Silver. 2: Toxicity in mammals and how its products aid wound repair

Multi-disciplinary management of type 1 and 2 skin tears using a silver-based hydrofiber dressing

Skin tear is a common problem encountered in the emergency department. If it is not properly managed, it can lead to wound infection, skin necrosis and a need for further surgical intervention and skin grafting. Current management is to cleanse the wound, replace the thin skin tear followed by coverage with a dressing that is inducive for wound healing. Several dressings have been suggested for the coverage of these wounds. But, up to now, there has been no mention of the use of a silver-based hydrofiber dressing in the management of this condition. The objective of this study was to explore the use of a silver-based hydrofiber dressing for the management of paper-thin skin tears. We retrospectively reviewed all patients with Type 1 or 2 skin tears that had undergone management using a silver-based hydrofiber dressing between October 2019 and October 2020. Demographic data and medical history was obtained by retrospective chart review. Data that was collected included: age, sex, comorbid illnesses, defect location, defect size, complications, number of times the silver-based hydrofiber dressing was replaced and the number of days required to achieve complete wound healing. A total of 65 patients were included in the study. There were 42 males and 23 females. There were 28 patients whose age was greater then 85 years old, of which 14 patients were over 90 years old. The mean number of outpatient visits was 2. The mean defect size was 33 cm2 (range 1 cm × 1 cm to 18 × 10 cm). The mean number of days required for total wound healing was 13 days (range 7-21). We did not encounter any patients that required further surgical debridement or split-thickness skin grafting. The use of a silver-based hydrofiber dressing was well tolerated by the elderly population as it provided an easy, efficient, economical and effective form of management of skin tears. We suggest that a silver-based hydrofiber dressing can be used as a first-line treatment method for type 1 and 2 skin tears.

The effects of aqueous extract of Labisia Pumila (Blume) Fern.-Vill. Var. Alata on wound contraction, hydroxyproline content and histological assessments in superficial partial thickness of second-degree burn model

Background: Burns are considered a critical care problem in emergency medicine, resulting in physical, psychological, and chronic disabilities. Silver sulfadiazine is the gold standard in topical burn treatment but was associated with toxicity to keratinocytes and fibroblasts, which may delay wound healing. In discovering potential alternative treatments for burn wound healing, this study was performed to determine the effect of Labisia Pumila (Blume) Fern.-Vill. Var. Alata (LPVa) extract on thermal-burn wounds in rats.

Methods: A total of 50 Sprague-Dawley male rats were categorized into five groups. There were three control groups; normal control (left untreated), negative control (given ointment base) and positive control (given silver sulfadiazine). Meanwhile, the two intervention groups were given with 2% LPVa leaf and root extracts, respectively. Burn wounds were inflicted on the loin region of the rat by applying a heated steel rod at 80°C for 10 s. On days 3, 7, 14, and 21, wounds were measured macroscopically using a digital calliper and one animals of each group were sacrificed, and the wounded skin were excised for histomorphological assessments. The wounds were excised for hydroxyproline content on Day 14 of treatment.

Result: For wound contraction percentage, both the leaf and root extracts of LPVa showed a significant reduction in burn wound size on Day 7 onwards, when compared to other groups. For hydroxyproline content, only the leaf extract of LPVa produced significantly higher content compared to both negative and normal control groups. In terms of histological examination, the leaf extract group demonstrated a superior healing effect than the root extract group.

Conclusion: Both leaf and root extracts of LPVa could promote wound healing in the thermal-burn wound rat model, with leaf extract being superior to root extract.

Nrf2 signaling pathway in trace metal carcinogenesis: A cross-talk between oxidative stress and angiogenesis

A large number of people worldwide are affected by chronic metal exposure, which is known to be associated with different type of malignancies. The mechanisms of metal carcinogenicity are complex in nature, and excessive reactive oxygen species (ROS) generation induced by chronic metal exposure, among the other factors, has been proposed as one of the major mechanisms involved in that process. In tumor cells, ROS buildup may lead to cell death through intrinsic and extrinsic signaling pathways. Furthermore, ROS-mediated redox signaling has a crucial role in angiogenesis, which is recognized as an essential step in tumor progression. There are several redox-modulating pathways and among them, the nuclear factor erythroid2-related factor2 (Nrf2), as a sensor of oxidative or electrophilic stress, has introduced as a master regulator of cellular response against environmental stresses. Activation of Nrf2 signaling induces expression of wide variety of antioxidant and detoxification enzymes genes. Thus, this transcription factor has recently received much attention as a target for cancer chemoprevention. But meanwhile, constitutive Nrf2 activation in cancerous cells may promote cancer progression and resistance to chemotherapy. The current review describes the major underlying mechanisms involved in carcinogenesis of trace metals: copper, silver, and cadmium, with a special focus on the Nrf2 signaling pathway as a crossroad between oxidative stress and angiogenesis.

The Efficacy of Five Different Wound Dressings on Some Histological Parameters in Children With Partial-Thickness Burns

An ideal dressing should ensure that the wound remains moist with exudates but not macerated. Currently, there is no dressing available to suit all wounds, at all stages of the healing process. Although silver-containing dressings are the gold standard for burn wound care, few high-level trials have been completed comparing the clinical utilities of these dressings. In our study, five different types of wound dressings: carboxymethyl cellulose hydrofiber dressing with ionized silver (CMCH-Ag), polyethylene-polyethylene terephthalate aqua fiber dressing with elementary silver (PPAF-Ag), calcium alginate (CA), calcium + zinc alginate (CZA), and 0.2% nitrofurazone-embedded (NF) gauze dressings were compared in regard to histopathological parameters. Children aged between 0 and 18 years with small or middle-sized partial-thickness burns that affected less than 30% of the total body surface area were included in this study. The study groups (CMCH-Ag, PPAF-Ag, CA, and CZA) and the control group (NF) were randomly attained. Wound healing was evaluated by punch biopsies on the 21st day. The thickness of the stratum corneum and the epithelium, the number of papillae, and the papillary length were calculated and compared. The histological parameters of healing, except the stratum corneum thickness, did not show any statistical significance among the groups (P > .05). The dressings that included silver, calcium, or zinc showed useful and similar effects in noninfective burn wounds when compared with nitrofurazone-only dressings. Thus, it may be concluded that silver-containing wound dressings should not be considered as the gold standard in noninfective partial-thickness burn wounds in children.

A multifunctional plasmonic chip for bacteria capture, imaging, detection, and in situ elimination for wound therapy

A multifunctional plasmonic gold chip has been constructed for early diagnosis and highly effective killing of bacteria, which is critical for human health. The chip features high bacterial capture efficiency, plasmon-enhanced fluorescence (PEF) and surface-enhanced Raman scattering (SERS) and can act as a highly sensitive sensor for dual-mode bacteria imaging and detection (down to 102 CFU mL-1) with good reliability and accuracy. The developed assay can distinguish Gram-positive S. aureus bacteria from Gram-negative E. coli bacteria, providing valuable information for therapy. Importantly, the chip presents excellent photothermal antibacterial activity (98%) and can inactivate both Gram-positive and Gram-negative bacteria in situ. Furthermore, the chip was used to effectively promote the wound healing process in bacteria infected mice in vivo, showing great potential for antibacterial applications.

A combined approach for the development of novel sutures with antibacterial and regenerative properties: the role of silver and silk sericin functionalization

Chronic wounds and related infections cause physical and psychological distress in patients, increased mortality, disability and high health care costs. The healing process can be delayed by several factors and in particular by the risk of infections, which can be further complicated by the increasing number of antibiotic-resistant microorganisms. New approaches in wounds management have been encouraged, aiming at preventing infections and improving wound healing. In this scenario, silver has emerged as an ideal antimicrobial agent due to its recognized efficacy against bacteria, viruses and fungi. Moreover, silk and in particular silk sericin from Bombyx mori has demonstrated excellent biological properties and can be considered a good candidate for skin tissue engineering. In this study absorbable PLGA sutures were functionalized with silk sericin and, then, they were treated with silver through an in situ photochemical deposition technology in order to develop an antibacterial and regenerative biomedical device. Morphological analysis was performed by Scanning Electron Microscopy and Energy Dispersive X-Ray Spectroscopy (SEM-EDX) in order to evaluate the presence and distribution of silver deposited on the sutures. The stability and durability of the sericin/silver coatings were tested and the results were related to both antibacterial properties and sample degradation. The biological analyses also aimed at studying the biocompatibility and wound healing properties of the device, evaluating the synergistic effect between sericin and silver.

Quantitative study of the capture of silver nanoparticles by several kinds of soils

The capacity of different soils to capture silver nanoparticles (AgNPs) by measuring changes of an AgNP intrinsic property such as the plasmon for the first time, was studied. In-tube solid-phase microextraction (IT-SPME) coupled on-line to capillary liquid chromatography (CapLC) with diode array detection (DAD) was employed for measuring the interactions between soil and in-contact AgNP dispersions. Its achieved LOD 9 pM assures quantitative retention measurements and selectivity for soil lixiviation was suitable. Electronic microscopy was employed for corroborating the entrapped Ag into the soils. Capture % of AgNPs was calculated in compost (>99%), mountain (>99%), orchard (15±1%) and urban (48±1%) soils. Also, the relation between some soil characteristics: solid organic matter (SOM), composition, pH, redox potential (Eh), electrical conductivity (EC) and size, and the retention of these metallic nanoparticles was studied. The results have also been estimated after sieving and the capture % of AgNPs was similar in the resulting fractions. AgNP adsorption on a given soil is mainly affected by its organic matter content for studied soils with higher SOM amounts (23-62%). However, for the soils with lower SOM amounts (4.6-8.3%) the role of HAs could prevent AgNP deposition onto soils. The proposed methodology can be utilized for quickly assessing the potential of a given soil considering its properties for capturing these nanoparticles, which can come at handy for their administration, characterization or remediation.

Antibacterial quaternary ammonium compounds in dental materials: A systematic review

OBJECTIVE

Quaternary ammonium compounds (QACs) represent one of the most effective classes of disinfectant agents in dental materials and resin nanocomposites. This reviews aims to give a wide overview on the research in the field of antibacterial QACs in dental materials and nanocomposites.

METHOD

An introduction to dental materials components as well as the microorganisms and methods of evaluation for the antimicrobial assays are presented. Then, the properties and synthesis route of QACs, as monomer and filler, are shown. Finally, antimicrobial monomers and fillers, specifically those contain quaternary ammonium salts (QASs), in dental materials are reviewed.

RESULTS

QACs have been used as monomer and micro/nanofiller in restorative dentistry. They possess one or more methacrylate functional groups to participate in polymerization reactions. QACs with multiple methacrylate groups can also be used as crosslinking agents. Furthermore, QACs with chain length from ∼12 to 16 have higher antimicrobial activity in cured dental resins. In general, increasing the chain length leads to a threshold value (critical point) and then it causes decrease in the antimicrobial activity.

SIGNIFICANCE

The current state of the art of dental materials and resin nanocomposites includes a wide variety of antimicrobial materials. Among them, QACs presents low cytotoxicity and excellent long-term antimicrobial activity without leaching out over time.

Recent Advances in Antimicrobial Hydrogels Containing Metal Ions and Metals/Metal Oxide Nanoparticles

Recently, the rapid emergence of antibiotic-resistant pathogens has caused a serious health problem. Scientists respond to the threat by developing new antimicrobial materials to prevent or control infections caused by these pathogens. Polymer-based nanocomposite hydrogels are versatile materials as an alternative to conventional antimicrobial agents. Cross-linking of polymeric materials by metal ions or the combination of polymeric hydrogels with nanoparticles (metals and metal oxide) is a simple and effective approach for obtaining a multicomponent system with diverse functionalities. Several metals and metal oxides such as silver (Ag), gold (Au), zinc oxide (ZnO), copper oxide (CuO), titanium dioxide (TiO₂) and magnesium oxide (MgO) have been loaded into hydrogels for antimicrobial applications. The incorporation of metals and metal oxide nanoparticles into hydrogels not only enhances the antimicrobial activity of hydrogels, but also improve their mechanical characteristics. Herein, we summarize recent advances in hydrogels containing metal ions, metals and metal oxide nanoparticles with potential antimicrobial properties.

New adhesive system based in metals cross-linking methacrylate

This study evaluated the anti-antibiofilm potential of silver methacrylate (Ag) or di-n-butyldimethacrylatetin (Sn) in experimental adhesive systems. Ag and Sn methacrylates were incorporated at 0.5mol%, 1mol% and 2mol% in an adhesive resin. The anti-antibiofilm potential, degree of conversion (DC), microtensile bond strength (μTBS), water sorption/solubility (W_SR/SL), bonded interfaces pattern (SEM), cytotoxicity and leaching of Ag and Sn ions were evaluated. Data were statistically analyzed considering α = 0.05. Only Ag at 2% affected DC and μTBS. Ag at 1% and 2% and Sn at 1% and 2% showed anti-biofilm potential against Mutans streptococci. Ag at 1% and 2% and Sn at 2% showed a statistically significant difference to the control in W_SR/SL (p < 0.05). The additions of metal methacrylate did not affect cell viability, being the adhesive resins statistically similar to controls. Leached metals of Ag were more than 100x higher than for Sn. Between the concentration tested, Ag and Sn methacrylate at 1% presented an anti-biofilm effect without altering the mechanical properties evaluated.

Apitherapeutics and phage-loaded nanofibers as wound dressings with enhanced wound healing and antibacterial activity

Aim: Develop green wound dressings which exhibit enhanced wound-healing ability and potent antibacterial effects. Methods: Honey, polyvinyl alcohol, chitosan nanofibers were electrospun and loaded with bee venom, propolis and/or bacteriophage against the multidrug-resistant Pseudomonas aeruginosa and examined for their antibacterial, wound-healing ability and cytotoxicity. Results: Among different formulations of nanofibers, honey, polyvinyl alcohol, chitosan-bee venom/bacteriophage exhibited the most potent antibacterial activity against all tested bacterial strains (Gram-positive and -negative strains) and achieved nearly complete killing of multidrug-resistant P. aeruginosa. In vivo testing revealed enhanced wound-healing results and cytotoxicity testing proved improved biocompatibility. Conclusion: The developed biocompatible nanofibers represent competitive wound-healing dressings with potent antibacterial and wound-healing activity.

Thermal Characterizations of Silver-containing Bioactive Glass-coated Sutures

This study utilized and compared a number of thermal analysis methods to characterize the thermal properties of commercial sutures with and without antimicrobial coatings of silver-doped bioactive glass (AgBG) interlocking particulates. The effect of a slurry dipping technique used to coat resorbable Vicryl® (polyglactin 910) and non-resorbable Mersilk® surgical sutures with AgBG was investigated using conventional differential scanning calorimetry (DSC), high speed calorimetry (or HYPERDSC™), and modulated temperature DSC (MTDSC). These methods were compared in terms of their ability to resolve the thermal transitions of the types of suture materials. Differential thermal analysis (DTA) and thermogravimetric analysis (TGA) were used to verify the thermal degradation temperatures of these materials and to quantify the AgBG coatings on the sutures.

The use of complementary thermal analysis techniques enabled the understanding of the effect of the AgBG coating technique on the morphological properties of the sutures. The slurry dipping technique had no significant effect on the thermal transitions of both types of materials. The use of high speed calorimetry through DSC offered better resolution for the transitions that appeared to be weak through conventional heating regimes, and was able to separate broad double transitions. Furthermore, it was shown not to compromise either the melting temperature or the enthalpy of melting. Therefore this method allows for the accurate determination of thermal transitions through much shorter experimental times thus allowing for an increased sample throughput. The combined DTA and TGA indicated that a greater AgBG coating was obtained in the case of the Mersilk® sutures.

Essential oils and metal ions as alternative antimicrobial agents: a focus on tea tree oil and silver

The increasing occurrence of hospital-acquired infections and the emerging problems posed by antibiotic-resistant microbial strains have both contributed to the escalating cost of treatment. The presence of infection at the wound site can potentially stall the healing process at the inflammatory stage, leading to the development of a chronic wound. Traditional wound treatment regimes can no longer cope with the complications posed by antibiotic-resistant strains; hence, there is a need to explore the use of alternative antimicrobial agents. Pre-antibiotic compounds, including heavy metal ions and essential oils, have been re-investigated for their potential use as effective antimicrobial agents. Essential oils have potent antimicrobial, antifungal, antiviral, anti-inflammatory, antioxidant and other beneficial therapeutic properties. Similarly, heavy metal ions have also been used as disinfecting agents because of their broad spectrum activities. Both of these alternative antimicrobials interact with many different intracellular components, thereby resulting in the disruption of vital cell functions and eventually cell death. This review will discuss the application of essential oils and heavy metal ions, particularly tea tree oil and silver ions, as alternative antimicrobial agents for the treatment of chronic, infected wounds.

Honey/Chitosan Nanofiber Wound Dressing Enriched with Allium sativum and Cleome droserifolia: Enhanced Antimicrobial and Wound Healing Activity

Two natural extracts were loaded within fabricated honey, poly(vinyl alcohol), chitosan nanofibers (HPCS) to develop biocompatible antimicrobial nanofibrous wound dressing. The dried aqueous extract of Cleome droserifolia (CE) and Allium sativum aqueous extract (AE) and their combination were loaded within the HPCS nanofibers in the HPCS-CE, HPCS-AE, and HPCS-AE/CE nanofiber mats, respectively. It was observed that the addition of AE resulted in the least fiber diameter (145 nm), whereas the addition of the AE and CE combination resulted in the least swelling ability and the highest weight loss. In vitro antibacterial testing against Staphylococcus aureus, Escherichia coli, Methicillin-resistant S. aureus (MRSA), and multidrug-resistant Pseudomonas aeruginosa was performed in comparison with the commercial dressing AquacelAg and revealed that the HPCS-AE and HPCS-AE/CE nanofiber mats allowed complete inhibition of S. aureus and the HPCS-AE/CE exhibited mild antibacterial activity against MRSA. A preliminary in vivo study revealed that the developed nanofiber mats enhanced the wound healing process as compared to the untreated control as proved by the enhanced wound closure rates in mice and by the histological examination of the wounds. Moreover, comparison with the commercial dressing Aquacel Ag, the HPCS, and HPCS-AE/CE demonstrated similar effects on the wound healing process, whereas the HPCS/AE allowed an enhanced wound closure rate. Cell culture studies proved the biocompatibility of the developed nanofiber mats in comparison with the commercial Aquacel Ag, which exhibited noticeable cytotoxicity. The developed natural nanofiber mats hold potential as promising biocompatible antibacterial wound dressing.

Ionically Crosslinked Chitosan Hydrogels for the Controlled Release of Antimicrobial Essential Oils and Metal Ions for Wound Management Applications

The emerging problems posed by antibiotic resistance complicate the treatment regime required for wound infections and are driving the need to develop more effective methods of wound management. There is growing interest in the use of alternative, broad spectrum, pre-antibiotic antimicrobial agents such as essential oils (e.g., tea tree oil, TTO) and metal ions (e.g., silver, Ag⁺). Both TTO and Ag⁺ have broad spectrum antimicrobial activity and act on multiple target sites, hence reducing the likelihood of developing resistance. Combining such agents with responsive, controlled release delivery systems such as hydrogels may enhance microbiocidal activity and promote wound healing. The advantages of using chitosan to formulate the hydrogels include its biocompatible, mucoadhesive and controlled release properties. In this study, hydrogels loaded with TTO and Ag⁺ exhibited antimicrobial activity against P. aeruginosa, S. aureus and C. albicans. Combining TTO and Ag⁺ into the hydrogel further improved antimicrobial activity by lowering the effective concentrations required, respectively. This has obvious advantages for reducing the potential toxic effects on the healthy tissues surrounding the wound. These studies highlight the feasibility of delivering lower effective concentrations of antimicrobial agents such as TTO and Ag⁺ in ionically crosslinked chitosan hydrogels to treat common wound-infecting pathogens.

Gingival Mesenchymal Stem Cell (GMSC) Delivery System Based on RGD-Coupled Alginate Hydrogel with Antimicrobial Properties: A Novel Treatment Modality for Peri-Implantitis

PURPOSE

Peri-implantitis is one of the most common inflammatory complications in dental implantology. Similar to periodontitis, in peri-implantitis, destructive inflammatory changes take place in the tissues surrounding a dental implant. Bacterial flora at the failing implant sites resemble the pathogens in periodontal disease and consist of Gram-negative anaerobic bacteria including Aggregatibacter actinomycetemcomitans (Aa). Here we demonstrate the effectiveness of a silver lactate (SL)-containing RGD-coupled alginate hydrogel scaffold as a promising stem cell delivery vehicle with antimicrobial properties.

MATERIALS AND METHODS

Gingival mesenchymal stem cells (GMSCs) or human bone marrow mesenchymal stem cells (hBMMSCs) were encapsulated in SL-loaded alginate hydrogel microspheres. Stem cell viability, proliferation, and osteo-differentiation capacity were analyzed.

RESULTS

Our results showed that SL exhibited antimicrobial properties against Aa in a dose-dependent manner, with 0.50 mg/ml showing the greatest antimicrobial properties while still maintaining cell viability. At this concentration, SL-containing alginate hydrogel was able to inhibit Aa growth on the surface of Ti discs and significantly reduce the bacterial load in Aa suspensions. Silver ions were effectively released from the SL-loaded alginate microspheres for up to 2 weeks. Osteogenic differentiation of GMSCs and hBMMSCs encapsulated in the SL-loaded alginate microspheres were confirmed by the intense mineral matrix deposition and high expression of osteogenesis-related genes.

CONCLUSION

Taken together, our findings confirm that GMSCs encapsulated in RGD-modified alginate hydrogel containing SL show promise for bone tissue engineering with antimicrobial properties against Aa bacteria in vitro.

Versatile synthesis of PHMB-stabilized silver nanoparticles and their significant stimulating effect on fodder beet (Beta vulgaris L.)

Silver nanoparticles (AgNPs) are well-known bactericidal agents. However, information about the influence of AgNPs on the morphometric parameters and biochemical status of most important agricultural crops is limited. The present study reports the influence of AgNPs stabilized with cationic polymer polyhexamethylene biguanide hydrochloride (PHMB) on growth, development, and biochemical status of fodder beet Beta vulgaris L. under laboratory and greenhouse conditions. PHMB-stabilized AgNPs were obtained via sodium borohydride reduction of silver nitrate in an aqueous solution. The average diameter of thus prepared AgNPs was 10 nm. It appears that the results of experiments with laboratory-grown beets in the nanosilver-containing medium, where germination of seeds and growth of roots were suppressed, do not correlate with the results of greenhouse experiments. The observed growth-stimulating action of PHMB-stabilized AgNPs can be explained by the change of activity of oxidases and, consequently, by the change of auxins amount in plant tissues. In beets grown in the presence of PHMB-stabilized AgNPs no negative deviations of biological parameters from normal values were registered. Furthermore, the SEM/EDS examination revealed no presence of silver in the tissues of the studied plants.

Benzyldimethyl[3-(miristoylamino)-propyl]ammonium chloride stabilized silver nanoparticles (Argumistin™) in medicine: results of clinical trials for treatment of infectious diseases of dogs and perspectives for humans

Increased interest in nanosilver during the last 10 years is mainly explained by the emergence and spread of pathogenic microorganisms with multiple drug resistance, including resistance to last-generation antibiotics. In this article, we for the first time, give a description of large-scale clinical trials of a new nanosilver based antibacterial drug [containing two active components: silver nanoparticles (AgNPs) (10–50 ppm) and benzyldimethyl[3-(miristoylamino)-propyl]ammonium chloride (100 ppm)] registered in Russia in 2015 as a veterinary drug under the brand name Argumistin™. This drug has been approved for application in a diluted dosage form – as eye drops, intranasal drops and orally; it has also been approved for application in a more concentrated dosage form (up to 50 ppm of nanosilver) as ear drops and as an antiseptic during demodicosis and gum disease treatment, open wound treatment, etc. We have registered the high therapeutic effectiveness of Argumistin™ during treatment of infectious conjunctivitis, gingivitis, parodontosis and enteritis of dogs. Application of this antibacterial drug gives considerable (up to 70% in case of periodontal diseases) reduction in the treatment period and prevention of complications. The results of clinical trials in the treatment of infectious diseases of dogs makes Argumistin™ a promising candidate for an effective antibacterial drug for human medicine.

Escherichia coli under Ionic Silver Stress: An Integrative Approach to Explore Transcriptional, Physiological and Biochemical Responses

For a better understanding of the systemic effect of sub-lethal micromolar concentrations of ionic silver on Escherichia coli, we performed a multi-level characterization of cells under Ag⁺-mediated stress using an integrative biology approach combining physiological, biochemical and transcriptomic data. Physiological parameters, namely bacterial growth and survival after Ag⁺ exposure, were first quantified and related to the accumulation of intracellular silver, probed for the first time by nano secondary ion mass spectroscopy at sub-micrometer lateral resolution. Modifications in E. coli biochemical composition were evaluated under Ag⁺-mediated stress by in situ synchrotron Fourier-transform infrared microspectroscopy and a comprehensive transcriptome response was also determined. Using multivariate statistics, correlations between the physiological parameters, the extracellular concentration of AgNO₃ and the intracellular silver content, gene expression profiles and micro-spectroscopic data were investigated. We identified Ag⁺-dependent regulation of gene expression required for growth (e.g. transporter genes, transcriptional regulators, ribosomal proteins), for ionic silver transport and detoxification (e.g. copA, cueO, mgtA, nhaR) and for coping with various types of stress (dnaK, pspA, metA,R, oxidoreductase genes). The silver-induced shortening of the acyl chain of fatty acids, mostly encountered in cell membrane, was highlighted by microspectroscopy and correlated with the down-regulated expression of genes involved in fatty acid transport (fadL) and synthesis/modification of lipid A (lpxA and arnA). The increase in the disordered secondary structure of proteins in the presence of Ag⁺ was assessed through the conformational shift shown for amides I and II, and further correlated with the up-regulated expression of peptidase (hfq) and chaperone (dnaJ), and regulation of transpeptidase expression (ycfS and ycbB). Interestingly, as these transpeptidases act on the structural integrity of the cell wall, regulation of their expression may explain the morphological damage reported under Ag⁺-mediated stress. This result clearly demonstrates that the cell membrane is a key target of ionic silver.

Characterization of silver nanoparticle-infused tissue adhesive for ophthalmic use

In this work, we demonstrate the successful enhancement of breaking strength, adhesive strength, and antibacterial efficacy of ophthalmic tissue adhesive (2-octyl cyanoacrylate) by doping with silver nanoparticles, and investigate the effects of nanoparticle size and concentration. Recent work has shown that silver nanoparticles are a viable antibacterial additive to many compounds, but their efficacy in tissue adhesives was heretofore untested. Our results indicate that doping the adhesive with silver nanoparticles reduced bacterial growth by an order of magnitude or more; nanoparticle size and concentration had minimal influence in the range tested. Tensile breaking strength of polymerized adhesive samples and adhesive strength between a T-shaped support and excised porcine sclera were measured using a universal testing machine according to ASTM (formerly American Society for Testing and Materials) standard techniques. Both tests showed significant improvement with the addition of silver nanoparticles. The enhanced mechanical strength and antibacterial efficacy of the doped adhesive supports the use of tissue adhesives as a viable supplement or alternative to sutures.

The Anti-Inflammatory and Antibacterial Action of Nanocrystalline Silver and Manuka Honey on the Molecular Alternation of Diabetic Foot Ulcer: A Comprehensive Literature Review

Honey and silver have been used since ancient times for treating wounds. Their widespread clinical application has attracted attention in light of the increasing prevalence of antibiotic-resistant bacteria. While there have been a number of studies exploring the anti-inflammatory and antibacterial effects of manuka honey and nanocrystalline silver, their advantages and limitations with regard to the treatment of chronic wounds remain a subject of debate. The aim of this paper is to examine the evidence on the use of nanocrystalline silver and manuka honey for treating diabetic foot ulcers through a critical and comprehensive review of in vitro studies, animal studies, and in vivo studies. The findings from the in vitro and animal studies suggest that both agents have effective antibacterial actions. Their anti-inflammatory action and related impact on wound healing are unclear. Besides, there is no evidence to suggest that any topical agent is more effective for use in treating diabetic foot ulcer. Overall, high-quality, clinical human studies supported by findings from the molecular science on the use of manuka honey or nanocrystalline silver are lacking. There is a need for rigorously designed human clinical studies on the subject to fill this knowledge gap and guide clinical practice.

Unprecedented Silver Resistance in Clinically Isolated Enterobacteriaceae: Major Implications for Burn and Wound Management

Increased utilization of inorganic silver as an adjunctive to many medical devices has raised concerns of emergent silver resistance in clinical bacteria. Although the molecular basis for silver resistance has been previously characterized, to date, significant phenotypic expression of these genes in clinical settings is yet to be observed. Here, we identified the first strains of clinical bacteria expressing silver resistance at a level that could significantly impact wound care and the use of silver-based dressings. Screening of 859 clinical isolates confirmed 31 harbored at least 1 silver resistance gene. Despite the presence of these genes, MIC testing revealed most of the bacteria displayed little or no increase in resistance to ionic silver (200 to 300 μM Ag(+)). However, 2 isolates (Klebsiella pneumonia and Enterobacter cloacae) were capable of robust growth at exceedingly high silver concentrations, with MIC values reaching 5,500 μM Ag(+). DNA sequencing of these two strains revealed the presence of genes homologous to known genetic determinants of heavy metal resistance. Darkening of the bacteria's pigment was observed after exposure to high silver concentrations. Scanning electron microscopy images showed the presence of silver nanoparticles embedded in the extracellular polymeric substance of both isolates. This finding suggested that the isolates may neutralize ionic silver via reduction to elemental silver. Antimicrobial testing revealed both organisms to be completely resistant to many commercially available silver-impregnated burn and wound dressings. Taken together, these findings provide the first evidence of clinical bacteria capable of expressing silver resistance at levels that could significantly impact wound management.

Honey: a potential therapeutic agent for managing diabetic wounds

Diabetic wounds are unlike typical wounds in that they are slower to heal, making treatment with conventional topical medications an uphill process. Among several different alternative therapies, honey is an effective choice because it provides comparatively rapid wound healing. Although honey has been used as an alternative medicine for wound healing since ancient times, the application of honey to diabetic wounds has only recently been revived. Because honey has some unique natural features as a wound healer, it works even more effectively on diabetic wounds than on normal wounds. In addition, honey is known as an "all in one" remedy for diabetic wound healing because it can combat many microorganisms that are involved in the wound process and because it possesses antioxidant activity and controls inflammation. In this review, the potential role of honey's antibacterial activity on diabetic wound-related microorganisms and honey's clinical effectiveness in treating diabetic wounds based on the most recent studies is described. Additionally, ways in which honey can be used as a safer, faster, and effective healing agent for diabetic wounds in comparison with other synthetic medications in terms of microbial resistance and treatment costs are also described to support its traditional claims.

The Improvement of the Resistance to Candida albicans and Trichophyton interdigitale of Some Woven Fabrics Based on Cotton

This paper presents the improvement of the antimicrobial character of woven fabrics based on cotton. The woven fabrics were cleaned in oxygen plasma and treated by padding with silver chloride and titanium dioxide particles. The existence of silver and titanium on woven fabrics was evidenced by electronic microscope images (SEM, EDAX) and by flame atomic absorption spectrophotometry. The antimicrobial tests were performed with two fungi: Candida albicans and Trichophyton interdigitale. The obtained antimicrobial effect was considerably higher compared to the raw fabrics. Treatment of dyed fabrics with a colloidal solution based on silver chloride and titanium dioxide particles does not considerably influence colour resistance of dyes.

Laundering durable antibacterial cotton fabrics grafted with pomegranate-shaped polymer wrapped in silver nanoparticle aggregations

To improve the laundering durability of the silver functionalized antibacterial cotton fabrics, a radiation-induced coincident reduction and graft polymerization is reported herein where a pomegranate-shaped silver nanoparticle aggregations up to 500 nm can be formed due to the coordination forces between amino group and silver and the wrapping procedure originated from the coincident growth of the silver nanoparticles and polymer graft chains. This pomegranate-shaped silver NPAs functionalized cotton fabric exhibits outstanding antibacterial activities and also excellent laundering durability, where it can inactivate higher than 90% of both E. coli and S. aureus even after 50 accelerated laundering cycles, which is equivalent to 250 commercial or domestic laundering cycles.

Antimicrobial, mechanical and thermal studies of silver particle-loaded polyurethane

Silver-particle-incorporated polyurethane films were evaluated for antimicrobial activity towards two different bacteria: Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus). Distributed silver particles sourced from silver nitrate, silver lactate and preformed silver nanoparticles were mixed with polyurethane (PU) and variously characterized by field emission scanning electron microscopy (FESEM), fourier transform infra-red (FTIR) spectroscopy, X-ray diffraction (XRD) and contact angle measurement. Antibacterial activity against E.coli was confirmed for films loaded with 10% (w/w) AgNO3, 1% and 10% (w/w) Ag lactate and preformed Ag nanoparticles. All were active against S. aureus, but Ag nanoparticles loaded with PU had a minor effect. The apparent antibacterial performance of Ag lactate-loaded PU is better than other Ag ion-loaded films, revealed from the zone of inhibition study. The better performance of silver lactate-loaded PU was the likely result of a porous PU structure. FESEM and FTIR indicated direct interaction of silver with the PU backbone, and XRD patterns confirmed that face-centred cubic-type silver, representative of Ag metal, was present. Young's modulus, tensile strength and the hardness of silver containing PU films were not adversely affected and possibly marginally increased with silver incorporation. Dynamic mechanical analysis (DMA) indicated greater thermal stability.

Microalgae associated Brevundimonas sp. MSK 4 as the nano particle synthesizing unit to produce antimicrobial silver nanoparticles

The biosynthesis of silver nanoparticles and its antimicrobial property was studied using bacteria isolated from Spirulina products. Isolated bacteria were identified as Bacillus sp. MSK 1 (JX495945), Staphylococcus sp. MSK 2 (JX495946), Bacillus sp. MSK 3 (JX495947) and Brevundimonas sp. MSK 4 (JX495948). Silver nanoparticles (AgNPs) were synthesized using bacterial culture filtrate with AgNO3. The initial syntheses of Ag nanoparticles were characterized by UV-vis spectrophotometer (by measuring the color change to intense brown). Fourier Transform Infrared Spectroscopy (FTIR) study showed evidence that proteins are possible reducing agents and Energy-dispersive X-ray (EDX) study showing the metal silver as major signal. The structure of AgNPs was determined by Scanning electron microscopy (SEM) and X-ray diffraction (XRD). Synthesized Ag nanoparticles with an average size of 40-65 nm have antimicrobial property against human pathogens like Proteus vulgaris, Salmonella typhi, Vibrio cholera, Streptococcus sp., Bacillus subtilis, Staphylococcus aureus, and Escherichia coli. Among the isolates Brevundimonas sp. MSK 4 alone showed good activity in both synthesis of AgNPs and antimicrobial activity. This work demonstrates the possible use of biological synthesized silver nanoparticles to combat the drug resistant problem.

Innovative approaches in wound healing: trajectory and advances

Wound is one of the oldest suffering associated with the mankind and its history is as old as humanity. Advances in the field of medical sciences created a pile of knowledge and paved the path for the development of a separate branch specifically devoted for wound healing. The understanding and treatment strategies for wound healing have gone through a great revolution. This article reviews all the aspects of wound healing including the pathway, types and recent advances made in the wound care management in particular moist wound dressings using natural polymers, skin grafts, debridement, growth factor and drug delivery.

Anti-microbial efficiency of silver diamine fluoride as an endodontic medicament - An ex vivo study

CONTEXT

Antisepsis achieved through appropriate use of irrigants is essential for endodontic success. Identification of newer anti-bacterial agents gives alternatives to clean the canal as eradication of the infection prior to obturation does affect prognosis.

OBJECTIVE

Comparison of the anti-bacterial action of 3.8% silver diamine fluoride and 2% chlorhexidine gluconate against Enterococcus faecalis in root canals.

MATERIALS AND METHODS

Forty-four single-rooted teeth were decoronated, and the root section was enlarged with peeso-reamer (No: 3) to standardize length and diameter. The samples were then autoclaved and divided into two study groups and two control groups. Enterococcus faecalis ATCC 29212 was inoculated into all test samples for 72 hours. The samples were enlarged with peeso-reamer (No: 5) after placement of respective medicament for 24 hours. Shavings were collected and inoculated on Brain Heart Infusion agar for 24 hrs to measure the colony forming units.

RESULTS

Both 3.8% silver diamine fluoride and 2% chlorhexidine showed a superior capacity to sterilize the root canals than control groups.

CONCLUSION

The use of silver diamine fluoride as an endodontic irrigant is feasible as it can effectively remove the microbes present in the canal and circumpulpal dentin.

Study on the interaction of silver(I) complex with bovine serum albumin by spectroscopic techniques

The interaction of silver(I) complex, [Ag (2,9-dimethyl-1,10-phenanthroline)(2)](NO(3))·H(2)O, and bovine serum albumin (BSA) was investigated by spectrophotometry, spectrofluorimetry and circular dichroism (CD) techniques. The experimental results indicated that the quenching mechanism of BSA by the complex was a static procedure. Various binding parameters were evaluated. The negative value of ΔH, negative value of ΔS and the negative value of ΔG indicated that van der Waals force and hydrogen bonding play major roles in the binding of the complex and BSA. Based on Forster's theory of non-radiation energy transfer, the binding distance, r, between the donor (BSA) and acceptor (Ag(I) complex) was evaluated. The results of CD and UV-vis spectroscopy showed that the binding of this complex could bind to BSA and be effectively transported and eliminated in the body.

Efficacy of a silver lipidocolloid dressing on heavily colonised wounds: a republished RCT

Nearly all open wounds are contaminated by microorganisms. This generally corresponds to simple bacterial growth, without leading to deleterious effects or compromising the progress of the healing process. In acute wounds, the probability of wound infection increases as the level of contamination does. However, it is more complex for chronic wounds, which are able to contain and tolerate large amounts of bacteria, many times higher than the usual threshold level (>105 bacteria/g of tissue) defining infection in acute wounds,1 without inducing local signs. Nevertheless, many clinical and experimental studies indicate that the probability for chronic wounds to heal properly is limited when the bacterial load exceeds this level of contamination; even when body defences are still able to prevent tissue invasion, bacteria can impair wound healing.

Green synthesis of silver nanoparticles using Terminalia chebula extract at room temperature and their antimicrobial studies

A green rapid biogenic synthesis of silver nanoparticles (Ag NPs) using Terminalia chebula (T. chebula) aqueous extract was demonstrated in this present study. The formation of silver nanoparticles was confirmed by Surface Plasmon Resonance (SPR) at 452 nm using UV-visible spectrophotometer. The reduction of silver ions to silver nanoparticles by T. chebula extract was completed within 20 min which was evidenced potentiometrically. Synthesised nanoparticles were characterised using UV-vis spectroscopy, Fourier transformed infrared spectroscopy (FT-IR), powder X-ray diffraction (XRD), transmission electron microscopy (TEM) and atomic force microscopy (AFM). The hydrolysable tannins such as di/tri-galloyl-glucose present in the extract were hydrolyzed to gallic acid and glucose that served as reductant while oxidised polyphenols acted as stabilizers. In addition, it showed good antimicrobial activity towards both Gram-positive bacteria (S. aureus ATCC 25923) and Gram-negative bacteria (E. coli ATCC 25922). Industrially it may be a smart option for the preparation of silver nanoparticles.

Nanocrystalline silver dressing and subatmospheric pressure therapy following neoadjuvant radiation therapy and surgical excision of a feline injection site sarcoma

CLINICAL SUMMARY: This is the first clinical report of use of a combination of nanocrystalline silver and subatmospheric pressure therapy to treat a resistant wound infection, following tumour removal and radiation therapy, in a difficult-to-manage surgical site in a cat.

PRACTICAL RELEVANCE

The therapy was well tolerated and the authors suggest it is a valid treatment protocol for management of non-healing or infected wounds in the cat.