Determining the effectiveness of prophylactic topical silver dressings in the treatment of sacrococcygeal pilonidal sinus wounds healing by secondary intention

A randomised controlled trial was conducted to determine if the prophylactic use of nanocrystalline silver alginate (SA) dressings could reduce the healing time for sacrococcygeal pilonidal sinus wounds healing by secondary intention.The SA dressing group had a mean time to wound healing of 46 days as compared to 66 days for the calcium alginate dressing group. On average, a 20% greater reduction in wound size was achieved with the SA dressing group

Advances in Wound Healing: A Review of Current Wound Healing Products

Successful wound care involves optimizing patient local and systemic conditions in conjunction with an ideal wound healing environment. Many different products have been developed to influence this wound environment to provide a pathogen-free, protected, and moist area for healing to occur. Newer products are currently being used to replace or augment various substrates in the wound healing cascade. This review of the current state of the art in wound-healing products looks at the latest applications of silver in microbial prophylaxis and treatment, including issues involving resistance and side effects, the latest uses of negative pressure wound devices, advanced dressings and skin substitutes, biologic wound products including growth factor applications, and hyperbaric oxygen as an adjunct in wound healing. With the abundance of available products, the goal is to find the most appropriate modality or combination of modalities to optimize healing

In Vivo Evaluation Of Complex Biogenic Silver Nanoparticle And Enoxaparin In Wound Healing

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)The burns treatment is difficult, uncomfortable for the patient, and expensive for health system. Due to antimicrobial properties of silver nanoparticles (AgNP), these particles can avoid bacterial infection in wound and accelerate the wound healing. Furthermore, the complexation of AgNP with enoxaparin (low molecular weight heparin) may improve the healing process of lesions due to anti-inflammatory and angiogenic activity of enoxaparin (Enox). The aim of this study was evaluated the activity and toxicity of biogenic AgNP and AgNP complexed with Enox in in vivo burn wound model. AgNP was produced by biosynthesis method using Fusarium oxysporum. AgNP (20-40 nm) exhibited high stability due to protein capping around the particles that was confirmed by TEM, fluorescence spectroscopy, and FTIR. The wound contraction in in vivo model, after 28 days of treatment, was 55, 89, 91, and 95% for control, Enox, AgNP, and AgNP-Enox groups, respectively. No clear toxic effects in the biochemistry and hematological parameters were verified in all treated groups. However, in the AgNP-Enox group, a statistically significant increase in the urea levels was observed indicating increased proteolysis due to inflammation process. The results demonstrated that the complex AgNP-Enox is interesting for wound healing decreasing the time of lesions healing.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

A Bacterial Cellulose - Nanosilver System

Both nanocrystalline silver and bacterial cellulose have been used as biomedical materials. Silver has been used as an antimicrobial agent, and bacterial cellulose as a wound dressing. The combination of both these technologies has the potential to create a synergistic scenario. A novel method for the attachment of nanocrystalline silver to bacterial cellulose has been developed. The cellulose is oxidized with sodium metaperiodate to dialdehyde cellulose and functionalized with silver using thiosemicarbazide, silver protienate and ammoniacal silver. The samples were prepared using both a commercially available bacteria cellulose wound dressing, Biofill, and lab made, wet pellicle, as the substrate. The antimicrobial efficacy against E. coli and S. aureus has been determined using a modified disk diffusion test procedure, and the release profiles of silver into deionized water were determined. These tests have shown an antimicrobial efficacy ranging between 1 day for the Biofill prepared samples and 5 days for the pellicle based samples

Progress and Perspectives in the Management of Wound Infections

The progress in nanotechnology and the medical application of novel generations of nanomaterials have opened new horizons in the definition of non-conventional approaches against multiple diseases. Biomaterials coated with antimicrobial metal nanoparticles, along with the topical applications of zinc, silver or copper-based formulations have demonstrated huge potential in prevention from infections associated with implantable medical devices and in biofilm eradication. In wound healing, in particular, the increasing healthcare costs and the antibiotic resistance demonstrated by several microorganisms have encouraged researchers and companies in the development of innovative wound dressings with antibacterial properties and capability to promote and enhance the healing process. Supported by scientific evidence, many formulations have been proposed and a large number of works involves the use of hybrid metal nanoparticles/polymer products, which have demonstrated encouraging results both in vitro and in vivo. In this chapter, recent progress in the development of novel wound dressings based on antibacterial metal nanoparticles is presented, along with the most interesting results achieved by the authors, mainly devoted to the application of silver nanocoatings in wound management

Antimicrobial silver nanoparticles for wound healing application: Progress and future trends

none2noRecent data have reported that the burden of infections related to antibiotic-resistant bacteria in the European Union and European Economic Area (EEA) can be estimated as the cumulative burden of tuberculosis, influenza, and human immunodeficiency virus (HIV). In wound management, the control of infections represents a crucial issue and a multi-billion dollar industry worldwide. For diabetic wounds ulcers, in particular, infections are related to the majority of amputations in diabetic patients, which today represent an increasing number of the elderly. The greatest barrier to healing is represented by the biofilm, an organized consortium of bacteria encapsulated in a self-produced extracellular polymeric substance with high resistance to conventional antimicrobial therapies. There is an urgent need for novel anti-biofilm strategies and novel antimicrobial agents and, in this scenario, silver nanotechnology has received tremendous attention in recent years in therapeutically enhanced healthcare. Due to its intrinsic therapeutic properties and the broad-spectrum antimicrobial efficacy, silver nanoparticles have opened new horizons towards novel approaches in the control of infections in wound healing. This review aims at providing the reader with an overview of the most recent progress in silver nanotechnology, with a special focus on the role of silver in the wound healing process.openPaladini F.; Pollini M.Paladini, F.; Pollini, M

DEVELOPMENT OF A NEXT-GENERATION ANTIMICROBIAL WOUND DRESSING

Odgođeno cijeljenje rana zbog infekcije je teret zdravstvenim sustavima, a jednako tako i pacijentu i onome koji skrbi za njega. Bitan čimbenik u nastajanju infekcije i odgođenog cijeljenja je razvoj i prisutnost biofi lma u ranama. Biofi lm je zajednica mikroorganizama, zaštićena izvanstaničnim sluzavim matriksom u rani, koji može tolerirati obranu domaćina i primijenjena antimikrobna sredstva, kao što su antibiotici ili antimikrobne obloge. Rastući broj znanstvenih dokaza upućuje da biofilm već egzistira u većini kroničnih rana, a može biti i prethodnik infekciji dok istodobno uzrokuje odgođeno cijeljenje. In vivo modeli pokazali su da su upala, granulacija i epitelizacija, te procesi normalnog cijeljenja rane narušeni prisustvom biofilma. Izazov u razvoju nove antimikrobne obloge za ranu bio je da standardna antimikrobna sredstva učinimo učinkovitija protiv biofilma, a rješenje je uslijedilo nakon opsežnih istraživanja i ispitivanja biofi lma. Kombinacija metalnog kelatora, površinski aktivne tvari i kontrole pH faktora pokazala je snažnu sinergističku anti-biofi lm akciju u oblozi od karboksimetilceluloze sa 1,2 % ionskog srebra. Ta je učinkovitost testirana i dokazana u kompleksnim in vitro i in vivo modelima rana s biofilmom, a zatim i u klinički kontroliranim studijama, i to u studiji na 42-pacijenta i 113 kliničkih evaluacija. Naknadno ispitivanje nastavljeno je nakon dostupnosti obloge u evaluaciji na 112 slučaja, gdje je obloga pokazala učinkovito kontroliranje eksudata i suspektnog biofi lma na ranama koje teško cijele i pri tome poticanje procesa cijeljenja rana i to nakon prosječno 4 tjedna primjene nove obloge u inače standardnom protokolu njege. To je bilo popraćeno niskim brojem nuspojava. U drugoj procjeni bili su evaluirani i klinički znakovi infekcije i podatci o veličini rane, prije i nakon procjene. Nakon prosječno 5,4 tjedana uporabe obloge, svi su klinički znakovi infekcije bili reducirani, s prosječnom učestalošću od 36 % do 21 %. U prosjeku u 62 % rana postignuta je redukcija veličine, uz smanjenje veličine do 90 % i 10 potpuno zacijeljenih rana. Najnoviji kliničkih dokazi za novu generaciju antimikrobne obloge za ranu potvrđuju njenu sigurnost i učinkovitost u kontroli eksudata, infekcije i biofi lma, a osim toga potvrđuju i zacijeljivanje rana koje dugo i teško ili uopće ne cijele. Znanstvenu potporu za najnoviju tehnologiju i generaciju antimikrobne obloge potvrđuju in vitro i in vivo dokazi, tako da su buduća komparativna i randomizirana klinička ispitivanja neophodna za potpuno razumijevanje kliničke i ekonomske učinkovitosti koju može donijeti ova najnovija tehnologija.Delayed wound healing due to infection is a burden on healthcare systems, and the patient and caregiver alike. An emerging factor in infection and delayed healing is the presence development of biofilm in wounds. Biofilm is communities of microorganisms, protected by an extracellular matrix of slime in the wound, which can tolerate host defences and applied antimicrobials such as antibiotics or antimicrobial dressings. A growing evidence base exists suggesting that biofi lm exists in a majority of chronic wounds, and can be a precursor to infection while causing delayed healing itself. In vivo models have demonstrated that the inflammatory, granulation and epithelialization processes of normal wound healing are impaired by biofi lm presence. The challenge in the development of a new antimicrobial wound dressing was to make standard antimicrobial agents more effective against biofilm, and this was answered following extensive biofilm research and testing. A combination of metal chelator, surfactant and pH control displayed highly synergistic anti-biofi lm action with 1.2% ionic silver in a carboxymethylcellulose dressing. Its effectiveness was challenged and proven in complex in vitro and in vivo wound biofi lm models, followed by clinical safety and performance demonstrations in a 42-patient study and 113 clinical evaluations. Post-market surveillance was conducted on the commercially available dressing, and in a 112-case evaluation, the dressing was shown to effectively manage exudate and suspected biofi lm while shifting diffi cultto-heal wounds onto healing trajectories, after an average of 4 weeks of new dressing use in otherwise standard wound care protocols. This was accompanied by a low frequency of dressing related adverse events. In a second evaluation, clinical signs of infection and wound dimension data, before and after the evaluations, were also available. Following an average of 5.4 weeks of dressing use, all signs of clinical infection were reduced, from an average frequency of 36% to 21%. An average of 62% wound size reduction was achieved, with 90% of wounds reducing in size and 10 wounds healing completely. The new clinical evidence for this next-generation antimicrobial wound dressing suggests it is safe and effective at managing exudate, infection and biofilm, while it can shift established, stubborn wounds onto healing trajectories. The scientific rationale for this new dressing technology is supported by in vitro and in vivo evidence, so now further comparative, randomized and outcome-based clinical studies are required to fully understand the clinical and economic benefits this new dressing technology can bring