A Silver Impregnated Antimicrobial Dressing Reduces Hospital Length of Stay for Pediatric Patients With Burns

Paddock, Heather N.; Fabia, Renata; Giles, Shelia; Hayes, John R.; Lowell, Wendi; Besner, Gail E.

doi:10.1097/bcr.0b013e318053d2b9

Cited by 34 publications

(27 citation statements)

References 7 publications

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“…There are several reports in the literature detailing use of silver-impregnated dressings in children, predominantly in burn care. [49][50][51] Wound dehiscence is a significant risk factor for postsurgical morbidity and mortality. Risk factors for wound dehiscence after laparotomy in children include age less than 1 year, presence of wound infection, median incision, and emergency surgery.…”

Section: Dressings and Products In Pediatric Wound Carementioning

confidence: 99%

Dressings and Products in Pediatric Wound Care

King

Stellar

Blevins

et al. 2014

Advances in Wound Care

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Significance: The increasing complexity of medical and surgical care provided to pediatric patients has resulted in a population at significant risk for complications such as pressure ulcers, nonhealing surgical wounds, and moistureassociated skin damage. Wound care practices for neonatal and pediatric patients, including the choice of specific dressings or other wound care products, are currently based on a combination of provider experience and preference and a small number of published clinical guidelines based on expert opinion; rigorous evidence-based clinical guidelines for wound management in these populations is lacking. Recent Advances: Advances in the understanding of the pathophysiology of wound healing have contributed to an ever-increasing number of specialized wound care products, most of which are predominantly marketed to adult patients and that have not been evaluated for safety and efficacy in the neonatal and pediatric populations. This review aims to discuss the available data on the use of both more traditional wound care products and newer wound care technologies in these populations, including medical-grade honey, nanocrystalline silver, and soft silicone-based adhesive technology. Critical Issues: Evidence-based wound care practices and demonstration of the safety, efficacy, and appropriate utilization of available wound care dressings and products in the neonatal and pediatric populations should be established to address specific concerns regarding wound management in these populations. Future Directions: The creation and implementation of evidence-based guidelines for the treatment of common wounds in the neonatal and pediatric populations is essential. In addition to an evaluation of currently marketed wound care dressings and products used in the adult population, newer wound care technologies should also be evaluated for use in neonates and children. In addition, further investigation of the specific pathophysiology of wound healing in neonates and children is indicated to promote the development of wound care dressings and products with specific applications in these populations. SCOPE AND SIGNIFICANCEGiven the lack of consensus on the optimal strategies for common wound care management issues in the neonatal and pediatric populations and the large number of wound care products on the market today, it can be challenging to make informed decisions regarding wound care in these populations. A comprehensive review of the literature on the following specific areas of focus: pressure ulcers, surgical wounds, epidermal stripping, intravenous extravasation injuries, moisture-associated skin damage (MASD), and use of negative-pressure wound therapy (NPWT) is presented, along with management recommendations based on the clinical experience of the authors.

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Section: Dressings and Products In Pediatric Wound Carementioning

confidence: 99%

Dressings and Products in Pediatric Wound Care

King

Stellar

Blevins

et al. 2014

Advances in Wound Care

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“…While the discovery of penicillin led to the era of synthetic antibiotics, increasing antibiotic resistance of bacteria and the ineffectiveness of synthetic antibiotics against some bacterial strains have led to the reemergence of interest in silver, silver salts, silver compounds, and nanocrystalline silver as antibacterial agents (8,18,41).…”

mentioning

confidence: 99%

Synergistic Combination of Chitosan Acetate with Nanoparticle Silver as a Topical Antimicrobial: Efficacy against Bacterial Burn Infections

Huang

Tegos

et al. 2011

Antimicrob Agents Chemother

158

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Chitosan and nanoparticle silver are both materials with demonstrated antimicrobial properties and have been proposed singly or in combination as constituents of antimicrobial burn dressings. Here, we show that they combine synergistically to inhibit the in vitro growth of Gram-positive methicillin-resistant Staphylococcus aureus (MRSA) and Gram-negative bacteria (Pseudomonas aeruginosa, Proteus mirabilis, and Acinetobacter baumannii), as judged by bioluminescence monitoring and isobolographic analysis, and also produce synergistic killing after 30 min of incubation, as measured by a CFU assay. The hypothesized explanation involves chitosan-mediated permeabilization of bacterial cells, allowing better penetration of silver ions into the cell. A dressing composed of freeze-dried chitosan acetate incorporating nanoparticle silver was compared with a dressing of chitosan acetate alone in an in vivo burn model infected with bioluminescent P. aeruginosa. The survival rates of mice treated with silver-chitosan or regular chitosan or left untreated were 64.3% (P ‫؍‬ 0.0082 versus regular chitosan and P ‫؍‬ 0.0003 versus the control), 21.4%, and 0%, respectively. Most of the fatalities occurred between 2 and 5 days postinfection. Silver-chitosan dressings effectively controlled the development of systemic sepsis, as shown by blood culture. These data suggest that a dressing combining chitosan acetate with silver leads to improved antimicrobial efficacy against fatal burn infections.

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“…With each dressing change, the precautions mentioned above should be followed to minimize aerosolization. Patients with partial thickness burns can be successfully treated with Aquacel Ag (ConvaTec, Princeton, NJ) in the inpatient or outpatient setting [48]. This mode of treatment is also comfortable for patients as the dressing separates from the body once the wound has epithelialized.…”

Section: Wound Carementioning

confidence: 99%

An Ounce of Prevention Saves Tons of Lives: Infection in Burns

Merchant

Smith

Jeschke

2015

Surgical Infections

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The treatment of infection and sepsis against highly adaptable bacteria is often insurmountable by ill patients. In this process, bioburden needs to be corralled to have any success. Thus, preventing organisms from entering the unit and transferring onto other patients, and eliminating the bacteria dwelling in the unit are all necessary actions in this battle. Ultimately, maintaining a culture that is constantly wary of this risk only can achieve this goal.

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A Silver Impregnated Antimicrobial Dressing Reduces Hospital Length of Stay for Pediatric Patients With Burns

Cited by 34 publications

References 7 publications

Dressings and Products in Pediatric Wound Care

Dressings and Products in Pediatric Wound Care

Synergistic Combination of Chitosan Acetate with Nanoparticle Silver as a Topical Antimicrobial: Efficacy against Bacterial Burn Infections

An Ounce of Prevention Saves Tons of Lives: Infection in Burns

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