Alkhalil A, Day A, Monger K W, Zhang J, Carney B C, Hoffman H N, Moffatt L T, Shupp J W
Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC, US.
The Burn Center, MedStar Washington Hospital Center, Washington, DC, US.
J Wound Care. 2017 Jul 1;26(Sup7):S15-S22. doi: 10.12968/jowc.2017.26.Sup7.S15.
As the number of commercially available wound dressings is increasing rapidly, it is important for clinicians to understand the strengths and limitations of each and to recognise relationships between wound type and dressing properties to obtain optimal healing results. Our aim is to test the antimicrobial activity of two dressings.
A hydroconductive (HC) dressing and a silver-impregnated foam (SIF) dressing were compared for their potential to reduce the levels meticillin-resistant Staphylococcus aureus (MRSA). We also assessed MRSA-derived biologically active components in liquid or agar matrices, simplified models for heavily exuding or dry wounds respectively, and in an in vivo animal model with MRSA infected wounds.
In the agar model (dry wounds) both dressings showed a strong reduction in MRSA activities within 24 hours post-application. The antibacterial effects of the SIF dressing were more pronounced in the liquid model, however, at an increasing cytotoxic cost. In agreement with these in vitro results, assessment of dressings using an MRSA-infected wound in an rat model showed a decrease in MRSA which was significant 7 days post-burn and inoculation, with more compromised viability of MRSA. Dressings showed a similar capability to reduced and eliminate toxic shock syndrome toxin (TSST-1) at day 7 post-burn in the animal model but not at day 4, where the SIF dressing was more potent Conclusion: These results confirm the advantages of using silver in reducing bacterial load in wound treatment, except for conditions of highly exuding wounds where the cytotoxic properties of silver may offset these advantages and HC dressing use is more suitable.
随着市售伤口敷料数量迅速增加，临床医生了解每种敷料的优缺点并认识伤口类型与敷料特性之间的关系以获得最佳愈合效果非常重要。我们的目的是测试两种敷料的抗菌活性。
比较了一种导水（HC）敷料和一种含银泡沫（SIF）敷料降低耐甲氧西林金黄色葡萄球菌（MRSA）水平的潜力。我们还评估了MRSA在液体或琼脂基质中产生的生物活性成分，分别为大量渗出或干燥伤口的简化模型，以及在MRSA感染伤口的体内动物模型中。
在琼脂模型（干燥伤口）中，两种敷料在应用后24小时内均显示出MRSA活性的显著降低。然而，SIF敷料在液体模型中的抗菌效果更明显，但细胞毒性成本增加。与这些体外结果一致，在大鼠模型中使用MRSA感染伤口对敷料进行评估显示，烧伤和接种后7天MRSA数量减少，且MRSA的生存能力更受影响。在动物模型中，烧伤后7天敷料显示出降低和消除毒性休克综合征毒素（TSST-1）的类似能力，但在第4天则不然，此时SIF敷料更有效。结论：这些结果证实了在伤口治疗中使用银减少细菌载量的优势，但在大量渗出伤口的情况下，银的细胞毒性可能抵消这些优势，使用HC敷料更合适。
