OBJECTIVETo evaluate the therapeutic effect of silver nitrate ointment on partial-thickness burn wounds, and observe its side-effects.

METHODSMulti-center, randomized, positive drug paralleled self-controlled trial was carried out. Eighty patients with superficial partial-thickness burns, and 40 with deep-partial thickness burns were randomized into AgNO3 group and SD-Ag group according to drug topically applied to the wounds. The wound healing time, wound healing rate and bacterial culture of the wound, the effect and safety of the drug, as well as drug irritation to the wounds were studied in these two groups.

RESULTSFor the patients with superficial partial-thickness burn wounds, the wound healing time in silver nitrate group was (9.5 +/- 2.7) days, which was obviously shorter than that in SD-Ag group [(10.8 +/- 3.4) days, P <0.01]. The wound healing rate in silver nitrate group on 7 post-burn day ( PBD) was (77.9 +/- 20.5)%, which was obviously higher than that in SD-Ag group [(67.3 +/- 22.6) %, P < 0.01]. For those with deep-partial thickness burn wounds, the wound healing time in silver nitrate group was (21.5 +/- 4.8) days, which was evidently shorter than that in SD-Ag group [(23.3 +/- 6.4) days, P <0.01]. The wound healing rate in silver nitrate group on 20 PBD was (86.6 +/- 15.9)%, which was evidently higher than that in SD-Ag group [(78.5 +/- 17.7)%, P < 0.01]. Silver nitrate ointment has the same antibacterial effect as 1% SD-Ag cream, but it was less painful when applied to the open wounds.

CONCLUSIONSilver nitrate ointment is an effective and safe medicament for the clinical management of partial-thickness burn wounds.

Adolescent ; Adult ; Anti-Infective Agents, Local ; therapeutic use ; Burns ; drug therapy ; pathology ; Female ; Humans ; Male ; Middle Aged ; Ointments ; Silver Nitrate ; therapeutic use ; Silver Sulfadiazine ; therapeutic use ; Wound Healing

OBJECTIVETo investigate the clinical efficacy and safety of Acticoat (nanocrystalline silver dressing) for the treatment of residual burn wounds.

METHODSNinety-eight patients with 166 residual burn wounds were enrolled in the multi-center randomized clinical trials. In addition to the routine treatment, Acticoat was applied onto the wounds of the trial group once a day if there was much exudation from the wound, or the dressing change was made every other two days when the wounds were clean. Silver sulfadiazine (SD-Ag) was used in the control group of patients. The healing time was observed up to 20 days. The healing rate on the 15th day after treatment was taken as the percentage of healing.

RESULTSThe average healing time was (12 +/- 5) days after the application of Acticoat, which was significantly shorter than that in control wounds with SD-Ag (16 +/- 6) days, (P = 0.005 < 0.01). The total effective rate of the wounds for trial was 97.05%, which was higher than that in control (94.17%) group, but there was no statistically significant difference. The bacterial clearing rate of the Acticoat group on the 6th and 12th post treatment day was 21.7% and 43.5% respectively, which was significantly higher than that in control group. No side-effect was observed in the two groups during the study.

CONCLUSIONActicoat with nanocrystalline silver can promote the healing of residual burn wounds effectively.

Adolescent ; Adult ; Aged ; Bandages ; Burns ; therapy ; Humans ; Male ; Middle Aged ; Nanoparticles ; Polyesters ; therapeutic use ; Polyethylenes ; therapeutic use ; Silver Sulfadiazine ; therapeutic use ; Single-Blind Method ; Skin, Artificial ; Wound Healing

OBJECTIVETo explore the influence of silver nanoparticle dressing on prevention of infection and healing of the second degree burn wound.

METHODSOne hundred and ninety-one burn patients with second degree including superficial and deep burn wound were randomly divided into three groups. Group A including 65 cases was treated by silver nanoparticle dressing on wounds, and group B (63 cases) and group C (63 cases) were treated by 1% silver sulfadiazine cream and vaseline gauze on their wounds, respectively. Dressing was changed daily, and wound swab bacterial cultures were performed before and after dressing change, and also wound healing times were recorded in each patient.

RESULTSGroup A and B were similar in their bacterium colonizations on wound after treatment with the silver nanoparticle dressing and 1% silver sulfadiazine cream, and they had a similar effect on reducing bacterium colonization on wound after treatment, while in vaseline gauze group bacterium colonization on wound increased after treatment. In group A the wound healing time of superficial second degree was significantly shorter than those in group B and group C (P < 0.01). In deep second degree wounds the healing time in group A was much shorter than that in group C (P < 0.01), but had no significant difference when compared with group B (P > 0.05).

CONCLUSIONSilver nanoparticle dressing can be used on second degree burn wound and can decrease the risk of wound infection and accelerate wound healing.

Adult ; Anti-Infective Agents, Local ; therapeutic use ; Bandages ; Burns ; therapy ; Female ; Humans ; Male ; Particle Size ; Petrolatum ; therapeutic use ; Silver ; therapeutic use ; Silver Sulfadiazine ; therapeutic use ; Surgical Sponges ; Wound Healing ; drug effects ; Wound Infection ; prevention & control

OBJECTIVETo investigate the effects of polysaccharide extracted from Aloe barbadensis and Aloe barbedensis containing gel on tissue water contents, nitric oxide (NO) and endothelin (ET) levels in wounds of burned rats.

METHODSFour areas of deep-partial thickness burn wounds with 3 cm in diameter were made on each back of 42 male Wistar rats. Single layer gauze impregnated either with 5% (W/W) aloe raw polysaccharide, 10% (W/W) aloe gel, 1% (W/W) sulfadiazine pyridine silver cream (SD-Ag), or normal saline was respectively applied on different wounds. According to different medications, the wounds were divided into aloe raw polysaccharide group, aloe gel group, SD-Ag group and normal saline group. Six rats in each group were sacrificed at 4, 12, 24, 48 post-scald hour (PSH) and on 7, 14, 21 post-scald day (PSD), and the full-thickness skin of wound was harvested for the determination of wound tissues water contents, NO and ET levels, and for calculation of NO/ET ratio. Another 6 normal rats served as normal controls.

RESULTSThe water content in the wound tissue in aloe raw polysaccharide group at 12, 24 and 48 PSH [(73.4 +/- 3.8)%, (76.6+/-3.0)%, (70.6+/-3.8)%] and aloe gel group [(74.5+/-2.6)%, (77.1+/-3.6)%, (71.2 +/- 3.1)%] was obviously lower than those in SD-Ag group [(80.1 +/- 4.1)%, (80.5 +/-3.9)%, (76.1 +/-3.8)%, P <0.05]. During 7-21 PSD, all of them returned to the normal level except that in SD-Ag group, as it was still higher than that in normal controls (P < 0.05). The NO content in wound tissue in each group reached the peak at 12 PSH, decreased thereafter, but it was still obviously higher than that of normal controls on 21 PSD (P < 0.05). The ET content in wound tissue of each group reached the peak on 7 or 14 PSD, decreased thereafter, but it was still evidently higher than that in normal controls on 7 or 14 PSD (P < 0.05). The NO content in wound tissue in aloe raw polysaccharide and aloe gel group were markedly lower than those in SD-Ag and normal saline groups at 12 and 24 PSH ( P < 0.05). The NO/ET ratio in each group reached the peak at 12 PSH, decreased thereafter, and it returned to normal value on 14 PSD. On 7 PSD, the NO/ET ratio in aloe gel, SD-Ag and normal saline groups were still significantly higher than that in normal controls, except that returned to normal value in aloe raw polysaccharide group.

CONCLUSIONBoth aloe raw polysaccharide and aloe gel can decrease wound tissue NO release, optimize NO/ET ratio, lighten vascular inflammatory reaction, and lessen permeability and edema.

Aloe ; Animals ; Burns ; drug therapy ; Disease Models, Animal ; Endothelins ; metabolism ; Male ; Nitric Oxide ; metabolism ; Phytotherapy ; Rats ; Rats, Wistar ; Silver Sulfadiazine ; therapeutic use ; Wound Healing

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.
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

OBJECTIVETo observe the effectiveness of MEBO in the treatment of burn patients with burn area over 50% TBSA.

METHODSTwo hundred and ninety-eight patients hospitalized in our hospital from May of 1991 to December of 2003 with burn area over 50% TBSA, who had MEBO treatment before hospitalization, were enrolled in the study as the experiment (E) group. Another group of 300 burn patients with burn area over 50% TBSA that treated with SD-Ag cream were enrolled in the study as the control (C) group. Bacterial culture results, major changes in injury and mortality were compared between the two groups.

RESULTSThere were 1 506 bacteria strains isolated from wounds in E group, and 9 main changes in injury (1679 cases) occurred with 20.8% mortality in this group. There were 353 bacteria strains isolated, with occurrence of 9 changes in injury (518 cases) and 4.7% mortality in the SD-Ag group.

CONCLUSIONMEBO is much less effective for the treatment of the burn patients with large burn area compared with SD-Ag cream treatment.

Adolescent ; Adult ; Bacteria ; isolation & purification ; Bandages ; Burns ; drug therapy ; microbiology ; pathology ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Injury Severity Score ; Male ; Middle Aged ; Phytotherapy ; Silver Sulfadiazine ; therapeutic use ; Treatment Outcome ; Wound Healing