Cell Physiology Research Group, Contipro a.s., Dolni Dobrouc, Czech Republic.
Department of Dermatovenereology, Third Faculty of Medicine, Charles University, Prague, Czech Republic.
FASEB J. 2021 May;35(5):e21580. doi: 10.1096/fj.202100065R.
Although silver is an efficient antimicrobial and is a widely used antiseptic in wound healing, previous studies have reported the cytotoxic in vitro effects of silver dressings. Moreover, few studies have addressed the distribution of silver in chronic wounds. The study compares the healing of chronic wounds treated with a standard-of-care silver dressing (Ag-CMC) and a dressing containing antiseptic octenidine (OCT-HA). Biopsies were taken from two wound areas before the commencement of treatment (baseline), after 2 weeks and after 6 weeks (the end of the study). We analyzed the histopathologic wound-healing score, silver distribution, and expression of selected genes. The wound-healing score improved significantly in the wounded area treated with OCT-HA after 2 weeks compared to the baseline and the Ag-CMC. The Ag-CMC wound areas improved after 6 weeks compared to the baseline. Moreover, collagen maturation and decreases in the granulocyte and macrophage counts were faster in the OCT-HA parts. Treatment with OCT-HA resulted in less wound slough. The silver, visualized via autometallography, penetrated approximately 2 mm into the wound tissue and associated around capillaries and ECM fibers, and was detected in phagocytes. The metallothionein gene expression was elevated in the Ag-CMC wound parts. This exploratory study determined the penetration of silver into human chronic wounds and changes in the distribution thereof during treatment. We observed that silver directly affects the cells in the wound and elevates the metallothionein gene expression. Octenidine and hyaluronan dressings provide a suitable alternative to silver and carboxymethyl cellulose dressings without supplying silver to the wound.
尽管银具有高效的抗菌作用，并被广泛用于伤口愈合的抗菌处理，但之前的研究报告称，银敷料具有细胞毒性的体外效应。此外，很少有研究涉及银在慢性伤口中的分布。本研究比较了标准治疗用银敷料（Ag-CMC）和含有抗菌剂奥替尼啶（OCT-HA）敷料治疗慢性伤口的愈合情况。在开始治疗前（基线）、2 周后和 6 周后（研究结束时），从两个伤口区域取活检。我们分析了组织病理学伤口愈合评分、银的分布以及选定基因的表达。与基线和 Ag-CMC 相比，OCT-HA 治疗的伤口区域在 2 周后伤口愈合评分显著改善。Ag-CMC 伤口区域在 6 周后与基线相比有所改善。此外，OCT-HA 部分的胶原成熟和粒细胞和巨噬细胞计数减少更快。OCT-HA 治疗导致更少的伤口坏死。通过自动金属染色观察到的银穿透伤口组织约 2mm，并围绕毛细血管和 ECM 纤维分布，并在吞噬细胞中检测到。Ag-CMC 伤口部位的金属硫蛋白基因表达升高。这项探索性研究确定了银在人慢性伤口中的渗透情况以及在治疗过程中其分布的变化。我们观察到银直接影响伤口中的细胞，并提高金属硫蛋白基因的表达。奥替尼啶和透明质酸敷料是银和羧甲基纤维素敷料的合适替代品，不会向伤口提供银。
