Treatment of experimentally induced partial-thickness burns in rats with different silver-impregnated dressings

Purpose: To evaluate the morphometric, macroscopic and microscopic aspects of experimentally induced partial-thickness burns in rats treated with different silver-based dressings. Methods: Wistar rats were used, divided into six treatments: saline (NaCl 0.9%); silver sulfadiazine 1%; Silvercel; Mepilex Ag; Aquacel Ag and Acticoat. The animals were monitored daily and euthanized at 7, 14 and 30 days after injury induction (DAI). Results: At 7 DAI, necrosis/crust was greater in control, silver sulfadiazine and Mepilex Ag treatments, granulation tissue was induced by Aquacel Ag, polymorphonuclear infiltrate (PMN) infiltration was intensified by Mepilex Ag; mononuclear infiltrate (MN) infiltration and angiogenesis were increased by Silvercel. At 14 DAI, hemorrhage was decreased by Silvercel and Mepilex Ag, PMN infiltration increased by Acticoat. At 30 DAI, angiogenesis was greater in the Acticoat treatment and fibroblasts were increased by Acticoat and Mepilex Ag. Collagen was induced at 14 DAI by silver sulfadiazine and Aquacel Ag and, at 30 DAI, by silver sulfadiazine and Silvercel treatments. Conclusions: Silvercel and Acticoat presented better results than the other products. However, all the dressings were better than the control at some point during the process, and may contribute to the healing of partial thickness burns. Silvercel and Aquacel Ag treatments induced better cosmetic outcomes regarding wound closure and scarring.

Treatment for Hydrofluoric Acid Chemical Burn Using Acticoat(R)

PURPOSE: Hydrofluoric acid(HF) is one of the most dangerous mineral acids with the dissociated fluoride ions. The initial corrosive burn is caused by free hydrogen ion, and the second and more severe burn is caused by penetration of fluoride ions into subcutaneous tissues. Silver is a cation producing dressing, an effective antimicrobial agent, but older silver-containing formulations are rapidly inactivated by wound environment, requiring frequent replenishment. But, Acticoat(R) is a relatively new form of silver dressing which helps avoid the problems of earlier agents. The aim of this study is to evaluate effects of Acticoat(R), silver-containing dressing on the treatment for HF injury wound. METHODS: From september 2006 to september 2007, the study was carried out with 10 patients who had HF partial thickness burns. Acticoat(R) dressing and 10% calcium gluconate wet gauze dressings in 10 cases. As a principle, in the emergency treatment, partial or complete removal of the nail and early bullectomy along with copious washing with normal saline was done, depending on the degree of HF invasion of the wound. Wound was dressed with Acticoat(R) and 10% calcium gluconate solution. The effect of dressing was investgated by serial bacterial culture and wound exudates assessment. RESULTS: We therefore reviewed 10 cases of HF- induced chemical burns and treatment principle. The 10 cases who came to the hospital nearly immediately after the injury healed completely without sequelae. CONCLUSION: As the industrial sector develops, the use of HF is increasing more and more, leading to increased incidences of HF-induced chemical burns. The education of patients regarding this subject should be empathized accordingly. In conclusion, Acticoat(R) dressing is a better choice for HF partial thickness burn injuries because of shorter healing time, less pain and more comfortable dressing.

Clinical experience of acticoat™ treatment in extensive burn wounds.

Acticoat™ (Smith & Nephew, Hull, UK) is a relatively new form of silver antimicrobial barrier dressing produces a moist healing environment along with the sustained release of ionic silver for improved microbial control. The benefits of acticoat™ in the management of extensive burn wounds have been well established. Acticoat™ has been reported to reduce wound infection and promote healing. No evidence has emerged of resistance or cytotoxicity to acticoat™. Given these potential advantages, we have used acticoat™ in a variety of treatment of extensive burn wounds at burn unit, Siriraj Hospital during September 2002-May 2005. We reviewed with attention to wound etiology, % of organism colonization, efficacy and cost effectiveness. Due to its long lasting properties led to less frequent dressing changes and reduce trauma and pain to burn patients. It is particularly benefit to patients who suffered from partial thickness burn wound especially in children and high% of total body surface area (TBSA) patients (>15%). Acticoat™ treatment in extensive burn wounds also confirmed its efficacy, low labor cost set up and cost effectiveness compared to conventional dressing with silver sulfadiazine.

Effectiveness of Nanocrystalline Silver(Acticoat(R) Dressing at Wound Infected by Multidrug Resistant Bacteria

PURPOSE: The emergency of multi-drug resistant stains of bacteria represents a challenge in the field of plastic surgery. Especially, MRSA(methicillin-resistant Staphylococcus aureus) and Pseudomonas aeruginosa have strong pathogenicity as well as multi-drug resistance so that they have become a lot more problematic strains. This study has been planned to reduce the bacterial burden by applying Acticoat(R)(Smith & Nephew Healthcare, Hull, England)?dressing into the chronic wounds infected by multi-drug resistant strains and to facilitate their healing. METHODS: Nanocrystalline silver dressings(Acticoat(R)) were applied to chronic wound infected by MRSA or Pseudomonas aeruginosa. Multi-drug resistant bacteria were smeared over a slide glass using sterilized cotton swabs and gram stains were performed directly before and after applying Acticoat(R) dressings at 1, 24, 48 and 72 hours. The gram-stained slides were observed using an optical microscope magnified 1000 times(x1000). The bacterial counts of the control group(0 hour) were compared to those of the experimental groups(1, 24, 48, and 72 hour). Paired T-test was used to assess a statistical significance. MRSA was cultured in two BAPs(blood agar plate) and two MacConkey plates with streak plate method. None were interventions on one culture plate, while on the other culture plate, Acticoat(R) was placed in a square shape and cultured for 72 hours at 37 degrees C, then plates were examined. Pseudomonas aeruginosa was cultured in the same manner as MRSA. RESULTS: There are the large amount of declination of bacterial counts with statistical significance after Acticoat(R) dressing. The bacteria grew in culture plate without specific intervention, but no bacteria grew in culture plate with applying of Acticoat(R) dressing. CONCLUSION: We believe that Acticoat(R) dressing could be used as an effective method of treating chronic wounds which are infected by multi-drug resistant organisms.

Comparative Study of Acticoat(R) & Allevyn(R) on Infected Full-thickness Wound of the Rat Skin

PURPOSE: Allevyn(R)(Smith & Nephew, England) is a type of polyurethane foam material with good wound discharge absorption. Acticoat(R)(Smith & Nephew, England) is a silver coated dressing material which is effective in infected wound. The purpose of this study is to compare the effects of dry gauze, Acticoat(R) and Allevyn(R) on infected full-thickness wound healing in rat. METHODS: One hundred and twenty rats were divided into 3 groups: group I(dressing with dry gauze, n=40), group II(dressing with Allevyn(R), n=40), group III(dressing with Acticoat(R), n=40). A 15x15mm square full-thickness wound was made on the dorsum and left open for 24 hours. The size of wound defects were measured each dressing changes. The histological evaluation was performed on the 3rd day, 7th day, 14th day, 21th day. RESULTS: After the wound was left open for 24 hours, typical findings of bacterial infection was observed. After the 7th day, group III showed larger area of epithelialization, smaller defect size compared to those of two other groups. Complete replacement by fibrotic scar tissue was observed in group III with no signs of inflammation on the 14th day. By day 21, the average defect size in group III was decreased from initial 100% to 3.63%. while in group I and II, it was decreased to 62.66% and 53.62%, respectively. CONCLUSION: Acticoat(R) is an effective tool in the treatment of infected wound.