Barillo David J, Croutch Claire R, Reid Frances, Culley Tara, Sosna William, Roseman Julie
From the *Disaster Response/Critical Care Consultants, LLC, Mount Pleasant, South Carolina; and †MRIGlobal Medical Countermeasures Division, Kansas City, Missouri.
J Burn Care Res. 2017 Sep/Oct;38(5):e818-e823. doi: 10.1097/BCR.0000000000000493.
Silver-based dressings are commonly used in burn care. Silver sulfadiazine use is associated with elevated blood, urine, and tissue levels of silver ion. We examined wound and tissue levels of silver ion in a two-species model of sulfur mustard chemical burn injury treated with two different silver-based dressings. Superficial dermal and moderate thickness dermal chemical burns were induced in 16 hairless guinea pigs and in 16 Gottingen minipigs by exposure to sulfur mustard vapor. After debridement, silver-nylon burn dressings or silver-calcium alginate dressings were applied and changed every 7 days until wound healing or a maximum of 60 days post exposure. At autopsy, liver, spleen, and wound samples were harvested. Silver ion was measured using inductively coupled plasma-mass spectrography with a lower level of detection of 0.02 parts per billion. Negligible silver ion levels were found in the liver (mean < 0.003 μg/g of tissue) and spleen (mean < 0.05 μg/g) of all 32 animals. Wound biopsies showed silver ion levels ranging from 0.07 to 19.5 μg/g of tissue. Wound levels were higher in minipigs than in hairless guinea pigs and were higher in animals treated with silver-nylon burn wound dressings than with silver-calcium alginate dressings. Silver ion could be detected in some wounds 40 days after dressings were removed. In a chemical burn model, application of silver-nylon or silver-calcium alginate dressings is associated with elevated wound levels but negligible tissue levels of silver ion.
银基敷料常用于烧伤护理。磺胺嘧啶银的使用与血液、尿液和组织中银离子水平升高有关。我们在用两种不同银基敷料治疗的芥子气化学烧伤损伤的双物种模型中检测了伤口和组织中的银离子水平。通过暴露于芥子气蒸汽，在16只无毛豚鼠和16只哥廷根小型猪中诱导了浅表真皮和中度厚度真皮化学烧伤。清创后，应用银尼龙烧伤敷料或银钙藻酸盐敷料，每7天更换一次，直至伤口愈合或暴露后最多60天。尸检时，采集肝脏、脾脏和伤口样本。使用电感耦合等离子体质谱仪测量银离子，检测下限为十亿分之0.02。在所有32只动物的肝脏（平均<0.003μg/g组织）和脾脏（平均<0.05μg/g）中发现银离子水平可忽略不计。伤口活检显示银离子水平为0.07至19.5μg/g组织。小型猪的伤口水平高于无毛豚鼠，使用银尼龙烧伤伤口敷料治疗的动物的伤口水平高于使用银钙藻酸盐敷料的动物。去除敷料40天后，在一些伤口中可检测到银离子。在化学烧伤模型中，应用银尼龙或银钙藻酸盐敷料与伤口水平升高有关，但组织中银离子水平可忽略不计。
