Silver alginate patch pediatric use

A comparative study of the dressings silver sulfadiazine and Aquacel Ag in the management of superficial partial-thickness burns. An open, parallel, randomized, comparative, multicenter study to evaluate the cost-effectiveness, performance, tolerance, and safety of a silver-containing soft silicone foam dressing intervention vs silver sulfadiazine cream. A prospective, randomized trial of acticoat versus silver sulfadiazine in the treatment of partial-thickness burns: which method is less painful?

J Burn Care Rehabil. J Med Assoc Thai. A randomized comparative trial between acticoat and SD-ag in the treatment of residual burn wounds, including safety analysis. Randomized clinical study of hydrofiber dressing with silver or silver sulfadiazine in the management of partial-thickness burns. Int Wound J. A silicone-coated nylon dressing reduces healing time in burned paediatric patients in comparison with standard sulfadiazine treatment: a prospective randomized trial.

Prospective, randomized study of the efficacy of mepitel on children with partial-thickness scalds. A randomized controlled study of silver-based burns dressing in a pediatric emergency department. Surgical site infections following colorectal cancer surgery: a randomized prospective trial comparing common and advanced antimicrobial dressing containing ionic silver.

World J Surg Oncol. Dressings for the prevention of surgical site infection. Silver-containing dressing for surgical site infection in clean and clean-contaminated operations: a systematic review and meta-analysis of randomized controlled trials. J Surg Res. Prospective, randomized, multi-institutional clinical trial of a silver alginate dressing to reduce lower extremity vascular surgery wound complications.

J Vasc Surg. Total occlusive ionic silver-containing dressing vs mupirocin ointment application vs conventional dressing in elective colorectal surgery: effect on incisional surgical site infection.

J Am Coll Surg. Use of closed incisional negative pressure wound therapy after revision total hip and knee arthroplasty in patients at high risk for infection: a prospective, randomized clinical trial. J Arthroplasty. A randomized clinical trial evaluating negative pressure therapy to decrease vascular groin incision complications. Prophylactic closed-incision negative-pressure wound therapy is associated with decreased surgical site infection in high-risk colorectal surgery laparotomy wounds.

Colorectal Dis ; 21 — Closed incision negative-pressure therapy cinpt reduces minor local complications in post-bariatric abdominoplasty body contouring: a retrospective case-control series. Obes Surg. Dressings used to prevent surgical site infection in the postoperative period of cardiac surgery: integrative review. A comparison of an antibacterial sandwich dressing vs dressing containing silver.

Effect of a wound cleansing solution on wound bed preparation and inflammation in chronic wounds: a single-blind RCT. J Wound Care. Subrahmanyam M. Topical application of honey in treatment of burns. A prospective randomised clinical and histological study of superficial burn wound healing with honey and silver sulfadiazine. Efficacy of a silver lipidocolloid dressing on heavily colonised wounds: a republished RCT.

Support Center Support Center. External link. Please review our privacy policy. Evaluate silver ion elution from silver-coated polyurethane NPWT sponge. Silver ion concentration in wound exudate rises over several days. Silver-coated polyurethane NPWT sponge achieves a larger zone of bacterial inhibition than plain polyurethane sponge With silver-coated polyurethane NPWT sponge, wound silver level reaches a peak at 5 days.

The addition of a silver dressing to polyurethane sponge enhances the antimicrobial activity of NPWT. Compare healing, pain, and cost with silver alginate versus gauze. Silver alginate reduces pain compared to gauze, but does not accelerate healing or decrease cost. Compare healing and odor with silver-containing dressing versus plain foam. Silver-containing dressing does not accelerate healing, but improves wound odor. Compare polyurethane to silver-coated polyurethane sponges for NPWT for infected diabetic foot ulcers.

NPWT with polyurethane sponge accelerates the healing of diabetic foot ulcers NPWT with silver-coated polyurethane sponge accelerates healing even more. Compare healing with SSD versus plain cream for chronic wounds. SSD slows epithelialization and increases hypertrophic scar formation. Evaluate healing with NPWT and promogran prisma in chronic wounds.

Promogran prisma accelerates healing due to its collagen component acting as a sacrificial substrate for proteases in the wound. NPWT promotes granulation tissue formation. Compare epithelialization with Acticoat versus occlusive, silver-free dressing for skin graft donor sites. Occlusive, silver-free dressing leads to faster epithelialization and better scar than Acticoat.

Compare epithelialization with silver-containing dressing versus octenidine for lower-extremity ulcers. Octenidine leads to faster healing and less pain than silver-containing dressing. Compare healing with nanocrystalline silver versus non-silver-containing dressings for lower-extremity venous ulcers. Nanocrystalline silver does not accelerate healing of lower-extremity venous ulcers. Compare healing with silver-containing dressings versus gauze for pressure ulcers.

Silver-containing dressings do not accelerate pressure ulcer healing. Compare healing with silver-containing dressings versus standard dressings for lower-extremity venous ulcers. Silver-containing dressings do not accelerate lower-extremity ulcer healing. Compare infection rates with silver-containing dressings versus non-silver-containing dressings for chronic wounds. Evaluate effectiveness of silver-containing dressings for diabetic foot ulcers. There are no good RCTs evaluating silver for diabetic foot ulcers.

Evaluate effectiveness of silver-containing dressings for lower-extremity ulcers. Silver-containing dressings do not accelerate lower-extremity ulcer healing Quality of evidence for silver is poor.

Evaluate effectiveness of silver alginate for pressure ulcers. Silver alginate does not accelerate pressure ulcer healing Quality of evidence for silver is poor.

Compare epithelialization with Mepilex Ag versus triple antibiotic ointment. Triple antibiotic ointment achieves faster epithelialization and less scarring than Mepilex Ag. Highest antimicrobial activity is achieved by Acticoat, followed by octenidine, then mupirocin, then SSD. Compare epithelialization and pain with SSD versus aloe vera. Compare epithelialization and infection with SSD versus honey.

Compare epithelialization, cost and infection with SSD versus honey. SSD leads to more infections, higher cost, and slower epithelialization. Compare epithelialization, pain and infection with SSD versus honey. SSD leads to more infections, more pain, and slower epithelialization. Compare epithelialization, hospital length of stay and cost with SSD versus Biobrane. SSD leads to slower epithelialization, longer hospital stay, and higher cost.

Healing times for pediatric tracheostomy wounds are unpredictable and protracted. Postoperative tracheostomy wounds are common complications. The use of maltodextrin gel MD and silver alginate foam pads AG provided an effective treatment for tracheostomy-related ulcers in pediatric patients. The institutional review board at the University of Arkansas for Medical Sciences approved this study. A retrospective chart review was performed. The charts of all subjects who underwent tracheostomy by the otolaryngology service at a tertiary care facility Arkansas Children's Hospital from December 29, until November 2, were reviewed.

Records reviewed and tabulated included the initial consultation, operative reports, and daily in-patient progress notes. A database including subject demographics, history, age, wound location, wound stage, treatment regimen, length of treatment, outcome, and complications was created.

This included 2 subjects who were transferred to the study facility with prior tracheostomies, as well as 6 subjects who received all of their treatment as out-patients. Ten out of 26 subjects After combining these groups, a total of 11 subjects both started and completed their treatment as in-patients and were thus included in the study population.

The average subject age was 5. The gender distribution for this same group was skewed toward male predominance with 9 male and 2 female subjects. Of the 11 subjects included in the study group, 8 had infrastomal wounds Fig. This is detailed in Table 1. Initial wound stage for this group is summarized in Table 1. Subject 6. Stomal and infrastomal pressure ulcer and operative wound before treatment. The average length of treatment for the study group was Each of the 11 subjects' wounds achieved complete epithelialization by completion of treatment see Figs.

A total of subjects were identified as having received tracheostomies by the otolaryngology service at the study institution during the study period December 29, through November 2, and the 5 y preceding December 29, through December 28, Unfortunately, during the 5 y before AG and MD were utilized for wound care, tracheostomy site surveillance, wound documentation, and wound care were not routinely recorded.

Comparative data were thus unavailable to provide a reliable control group for the study population. For example, only 5 subjects outside the study period were documented as having tracheostomy wounds that required treatment. Of these, 3 subjects had wounds documented for several months with no clear resolution. Another subject's wound lasted for 1 month, and the other subject's lasted for 2 weeks using a variety of methods for wound care.

Therefore, this information was not included in the data analysis, and statistical comparisons of treatment outcomes could not be formulated. In the pediatric population, pressure- and friction-related wounds secondary to the tracheostomy tube and ties are frequently encountered and require special attention.

Prevention and early detection are the cornerstones to effective tracheostomy wound care, as described by Boesch et al. However, despite these preventive efforts, wounds related to tracheostomy tubes still occur in pediatric patients.

Hypothetically, this may be due to their comparatively shorter necks, increased wet environment from secretions and perspiration, frequent and rapid head and neck movements compared with more sedentary adults, and the routine use of firm and inflexible methods to secure the tube to prevent accidental decannulation. All of these factors likely lead to areas of pressure and friction that may result in open wounds. Despite this common occurrence, tracheostomy-related wounds have no standardized treatment, and very little can be found in the literature about management of these unique wounds.

Of the few articles that address the topic of tracheostomy-related wounds, the occurrence of wounds is mentioned, but specific treatments administered, duration of treatment, or recommendations are not described.

As these wounds lie in close proximity to the respiratory tract, it is important to also bear in mind the absorptive properties inherent in this region and to pay careful attention to the treatment options considered.

Silver-containing compounds have been utilized extensively for wound care in both adults and children. Multiple studies have described the bactericidal properties of silver. The release of silver ions has been found to be at a fairly constant rate over a total of 10 d, although the pads are recommended to be changed after 7 d.

The safety of silver usage in both infants and adults has also been thoroughly investigated. Although silver has been utilized ubiquitously in wound care, maltodextrin and related sugars have not been as widely employed.

However, the benefit of maltodextrin for wound healing and its mechanisms have been described. Effectively, MD serves as a chemotactant for white blood cells, macrophages, and fibroblasts. The influx of fibroblasts also promotes collagen formation, which is critical for healing.

The gel form also provides the wound with a moist environment, which has been shown to be beneficial for healing. Both products, AG and MD, effectively eliminate infection and promote granulation tissue to assist in the healing process.

The AG product also has the added benefit of serving as a barrier pad, which relieves pressure from the tube and its associated ties. The location of tracheostomy wounds has always presented an interesting dilemma to wound care. Due to the increased absorptive capabilities of the trachea, the usage of materials that can cause toxicity or potential irritation are avoided.

Both MD and AG have been found to be safe for use in this delicate region. We identified no adverse effects from the use of these products for the subjects included in this retrospective study. Although both AG and MD have been described as safe and effective in wound care, no reports of the use of AG or MD for tracheostomy wounds are found in the literature.

Unfortunately, catheter related blood stream infections still remain one of the major causes of morbidity in VLBW infants. In the United States, approximately , infections are attributed to catheters annually, occurring primarily in intensive care unit patients.

One approach to reducing the incidence of infection could be utilizing the antimicrobial properties of silver. Silver alginate has been proven safe and beneficial in the adult population in preventing catheter related infections.

However, there is no clinical evidence of efficacy in VLBW neonatal population. Based on the data from our pilot safety study, we hypothesize that using silver alginate dressing in this population will be efficacious in the prevention of blood stream infections. Although initial studies suggest that absorbed silver is not in a range toxic to human infants, we will continue to monitor silver levels in certain infants. Safety will be assessed by obtaining silver levels, skin integrity, and adverse events related to the dressing.

Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies. Infants with birth weights between and grams admitted to the NICU with any of the following lines will be eligible for inclusion in this study.

Any infant born with a lethal abnormality or who has received topical Silver therapy will be excluded from the study. Try the modernized ClinicalTrials. Another advantage of the alginate-based dressing was its ability to be removed by dissolution because of its gel-forming property.

An uniform morphology of the nanofibers can also be obtained by adding lecithin as a natural surfactant [ 93 ], or arginine—glycine—aspartic acid RGD [ ]. The resulting photo-cross-linked nanofibers can also be coated with gold.

Before the cross-linking the fiber diameters were between The 3D bi-layered scaffold made of polyethylene glycol PEG -chitosan hydrogel and chitosan-alginate can also help tissue regeneration after injury by holding fibroblasts on the upper surface and keratinocytes on the lower one [ , ].

The wound pH is a reliable factor when discussion the healing status, because it shifts from high when infected to low when healed either naturally or because it was modulated through applying different treatments [ , , ]. The diffusion of both drugs from the annealed wafers takes place slowly, making them potentially useful in highly exuding wounds [ 23 , ]. Because wound pH-variation has a strong effect on the healing process, researchers also developed, through microfluidic spinning using their electrostatic interactions, a mesoporous particle hydrogel alginate-based flexible microfiber linked to a pH-responsive dye linked onto a transparent medical tape place on top of a wound, in order to observe the pH modifications in real-time [ ].

A 3D porous sponge was obtained after a pre-gelled with bivalent cations alginate was frozen and then lyophilized. This pore size was appropriate for fibroblast seeding [ ]. PEG addition to the aforementioned sponge increases the flexibility while having a plasticizing effect.

Furthermore, its concentration and molecular weight significantly modifies the tensile strength of the sponge. For low molecular weight PEG of 1. For high molecular weight PEG 10 kDa the concentration increases from 0. While comparing the results between the uses of different molecular weight PEG in the sponge, the one with a molecular weight of 1.

The researchers state the dressings proved their activity against E. Silver creates a barrier against a broad spectrum of bacteria [ ] for as long as seven days [ ]. When a patient is unable to move, pressure ulcers may appear.

After the eschar resection, wound debridement, and 21 days of the first dressing, the next step was applying the second one for two weeks, and the third for an unmentioned period. After two months from the first treatment the wound was completely healed [ ], with minimal scaring and thus confirming the benefits of wound treatments involving hyaluronic acid in combination with sodium alginate. The development of alginate-based biomaterials for wound healing has an accelerated pace.

The versatility of alginate-based wound dressings, the promising results after both in vivo and in vitro trials and the cost-effectiveness of obtaining them makes alginate one of the favorites when choosing the material that could act both as a support and as a carrier for the bio-active compounds that have to reach a wound. Conceptualization, A. All authors have read and agreed to the published version of the manuscript. National Center for Biotechnology Information , U. Journal List J Pers Med v.

J Pers Med. Published online Sep 7. Find articles by Andreea Barbu. Find articles by Ciprian Bacila. Author information Article notes Copyright and License information Disclaimer. Received Aug 15; Accepted Sep 5. Abstract Chronic wounds represent a major public health issue, with an extremely high cost worldwide. Keywords: alginate, biomaterial, dressing, fibers, hydrogel, nanofibers, commercially available, wound care, wound healing.

Introduction Chronic wounds represent a major public health issue, with an extremely high cost worldwide. Chronic Wounds Mechanisms and Alginates Roles Wound healing mechanisms involve multiple cellular events, while also being related to the biodynamic of the bacterial film on the wound surface.

Alginate Physical Properties Alginates ALG , are linear water soluble high swelling natural anionic polysaccharides obtained from brown algae cell walls and from some bacteria strains such as Pseudomonas or Azotobacter [ 6 , 38 , 39 , 40 ]. Open in a separate window. Figure 1. Alginate-Based Hydrogels for Wound Healing One of the most promising alginate forms being used in helping wound healing is the hydrogel because it keeps the moisture and absorbs the excessive exudate, it reduces local pain because it has a cooling effect, it does not adhere to the wound bed and it can hold active compounds such as various drugs, signaling molecules, or stem cells.

Figure 2. A 3D model of porous hydrogel with fibroblasts and keratinocytes. Table 1 Alginate-based hydrogels used for wound healing. Characterization, crosslinking degree, antimicrobial activity. Best results: 0. Table 2 Alginate-based beads and microcapsules used for wound healing.

Figure 3. Table 3 Alginate-based nanofibers and fibers used for wound healing. Table 4 Other alginate-based dressings used for wound healing. Na ALG—0. Table 5 Alginate-based commercially available pharmaceutical products used in wound healing.

If used with H 2 O 2 and SCN- it has a bacteriostatic effect against both gram-positive and gram-negative bacteria. First and second partial thickness burns. Conclusions The development of alginate-based biomaterials for wound healing has an accelerated pace. Author Contributions Conceptualization, A. Funding This research received no external funding.

Institutional Review Board Statement Not applicable. Informed Consent Statement Not applicable. Conflicts of Interest The authors declare no conflict of interest.

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