Comparison of the effectabout improved negative pressure wound therapy with filling dressing for treating traumatic wounds / 医学研究生学报

Objective The purpose of this study is to use nano-silver dressing as filling dressing for negative pressure wound therapy, and to observe the effect of treating traumatic infected wounds, so as to provide a basis for optimizing negative pressure wound therapy technology. Methods Eighty patients with physical traumatic wounds were enrolled in the outpatient wound care center. They were randomly divided into the intervention group and the control group (n=40 in each group). In the intervention group, the filling dressing for negative pressure wound therapy used nano silver dressing. In the control group, the standard negative pressure wound therapy with normal saline gauze as filling dressing was adopted. All patients were treated with negative pressure for at least 14 days, and then were treated with moist wound therapy until followed up for wound healed. The wound volume reduction rate was the main outcome indicator 14 days after intervention in the two groups. The bacterial positive rate and the wound healing rate at the end of 3 months follow-up, and final healing time were the secondary outcome indicators. Results 36 cases in the control group and 40 cases in the intervention group completed the expected negative pressure wound therapy time and follow-up. The baseline data of the two groups had no difference. The wound volume reduction rate (70.95±20.73)% in the intervention group after 14 days of treatment was significantly higher than that in the control group (64.42±22.33)% (P< 0.05), and the bacterial positive rate (20%) was lower than that in the control group (44.44%)(P< 0.05). At the end of the follow-up, the healing rate of the intervention group (97.50%) was higher than that of the control group (66.67%)(P<0.001). The healing time of the intervention group（50.85±15.81d）was shorter than of the intervention group (62.58±16.18d)(P<0.05). Conclusion Improving the filling dressing for negative pressure wound therapy can effectively reduce the volume of traumatic wound and the positive rate of pathogenic bacteria, and help to control wound infection and improve wound healing outcomes.

Biobrane dressing for paediatric burns in Singapore: a retrospective review

<p><b>INTRODUCTION</b>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.</p><p><b>METHODS</b>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.</p><p><b>RESULTS</b>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.</p><p><b>CONCLUSION</b>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.</p>

Management of malodour fungating wound with nanocrystalline silver coated dressing

Chronic exudative malodorous fungating wound of four years at the right arm due to diffuse large B cell lymphoma managed with silver dressings. In two months of application with nanocrystalline silver coated dressings, there was significant improvement in wound.

Experimental and clinical study on negative pressure suction combined with nano-silver dressing for promoting healing of infected incision / 中国感染控制杂志

Objective To evaluate the advantage of homemade negative pressure device combined with nano-silver dressing for promoting the healing of infected incision in rats,and explore its clinical curative effect.Methods In-fected incision model rats were randomly divided into conventional treatment group,and simple pressure suction group,pressure suction combined with silver ion dressing group.The healing time and healing area of rats in each group after treatment were evaluated,immunohistochemical and fluorescent quantitative analysis of inflammatory factors in incisional wound tissue were performed.Three methods were applied to patients with surgical site infec-tion(SSI),granulation coverage time,granulation recovery time,and incision healing time of three groups of pa-tients were compared.Results Immunohistochemistry and its IOD value,the relative mRNA expression levels of TNF-α,IL-2,and IL-8 in rat wound tissue treated with pressure suction combined with silver ion dressing were all inferior to conventional treatment group and simple negative pressure suction group,difference was statistically sig-nificant (P < 0.05);in clinical application,wound healing time,postoperative C-reactive protein level,and pain as-sessment scores in patients treated with pressure suction combined with silver ion dressing were all superior to con-ventional treatment group and simple negative pressure suction group,difference were all statistically significant (all P < 0.05).Conclusion Compared with conventional treatment method,pressure suction with silver ions dressing treatment can more effectively control SSI,reduce local inflammation of incision,and promote incision healing.

Experimental and clinical study on negative pressure suction combined with nano-silver dressing for promoting healing of infected incision / 中国感染控制杂志

Objective To evaluate the advantage of homemade negative pressure device combined with nano-silver dressing for promoting the healing of infected incision in rats,and explore its clinical curative effect.Methods In-fected incision model rats were randomly divided into conventional treatment group,and simple pressure suction group,pressure suction combined with silver ion dressing group.The healing time and healing area of rats in each group after treatment were evaluated,immunohistochemical and fluorescent quantitative analysis of inflammatory factors in incisional wound tissue were performed.Three methods were applied to patients with surgical site infec-tion(SSI),granulation coverage time,granulation recovery time,and incision healing time of three groups of pa-tients were compared.Results Immunohistochemistry and its IOD value,the relative mRNA expression levels of TNF-α,IL-2,and IL-8 in rat wound tissue treated with pressure suction combined with silver ion dressing were all inferior to conventional treatment group and simple negative pressure suction group,difference was statistically sig-nificant (P < 0.05);in clinical application,wound healing time,postoperative C-reactive protein level,and pain as-sessment scores in patients treated with pressure suction combined with silver ion dressing were all superior to con-ventional treatment group and simple negative pressure suction group,difference were all statistically significant (all P < 0.05).Conclusion Compared with conventional treatment method,pressure suction with silver ions dressing treatment can more effectively control SSI,reduce local inflammation of incision,and promote incision healing.

Evaluation of the Antimicrobial Effect of Carboxymethyl Cellulose versus Silver with Saline Dressing in Diabetic Ulcers.

Background: The diabetic foot ulcer is a major complication of diabetes mellitus. (1) It occurs in 15% of all patients with diabetes and precedes 84% of all lower leg amputations. (2) Diabetes mellitus impedes wound healing by prolonging the inflammatory phase. Increased glucose in the tissue precipitates infection. (3) Diabetic microangiopathy which affects microcirculation. Increased glycosylated hemoglobin decreases the oxygen dissociation. Increased glycosylated tissue protein decreases the oxygen utilization. This study is intended to show the efficacy of carboxymethyl cellulose (CMC) dressing for a faster healing of diabetic ulcers when compared with the conventional saline dressing. Materials and Methods: This study was a prospective case–control comparative study conducted at the Department of General Surgery and Gastroenterology, father Muller Medical College, Mangalore, from August to July 2016. 80 consenting patients who met the predefined criteria were taken for the study and divided into two groups, 40 patients each is put in the CMC with silver dressing group and the conventional saline dressing group. Results: There was no statistically significant difference between the two groups in terms of gender, age, glycemic control, and site of ulcer P < 0.001. In our study, we found that there was statistically significant difference in the rate of infection between the two groups. Conclusion: Silver impregnate dressings have a role in the management of diabetic ulcers by reducing the local burden of infection which is an important cause for non-healing ulcer analgesia.

Comparison of the Efficacies of Silver-Containing Dressing Materials for Treating a Full-Thickness Rodent Wound Infected by Methicillin-resistant Staphylococcus aureus / 대한진단검사의학회지

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) may cause infections during wound dressing. We aimed to compare the antibacterial activities and wound-healing effects of commercially available silver-coated or silver-impregnated wound dressings on MRSA-infected wounds. METHODS: Full-thickness skin defects were made on the back of rats (N=108) and were infected with MRSA. The rats were divided into the following 6 groups according to the dressing used for the wounds: nanocrystalline silver (Acticoat(R)), silver carboxymethylcellulose (Aquacel(R)-Ag), silver sulfadiazine (Medifoam silver(R)), nanocrystalline silver (PolyMem silver(R)), silver sulfadiazine (Ilvadon(R)), and 10% povidone iodide (Betadine(R)). We analyzed the wound sizes, histological findings, and bacterial colony counts for the groups. We also inoculated the silver materials on Mueller-Hinton agar plates containing MRSA and compared the inhibition zones in the agar plates. RESULTS: The order of the rate of wound-size decrease was Acticoat(R)>Aquacel(R)-Ag>PolyMem silver(R)>Medifoam silver(R)>Ilvadon(R)>Betadine(R). The histological findings revealed that the Acticoat(R) showed more reepithelialization and granulation tissue formation and less inflammatory cell infiltration than the other materials. The order of the time required for wound healing was Acticoat(R)>Aquacel (R)-Ag>PolyMem silver(R)>Ilvadon(R)>Medifoam silver(R)>Betadine(R). The bacterial colony counts reduced in all the groups, except in the Medifoam silver(R) group. The order of the size of the inhibition zone was Acticoat(R)>Aquacel(R)-Ag>Ilvadon(R)>PolyMem silver(R)>Betadine(R)>Medifoam silver(R). CONCLUSIONS: Silver-coated or silver-impregnated wound dressings can be used for treating MRSAinfected wounds. Considering its superior efficacy in comparison to the efficacies of other silver-coated or silver-impregnated wound dressings, Acticoat(R) should be preferentially used for the treatment of MRSA-infected skin wounds.

Comparative Efficacy of Silver Containing Dressing Materials to Staphylococcus aureus and Pseudomonas aeruginosa on Infected Full Thickness Skin Wound in the Rat

PURPOSE: The purpose of this study is to compare the effect of antibacterial activities and wound healing effect of silver containing dressings such as Staphylococcus aureus and Pseudomonas aeruginosa with against Betadine. METHODS: One full thickness skin defects in rats(n=72) were developed on the back and were given rise to infection with S. aureus(n=36) and P. aeruginosa(n= 36). The 72 mice were divided into 6 groups:Acticoat(R), Aquacel(R)-Ag, Medifoam silver(R), Polymen silver(R), Ilvadon(R) and Betadine(control group) dressing groups. Five silver containing dressings and Betadine were assesed on infected wound. Measurement of wound size change, bacterial colonies count and histologic findings was applied. Antibacterial activity was analyzed with bacterial restricted zone in Mueller Hinton agar. RESULTS: For S. aureus, wound size was more decreased in all treated groups compared to betadine group, however Ilvadon(R)-treated wound was less decreased on P. aeruginosa. In histologic findings, experimental group showed more effective findings than others on S. aureus, however on P. aeruginosa, which was shown similar. Acticoat(R) was best effective in wound healing against both S. aureus and P. aeruginosa. The bacterial colonies count was increased in all treated groups except Acticoat(R) compared to the control group on S. aureus, which was decreased in Acticoat(R) and Ilvadon(R) group on P. aeruginosa. There were not statistical differences. The restricted zone was shown in Mueller-Hinton agar of all groups except Medifoam silver(R) group on S. aureus, which was shown in all groups on P. aeruginosa. There were statistical differences. CONCLUSION: This study suggests that silver containing dressings may not have better potential than Betadine in assisting management of wounds at risk of infection on S. aureus and P. aeruginosa. However, which have better antibacterial activity on S. aureus and P. aeruginosa.

The Effectiveness of Vacuum-Assisted Closure (V.A.C) Dressing combined with Silver Dressing Material in Open Fracture of the Foot and Ankle / 대한족부족관절학회지

PURPOSE: Open fractures of the foot and ankle require prompt repair of the wound due to the complexity of anatomy, insufficiency of soft tissues and inadequate blood supply. Early flaps and skin grafts are used for this purpose yet general condition of the patient as well as local wound environment often precludes such treatment options. Vacuum-Assisted Closure (VAC) is recently being used in such cases. This study was done to validate the use of VAC together with silver antimicrobial dressing materials in contaminated open fracture wounds. MATERIALS AND METHODS: We have selected 10 patients with Gustillo-Anderson type III open fractures of the foot & ankle treated with VAC and silver antimicrobial dressing materials from March 2007 to January 2008. The relationship between duration of treatment with wound size, contamination, and degree of soft tissue damage was analyzed. RESULTS: The average age of patients was 36.6 years. The average amount of VAC application time was 23.4 days. Silver dressing materials were used for 16.8 days. Average wound healing time was 51.9 days. Statistically significant relationship was found between wound size, VAC application time and silver dressing material application time. No complications such as osteomyelitis were found after treatment. CONCLUSION: VAC technique is recently being used in open fractures with wide skin and soft tissue defects, producing good results. A wide array of dressing materials such as silver dressing is in development. We have incorporated the VAC technique together with silver dressing materials in the treatment of open fractures and achieved complication free results.

Application of Modified Vacuum Assisted Closure with Silver Materials in Chronic Infected Wound

PURPOSE: Chronic infected wounds sustained over 4 weeks with exposed tendon or bone are difficult challenges to plastic surgeons. Vacuum assisted closure (VAC) device has been well used for the management of chronic wounds diminishing wound edema, reducing bacterial colonization, promoting formation of granulation tissue and local blood flow by negative pressure to wounds. But Commercial ready-made VAC device might have some difficulties to use because of its high expenses and heavy weight. So we modified traditional VAC device with silver dressing materials as topical therapeutic agents for control of superimposed bacterial wound infection such as MRSA, MRSE and peudomonas. METHODS: We designed the modified VAC device using wall suction, 400 cc Hemovac and combined slow release silver dressing materials. We compared 5 consecutive patients' data treated by commercial ready-made VAC device(Group A) with 11 consecutive patients' data treated by modified VAC device combined with silver dressing materials(group B) from September 2004 to June 2007. Granulation tissue growth, wound discharge, wound culture and wound dressing expenses were compared between the two groups. RESULTS: In comparison of results, no statistical differences were identified in reducing rate of wound size between group A and B. Wound discharge was significantly decreased in both groups. Modified VAC device with silver dressing materials showed advantages of convenience, cost effectiveness and bacterial reversion. CONCLUSION: In combination of modified VAC device and silver dressing materials, our results demonstrated the usefulness of managing chronic open wounds superimposed bacterial infection, cost effectiveness compared with traditional VAC device and improvement of patient mobility.

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.

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.

Oberservation of the protective effect on nanometer silver dressing in burn wound / 中国医师进修杂志

Objective To investigate the protective effect of wound in burn part of wound on nanometer silver dressing.Methods Selected 48 fleet Ⅱ degree and deep Ⅱ degree burn patients of burn deepness equality opposite nonarthrosis place.Two burn wound of deepness equality consistent of the each case were randomly divided in two comparison area.The treatment groups adopted nanometer silver dressing apply.The comparison groups adopted 1%SD-Ag cool frost apply on vaseline gauze.Put up wound secretion germiculture and judged with two groups wound at 3 postburn day(PBD3),PBD5,PBD9 and PBD14.Observed and noted the wound heal instance and speed.Observed the medicament badness responses.Results The wound germ tested rate compare: the masculine rate fleet Ⅱ degree 3.84% and deep Ⅱ degree 9.09% in the treatment groups.The masculine rate fleet Ⅱ degree(11.53)% and deep Ⅱ degree 18.18% in the comparison groups.The wound heal time compare: the treatment groups average shorter two-three days than the comparison groups in the fleet Ⅱ degree.The treatment groups average shorter four-five days than the comparison groups in the deep Ⅱ degree,P

Observation of the efficacy of Ionic silver dressing + GEL in local treating diabetic foot / 重庆医科大学学报

Objective:To observe the efficacy of Ionic silver dressing + gel in treating diabetic foot ulcer. Methods:43 cases of this disease were divided into two groups randomly. In treating group(A),the wounds were treated with Ionic silver dressing + gel and the wounds were treated with basic method in controlling group(B). Results:Ionic silver dressing + gel could control wound infection,promote wound granulation and epithelium regeneration and lessen inflammatory reaction. In treating group,the average wound healing time decreased to (53.18?9.49)days from (66.86?7.90)days in control group(P