Demling Robert H, Leslie DeSanti M D
Department of Surgery, Trauma and Burn Center, Brigham & Women's Hospital, 75 Francis Street, PBB-B4, Boston, MA 02115, USA.
Burns. 2002 May;28(3):264-6. doi: 10.1016/s0305-4179(01)00119-x.
The objective in this study was to determine whether exposure to pure silver increases the rate of re-epithelialization across a partial thickness wound. A meshed skin graft, placed on an excised burn wound was used as a healing model.
The rate of meshed skin graft epithelial closure on an exposed burn using a moist healing environment was shown. A moistened silver delivery system (Acticoat) was compared with a standard xeroform and eight ply gauze dressing continually moistened with a 0.01% neomycin and polymyxin solution (NP). Twenty burn patients with deep burns of over 15% of TBS were excised and grafted with 2:1 meshed grafts. One graft area was treated with the antibiotic solution and another with the silver delivery. The meshed graft was performed within 3 days of injury.
No infections were noted and quantitative swab cultures gave less than 10(2) bacteria in all cases at wound closure. At day 7, re-epithelialization was complete with silver and 55% closed with NP solution. Wound closure was complete in the NP solution group at day 10. Silver increased re-epithelialization rate by over 40%, a significant increase. Graft take was over 95% in both groups.
Silver released in a moist wound surface environment significantly increases the rate of re-epithelialization compared to a standard antibiotic solution.
本研究的目的是确定暴露于纯银是否会提高部分厚度伤口的再上皮化速率。将网状皮肤移植物置于切除的烧伤伤口上作为愈合模型。
展示了在湿润愈合环境下暴露烧伤处网状皮肤移植物的上皮闭合速率。将一种湿润的银输送系统（Acticoat）与一种标准的干纱布和用0.01%新霉素和多粘菌素溶液（NP）持续湿润的八层纱布敷料进行比较。20例烧伤面积超过总体表面积15%的深度烧伤患者接受了切除并移植了2:1的网状移植物。一个移植物区域用抗生素溶液处理，另一个用银输送系统处理。网状移植物在受伤后3天内进行。
未观察到感染，伤口闭合时所有病例的定量拭子培养细菌数均少于10² 。在第7天，使用银的情况下再上皮化完成，使用NP溶液的情况下55%闭合。NP溶液组在第10天伤口完全闭合。银使再上皮化速率提高了40%以上，显著增加。两组的移植物成活率均超过95%。
与标准抗生素溶液相比，在湿润伤口表面环境中释放的银显著提高了再上皮化速率。
