84121 2) In infected wounds, dressings containing nanocrystalline silver are helpful in the early treatment phase (first 23 weeks) to reduce bacterial counts and mitigate wound odor. Fifty-nine studies were included in this qualitative analysis. A silicone-coated nylon dressing reduces healing time in burned paediatric patients in comparison with standard sulfadiazine treatment: a prospective randomized trial. It gently removes dead and damaged tissue and has a seven day wear time.
Vacuum-assisted closure: a new method for wound control and treatment: animal studies and basic foundation. Interdry Ag is a Coloplast product designed for skin fold moisture management. Negative pressure wound therapy after partial diabetic foot amputation: a multicentre, randomised controlled trial.
Silver delivery approaches in the management of partial thickness burns: a systematic review and indirect treatment comparison. Silvasorb Gel by Medline comes in various tube sizes to reduce microbial contamination. Nanocrystalline silver satisfies the above requirements. Gotschall CS, Morrison MI, Eichelberger MR. A prospective, randomized trial of acticoat versus silver sulfadiazine in the treatment of partial-thickness burns: which method is less painful? The https:// ensures that you are connecting to the Stanirowski PJ, Wnuk A, Cendrowski K, et al. These additional functions include easy application, sustained silver dispersal, less frequent dressing changes, exudate absorption, maintenance of a moist wound environment, and autolytic debridement. The bandage contains gelling fiber to help manage chronic wounds. Our purpose in this study was to evaluate the existing evidence on the use of silver in wound care. The role of silver sulphadiazine in the conservative treatment of partial thickness burn wounds: a systematic review. Surgical site infections following colorectal cancer surgery: a randomized prospective trial comparing common and advanced antimicrobial dressing containing ionic silver. (801) 733-4449 2) What are the advantages and disadvantages of various silver delivery systems? A randomized clinical trial evaluating negative pressure therapy to decrease vascular groin incision complications. 
Optimal treatment of partial thickness burns in children: a systematic review. 
Offering high absorbency Maxorb Ag is a good match for deep wound healing. UT
For high-risk closed surgical incisions (in patients who smoke, who have diabetes, etc. National Library of Medicine 
When selecting a dressing containing silver, wound care goals are much the same as when not using a silver dressing: obtain and maintain a clean wound bed, absorb excess exudate, and provide moisture if the wound is dry, while also filling, covering, and protecting the wound. In vitro cytotoxity of silver: implication for clinical wound care. Effectiveness of aloe vera gel compared with 1% silver sulphadiazine cream as burn wound dressing in second degree burns. [R]egular wound assessment combined with knowledge of basic wound dressing categories will provide guidance on product selection for different clinical situations and wound types.5, When selecting a dressing containing silver, wound care goals are much the same as when not using a silver dressing: obtain and maintain a clean wound bed, absorb excess exudate, and provide moisture if the wound is dry, while also filling, covering, and protecting the wound .The Mepilex Ag from Molnlycke is a foam absorption pad. Active Ingredient: SILCRYST nanocrystalline Silver. More recently, dressing with nanocrystalline silver has been developed. Prospective, randomized, multi-institutional clinical trial of a silver alginate dressing to reduce lower extremity vascular surgery wound complications. Mepilex Ag bandage may be cut to fit the wound size. Nanocrystalline silver: a systematic review of randomized trials conducted on burned patients and an evidence-based assessment of potential advantages over older silver formulations. Alginate dressings for treating pressure ulcers. This is due to molecules within the extracellular polymeric substance of the biofilm that interfere with antibiotic function25 or physically shield the bacteria.26 One strategy to combat biofilm and jumpstart healing is by disrupting the biofilm and displacing the bacteria into a planktonic (rather than sessile) state, where they are more susceptible to systemic antibiotics. Promogran prisma accelerates healing due to its collagen component acting as a sacrificial substrate for proteases in the wound. Maxorb Extra AG is an antimicrobial wound dressing manufactured by Medline. Efficacy of topical sucralfate versus silver sulfadiazine in the management of burns: a 1-year randomized controlled trial. Honey has a low pH and generates a low, sustained concentration of hydrogen peroxide, which gives it broad antimicrobial activity against both Gram-positive and Gram-negative organisms, without toxic effects on tissue.88 Honey leads to faster burn epithelialization than SSD.89. sharing sensitive information, make sure youre on a federal Abarca-Buis RF, Mungua NM, Gonzalez JM, et al. It consists of a coated textile polyester surface that manages odor and inflammation for skin-to-skin contact areas.
The questions that we sought to answer were: A PubMed literature search was performed using the following search parameters: silver AND (antimicrobial OR antibacterial) AND wound AND randomized; Silver AND epithelialization AND randomized; Silver AND negative pressure. It works well for medium wounds, presure ulcers, leg ulcers, and exuding burns. Accessibility Infection and the chronic wound: a focus on silver. Vieira ALG, Stocco JGD, Ribeiro ACG, et al. The Acticoat Flex 3 serves and infected wound bed for 3-days while the Acticoat Flex 7 lasts for up to 7 days before requiring a change. Lazareth I, Meaume S, Sigal-Grinberg ML, et al. There are several silver-free antimicrobial topical wound treatments that have been shown to be effective. A prospective randomised clinical and histological study of superficial burn wound healing with honey and silver sulfadiazine. However, it also has the potential to impair healing by exerting toxic effects on keratinocytes and fibroblasts. In addition, many of the published studies are funded,10,11 or even written, by manufacturers of silver-containing dressings.12, While the silver ion is a very powerful bactericidal agent, it also has toxic systemic and local effects. Aquacel Ag is available in many different options from hydrofiber ribbons to rectangular dressing pads to border dressings. Silverlon is appropriate for pressure ulcers, diabetic ulcers, surgical wounds, and 1st and 2nd degree burns. The In addition, it should not be used as the gold standard for burn research. The .gov means its official. Below is a list of elements commonly added to silver dressings to form a compound dressing to append additional benefits to wound healing. This has been demonstrated in numerous randomized-controlled trials examining both clean and clean-contaminated operations.7680 One surgical dressing that has been shown to reduce infection, wound healing complications, and reoperation is incisional NPWT, such as Prevena (Silver-impregnated foam, KCI, San Antonio, Tex.) The remaining articles were analyzed in detail qualitatively, to extract answers to our study questions. Vermeulen H, van Hattem JM, Storm-Versloot MN, Ubbink DT. Jeffrey E. Janis, MD, FACS, Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, 915 Olentangy River Rd, Columbus, OH 43212, Phone: (614) 366-1242, Fax: (614) 293-9024, E-mail: Received 2019 Mar 28; Accepted 2019 Jun 19. Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio. Below are some noteworthy quotes from some of these studies. The top layer of the bandage is waterproof, allowing the user to shower and bathe. Heyneman A, Hoeksema H, Vandekerckhove D, et al. A prospective study and review of the literature. Closed incision negative-pressure therapy (cinpt) reduces minor local complications in post-bariatric abdominoplasty body contouring: a retrospective case-control series. There are advantages and disadvantages to each of these formulations: Acticoat tends to adhere to the wound bed and can be painful upon removal,19 unlike Mepitel Ag and Mepilex Ag, both of which have a silicone interface, allowing them to adhere to the surrounding normal skin, but not to the wound itself (Table Table22).19 Promogran Prisma contains collagen, which acts as a sacrificial substrate for matrix metalloproteinases, enhancing wound healing.20,21 The silver-coated polyurethane negative-pressure wound therapy (NPWT) sponge combines the advantages of NPWT with a sustained release of 20 to 40ppm of silver,22,23 which is below the toxic threshold to keratinocytes and fibroblasts. The resulting decrease in bedtime and subsequently nursing time in this study means that Acticoat has been demonstrated to lower overall treatment costs compared to silver sulfadiazine in the high cost burns arena.8. Our qualitative literature review on silver has limitations: it is not a quantitative systematic review. A comparative study to evaluate the effect of honey dressing and silver sulfadiazene dressing on wound healing in burn patients. Prophylactic closed-incision negative-pressure wound therapy is associated with decreased surgical site infection in high-risk colorectal surgery laparotomy wounds. A prospective, randomized trial of silver containing hydrofiber dressing versus 1% silver sulfadiazine for the treatment of partial thickness burns. Khansa, Kraft, and Schoenbrunner have no financial disclosures. Interdry is a knited polyester fabric inpregnated with silver for antimicrobial properties. Do silver-based wound dressings reduce pain? A pharmacological and toxicological profile of silver as an antimicrobial agent in medical devices. Mepilex Ag is also available in the following: Acticoat Flex is a silver coated dressing available in two formats--Flex 3 and Flex 7. Effectiveness of honey dressing and silver sulfadiazine dressing on wounds healing in burn patients. Silver sulfadiazine (SSD) is a very widely used silver formulation, especially in burns. This wound dressing works will with burns, surgical wounds, diabetic ulcers, leg pressure ulcers, and partial and full thickness wounds. ; Facial Burns Group. On the other hand, for the silver ion to have effective bactericidal activity, a concentration of 30 to 40ppm is needed.1. Ruiz-Tovar J, Llavero C, Morales V, et al. 8600 Rockville Pike Silver sulfadiazine added to creams helps to treat burns and infections. Manufacturers also add additional benefits to silver dressings by compounding with other elements like alginate, calcium, carboxymethylcellulose, charcoal, collagen, hydrocolloid, hydrogel, or sulfate to bring additional properties like more absorption, odor control, re-epithelialization, granulation, and pain reduction. In an animal study of clean burns, Mepilex Ag had slower healing than triple antibiotic ointment.44 For skin graft donor sites, Acticoat has been found to delay epithelialization by more than 50% when compared to occlusive dressings.45 As mentioned above, dressings containing nanocrystalline silver lead to silver ion concentrations in the wound of up to 70ppm, which is above the toxic threshold for keratinocytes and fibroblasts.16, Even though SSD is widely used for the treatment of second-degree burns,46 it has been shown to have some of the worst outcomes in burn treatment, in terms of infection and epithelialization.47,48 It is less effective than aloe vera,49,50 sucralfate,51 petrolatum gel,52 honey,5358,85,86 and Biobrane (nylon, silicone and collagen composite, Smith & Nephew, London, UK).5962 In addition to slowing epithelialization, SSD has been shown to increase the rate of hypertrophic scar formation.63, In contrast, dressings containing nanocrystalline silver have been found to be superior to SSD and to silver-free dressings for burns, in terms of epithelialization, infection, pain, and cost.18,6473 In addition, dressings containing nanocrystalline silver significantly reduce the cost of care when compared to SSD.57,61,62,66,70,71,73 In an animal study examining several dressings for burns, Selcuk et al found that the most effective dressing against Acinetobacter baumannii was Acticoat, followed by octenidine, then mupirocin, with SSD being the least effective dressing.74 Brown et al found that Aquacel Ag and Acticoat were equivalent for burn healing.75, One study found that the use of Silverlon as a dressing over closed surgical incisions resulted in less pain.2 However, there is no evidence that the use of a silver-containing dressing to cover a closed surgical incision reduces infection or accelerates healing. The bandage is gentle to the wound bed and provides less trauma during removal. The silver difference is bioburden management.2, Silver remains a reasonable addition to the armamentarium against infection and has relatively few side effects. Wound care manufacturers also add additional functions and benefits to Silver Dressings. Vitality Medical Use of closed incisional negative pressure wound therapy after revision total hip and knee arthroplasty in patients at high risk for infection: a prospective, randomized clinical trial. The use of this website is subject to terms and conditions. Total occlusive ionic silver-containing dressing vs mupirocin ointment application vs conventional dressing in elective colorectal surgery: effect on incisional surgical site infection. Vloemans AF, Hermans MH, van der Wal MB, et al. Commonly Used Dressings Containing Nanocrystalline Silver. However, even with adequate debridement, even a few remaining bacteria can recreate the biofilm within 48 hours.27. Most prior reviews found that the quality of the published data on the use of silver in wound care is poor.8,9 This is due to the fact that these studies use inconsistent, and sometimes subjective, outcomes measures, such as pain with dressing change, days until reepithelialization, number of dressing changes until reepithelialization, wound size reduction at various time points, presence of infection, etc.
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