Silver from Polyurethane Dressing Is Delivered by Gradient to Exudate, Tissue, and Serum of Patients Undergoing Negative-Pressure Wound Treatment

Abstract

The high concentration of silver found in wound exudate reflects not only the affinity for silver in serum components and wound fluids, but also that most silver ions are not distributed systemically in the patient; instead, they are transported by the vacuum created by therapy.

Negative pressure and nanocrystalline silver dressings for nonhealing ulcer: A randomized pilot study

“…This means that silver ions are released and then absorbed by the dressing, and that silver is not lost during the vacuum therapy and can exert its antimicrobial effect on the wound bed without increasing its systemic toxicity. These results are consistent with data from other authors supporting the hypothesis that silver stays on the wound bed; moreover, its antimicrobial effect might even be enhanced by the acid environment caused by the vacuum …”

“…These results are consistent with data from other authors supporting the hypothesis that silver stays on the wound bed; moreover, its antimicrobial effect might even be enhanced by the acid environment caused by the vacuum. 11,21,22 Nanocrystalline silver (Acticoat) in patients with burns has been shown to be safe, with maximum silver levels in serum of 56.8 mg L 21 after a median time of 9 days, which were not associated with hematologic or biochemical toxicity. 23 Besides transient changes in the metabolism of certain enzymes, severe liver damage or advanced argyria have not been reported, even with blood silver levels in blood >200 mg L 21 .…”

“…In a contaminated open fracture model of the proximal left legs of anesthetized goats, the addition of silver dressings had a more pronounced effect on bacterial load particularly on Staphylococcus aureus (25 6 8%) compared with the standard NPWT group (115 6 19%). 8 In clinical practice, improved healing outcomes combining NPWT with silver dressings has been reported in a case report of necrotizing fasciitis 9 and in two clinical series of 20 patients 10 and 6 patients, 11 respectively. In one of these studies, 11 silver release was evaluated by atomic absorption and dispersed x-ray spectroscopy.…”

“…In clinical practice, improved healing outcomes combining NPWT with silver dressings has been reported in a case report of necrotizing fasciitis and in two clinical series of 20 patients and 6 patients, respectively. In one of these studies, silver release was evaluated by atomic absorption and dispersed x‐ray spectroscopy. Silver was delivered to wound exudate at rates 102 to 104 times greater than in corresponding serum, and few surface silver deposits were detected in treated tissue.…”

A Wireless Electroceutical Dressing Lowers Cost of Negative Pressure Wound Therapy

“…However, it is reported that such a dressing is not effective in delivering silver ions to the wound and most silver is removed by the suction force and found in the wound exudate. 27 In case of using WED, the wound maintains a direct contact with the dressing and receives the benefit of continuous microcurrent generated by WED. Recent work in our laboratory shows that WED disrupts Pseudomonas aeruginosa PAO1 biofilm by a redox-sensitive pathway.…”