A retrospective analysis of ambulatory burn patients: focus on wound dressings and healing times

Abstract

Ann R Coll Surg Engl 2010; 92: 118-123 118Dressings have always been an important issue in reconstructive surgery to obtain better aesthetic and functional outcomes. This is particularly true in burns, where infections and contractures are more frequent than in other fields. Over latter years, pharmacological research has produced several products with different purposes: avoidance of infection (i.e. silvercontaining products), promotion of re-epithelialisation (alginates, hyaluronic acid-derived products), or both.In the ambulatory facility of our burn centre, we use different products for different purposes. Although we try to use them according to burn thickness and local status, no clear guideline exists and much of the decision is often left to the surgeon's personal experience. During the last days of 2005, new silver-based products (nanocrystalline silverActicoat, Smith and Nephew, and silver carboxymethylcellulose -Aquacel Ag, Convatec) were introduced in our clinical practice. In the present study, we analysed burn outcomes, in terms of healing times, during the last 2 months of 2005 and the first 2 months of 2006, to see if changes in wound care corresponded to an amelioration of healing times. We also tried to correlate eventual differences with those obtained from other products already in use. Patients and MethodsAfter local Institutional Review Board approval was obtained, we gathered data from patients treated in the ambulatory facility of our burn centre during the last 2 months of 2005 and the first 2 months of 2006. We excluded from the study: (i) admitted patients; (ii) patients with mixed superficial partial thickness and deep partial thickness burns; (iii) patients with full-thickness burns; and (iv) operated (2006, 19; 2005, 29 days; Student's t-test, P < 0.01). Among all dressings, paraffin gauzes had the shortest healing times in superficial burns (5 days); with silver-based dressings in deep burns, the healing times were nanocrystalline silver (16 days) and silver carboxymethylcellulose (21 days). CONCLUSIONS Results of our retrospective study would suggest that paraffin gauzes are a valuable option in superficial burns, while silver-based dressings are preferable in deep burns. RECONSTRUCTIVE SURGERY

Active Silver Nanoparticles for Wound Healing

“…This result of complete patient healing by the 17th day shows that, despite the presence of Ag NPs in the tissue and inside the cells, the healing process does not seem to be impeded. Our results agree with and support the results recently published by Gravante et al [46]. They found that Acticoat™ Flex 3 was the dressing with the shortest healing times for deep partial thickness burns (16 days average; our result, 17 days).…”

Silver Nanoparticles as Potential Antibacterial Agents

“…Also, bone cements modified with AgNPs significantly reduced biofilm formation on the surface of the cement [96]. Some medical devices, as well as surgical masks [97], coated with AgNPs are already in clinical trials [93] with promising results [98,99]. Furthermore, recent studies suggest the use of wound dressings treated with AgNPs to prevent or reduce microbial growth in wounds and to improve the outcomes of healing [100].…”

New Strategies in the Development of Antimicrobial Coatings: The Example of Increasing Usage of Silver and Silver Nanoparticles

“…Interestingly, in a recent analysis Gravante and colleagues showed that nano-silver showed improved prevention of burn wound infections when compared to other silver formulations (silver-sulfadiazine and silver nitrate) [91]. They also described faster healing of deep burns was associated with the use of nanocrystalline silver impregnated dressings [94]. This means that the full potential of silver antimicrobial activity is not being used, and that new dressings using nano-silver particles may improve the efficiency of wound dressings even further in the near future.…”