, Storm-Versloot MN, Ubbink DT. Topical silver for treating infected wounds. Cochrane Database Syst Rev. 2007(1);CD005486. Clinical Question: ...