Practical extended use of antimicrobial silver (PExUS)

Abstract

Background: Antimicrobial silver has had a role in wound antisepsis throughout history and, with the rise in acquired antibiotic resistance, silver dressings are once again commonly used. Issues with silver dressings include the important environmental consideration of nanoparticle manufacture, and the significant financial cost of these products. One solution to these problems may be to adopt an opened-but-unused model of wound care whereby dressing materials are used in piecemeal fashion and excess stored in between dressing changes. Due to a lack of literature on the topic, this project was designed with the aim of testing the antimicrobial efficacy of available silver dressings during storage after opening. Methods: Four commonly used silver dressings were tested for antimicrobial activity using a zone of inhibition assay against clinically important pathogens. The assay was performed on opening of dressings and repeated over 3 months in storage at 4, 25 or 37 C. Analysis was performed using repeated measures ANOVA. Swab cultures were taken at each simulated dressing change to detect microbial contamination of the dressings during storage. Results: There was no effect of time or storage temperature on the zone of inhibition over the 12 week test period. No swabs taken returned culture consistent with microbial contamination of stored dressings. Conclusion: Opened silver dressings maintain antimicrobial activity for at least 12 weeks in storage and are resistant to contamination. An opened-but-unused model for wound care is likely to improve cost-effectiveness while preserving effectiveness and safety.

Skin integrity, antimicrobial stewardship and infection control: a critical review of current best practice

“…54,55 Research has also focused on practical assessment of antimicrobial dressings evaluating their efficacy during storage and after opening to better understand their effects on AMR development and cost-effectiveness, while preserving clinical efficacy and safety. 56 In the context of skin integrity, researchers are continuously generating and implementing evidence-based wound care tools, educational resources, including best practice statements, and skin integrity prevention models to facilitate clinical translation and uptake of evidencebased practice. 57,58,59,60 Lastly, researchers and clinicians are also exploring standardisation of methods to calculate effectiveness of antimicrobial dressings against both planktonic and biofilm bacteria, and microbial communities associated with wounds.…”

Bactericidal Activity of Silver Nanoparticles on Oral Biofilms Related to Patients with and without Periodontal Disease

“…In this sense, it is necessary to explore new and more effective antimicrobial agents [ 25 , 26 , 27 ] with properties that improve periodontal therapy through bacterial growth inhibition and the reduction of antibiotic resistance. The literature has recommended the use of silver nanoparticles (AgNP) for the control of bacterial proliferation, due to their excellent bacteriostatic and bactericidal properties in many microbial species, including oral microorganisms [ 28 , 29 , 30 , 31 , 32 , 33 ]. A significant number of researchers report the evaluation of the bactericidal effect of the AgNP against specific bacterial species using standard bacterial stocks provided by Microbial Type Culture Collection (MTCC) [ 34 ] or American Type Culture Collections (ATCC) [ 35 , 36 ] catalogs.…”