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Connery S, Tanner JP, Odibo L, Raitano O, Nikolic-Dorschel D, Louis JM. Effect of Using Silver Nylon Dressings on Postoperative Pain after Cesarean Delivery. Am J Perinatol 2023; 40:1811-1819. [PMID: 34839470 DOI: 10.1055/s-0041-1739521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Silver dressings have been associated with a decrease in postoperative pain in selected populations, but it is unknown if the benefit can be observed after cesarean deliveries. We sought to evaluate the impact of silver nylon dressings in reducing postoperative pain after cesarean delivery. STUDY DESIGN A secondary analysis of data from a blinded randomized clinical trial of women undergoing cesarean delivery scheduled and unscheduled at a single site was conducted. Women were recruited for participation from a single site and randomized to a silver nylon dressing or an identical-appearing gauze wound dressing. Wounds were evaluated in the outpatient clinic at 1 and 6 weeks after delivery and patient responded to the modified patient scar assessment scale. The primary outcome of this analysis was inpatient opioid and nonopioid analgesic dispensed. The secondary outcome was patient-reported pain at the 1- and 6-week postpartum visits. Data were analyzed using chi-square test, Student's t-test, Fisher's exact test, Wilcoxon-Mann-Whitney's test, and logistic regression where appropriate. A p-value of < 0.05 was considered significant. RESULTS Among the 649 participants, women allocated to the silver nylon dressing group, when compared with the gauze group, were similar in the amount of dispensed opioid and nonopioid analgesic medications (morphine equivalent milligrams of opioids dispensed [82.5 vs. 90 mg, p = 0.74], intravenous nonsteroidal anti-inflammatory drugs (NSAIDs) [120 vs. 120 mg, p = 0.55], and oral NSAIDs [4,800 vs. 5,600 mg in the gauze group, p = 0.65]). After adjusting for confounding variables, postoperative wound infection (adjusted odds ratio [aOR]: 11.70; 95% confidence interval [CI]: 4.51-30.31) at 1-week postoperative and again at 6-week postoperative (aOR: 5.59; 95% CI: 1.03-30.31) but not gauze dressing was associated with patient-reported postoperative pain. CONCLUSION Among women undergoing cesarean delivery, silver nylon dressing was not associated with a reduction in postoperative pain. KEY POINTS · Silver dressings showed no decrease in pain medications.. · Wound infection is associated with pain postoperatively.. · Silver dressings did not reduce postoperative pain..
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Affiliation(s)
- Sheila Connery
- Department of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Jean Paul Tanner
- College of Public Health, University of South Florida, Tampa, Florida
| | - Linda Odibo
- Department of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Olivia Raitano
- Creighton University School of Medicine, Omaha, Nebraska
| | | | - Judette M Louis
- Department of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampa, Florida
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2
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Liu B, Zhu X, Feng C, Huang J, Yan D, Wang B. Bacteriostatic effect of Ag@TiO 2-Poly(p-dioxanone)-coated gauzes in vitro and in vivo on otitis media pathogens. Heliyon 2023; 9:e19375. [PMID: 37681170 PMCID: PMC10480629 DOI: 10.1016/j.heliyon.2023.e19375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 08/21/2023] [Accepted: 08/21/2023] [Indexed: 09/09/2023] Open
Abstract
The application of packing agents affects the final surgical outcomes in treating otitis media (OM) and introduces the risk of infection. To decrease the infectious risks of packing agents and even introduce positive bacteriostatic functions, a kind of PPDO-grafted Ag-incorporated TiO2 nanoparticles (Ag@TiO2-PPDO NP)-coated gauzes were prepared by a solution immersion method. Morphologies and in vitro Ag+ releasing of Ag@TiO2-PPDO NP coated gauzes were determined by scanning electron microscope (SEM) and inductively coupled plasma-mass spectrum (ICP-Ms). Ag@TiO2-PPDO NP could respond to visible light, which might make Ag@TiO2-PPDO NP inhibit the proliferation of bacteria continually and positively with irradiation of visible light. Then the bacteriostatic effects of these gauzes on OM pathogens were investigated in vitro and in vivo. These gauzes could inhibit the proliferation of pathogenic Staphylococcus aureus (S. aureus) and Streptococcus pneumoniae (S. pneumoniae) in vitro and rat subcutaneous infection models. Specifically, the bacteriostatic effect of these gauzes on S. aureus and S. pneumoniae could be enhanced with irradiation by visible light in vitro. Further, the rat external auditory canal infection model verified the enhanced bacteriostatic effect of Ag@TiO2-PPDO-coated gauzes on S. aureus with irradiation by visible light. The Ag@TiO2-PPDO-coated gauzes are promising for packing materials after OM surgery and could reduce postoperative antibiotic requirements.
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Affiliation(s)
- Biyao Liu
- Department of Otolaryngology Head and Neck Surgery, Affiliated Hospital of North Sichuan Medical College & School of Clinical Medicine, North Sichuan Medical College, China
| | - Xin Zhu
- Department of Otolaryngology Head and Neck Surgery, Affiliated Hospital of North Sichuan Medical College, China
| | - Chengmin Feng
- Department of Otolaryngology Head and Neck Surgery, Affiliated Hospital of North Sichuan Medical College, China
| | - Jing Huang
- Department of Otolaryngology Head and Neck Surgery, Affiliated Hospital of North Sichuan Medical College & School of Clinical Medicine, North Sichuan Medical College, China
| | - Dazhong Yan
- Department of Otolaryngology Head and Neck Surgery, Affiliated Hospital of North Sichuan Medical College, China
| | - Bing Wang
- Department of Chemistry, School of Pharmacy, North Sichuan Medical College, Nanchong, 637000, China
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3
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Efficacy of gelatamp in controlling the postoperative sequelae following mandibular posterior teeth extraction - A split-mouth study. J Oral Biol Craniofac Res 2023; 13:96-103. [PMID: 36561420 PMCID: PMC9763509 DOI: 10.1016/j.jobcr.2022.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 08/26/2022] [Accepted: 11/28/2022] [Indexed: 12/02/2022] Open
Abstract
Purpose This study aimed to evaluate the effectiveness of gelatamp on soft tissue healing, bleeding, and pain following mandibular posterior teeth extraction. Methods This study was designed as a split-mouth, prospective randomized double-blind controlled trial conducted in a single tertiary care center. Thirty-five subjects indicated for routine mandibular posterior teeth extraction were divided into two groups using the lottery technique: the experimental group (n = 30), which received gelatamp after extraction, and the control group (n = 30), which received no intervention. The primary outcomes included soft tissue healing(Landry, Turnbull, Howley index) and Pain(VAS score). The secondary outcomes assessed were bleeding(Maani et al. index) and swelling(Sauza and Consone assessment). Result The results showed a statistically significant difference in soft tissue healing on the third and seventh days in the experimental group (p ≤ 0.05) than in the control group. A significant difference in bleeding scores at 5 min, 30 min, and 2 h postoperatively in the study group (p ≤ 0.05) was noted. There was no significant difference between the groups for pain on the first, third or seventh day postoperatively (p ≤ 0.05). The swelling assessment also showed no significant changes (p = 0.831) for the study and the control group. Conclusion Based on the findings of this study, gelatamp can be effectively used to reduce postoperative sequelae such as bleeding with better soft tissue healing following extractions and surgical removal of tooth.
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4
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Carvalho CDS, Bernardes MJC, Gonçalves RC, Vilela MS, da Silva MVM, Oliveira VDS, da Rocha MR, Vinaud MC, Galdino H, Lino RDS. Treatment of experimentally induced partial-thickness burns in rats with different silver-impregnated dressings. Acta Cir Bras 2022; 37:e370801. [PMID: 36449949 PMCID: PMC9708113 DOI: 10.1590/acb370801] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 07/20/2022] [Indexed: 11/29/2022] Open
Abstract
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.
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Affiliation(s)
- Carolyna de Sousa Carvalho
- MSc. Universidade Federal de Goiás – Tropical Pathology and Public Health Institute – Tropical Medicine and Public Health Graduation Program – Goiânia (GO), Brazil
| | - Milton Junio Cândido Bernardes
- PhD. Universidade Federal de Goiás – Tropical Pathology and Public Health Institute – Biology of the Host-Parasite Relationship Graduation Program – Goiânia (GO), Brazil
| | - Randys Caldeira Gonçalves
- MSc. Universidade Federal de Goiás – Tropical Pathology and Public Health Institute – Tropical Medicine and Public Health Graduation Program – Goiânia (GO), Brazil
| | | | | | - Vinicius da Silva Oliveira
- Graduate student. Universidade Federal de Goiás – Medicine School – Medicine Course – Goiânia (GO), Brazil
| | - Marcelo Ribeiro da Rocha
- Graduate student. Universidade Federal de Goiás – Medicine School – Medicine Course – Goiânia (GO), Brazil
| | - Marina Clare Vinaud
- PhD. Universidade Federal de Goiás – Tropical Pathology and Public Health Institute – Biosciences Department – Goiânia (GO), Brazil
| | - Hélio Galdino
- PhD. Universidade Federal de Goiás – Nursing School – Goiânia (GO), Brazil
| | - Ruy de Souza Lino
- PhD. Universidade Federal de Goiás – Tropical Pathology and Public Health Institute – Biosciences Department – Goiânia (GO), Brazil.,Corresponding author:
- (55 62) 3209-6113
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Lawrie K, Waldauf P, Baláž P, Drozd J, Brat'ka P, Loveček M, Klos D, Skalický P, Peňázová Kurečková P, Kráčmar O, Kala Z, Makajevová V, Hodačová L, Šimša J, Gürlich R. Silver-Based Dressings in the Prevention of the Incisional Surgical Site Infection: A Prospective Multicenter Observational Controlled Trial. Surg Infect (Larchmt) 2022; 23:682-690. [PMID: 35930248 DOI: 10.1089/sur.2022.084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: A new silver-based dressing has been designed to reduce surgical sited infections. Patients and Methods: A prospective multicenter observational study was conducted from January 2020 to October 2021. Patients with and without silver-based dressing after surgical incision were observed and their data analyzed. The study aimed to assess the incidence of incisional surgical site infection and primary healing after general surgery procedures. Results: Overall, 218 patients with silver-based (n = 109) and conventional silver-free dressing (n = 109) were analyzed. Surgical site infection (SSI) and primary incision healing were reported in 10 (9.2%) versus 21 (19.3%) (p = 0.037) and in 95 (87.2%) versus 86 (78.9%) (p = 0.107) patients treated with and without silver-based dressing, respectively. Conclusions: Silver-based dressing demonstrated a lower incidence of incisional SSI and improved primary healing in comparison with patients in whom conventional non-silver-based dressing has been used.
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Affiliation(s)
- Kateřina Lawrie
- Department of Surgery, University Hospital Královské Vinohrady, Third Faculty of Medicine, Charles University, Prague, Czech Republic.,Cardiocenter, University Hospital Královské Vinohrady, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Petr Waldauf
- Department of Anaesthesiology and Resuscitation, University Hospital Královské Vinohrady, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Peter Baláž
- Department of Surgery, University Hospital Královské Vinohrady, Third Faculty of Medicine, Charles University, Prague, Czech Republic.,Cardiocenter, University Hospital Královské Vinohrady, Third Faculty of Medicine, Charles University, Prague, Czech Republic.,Department of Vascular Surgery, National Institute for Cardiovascular Diseases, Bratislava, Slovak Republic
| | - Jan Drozd
- Department of Surgery, University Hospital Královské Vinohrady, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Petr Brat'ka
- Faculty of Biomedical Engineering Czech Technical University in Prague, Kladno, Czech Republic
| | - Martin Loveček
- Department of Surgery I, Faculty of Medicine and Dentistry, Palacký University and University Hospital Olomouc, Czech Republic
| | - Dušan Klos
- Department of Surgery I, Faculty of Medicine and Dentistry, Palacký University and University Hospital Olomouc, Czech Republic
| | - Pavel Skalický
- Department of Surgery I, Faculty of Medicine and Dentistry, Palacký University and University Hospital Olomouc, Czech Republic
| | | | - Ondřej Kráčmar
- Department of Surgery, The University Hospital Brno, Czech Republic
| | - Zdeněk Kala
- Department of Surgery, The University Hospital Brno, Czech Republic
| | - Veronika Makajevová
- Department of Surgery, First Faculty of Medicine, Charles University and Thomayer University Hospital, Prague, Czech Republic
| | - Linda Hodačová
- Department of Surgery, First Faculty of Medicine, Charles University and Thomayer University Hospital, Prague, Czech Republic
| | - Jaromír Šimša
- Department of Surgery, First Faculty of Medicine, Charles University and Thomayer University Hospital, Prague, Czech Republic
| | - Robert Gürlich
- Department of Surgery, University Hospital Královské Vinohrady, Third Faculty of Medicine, Charles University, Prague, Czech Republic
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6
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Goodman JR, Durazo-Arvizu R, Nashif S, McAlarnen LA, Wagner SA, Lal AK. Preventing caesarean section wound complications: use of a silver-impregnated antimicrobial occlusive dressing. J Wound Care 2022; 31:S5-S14. [PMID: 35797250 DOI: 10.12968/jowc.2022.31.sup7.s5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To investigate the role of an adherent soft silicone antimicrobial occlusive foam silver-impregnated dressing for reduction of surgical site infections (SSI) in primary low-transverse caesarean section (1°LTCS) delivery. METHOD Women aged 18-45 years admitted to the labour and delivery or the antepartum unit undergoing a 1°LTCS were recruited. Exclusion criteria included repeat caesarean, vertical skin incision, intrapartum fever and closure with staples. Consented participants delivered by scheduled or unscheduled 1°LTCS received the silver-impregnated dressing. Those who declined to participate and were delivered by scheduled or unscheduled caesarean received a standard gauze with tape dressing (controls). Surgical preparation and preoperative antibiotics were administered as per hospital policy. RESULTS A total of 362 participants were consented for use of the silver-impregnated dressing, with 190 participants undergoing 1°LTCS, of whom 185 were included in the final analysis. Of those who declined to participate, 190 ultimately underwent 1°LTCS during the same time period. Cases and controls were similar in demographics, body mass index, diabetes status, labour and procedure length, and tobacco use. The overall incidence of SSI was 3.7%. A 50% reduction in incidence of SSI was observed in the silver-impregnated dressing group compared with control group (2.7% versus 4.7%, respectively), but this was not statistically significant (p=0.08; odds ratio 0.55; 95% confidence interval: 0.18-1.67). CONCLUSION Among women undergoing 1°LTCS with subcuticular closure of a transverse incision, use of a silver-impregnated dressing reduced the rate of SSI by >50% but was not statistically significant.
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Affiliation(s)
- Jean Ricci Goodman
- Department of Obstetrics, Gynecology, and Women's Health, University of Missouri, Columbia, Missouri, US
| | - Ramon Durazo-Arvizu
- Department of Biostatistics, Loyola University Chicago Health Sciences Division, Maywood, Illinois, US
| | - Sereen Nashif
- Department of Obstetrics and Gynecology, Loyola University Medical Center, Maywood, Illinois, US
| | - Lindsey A McAlarnen
- Department of Obstetrics and Gynecology, Loyola University Medical Center, Maywood, Illinois, US
| | - Sarah A Wagner
- Department of Obstetrics and Gynecology, Loyola University Medical Center, Maywood, Illinois, US
| | - Ann K Lal
- Department of Obstetrics and Gynecology, Loyola University Medical Center, Maywood, Illinois, US
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7
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Toczek J, Sadłocha M, Major K, Stojko R. Benefit of Silver and Gold Nanoparticles in Wound Healing Process after Endometrial Cancer Protocol. Biomedicines 2022; 10:679. [PMID: 35327481 PMCID: PMC8945154 DOI: 10.3390/biomedicines10030679] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 03/08/2022] [Accepted: 03/14/2022] [Indexed: 11/29/2022] Open
Abstract
It is intractable to manage the vast majority of wounds in a classical surgical manner, however if silver, likewise gold and its representative nanoparticles, can lead to the amelioration of the wound healing process after extensive procedures, they should be employed in the current gynecological practice as promptly as possible. Most likely due to its antimicrobial properties, silver is usually applied as an additional component in the wound healing process. In wound management, we obtained various aspects that can lead to impaired wound healing; the crucial aspect for the wound milieu is to prevent the offending agents from occurring. The greatest barrier to healing is represented by the bacterial biofilm, which can occur naturally or in other ways. Biofilm bacteria can produce extracellular polymers, which can then resist concentrated anti-bacterial treatment. The published literature on the use of silver nanoparticles' utilization in wound healing becomes slightly heterogenous and requires us in difficult moments to set up proper treatment guidelines.
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Affiliation(s)
- Jakub Toczek
- Department of Gynecology, Obstetrics and Oncological Gynecology, Medical University of Silesia in Katowice, Markiefki 87, 40-211 Katowice, Poland; (M.S.); (K.M.); (R.S.)
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8
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O'Neill L, Nelson Z, Ahmad N, Fisher AH, Denton A, Renzi M, Fraimow HS, Stanisce L. Malignant Fungating Wounds of the Head and Neck: Management and Antibiotic Stewardship. OTO Open 2022; 6:2473974X211073306. [PMID: 35155974 PMCID: PMC8832587 DOI: 10.1177/2473974x211073306] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 11/13/2021] [Indexed: 11/15/2022] Open
Abstract
Objective Malignant fungating wounds (MFWs) are unfortunate and underreported manifestations of some advanced head and neck cancers. The management of MFWs is complex and challenging. MFWs are often mistaken for infectious processes/abscesses and treated indiscriminately with oral or intravenous antibiotics. Our aim is to promote awareness of MFWs and provide education on their management. We summarize their cost-effective and evidence-based therapies and highlight antibiotic stewardship with respect to their management. Data Sources A literature review was performed of PubMed, Cochrane Review, SCOPUS, Embase, and Google Scholar databases regarding topical and systemic treatments for MFWs. Review Methods Full-text articles were identified with the following terms: fungating, ulcerative, wound, tumor, malignancy, antibiotics, topical, dressings, radiotherapy, head, neck, scalp, face, lip, and ear. Treatment recommendations were extrapolated, categorically summarized, and retrospectively assigned with an evidence level based on the GRADE system (Grading of Recommendations, Assessment, Development, and Evaluation). Conclusions In the absence of systemic signs and symptoms of infections, MFWs should not be treated as conventional infections or abscesses, with prophylactic oral or intravenous antibiotics. Topical treatments such as ointments and wound dressings are the mainstay in terms of managing the unsightly appearance and fetid odor from these entities. Implications for Practice MFWs are most often not amenable to definitive/curative surgical or nonsurgical therapy, but consultation with a head and neck oncologic specialist will help to determine if the underlying malignancy requires surgery, radiation therapy, or palliative treatment.
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Affiliation(s)
- Liam O'Neill
- Cooper Medical School of Rowan University, Camden, New Jersey, USA
| | - Zach Nelson
- Cooper Medical School of Rowan University, Camden, New Jersey, USA
| | - Nadir Ahmad
- Cooper Medical School of Rowan University, Camden, New Jersey, USA.,Division of Otolaryngology-Head and Neck Surgery, Cooper University Hospital, Camden, New Jersey, USA
| | - Alec H Fisher
- Division of Plastic and Reconstructive Surgery, Cooper University Hospital, Camden, New Jersey, USA
| | - Ana Denton
- Division of Otolaryngology-Head and Neck Surgery, Cooper University Hospital, Camden, New Jersey, USA
| | - Michael Renzi
- Department of Dermatology, Cooper University Hospital, Camden, New Jersey, USA
| | - Henry S Fraimow
- Cooper Medical School of Rowan University, Camden, New Jersey, USA.,Division of Infectious Disease, Cooper University Hospital, Camden, New Jersey, USA
| | - Luke Stanisce
- Division of Otolaryngology-Head and Neck Surgery, Cooper University Hospital, Camden, New Jersey, USA
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9
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Shu W, Wang Y, Zhang X, Li C, Le H, Chang F. Functional Hydrogel Dressings for Treatment of Burn Wounds. Front Bioeng Biotechnol 2021; 9:788461. [PMID: 34938723 PMCID: PMC8685951 DOI: 10.3389/fbioe.2021.788461] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 11/11/2021] [Indexed: 12/18/2022] Open
Abstract
The therapy of burns is a challenging clinical issue. Burns are long-term injuries, and numerous patients suffer from chronic pain. Burn treatment includes management, infection control, wound debridement and escharotomy, dressing coverage, skin transplantation, and the use of skin substitutes. The future of advanced care of burn wounds lies in the development of “active dressings”. Hydrogel dressings have been employed universally to accelerate wound healing based on their unique properties to overcome the limitations of existing treatment methods. This review briefly introduces the advantages of hydrogel dressings and discusses the development of new hydrogel dressings for wound healing along with skin regeneration. Further, the treatment strategies for burns, ranging from external to clinical, are reviewed, and the functional classifications of hydrogel dressings along with their clinical value for burns are discussed.
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Affiliation(s)
- Wentao Shu
- Department of Biobank, Division of Clinical Research, The First Hospital of Jilin University, Changchun, China
| | - Yinan Wang
- Department of Biobank, Division of Clinical Research, The First Hospital of Jilin University, Changchun, China.,Key Laboratory of Organ Regeneration and Transplantation of the Ministry of Education, The First Hospital of Jilin University, Changchun, China
| | - Xi Zhang
- Department of Burn Surgery, The First Hospital of Jilin University, Changchun, China
| | - Chaoyang Li
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, China
| | - Hanxiang Le
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, China
| | - Fei Chang
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, China
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10
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Hayashida K, Yamakawa S. Topical odour management in burn patients. BURNS & TRAUMA 2021; 9:tkab025. [PMID: 34458382 PMCID: PMC8389170 DOI: 10.1093/burnst/tkab025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/25/2021] [Indexed: 12/31/2022]
Abstract
Preventing microbial colonization or infections that cause offensive smells may lead to odor reduction. As both anaerobic and aerobic bacteria cause the release of malodor from wounds, the most direct way of avoiding or eliminating wound odor is to prevent or eradicate the responsible infection through the debridement of necrotic tissues. However, some burn patients with malodorous wounds are unable to undergo debridement due to systemic conditions, especially in the acute stage. Moreover, the optimal drug doses and dressings to ensure the efficacy and cost-effectiveness of odorous burn wound management is unclear. The purpose of this commentary is to outline the odor management options available for burn patients, focusing on topical strategies. Numerous potential therapies for treating odorous wounds after burn injuries are suggested.
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Affiliation(s)
- Kenji Hayashida
- Division of Plastic and Reconstructive Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-0021, Japan
| | - Sho Yamakawa
- Division of Plastic and Reconstructive Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-0021, Japan
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11
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Khansa I, Schoenbrunner AR, Kraft CT, Janis JE. Silver in Wound Care-Friend or Foe?: A Comprehensive Review. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2019; 7:e2390. [PMID: 31592393 PMCID: PMC6756674 DOI: 10.1097/gox.0000000000002390] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 06/19/2019] [Indexed: 12/12/2022]
Abstract
Due to its strong antimicrobial activity, silver is a commonly used adjunct in wound care. However, it also has the potential to impair healing by exerting toxic effects on keratinocytes and fibroblasts. The published literature on the use of silver in wound care is very heterogeneous, making it difficult to generate useful treatment guidelines. METHODS A search of high-quality studies on the use of silver in wound care was performed on PubMed. A detailed qualitative analysis of published articles was performed to evaluate the evidence for the use of silver in infected wounds, clean wounds, burns, and over closed surgical incisions. RESULTS Fifty-nine studies were included in this qualitative analysis. We found that, overall, the quality of the published research on silver is poor. While there is some evidence for short-term use of dressings containing nanocrystalline silver in infected wounds, the use of silver-containing dressings in clean wounds and over closed surgical incisions is not indicated. Negative-pressure wound therapy accelerates the healing of contaminated wounds, especially when silver is used as an adjunct. For burns, silver sulfadiazine slows healing and should not be used. Instead, nanocrystalline silver, or alternatives such as octenidine and polyhexanide, lead to less infection and faster healing. CONCLUSIONS In infected wounds, silver is beneficial for the first few days/weeks, after which nonsilver dressings should be used instead. For clean wounds and closed surgical incisions, silver confers no benefit. The ideal silver formulations are nanocrystalline silver and silver-coated polyurethane sponge for negative-pressure wound therapy. Silver sulfadiazine impairs wound healing. Proper use of silver-containing dressings is essential to optimize wound healing.
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Affiliation(s)
- Ibrahim Khansa
- From the Division of Plastic and Reconstructive Surgery, Nationwide Children’s Hospital, Columbus, Ohio
- Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Anna R. Schoenbrunner
- Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Casey T. Kraft
- Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Jeffrey E. Janis
- Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
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12
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Abstract
Pediatric burns are a leading cause of injury and mortality in children in the United States. Prompt resuscitation and management is vital to survival in severe pediatric burns. Although management principles are similar to their adult counterparts, children have unique pathophysiologic responses to burn injury thus an understanding of the differences in fluid resuscitation requirements, airway management, burn and wound care is essential to optimize their outcomes.
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Affiliation(s)
- Mary K Arbuthnot
- Naval Medical Center Camp Lejeune, Department of General Surgery, 100 Brewster Blvd., Camp Lejeune, NC 28547, USA.
| | - Alejandro V Garcia
- Johns Hopkins Hospital, Department of Pediatric Surgery, 1800 Orleans St. Bloomberg Bldg 7313, Baltimore, MD 21287, USA.
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Mirel S, Voica C, Colobățiu L, Mirel V, Matinca D, Flonta M, Lupșe M. In vitro Comparison of the Antimicrobial Efficiency of Commercially Available Silver-Wound Dressings Correlated with the Evaluation of Silver Release by Inductively Coupled Plasma–Mass Spectrometry. ANAL LETT 2019. [DOI: 10.1080/00032719.2017.1421960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Simona Mirel
- Medical Devices Department, Faculty of Pharmacy, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Cezara Voica
- Mass Spectrometry, Chromatography and Applied Physics Department, National Institute for Research and Development of Isotopic and Molecular Technologies, Cluj-Napoca, Romania
| | - Liora Colobățiu
- Medical Devices Department, Faculty of Pharmacy, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Valentin Mirel
- Mass Spectrometry, Chromatography and Applied Physics Department, National Institute for Research and Development of Isotopic and Molecular Technologies, Cluj-Napoca, Romania
| | - Doina Matinca
- Microbiology Department, Faculty of Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Mirela Flonta
- Clinical Laboratory, Clinical Hospital of Infectious Diseases, Cluj-Napoca, Romania
| | - Mihaela Lupșe
- Infectious Diseases Department, Faculty of Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Topical treatment with a transient receptor potential ankyrin 1 (TRPA1) antagonist reduced nociception and inflammation in a thermal lesion model in rats. Eur J Pharm Sci 2018; 125:28-38. [DOI: 10.1016/j.ejps.2018.09.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 08/29/2018] [Accepted: 09/15/2018] [Indexed: 02/06/2023]
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Bailey JK, Sammet S, Overocker J, Craft-Coffman B, Acevedo CM, Cowan ME, Powell HM. MRI compatibility of silver based wound dressings. Burns 2018; 44:1940-1946. [PMID: 29921487 DOI: 10.1016/j.burns.2018.05.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 05/22/2018] [Accepted: 05/22/2018] [Indexed: 12/11/2022]
Abstract
As silver dressings gain more widespread use, it is more likely that patients with silver-based dressings will also undergo magnetic resonance imaging (MRI). In current practice, these dressings are removed prior to imaging due to concerns over heating and image distortion. As dressing changes can be painful, the need to remove dressings simply for MRI may increase pain and contribute to opioid dependency. To examine the need for dressing removal, American Society for Testing and Materials International standards for assessing device deflection and torque were performed on 5 silver containing and 3 non-silver control dressings. Magnetically induced heating and image distortion were examined in a porcine hind limb wound dressed with control and test dressings. The limb was scanned in a clinical high field 3T MRI scanner using a series of standard MRI sequences (Survey, T1-weighted SE, T1-weighted IR TSE, T2-weighted TSE, DUAL TSE, and FLAIR). Deflection and torsion were not detected in control or silver-based dressings. For all combinations of dressings and MRI scans, average heating was between 0-0.2°C. Additionally, dressings, in dry and hydrated forms, caused no image distortion in any MRI scan performed. Evaluation of MRI safety and compatibility revealed no concerns for safety or image distortion in any of the silver-containing wound dressings tested thus it would be acceptable to leave these dressings intact during MRI. The ability to leave dressings in place during imaging will provide a significant benefit to patient care by reducing pain associated with dressing removal.
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Affiliation(s)
- J Kevin Bailey
- Department of Surgery, Critical Care, Trauma and Burns, The Ohio State University, Columbus, OH, United States; Research Department, Shriners Hospitals for Children, Cincinnati, OH, United States
| | - Steffen Sammet
- Department of Radiology, University of Chicago Medical Center, Chicago, IL, United States; Department of Radiology, The Ohio State University, Columbus, OH, United States
| | - Jason Overocker
- Saint Alphonsus Medical Group, Department of General Surgery, Nampa, ID, United States
| | | | | | - Martin E Cowan
- Milliken Healthcare Products LLC, Spartanburg, SC, United States
| | - Heather M Powell
- Research Department, Shriners Hospitals for Children, Cincinnati, OH, United States; Department of Materials Science and Engineering, The Ohio State University, Columbus, OH, United States; Department of Biomedical Engineering, The Ohio State University, Columbus, OH, United States.
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Use of a Silver Nylon Dressing Following Total Hip and Knee Arthroplasty Decreases the Postoperative Infection Rate. JOURNAL OF THE AMERICAN ACADEMY OF ORTHOPAEDIC SURGEONS GLOBAL RESEARCH AND REVIEWS 2017; 1:e034. [PMID: 30211361 PMCID: PMC6132300 DOI: 10.5435/jaaosglobal-d-17-00034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Introduction: Prosthetic joint infection (PJI) is a potentially catastrophic complication of total joint replacement. Our purpose was to determine whether the use of a silver dressing reduces the incidence of superficial and deep PJI following primary total hip replacement and total knee replacement. Methods: A case-control study of primary total hip replacement and total knee replacement was performed to compare the incidence of superficial and deep PJI in patients who received a silver nylon dressing with patients who received a standard dressing. Results: The incidence of infection was significantly lower in the study group compared with the control group. There were no deep PJIs in the silver dressing group. Twelve patients (2.3%) in the control group developed PJI. Discussion: The use of a silver dressing significantly reduced the incidence of superficial and deep PJI following total joint replacement (P = 0.010). Given the financial impact of PJI, the application of silver dressings may result in considerable cost savings, and a formal cost-benefit analysis could be investigated.
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Li HZ, Zhang L, Chen JX, Zheng Y, Zhu XN. Silver-containing dressing for surgical site infection in clean and clean-contaminated operations: a systematic review and meta-analysis of randomized controlled trials. J Surg Res 2017; 215:98-107. [PMID: 28688669 DOI: 10.1016/j.jss.2017.03.040] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 02/27/2017] [Accepted: 03/24/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND Silver-containing dressings for the prevention of surgical site infections (SSIs) remained controversial, and accumulating evidence was lacking, so a meta-analysis was conducted to systematically assess the effectiveness and safety of silver-containing dressings for clean and clean-contaminated surgical incisions. METHODS Pubmed, Embase, and the Cochrane Library were searched from the inception to February 2016 for randomized controlled trials (RCTs), which explored silver-containing dressings for the prevention of SSIs in clean and clean-contaminated operations. Relative risk (RR) with 95% confidence interval (CI) was pooled using random effects model. Predefined subgroup analyses, sensitivity analyses, and influence analyses were further undertaken. RESULTS Nine RCTs totaling 2196 patients (1141 in silver-containing group and 1055 in control group) were included. Silver-containing dressings did not effectively prevent the incidence of SSIs (9 RCTs; RR: 0.92; 95% CI: 0.66-1.29; I2 = 40%), superficial SSIs (5 RCTs; RR: 0.67; 95% CI: 0.36-1.24; I2 = 36%), and deep SSIs (5 RCTs; RR: 0.78; 95% CI: 0.41-1.49; I2 = 0). Subgroup analyses, sensitivity analyses, and influence analyses confirmed the robustness of the pooled estimate. CONCLUSIONS The current available evidence indicated that silver-containing dressing as compared with silver-free dressing was not associated with lower incidence of SSIs. Considering the quality of evidence ranking very low, further studies with higher quality should be warranted.
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Affiliation(s)
- Hui-Zi Li
- Department of General Surgery, The Fourth Affiliated Hospital of NanChang University, Nanchang, Jiangxi, China
| | - Lei Zhang
- Department of Biliary-Pancreatic Surgery, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics, Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jia-Xi Chen
- Department of General Surgery, The Fourth Affiliated Hospital of NanChang University, Nanchang, Jiangxi, China
| | - Yang Zheng
- Department of General Surgery, The Fourth Affiliated Hospital of NanChang University, Nanchang, Jiangxi, China
| | - Xiang-Nan Zhu
- Department of General Surgery, The Fourth Affiliated Hospital of NanChang University, Nanchang, Jiangxi, China.
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External Nursing Applications in the Supportive Management of Prolonged Postoperative Ileus: Description of Interventions and Case Report. Holist Nurs Pract 2017; 30:216-21. [PMID: 27309410 DOI: 10.1097/hnp.0000000000000158] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Prolonged postoperative ileus is a common but clinically challenging problem that leads to patient discomfort and prolonged hospitalization; the condition is managed through a multimodular program of supportive measures. In anthroposophic nursing, the management of prolonged postoperative ileus involves additional tools, including external abdominal compresses and massages with plant or silver-containing oils and ointments. We describe 3 typical techniques: Oxalis tincture compresses, Thuja/Argentum ointment compresses, and massage with "Wala Melissenöl" (containing Melissa officinalis, Carvum cari, Foeniculum amari, and Origanum majorana). A 61-year-old man with chronic pain from adhesions after multiple abdominal surgical procedures developed a prolonged postoperative ileus after an elective ileostomy reversal. Following slow recovery during the first postoperative days, he began vomiting. A nasogastric tube was inserted, and daily Oxalis tincture compresses and massage with "Wala Melissenöl" and Thuja/Argentum ointment compresses were applied on the abdomen. The patient's symptoms gradually improved over the next 10 days. No prokinetic medications were needed to manage this episode. External abdominal nursing applications with plant substances and silver can be an additional tool in the management of prolonged postoperative ileus.
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Paladini F, Di Franco C, Panico A, Scamarcio G, Sannino A, Pollini M. In Vitro Assessment of the Antibacterial Potential of Silver Nano-Coatings on Cotton Gauzes for Prevention of Wound Infections. MATERIALS 2016; 9:ma9060411. [PMID: 28773531 PMCID: PMC5456794 DOI: 10.3390/ma9060411] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 05/12/2016] [Accepted: 05/16/2016] [Indexed: 12/20/2022]
Abstract
Multidrug-resistant organisms are increasingly implicated in acute and chronic wound infections, thus compromising the chance of therapeutic options. The resistance to conventional antibiotics demonstrated by some bacterial strains has encouraged new approaches for the prevention of infections in wounds and burns, among them the use of silver compounds and nanocrystalline silver. Recently, silver wound dressings have become widely accepted in wound healing centers and are commercially available. In this work, novel antibacterial wound dressings have been developed through a silver deposition technology based on the photochemical synthesis of silver nanoparticles. The devices obtained are completely natural and the silver coatings are characterized by an excellent adhesion without the use of any binder. The silver-treated cotton gauzes were characterized through scanning electron microscopy (SEM) and thermo-gravimetric analysis (TGA) in order to verify the distribution and the dimension of the silver particles on the cotton fibers. The effectiveness of the silver-treated gauzes in reducing the bacterial growth and biofilm proliferation has been demonstrated through agar diffusion tests, bacterial enumeration test, biofilm quantification tests, fluorescence and SEM microscopy. Moreover, potential cytotoxicity of the silver coating was evaluated through 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide colorimetric assay (MTT) and the extract method on fibroblasts and keratinocytes. Inductively coupled plasma mass spectrometry (ICP-MS) was performed in order to determine the silver release in different media and to relate the results to the biological characterization. All the results obtained were compared with plain gauzes as a negative control, as well as gauzes treated with a higher silver percentage as a positive control.
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Affiliation(s)
- Federica Paladini
- Department of Engineering for Innovation, University of Salento, Via per Monteroni, Lecce 73100, Italy.
| | | | - Angelica Panico
- Department of Engineering for Innovation, University of Salento, Via per Monteroni, Lecce 73100, Italy.
| | - Gaetano Scamarcio
- CNR-IFN U.O.S. Bari, Via Amendola 173, Bari 70126, Italy.
- Dipartimento Interateneo di Fisica, University of Bari Aldo Moro, Via Amendola 173, Bari 70126, Italy.
| | - Alessandro Sannino
- Department of Engineering for Innovation, University of Salento, Via per Monteroni, Lecce 73100, Italy.
| | - Mauro Pollini
- Department of Engineering for Innovation, University of Salento, Via per Monteroni, Lecce 73100, Italy.
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Rowan MP, Cancio LC, Elster EA, Burmeister DM, Rose LF, Natesan S, Chan RK, Christy RJ, Chung KK. Burn wound healing and treatment: review and advancements. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2015; 19:243. [PMID: 26067660 PMCID: PMC4464872 DOI: 10.1186/s13054-015-0961-2] [Citation(s) in RCA: 468] [Impact Index Per Article: 52.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Burns are a prevalent and burdensome critical care problem. The priorities of specialized facilities focus on stabilizing the patient, preventing infection, and optimizing functional recovery. Research on burns has generated sustained interest over the past few decades, and several important advancements have resulted in more effective patient stabilization and decreased mortality, especially among young patients and those with burns of intermediate extent. However, for the intensivist, challenges often exist that complicate patient support and stabilization. Furthermore, burn wounds are complex and can present unique difficulties that require late intervention or life-long rehabilitation. In addition to improvements in patient stabilization and care, research in burn wound care has yielded advancements that will continue to improve functional recovery. This article reviews recent advancements in the care of burn patients with a focus on the pathophysiology and treatment of burn wounds.
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Affiliation(s)
- Matthew P Rowan
- United States Army Institute for Surgical Research, 3698 Chambers Pass, Fort Sam Houston, TX, 78234, USA.
| | - Leopoldo C Cancio
- United States Army Institute for Surgical Research, 3698 Chambers Pass, Fort Sam Houston, TX, 78234, USA
| | - Eric A Elster
- Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD, 20814, USA
| | - David M Burmeister
- United States Army Institute for Surgical Research, 3698 Chambers Pass, Fort Sam Houston, TX, 78234, USA
| | - Lloyd F Rose
- United States Army Institute for Surgical Research, 3698 Chambers Pass, Fort Sam Houston, TX, 78234, USA
| | - Shanmugasundaram Natesan
- United States Army Institute for Surgical Research, 3698 Chambers Pass, Fort Sam Houston, TX, 78234, USA
| | - Rodney K Chan
- United States Army Institute for Surgical Research, 3698 Chambers Pass, Fort Sam Houston, TX, 78234, USA.,Brooke Army Medical Center, 3551 Roger Brook Dr, Fort Sam Houston, TX, 78234, USA
| | - Robert J Christy
- United States Army Institute for Surgical Research, 3698 Chambers Pass, Fort Sam Houston, TX, 78234, USA
| | - Kevin K Chung
- United States Army Institute for Surgical Research, 3698 Chambers Pass, Fort Sam Houston, TX, 78234, USA.,Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD, 20814, USA
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