Department of Plastic and Reconstructive Surgery, John Radcliffe Hospital, Headington, Oxford OX39DU, UK.
Burns. 2010 Sep;36(6):751-8. doi: 10.1016/j.burns.2009.04.008. Epub 2010 Mar 25.
The virtues of silver as an antimicrobial agent have been known for some time. Various silver containing dressings are currently used for the treatment of wounds. Introduced in the late 1990s, Acticoat is a nanocrystalline silver dressing developed to overcome some shortcomings of the older dressings by providing sustained release of silver up to 7 days. We aim to determine the level of evidence available in the literature in view of recent increased usage of Acticoat. A Medline search was conducted to identify articles evaluating the use of Acticoat in burn wounds. A level of evidence adapted from the Oxford Centre for Evidence-Based-Medicine was assigned to each of these articles. Only one study was considered to be LOE 1, which is a multicentre randomised controlled trial comparing Acticoat against Silver Sulfadiazine. One further randomised control trial was downgraded to LOE 2 due to a wide confidence interval. Twenty studies (66%) were LOE 5 of which 6 were case reports and 14 were in vitro/animal studies. The available LOE 1 study demonstrates that Acticoat has better antimicrobial activity compared to another available silver dressing. Other studies suggest Acticoat has fewer adverse effects and reduces healing times. Its ease of application and low frequency of change makes it an ideal dressing in burn wounds. More well designed and properly reported randomised controlled trials are essential for informed clinical decision-making.
银作为一种抗菌剂的优点已经为人所知一段时间了。目前各种含银的敷料都被用于治疗伤口。Acticoat 是一种纳米晶银敷料，于 20 世纪 90 年代末推出，旨在克服旧敷料的一些缺点，通过持续释放银长达 7 天。鉴于 Acticoat 的使用最近有所增加，我们旨在确定文献中可用的证据水平。我们进行了 Medline 搜索，以确定评估 Acticoat 在烧伤伤口中使用的文章。根据牛津循证医学中心（Oxford Centre for Evidence-Based-Medicine）的证据水平，为这些文章中的每一篇文章分配了一个证据水平。只有一项研究被认为是 LOE 1，这是一项比较 Acticoat 与磺胺嘧啶银的多中心随机对照试验。由于置信区间较宽，进一步的随机对照试验被降级为 LOE 2。20 项研究（66%）为 LOE 5，其中 6 项为病例报告，14 项为体外/动物研究。可用的 LOE 1 研究表明，Acticoat 与另一种可用的银敷料相比具有更好的抗菌活性。其他研究表明，Acticoat 具有更少的不良反应，并缩短了愈合时间。其易于应用和低更换频率使其成为烧伤伤口的理想敷料。更精心设计和正确报告的随机对照试验对于明智的临床决策至关重要。
