• Archives of Plastic Surgery
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• v.38 no.4
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• pp.359-368
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• 2011

Purpose: Aquacel Ag$^{(R)}$ is a hydrofiber wound dressing integrated with ionic silver. Sorbact$^{(R)}$ is a hydrophobiccoated dressing that uses the hydrophobic interaction with microbes. In this study, we compared the wound healing effects and the antibacterial effects of Medifoam$^{(R)}$, Betadine soaked, Aquacel Ag$^{(R)}$ and Sorbact$^{(R)}$ dressings against MRSA-infected wounds. Methods: Eighty rats were divided into four groups: Medifoam$^{(R)}$; Betadine soaked; Aquacel Ag$^{(R)}$; and Sorbact$^{(R)}$. A $1.5{\times}1.5cm$ square full-thickness wound was made on the dorsum of each rat and infected with MRSA. Twenty-four hours thereafter, each dressing was applied to the wound and changed every other day. One, 3, 7, 11 and 15 days after the wound infection, swab culture grade, wound bed appearance score, and wound defect size change were evaluated, and 7 and 15 days after, histologic evaluation was compared between the groups. Results: The bacteria load of wounds in the Sorbact$^{(R)}$ group decreased earlier than in the other groups. The wound bed appearance score of the Sorbact$^{(R)}$ group also increased quicker, compared with the other groups. However, the size of wounds of the Aquacel Ag$^{(R)}$ group decreased more rapidly, compared with other groups. From the histologic point of view, there was no significant difference between Betadine soaked, Aquacel Ag$^{(R)}$ and Sorbact groups. Conclusion: The hydrophobic dressing using Sorbact$^{(R)}$ showed a more rapid reduction in the MRSA load and an elevation in the wound bed appearance score, but a slower decrease in wound size change due to detachment of wound bed tissue when the dressing was eliminated in the low exudate wound. The silver-containing hydrofiber dressing using Aquacel Ag$^{(R)}$ was more effective in ultimate wound size reduction, but some debris was trapped in the wound tissue and induced foreign body reaction in the high exudate wound. Thus, ongoing selection process of treatment based on the evaluation of the infectious wound state will be very important.

• Archives of Plastic Surgery
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• v.34 no.3
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• pp.305-313
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• 2007

Purpose: Wound healing is a result of complex processes whose components, such as cells, extracellular matrix, proteolytic enzymes, and their inhibitors receive effects from immune compartments, cytokines, chemokines, and growth factors. Impairment of normal physiologic response to wounding makes nonhealing chronic wounds. Wound infection and exacerbated proteolytic process may induce uncontrolled tissue degradation or exudates formation, which may result in the development of a nonhealing chronic wound. Thus proper management of wound infection and exudates is critical to prevent and treat nonhealing wound. The aim of this study is to evaluate effects of Aquacel AG, silver-containing carboxymethylcellulose dressing on treatment for exudative infected wound. Methods: The study included 31 patients with nonhealing wound. Wound was dressed with Aquacel AG. The effect of dressing was investigated by serial bacterial culture and wound exudates assessment. Each infection and exudates control time was determined and statistically analyzed. Results: Wound infection and exudates were effectively managed using Aquacel AG dressing. Mean infection and exudates control time were $3.4{\pm}1.2$ and $5.7{\pm}1.4$ weeks, respectively. Statistical analysis of the data indicated that infection control time correlated positively to age and exudates control time (p<0.05). Conclusion: There is as yet no ideal dressing for the topical treatment of chronic nonhealing wound. But silver-containing carboxymethylcellulose dressing can be used effectively for exudative, infected nonhealing wound.

• Archives of Plastic Surgery
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• v.36 no.4
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• pp.372-379
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• 2009

Purpose: The purpose of this study was to compare the effect on antibacterial activities and wound healing effect of silver containing dressings with which of Betadine against Staphylococcus aureus and Pseudomonas aeruginosa. Methods: One full thickness skin defects in rats(n=72) were developed on the back and were given rise to infection with S. aureus(n=36) and P. aeruginosa(n=36). The 72 mice were divided into 6 groups : Acticoat$^{(R)}$, Aquacel$^{(R)}$-Ag, Medifoam silver$^{(R)}$, Polymen silver$^{(R)}$, Ilvadon$^{(R)}$ and Betadine(control group) dressing groups. Five silver containing dressings and Betadine were assesed on infected wound. Measurement of wound size change, bacterial colonies count and histologic findings was applied. Antibacterial activity was analyzed with bacterial restricted zone in Mueller Hinton agar. Results: On S. aureus, wound size was more decreased in all treated groups as compared with betadine, however Ilvadon$^{(R)}$ was less decreased on P. aeruginosa. In histologic findings, experimental group showed more effective findings than others on S. aureus, however on P. aeruginosa, which was showed similar. Acticoat$^{(R)}$ was best effective in wound healing against S. aureus and P. aeruginosa. The bacterial colonies count was increased in all treated groups except Acticoat$^{(R)}$ as compared with the control group on S. aureus, which was decreased in Acticoat$^{(R)}$ and Ilvadon$^{(R)}$ group on P. aeruginosa. There were not statistical differences. The restricted zone was shown in Mueller - Hinton agar of all groups except Medifoam silver$^{(R)}$ group on S. aureus, which was shown of all groups on P. aeruginosa. There were statistical differences. Conclusion: This study suggests that silver containing dressings may have not better potential than Betadine in assisting management of wounds at risk of infection on S. aureus and P. aeruginosa. However, which have better antibacterial activity on S. aureus and P. aeruginosa.