https://cmapspublic3.ihmc.us/rid=1J2LQ1265-1DFQC1W-TTL/2MAIN_Effect%20of%20silver%20on%20burn%20wound%20infection%20control%20and%20healing_review%20of%20the%20literature.pdf

Effect of silver on burn wound infection control and healing: review of the literature.

A facile method for electrospinning of Ag nanoparticles/poly (vinyl alcohol)/carboxymethyl-chitosan nanofibers

HemCon s bandage is an engineered chitosan acetate preparation designed as a hemostatic dressing, and is under investigation as a topical antimicrobial dressing. We studied its effects on healing of excisional wounds that were or were not infected with Staphylococcus aureus, in normal mice or mice previously pretreated with cyclophosphamide (CY). CY significantly suppressed wound healing in both the early and later stages, while S. aureus alone significantly stimulated wound healing in the early stages by preventing the initial wound expansion. CY plus S. aureus showed an advantage in early stages by preventing expansion, but a significant slowing of wound healing in later stages. In order to study the conflicting clamping and stimulating effects of chitosan acetate bandage on normal wounds, we removed the bandage from wounds at times after application ranging from 1 hour to 9 days. Three days application gave the earliest wound closure, and all application times gave a faster healing slope after removal compared with control wounds. Chitosan acetate bandage reduced the number of inflammatory cells in the wound at days 2 and 4, and had an overall beneficial effect on wound healing especially during the early period where its antimicrobial effect is most important.

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Effect of chitosan acetate bandage on wound healing in infected and noninfected wounds in mice

Aim. The purpose of this study was to examine the efficacy of silver-releasing dressings in the management of non-healing chronic wounds. Background. Non-healing chronic wounds often have a negative physical impact on patients and place a financial burden on healthcare systems. Silver dressings are wound products designed to control infection and provide a wound environment conducive to healing. However, validation of the clinical efficacy of these dressings is lacking. Design. Systematic review and meta-analysis. Methods. A systematic search of the major electronic databases PubMed, CINAHL, Cochrane, MEDLINE, British Nursing Index, EBSCO, OCLC and Proquest between 1950‐June 2007 was conducted. Hand searches of selected periodicals, textbooks and checking reference lists and contacting experts was also performed. Results. Eight studies were selected from a potentially relevant 1957 references screened. Analysis incorporated data from 1399 participants in the eight randomised control trials. We found that silver dressings significantly improved wound healing (CI95: 0AE16‐0AE39, p < 0AE001), reduced odour (CI95 :0 AE24‐0AE52, p < 0AE001) and pain-related symptoms (CI95 :0 AE18‐0AE47, p < 0AE001), decreased wound exudates (CI95 :0 AE17‐0AE44, p < 0AE001) and had a prolonged dressing wear time (CI95 :0 AE19‐0AE48, p =0 AE028) when compared with alternative wound management approaches. An analysis of sensitivity in these studies by subgroup analysis generally supported these associations. Furthermore, studies indicated an improvement in quality of life (CI95 :0 AE04‐ 0AE33, p =0 AE013) using silver dressings in wound management with no associated severe adverse events. Conclusion. This meta-analysis confirms the effectiveness of silver dressings in wound healing and improving patients’ quality of life. However, it also highlights the need for additional well-designed randomised controlled trials to evaluate the effectiveness of silver-related dressings further. Relevance to clinical practice. The results of this study provide objective data on the effectiveness of silver-related dressing when applied to non-healing chronic wounds.

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The effectiveness of silver-releasing dressings in the management of non-healing chronic wounds: a meta-analysis.

Aim. This paper is a systematic review with the objective of determining the effectiveness of silver-releasing dressing in the management of infected chronic wounds.



Background.  Chronic wounds exhibit increased bacterial burdens which not only result in a negative physical impact on patients, impairing their quality of life, but also increase treatment costs. Silver dressings are wound products designed to control and inhibit infection and provide a wound environment conducive to healing. However, there is limited evidence on their effectiveness in doing so.



Methods.  A systematic review of literature from 1950–May 2007 was conducted using the PubMed, CINAHL, Cochrane, MEDLINE, British Nursing Index, EBSCO Host, OCLC, Proquest and PsychInfo databases. The review included randomised or non-randomised control trials, published in English or non-English, of silver-releasing dressings in infected chronic wounds.



Results.  Of the over 1957 potentially releasing studies examined, 14 pertinent articles involving 1285 participants were identified. Almost all the participants reported one or more statistically significant outcomes. The main points to emerge from this review of studies are that silver-releasing dressings show positive effects on infected chronic wounds. The quality of the trials was limited by the potential for bias associated with inadequate concealment, no detailed description of the outcome measurement and no reported intention-to-treat analysis. Moreover, problems existed in some studies with confounding factors.



Conclusion.  The review clearly highlights the need for well-designed, methodologically standardised outcome measurement research into the effectiveness of silver-releasing dressings. It also points to the need for a comprehensive assessment of wound bed status in further studies.



Relevance to clinical practice.  This review strengthens the case for the use of silver dressings when managing infected chronic wounds. They appear more effective and are tolerated well by patients. However, their use should be accompanied by a comprehensive wound assessment.

A systematic review of silver‐releasing dressings in the management of infected chronic wounds

Bacterial colonisation of wounds may delay wound healing. Modern silver-containing dressings are antimicrobial, yet cellular toxicity is a serious side-effect. We provide data for a newly formulated s

D. Spaeth

Papers

Reduced cellular toxicity of a new silver-containing antimicrobial dressing and clinical performance in non-healing wounds.