International wound journal
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Randomized Controlled Trial Multicenter Study Comparative Study
A prospective randomised open label study to evaluate the potential of a new silver alginate/carboxymethylcellulose antimicrobial wound dressing to promote wound healing.
The aim of this study was to observe both the clinical signs and symptoms of wounds at risk of infection, that is critically colonised (biofilm infected) and antimicrobial-performance of an ionic silver alginate/carboxymethylcellulose (SACMC) dressing, in comparison with a non silver calcium alginate fibre (AF) dressing, on chronic venous leg and pressure ulcers. Thirty-six patients with venous or pressure ulcers, considered clinically to be critically colonised (biofilm infected), were randomly chosen to receive either an SACMC dressing or a non silver calcium AF dressing. The efficacy of each wound dressing was evaluated over a 4-week period. ⋯ The SACMC group showed a statistically significant (P = 0.017) improvement to healing as indicated by a reduction in the surface area of the wound, over the 4-week study period, compared with AF controls. In conclusion, the SACMC dressing showed a greater ability to prevent wounds progressing to infection when compared with the AF control dressing. In addition, the results of this study also showed an improvement in wound healing for SACMC when compared with a non silver dressing.
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Randomized Controlled Trial Comparative Study
A prospective, randomized trial of silver containing hydrofiber dressing versus 1% silver sulfadiazine for the treatment of partial thickness burns.
Silver sulfadiazine has been used as a topical burn wound treatment for many years. Pain associated with dressing changes is a common problem in burn wounds. Aquacel Ag, a hydrofiber dressing coated with ionic silver has been reported to reduce burn wound infection and promote antimicrobial activity. ⋯ Total cost of treatment was 52 +/- 29 US dollars for the Aquacel Ag-treated group versus 93 +/- 36 US dollars for the silver sulfadiazine-treated group. This study showed that Aquacel Ag increased time to healing, decreased pain symptoms and increased patient convenience because of limiting the frequency of replacement of the dressing at lower total cost. This study confirms the efficacy of Aquacel Ag for the treatment of partial thickness burns at an outpatient clinic.
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The aim of the study was to evaluate the potential of autologous bone marrow-derived nucleated cells to enhance the rate of healing of full-thickness excisional skin wounds in rabbits. The study was conducted on 20 New Zealand white rabbits of either sex. Two, 2 x 2 cm full-thickness skin (thoracolumabar region) excisional wounds were created; one on each side of the dorsal midline in each animal. ⋯ Histopathological examination of the healing tissue showed early disappearance of inflammatory reaction, significantly more neovascularisation, and more fibroplasias and early lay down and histological maturation of collagen in BI wounds than in control wounds. It was concluded that injection of autologous bone marrow-derived nucleated cells in the wound margins induced faster and better quality healing of excisional skin wounds in rabbits when compared with normal saline. The injection of autologous bone marrow-derived nucleated cells can be used to promote healing of large full-thickness skin wounds in rabbits.
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The physical capacity of negative pressure wound therapy (NPWT) dressing on the bacterial growth in an in vitro wound model was investigated. Standardised wounds were contaminated with a clinical Staphylococcus aureus strain and incubated at 35 degrees C for 6 hours. Four wounds were treated with continuous negative pressure (125 mmHg) and four controls without. ⋯ This observation was independent of the physical effect of continuous negative pressure at 125 mmHg. The reduction in bacteria demonstrated in previous studies appears to be caused by other effects than physical suction alone. However, the results obtained are limited as non viable tissue was used and the effect of suction on dead tissue might be very different from that occurring on perfused tissue, for example, in an animal model or in patients.