The effect of a silver hydrogel sheet dressing on postsurgical incision healing after foot and ankle surgery

Abstract

Introduction Silver hydrogel dressings are antimicrobial dressings with the potential to aid post-surgical healing. The purpose of this study is to evaluate the effects of a silver hydrogel dressing on postoperative scarring and complications. Methods 40 foot and ankle patients (48.43 ± 16.82 years) were included in the study with 20 patients in each group. Postoperatively, the treatment group was treated with a silver hydrogel sheet dressing, and the control group was treated with a standard petroleum-based dressing. Follow-up was performed at two, six, and 12 weeks. Postoperative scarring and complications were evaluated and compared between groups. Scarring was evaluated using the Patient and Observer Scar Assessment Scale (POSAS). Scar length and width were measured using digital calipers and used to compute scar area. Results The treatment group demonstrated statistically significant improvements in the POSAS observer score and observer opinion at six and 12 weeks ( p < 0.001). Additionally, patient reported pain was significantly lower for the treatment group than the control group at 12 weeks ( p < 0.001). Patient reported itch declined across time for both groups ( p < 0.001) with significantly less itching reported by the treatment group ( p = 0.027). Scar area was also significantly lower for the treatment group than the control group at six weeks and 12 weeks ( p ≤ 0.002). Neither group experienced any postoperative complications. Conclusion These results suggest that the inherent properties of the silver hydrogel dressing may improve postsurgical scarring. Lay Summary Surgical incisions result in scar, which can present both cosmetic and rehabilitation concerns after foot or ankle surgery. It is standard to use a petroleum-based dressing on incisions after surgery, however, advancements in incisional dressings have been made over the past 20 years. One such advancement is silver-impregnated hydrogel sheet dressings which have been shown to maintain a moist wound environment conducive to healing, while decreasing the chance of infection through its antimicrobial properties. This paper evaluates scar healing after foot or ankle surgery in patients treated with either the standard petroleum-based dressing, or the silver hydrogel sheet dressing. Patients who were treated with the silver hydrogel dressing had less itching and pain, as well as a smaller scar area than patients in the standard dressing group. Therefore, our results suggest that the silver hydrogel dressing may improve scarring after surgery.

Alternative therapeutic strategies in diabetes management

“…Several types of films or sheets of hydrogels have been successfully developed for treating various types of ulcers and wounds in different pathophysiological contexts[ 206 - 208 ]. The surface of diabetic ulcer wounds, however, typically exhibits a complex and uneven topography, making the hydrogel dressing more prone to detachment due to weak adhesion to the wound surface, and is susceptible to bacterial infections[ 209 ].…”

Advances of Nanobiomaterials for Treating Skin Pathological Fibrosis

“…After incorporating the hydrogels with anti-bacterial NPs, the wound exhibited fewer newly formed vessels in the scar. [94,95] Furthermore, the sustained release of Zn 2þ ions and the production of hypochlorous acid (HClO) contributed to ongoing sterilization. Consequently, the resistance to wound infection exhibited persistent improvement, with notable downregulation of TGF-β1 expression in the later stages.…”

Beneficial Effect of Wound Dressings Containing Silver and Silver Nanoparticles in Wound Healing—From Experimental Studies to Clinical Practice

“…Although acute wounds heal quickly and effectively, can leave scars that stay for the rest of patients’ lives. Miner et al [ 91 ] decided to investigate whether a hydrogel containing silver particles can not only accelerate the healing of a postoperative wound, but also decrease the probability of scar formation. 40 patients with foot and ankle injuries were enrolled in the study, 20 of them postoperatively received silver hydrogel sheet (SHS) dressing while the other 20 received standard petroleum-based dressings.…”