Silver Nitrate Therapy Research Articles

Our treatment outcomes in bartholin cysts or abscesses

The purpose of this study was to examine the outcomes of Bartholin abscess or cyst surgery, silver nitrate therapy, and cyst or abscess excision in terms of recurrence, duration of the procedure, and healing times. The files of 100 patients treated in our hospital for Bartholin cysts or abscesses between March 2022 and December 2022 were reviewed retrospectively. The patients’ demographic characteristics were recorded. Demographic data, the location and size of Bartholin abscesses, complaints at presentation, and cases with recurrence were noted. The patients were divided into three groups according to the treatment applied and were compared with one another, especially in terms of recurrence, operative time, and recovery time. Group 1 consisted of those who underwent drainage due to Bartholin cyst or abscess, Group 2 of those treated with silver nitrate, and Group 3 of those who underwent cyst excision. Recurrence was detected in 12 (40%) of the cases in Group 1. Relapsed cases were treated with silver nitrate. Recurrence was observed in only one patient in the group treated with silver nitrate (Group 2). Bartholin cyst excision was performed on that patient. Mean operation times were 2.80 min in Group 1, 4.40 min in Group 2, and 23 min in Group 3 (p=0.0001). Mean recovery times were 3.37±0.49 days in Group 1, 6.13±0.73 days in Group 2, and 13.70±2.09 days in Group 3 (p=0.0001). A comparison of the patients in all three groups revealed that the recurrence rate was higher in the group receiving abscess drainage. While recurrence was observed in only one patient in the silver nitrate group, no recurrence occurred in the cyst excision group (p<0.001). This study emphasizes that silver nitrate application is a simple practical method that can be performed using local anesthesia, and involving minimal scar tissue, a faster procedure time, and faster recovery.

Medical uses for silver nitrate in the urinary tract (Review)

Silver nitrate has been used for centuries for the treatment of a variety of diseases and in the prevention of infection. Silver nitrate exerts astringent, cauterizing and corrosive effects, as well as antimicrobial activities. Silver nitrate injection therapy has a long history of use in urology. It is reportedly effective for hemorrhagic cystitis, interstitial cystitis, renal hematuria and chyluria. The present review article summarizes the medical applications of silver nitrate in urology. The published studies available on the medical uses of silver nitrate are essentially older and retrospective, involving smaller numbers of patients. In the absence of comparative studies with other treatments, it is thus impossible to determine the relative benefits of silver nitrate. However, the outcomes of silver nitrate therapy have been fairly well established. Silver nitrate therapy may prove to be a treatment option for patients who are poor candidates for invasive treatment. Further studies on the uses of silver nitrate however, are required, and improvements also need to be made in the injection technique to reduce the rate of complications.

Treating Umbilical Granuloma with Topical Corticosteroid: A Systematic Review and Meta-analysis

Background: Umbilical granuloma so far can be treated with surgery or with silver nitrate. In limited facilities such as in remote areas where the surgeon is limited, pharmacological therapy with silver nitrate or topical steroid can be given. However, treatment with silver nitrate requires medical personnel and has unfavorable adverse effects if done by improper technique. This systematic review aimed to evaluate the effectiveness of topical steroid for treating an umbilical granuloma compared to silver nitrate therapy. Method: The literature search was done using search engines including PubMed, Embase, and Google Scholar. Literature selection was performed with limitations from 2000 to 2020 to get the novelty and written in the English language with a target population of infants less than 6 months were included. To retrieve the articles, topical corticosteroids, topical steroids, and umbilical granuloma were used as keywords. Results: The findings from the included studies show similar sample characteristics. The study conducted by Brodsgaard et al. had an older mean sample age than the study of Ogawa et al. (53.4 vs 31 days). The risk of topical steroid treatment failure on an individual study conducted by Brodsgaard et al. and Ogawa et al. was 3.0 (0.33–27.23, p = 0.33) and 0.94 (0.40–2.21; p = 0.33), respectively. Overall analysis, the risk of treatment failure was 1.09 (0.49–2.43, p = 0.82), there was no difference between the two interventions. Conclusions: One of the umbilical granuloma treatment options that can be considered is topical steroids, such as clobetasol proprionate 0.05% or betamethasone valerate 0.12%. When compared to silver nitrate, topical steroids have a longer therapeutic healing time but with a better safety profile. The non-inferiority study of topical steroids to silver nitrate has not been met yet.

Intravesical silver nitrate for refractory hemorrhagic cystitis

Hemorrhagic cystitis is a challenging clinical entity with limited evidence available to guide treatment. The use of intravesical silver nitrate has been reported, though supporting literature is sparse. Here, we sought to assess outcomes of patients treated with intravesical silver nitrate for refractory hemorrhagic cystitis. We identified nine patients with refractory hemorrhagic cystitis treated at our institution with intravesical silver nitrate between 2000-2015. All patients had failed previous continuous bladder irrigation with normal saline and clot evacuation. Treatment success was defined as requiring no additional therapy beyond normal saline irrigation after silver nitrate instillation prior to hospital discharge. Median patient age was 80 years (IQR 73, 82). Radiation was the most common etiology for hemorrhagic cystitis 89% (8/9). Two patients underwent high dose (0.1%-0.4%) silver nitrate under anesthesia, while the remaining seven were treated with doses from 0.01% to 0.1% via continuous bladder irrigation for a median of 3 days (range 2-4). All nine patients (100%) had persistent hematuria despite intravesical silver nitrate therapy, requiring additional interventions and red blood cell transfusion during the hospitalization. There were no identified complications related to intravesical silver nitrate instillation. Although well tolerated, we found that intravesical silver nitrate was ineffective for bleeding control, suggesting a limited role for this agent in the management of patients with hemorrhagic cystitis.

Evaluating the Efficacy of Topical Silver Nitrate and Intramuscular Antimonial Drugs in the Treatment of Cutaneous Leishmaniasis in Sokoto, Nigeria

Background: Cutaneous leishmaniasis (CL) is a disease of public health importance in Nigeria, with high prevalence in the Northwest and Northeastern part of the country. The side effects of antimonial drugs {stibogluconate (SSG) and meglumine antimoniate} in the treatment of CL have often resulted in poor drug adherence and default by patients and possible drug resistance. The increasing default to follow-up and the significant side effects associated with antimonial therapy necessitated the dire need of alternative therapeutic modalities. Thus, this study aimed at comparing the efficacy of topical silver nitrate with the antimonial drugs in the treatment of CL. Methods: A total of 95 patients with clinically diagnosed leishmaniasis and parasitologically proven CL participated in the study after their informed-consent had been obtained. The treatment selection was optional to the participants. Sixty (63.2%) patients received alternative therapy of topical silver nitrate as a single dose while 35(36.8%) patients received antimonial therapy for 21 days at 20mg/kg body weight. Results: On day 30 of treatment, 68 (86.1%) lesions among patients on topical silver nitrate healed completely as compared with only 5 (6.8%) among those on i.m. SSG. There was no improvement in 25 (34.2%) lesions among those on i.m. SSG compared with only 1 (1.2%) lesion among those on topical silver nitrate. Overall, there was a  statistically significant difference in the cure rate among patients on silver nitrate as compared with those on i.m. SSG on the 21st and 30th days of treatment.(p<0.05). Conclusion: Topical silver nitrate therapy is an effective and better drug treatment for CL among this studypopulation.Keywords: Cutaneous leishmaniasis, efficacy, Silver nitrate, Sodium Stibogluconate, Sokoto

An unusual complication of silver nitrate therapy for chyluria

An unusual complication of silver nitrate therapy for chyluria

An unusual complication of silver nitrate therapy for chyluria

Chyluria is a common disorder in the tropics. In our country it is most commonly managed by instillation of silver nitrate. We report a patient who developed severe perinephric hematoma due to pseudoaneurysm of renal artery following silver nitrate instillation. He was managed by angioembolisation followed by drainage of infected perinephric hematoma. We discuss various modalities of treatment of chyluria including complications of silver nitrate therapy.

Bilateral epistaxis in children: efficacy of bilateral septal cauterization with silver nitrate

To evaluate the rate of control of epistaxis in patients with bilateral complaints using silver nitrate and to assess short-term complications from this therapy. Retrospective chart review with prospective incident case identification in a tertiary referral pediatric otolaryngology practice. Forty-six consecutive patients presenting to a single pediatric otolaryngologist with complaints of bilateral epistaxis received bilateral silver nitrate cauterization to the anterior septum and were seen in follow-up 2 months later to assess for control of epistaxis and complications from this therapy. Ninety-three percent (43/46) of patients followed-up at 2 months after therapy. About 93% (40/43) had total or near-total resolution of their epistaxis. Five percent (2/43) of patients returned to the clinic after initial successful control for a second cauterization during the period of study. No significant complications of infection, perforation, long-term crusting, tattooing or mucocutaneous or allergic reactions were identified. Bilateral epistaxis can be treated at a single visit with bilateral silver nitrate therapy in children. This treatment is highly effective, well-tolerated, and appears to have a low rate of complications.

4736 Percutaneous endoscopic gastrostomy and tumor seeding: an emerging complication of the pull technique in patients with head and neck cancer.

The use of percutaneous endoscopic gastrostomy (PEG) tube for enteral feeding has gained wide acceptance in various clinical settings. Head and neck cancer (HN H&NC and non H&NC.We looked specifically for the complication of tumor seeding at the site of PEG tube placement. Results: 330 cancer patients had PEG tube placed during the period of study using the pull technique. 248 patients had H&NC, mean age 66.5 (39-85) years, male/female ratio was 167/81. The non H&NC were 82 patients, mean age 64 (17-88) years, male/female ratio was 55/27. None of the non H&NC patients had tumor seeding and only two patients with H&NC had tumor seeding at the PEG exit site. The first patient was a 58-year-old man with a history of invasive squamous cell carcinoma (SCC) of the right maxillary sinus involving the palate. Following surgical resection a PEG tube was placed. Fourteen weeks later he presented with a mass around the PEG tube exit. The mass was resected and the histology confirmed SCC. The second patient was a 48-year-old man with a history of SCC of the piriform sinus treated with preoperative chemoradiation. The patient underwent a PEG tube placement prior to surgery. Four months later he presented with a slowly growing granulation tissue with purulent discharge that did not respond to antibiotics and local silver nitrate therapy. A biopsy of the tissue confirmed SCC. The patient underwent endoscopy which showed a large submucosal mass. He underwent wide local excision of the abdominal wall with partial gastrectomy. Conclusions: Metastatic implantation of H&NC at the site of PEG tube is a newly emerging complication following the pull technique. We encounterd 2 patients among 248 H&NC patients (0.8%) who developed this complication. Both of our patients had viable tumor in the oropharyngeal cavity. We recommend careful assessment of the oropharynx prior to PEG tube placement to avoid tumor seeding. In patients with viable tumor in the oropharynx, alternative methods of tube placement should be considered.

Methemoglobinemia secondary to topical silver nitrate therapy—a case report

Methemoglobinemia is a rare complication in individuals exposed to nitrates or nitrites. Whereas methemoglobinemia is a recognized potential complication in burn patients treated with topical 0.5% silver nitrate solution, no report of methemoglobinemia in burn patients has been present in the literature for more than 15 years. We raise consciousness about this complication with a case report of a 12-month-old child with necrotizing fasciitis resulting from a cutaneous flank infection. The patient developed cyanosis 20 days after initiation of topical treatment with 0.5% silver nitrate solution. Intravenous injection of methylene blue can restore normal blood oxygenation.

Silver nitrate therapy as an adjunct in the treatment of myelomeningocele.

✓ Fifteen patients in whom immediate closure of a myelomeningocele sac was not possible were treated by continuous application of dilute solutions of silver nitrate. Local infection of the sac was prevented or irradicated in 14 of the 15 patients within 72 hours. There were no infections in subsequent shunting procedures. No adverse neurological effects were noted, although the method was usually restricted to patients with neurological deficits below the level of the myelomeningocele sac. One patient who developed persistent hyponatremia and hypochloremia after prolonged application responded well to cessation of the therapy.

Methemoglobinemia: A Complication of Silver Nitrate Therapy Used in Burns

Methemoglobinemia: A Complication of Silver Nitrate Therapy Used in Burns

Successful treatment of methemoglobinemia secondary to silver nitrate therapy.

THE use of silver nitrate though beneficial in the care of the burn patient has added special problems inherent to this form of treatment. Toxic methemoglobinemia has recently been reported as a post-mortem finding after the use of this mode of therapy.1 Case ReportM.J., a 2-year-old girl, was admitted to Stanford Medical Center after sustaining a flame burn involving 50 per cent of her body surface. At the same time as resuscitative measures, 0.5 per cent silver nitrate dressings continuously saturated were started.Eleven days later, she demonstrated a continued tachypnea and became cyanotic. The arterial Po2 was . . .

Comparison of silver nitrate with open or closed treatment of extensive burns from 1962 through 1967

Evaluation is made of eighty-three patients admitted to the San Francisco General Hospital between 1962 and 1967 with second and third degree burns covering more than 20 per cent of body surface. Comparison with a similar study between 1943 and 1956 demonstrated no significant change in the mortality until the advent of silver nitrate therapy in 1956. During the period before silver nitrate was used, there were no survivors with greater than 60 per cent burns and the mortality for patients will less than 50 per cent burns was 29 per cent. The use of frequent topical application of .005 per cent silver nitrate resulted in no deaths in patients with less than 50 per cent burns, regardless of age, and survival in three patients with greater than 60 per cent burns. The present regimen for severely burned patients is described in detail.

Methemoglobinemia with silver nitrate therapy of a burn: Report of a case

Methemoglobinemia with silver nitrate therapy of a burn: Report of a case

The Control of Burn Wound Sepsis with 0.5% Silver Nitrate.

Recent adoption of 0.5% silver nitrate dressings as a topical treatment of the burn wound at the Massachusetts General Hospital and other centres has led to an impressive reduction of infection. Infection is the major cause of the mortality in burns today. The use of topical silver nitrate is described, together with a report of the problems associated with such therapy. It is concluded that topical silver nitrate therapy represents a major advance in the care of the burn wound.

Results of the treatment of burns with silver nitrate.

SUMMARYA review of 20 months’ utilization of silver nitrate therapy for the treatment of burns has been carried out. These results have been compared with figures utilizing previous standard methods of therapy.This preliminary study with silver nitrate indicates the length of time necessary for hospitalization of burn patients to complete epithelization has been markedly shortened. The mortality rate has been reduced. The complication rate has also been reduced.

Silver nitrate therapy in epidermolysis bullosa hereditaria of the newborn

1. Cahill, J. L., Talbert, J. L., Ottesen, O. E., Rowe, R. D. and Haller, J. A.: Arterial complications following cardiac catheterization in infants and children, J. Pediat. Surg. 2: 134, 1967. 2. Vlad, P, Hohn, A., and Lambert, E. C.: Retrograde arterial catheterization of left heart: experience with 500 infants and children, Circulation 29: 787, 1964. 3. Mortensen, J. D.: Clinical sequelae from arterial needle puncture, cannulation and incision, Circulation 35: 1118, 1967. 4. Vengsarker, A. S., and Swan, H. J. C.: Arteriotomy for cardiac catheterization and angiocardiography in infants and children, Mayo CIin. Proc. 37: 619, 1962. 5. Voci, G., and Hamer, N. A. J.: Retrograde arterial catheterization of the left ventricle, Am. J. Cardiol. 5: 493, 1960. 6. Aguilar, S., Kaulback, M. G., and Hugenholtz, P. G.: Retrograde arterial catheterization of the left ventricle in 388 patients with special reference to aortic valve disease and coarctation of the aorta, New England J. Med. 274: 312, 1966. 7. Kinmonth, J. B.: The physiology and relief of traumatic arterial spasm, Brit. M. J. 1: 59, 1952. 8. Husson, G. S., and Blackman, M. S.: Arteriotomy for catheterization of the left side o1 the heart in children. New England J. Med. 268: 545, 1963. 9. Schobinger, R. A., and Ruzicka, F, F.: Venipuncture and vascular cutdown, in vascular roentgenology, arteriography, phlebography, lymphography. New York, 1964, the Macmillan Company, p. 27.

Organ Deposition of Silver Following Silver Nitrate Therapy of Burns

* Sponsored by Paul W. Greeley, M.D. This work was done by Dr. Bader while rotating through the Plastic Surgery Service as a general surgery resident. He will begin training in plastic surgery on July 1, 1966. Chicago, Illinois