Issn Print: 1071-5754
Publication Date: 2005/05/01
THE USE OF VACUUM-ASSISTED CLOSURE IN COMBINATION WITH A NANOCRYSTALLINE SILVER DRESSING—A CLINICAL EVALUATION: 623
Excerpt
The topical negative pressure (TPN) has become a widely accepted technique in the management of chronic and acute wounds. Ulcers that are difficult to close or heavily colonized may still remain a challenge. The aim of this study was to evaluate the efficacy of a nanocrystalline silver dressing (NSD) in difficult-to-heal colonized wounds in combination with TPN, with regard to bacterial load, frequency of dressing changes and patient comfort. This was an uncontrolled, prospective study of a case series of 9 patients with a variety of heavily colonized non-healing wounds. Microbiologic swabs were taken weekly. Dressing regime consisted of cleansing of the wound with an antiseptic solution, the application of the NSD to the surface of the wound (which was covered with a carbonate sponge). The site was sealed with an adhesive transparent dressing drape. Negative pressure of −125 mmHg was applied. A marked clinical improvement was noticed in all the wounds. There was decreased erythema of the wound edges and decreased exudate. The swabs showed a decrease in the wound surface bacterial load. Only in one case were systemic antibiotics administered (for 1 week). Within 14-21 days, the wound bed appeared clean and healthy granulation tissue was present in all wounds. At this point, the TPN therapy and NSD were discontinued and a different therapy was adopted. All the wounds closed. In 4 of the wounds, skin graft was used for wound closure. The remaining 5 wounds closed with other therapies. It would appear from the results obtained that there was positive synergy between the NSD and the TPN system. This association was effective in the management of infection; it also increased patient comfort through reduced dressing changes.
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