Acticoat™ stimulates inflammation, but does not delay healing, in acute full‐thickness excisional wounds

Abstract

Acticoat™ has antimicrobial and anti-inflammatory effects which aid wound healing. However, in vitro studies indicate that Acticoat™ is cytotoxic and clinical and in vivo studies suggest that it may delay healing in acute wounds. Therefore, this study investigated the effects of Acticoat™ on healing in acute full-thickness excisional wounds. Using a porcine model, healing was assessed on days 3, 6, 9 and 15 post-wounding. Five wounds dressed with Acticoat™ and five wounds dressed with polyurethane film (control) were assessed per day (n = 40 wounds). The rate of healing, inflammatory response, restoration of the epithelium and blood vessel and collagen formation were evaluated. No difference was found in the rate of healing between wounds treated with Acticoat™ and the control wounds. Inflammation was increased in Acticoat™-treated wounds on day 3 post-wounding compared to the control wounds. However, by day 15 post-wounding, the epithelium of the Acticoat™-treated wounds closely resembled normal epithelium. Acticoat™-treated wounds also contained a higher proportion of mature blood vessels, and differences in collagen deposition were apparent. Despite inducing an inflammatory response, Acticoat™ did not delay healing in acute wounds. Conversely, the improved quality of the epithelium and blood vessels within Acticoat™-treated wounds indicates that Acticoat™ has a beneficial effect on healing.

Silver distribution in chronic wounds and the healing dynamics of chronic wounds treated with dressings containing silver and octenidine

“…Silver sulfadiazine (SSD) was observed to retard the healing of a burn wound in mice and to induce an increase in the number of neutrophils and a decrease in the amount of macrophages 12 . Similarly, nanocrystalline silver (Acticoat) was seen to more than double the number of pro‐inflammatory cells in acute porcine wounds, although the overall wound healing rate was not affected 64 …”

Nanocomposite scaffolds for accelerating chronic wound healing by enhancing angiogenesis

“…The wound dressing contains silver nanoparticles that could be released slowly during the healing process. The antibacterial properties of these nanoparticles minimize the need for several wound dressings to be used during the healing of chronic wounds and also reduce the inflammatory response [165]. There is still no FDA-approved skin product with angiogenic nanomaterials in its structure, but the emerging number of related studies shows the potential of these nanobiomaterials for skin regeneration.…”

Managing severe burn injuries: challenges and solutions in complex and chronic wound care

“…Most silver products have been shown to be cytotoxic in vitro. 20,21 Nevertheless, there are umpteen commercially available silver dressings, with representatives from each dressing category. The most popular silver dressing in our facility is currently Acticoat (Smith and Nephew, Hull, UK), which is advertised to have both antimicrobial and anti-inflammatory properties.…”

“…• Inhibition of electron transport system/respiratory chain in bacteria • Interaction and rupture of the cell membrane and cell wall • Interference with bacterial cell DNA • Silver free radical production, using all the mechanisms mentioned 20,21 Acticoat (Smith and Nephew) is principally used with prophylactic indications in this burn center, considerably reducing the number of dressings while awaiting wound evolution, or over nonadherent dressings after skin grafting. Clinicians generally do not consider its use to demonstrably compromise wound healing.…”