Korean J Lab Med.  2010 Feb;30(1):20-27. 10.3343/kjlm.2010.30.1.20.

Comparison of the Efficacies of Silver-Containing Dressing Materials for Treating a Full-Thickness Rodent Wound Infected by Methicillin-resistant Staphylococcus aureus

• Lee JH
• Chae JD
• Kim DG
• Hong SH
• Lee WM
• Ki M

• KMID: 1096814
• DOI: http://doi.org/10.3343/kjlm.2010.30.1.20

Abstract

BACKGROUND
Methicillin-resistant Staphylococcus aureus (MRSA) may cause infections during wound dressing. We aimed to compare the antibacterial activities and wound-healing effects of commercially available silver-coated or silver-impregnated wound dressings on MRSA-infected wounds.
METHODS
Full-thickness skin defects were made on the back of rats (N=108) and were infected with MRSA. The rats were divided into the following 6 groups according to the dressing used for the wounds: nanocrystalline silver (Acticoat(R)), silver carboxymethylcellulose (Aquacel(R)-Ag), silver sulfadiazine (Medifoam silver(R)), nanocrystalline silver (PolyMem silver(R)), silver sulfadiazine (Ilvadon(R)), and 10% povidone iodide (Betadine(R)). We analyzed the wound sizes, histological findings, and bacterial colony counts for the groups. We also inoculated the silver materials on Mueller-Hinton agar plates containing MRSA and compared the inhibition zones in the agar plates.
RESULTS
The order of the rate of wound-size decrease was Acticoat(R)>Aquacel(R)-Ag>PolyMem silver(R)>Medifoam silver(R)>Ilvadon(R)>Betadine(R). The histological findings revealed that the Acticoat(R) showed more reepithelialization and granulation tissue formation and less inflammatory cell infiltration than the other materials. The order of the time required for wound healing was Acticoat(R)>Aquacel (R)-Ag>PolyMem silver(R)>Ilvadon(R)>Medifoam silver(R)>Betadine(R). The bacterial colony counts reduced in all the groups, except in the Medifoam silver(R) group. The order of the size of the inhibition zone was Acticoat(R)>Aquacel(R)-Ag>Ilvadon(R)>PolyMem silver(R)>Betadine(R)>Medifoam silver(R).
CONCLUSIONS
Silver-coated or silver-impregnated wound dressings can be used for treating MRSAinfected wounds. Considering its superior efficacy in comparison to the efficacies of other silver-coated or silver-impregnated wound dressings, Acticoat(R) should be preferentially used for the treatment of MRSA-infected skin wounds.

Keyword

Methicillin-resistant Staphylococcus aureus; Skin defect; Infection; Silver dressing

MeSH Terms

Animals
Bandages
Carboxymethylcellulose Sodium/therapeutic use
Female
Metal Nanoparticles/therapeutic use
*Methicillin-Resistant Staphylococcus aureus
Povidone-Iodine/therapeutic use
Rats
Rats, Sprague-Dawley
Silver/chemistry/*therapeutic use
Silver Sulfadiazine/therapeutic use
Skin/pathology
Staphylococcal Infections/*drug therapy/pathology
Wound Healing/*drug effects

Figure

• 

  Fig. 1. Antibacterial effect of silver-based dressing materials in Mueller-Hinton agar. The antibacterial effect was evaluated by measuring the growth-inhibition zones on the agar plate. After 24 hr, additional inhibition zones were observed along the edges of the dressing material. Abbreviations: Ac, Acticoat®; Aq, Aquacel®-Ag; P, PolyMem silver®; M, Medifoam silver®.

• 

  Fig. 2. Error bars indicating the standard deviation for the antibacterial effects of silver dressing materials (Acticoat® [Ac], Aquacel®-Ag [Aq], PolyMem silver® [P], Medifoam silver® [M], Ilvadon® [I], and Betadine® [B] groups) in Mueller-Hinton agar. Statistically significant differences were observed among the groups (oneway ANOVA, P<0.001).

• 

  Fig. 3. Error bars indicating the standard deviation for wound size change (%) according to the day and type of wound dressing (Acticoat® [Ac], Aquacel®-Ag [Aq], PolyMem silver® [P], Medifoam silver® [M], Ilvadon® [I], and Betadine® [B] groups). The differences among the groups were statistically significant (two-way ANOVA, P<0.001).

• 

  Fig. 4. Histological findings in each group (hematoxylin and eosin stain, ×200) at 10 days .

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  Fig. 5. Mean wound-healing grade by day and dressing groups (Acticoat® [Ac], Aquacel®-Ag [Aq], PolyMem silver® [P], Medifoam silver® [M], Ilvadon® [I], and Betadine® [B] groups). The differences among the groups were statistically significant (Kruskal-Wallis test, P<0.001).

• 

  Fig. 6. Mean number of colonies (× 105 CFU/mL) by day and dressing groups (Acticoat® [Ac], Aquacel®-Ag [Aq], PolyMem silver® [P], Medifoam silver® [M], Ilvadon® [I], and Betadine® [B] group). The differences among the groups were statistically significant (Kruskal-Wallis test, P<0.001).

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