Tredget E E, Shankowsky H A, Groeneveld A, Burrell R
Department of Surgery, University of Alberta Hospital, Edmonton, Canada.
J Burn Care Rehabil. 1998 Nov-Dec;19(6):531-7. doi: 10.1097/00004630-199811000-00013.
A new silver-coating technology was developed to prevent wound adhesion, limit nosocomial infection, control bacterial growth, and facilitate burn wound care through a silver-coated dressing material. For the purposes of this article, Acticoat (Westaim Biomedical Inc, Fort Saskatchawan, Alberta, Canada) silver-coated dressing was used. After in vitro and in vivo studies, a randomized, prospective clinical study was performed to assess the efficacy and ease of use of Acticoat dressing as compared with the efficacy and ease of our institution's standard burn wound care. Thirty burn patients with symmetric wounds were randomized to be treated with either 0.5% silver nitrate solution or Acticoat silver-coated dressing. The dressing was evaluated on the basis of overall patient comfort, ease of use for the wound care provider, and level of antimicrobial effectiveness. Wound pain was rated by the patient using a visual analog scale during dressing removal, application, and 2 hours after application. Ease of use was rated by the nurse providing wound care. Antimicrobial effectiveness was evaluated by quantitative burn wound biopsies performed before and at the end of treatment. Patients found dressing removal less painful with Acticoat than with silver nitrate, but they found the pain to be comparable during application and 2 hours after application. According to the nurses, there was no statistically significant difference in the ease of use. The frequency of burn wound sepsis (> 10(5) organisms per gram of tissue) was less in Acticoat-treated wounds than in those treated with silver nitrate (5 vs 16). Secondary bacteremias arising from infected burn wounds were also less frequent with Acticoat than with silver nitrate-treated wounds (1 vs 5). Acticoat dressing offers a new form of dressing for the burn wound, but it requires further investigation with greater numbers of patients in a larger number of centers and in different phases of burn wound care.
一种新的银涂层技术被开发出来，通过一种银涂层敷料材料来防止伤口粘连、限制医院感染、控制细菌生长并促进烧伤创面护理。在本文中，使用了Acticoat（加拿大艾伯塔省萨斯卡通堡的Westaim生物医学公司）银涂层敷料。经过体外和体内研究后，进行了一项随机、前瞻性临床研究，以评估Acticoat敷料与本机构标准烧伤创面护理的疗效和易用性。30名有对称伤口的烧伤患者被随机分为两组，分别用0.5%硝酸银溶液或Acticoat银涂层敷料进行治疗。根据患者的总体舒适度、伤口护理人员的易用性以及抗菌效果水平对敷料进行评估。在去除敷料、应用敷料时以及应用后2小时，患者使用视觉模拟量表对伤口疼痛进行评分。由提供伤口护理的护士对易用性进行评分。通过在治疗前和治疗结束时进行的定量烧伤创面活检来评估抗菌效果。患者发现使用Acticoat去除敷料时比使用硝酸银时疼痛减轻，但他们发现在应用敷料时和应用后2小时疼痛程度相当。根据护士的评估，在易用性方面没有统计学上的显著差异。Acticoat治疗的伤口中烧伤创面脓毒症（每克组织>10(5)个微生物）的发生率低于硝酸银治疗的伤口（5例对16例）。Acticoat治疗的伤口中因感染烧伤创面引起的继发性菌血症也比硝酸银治疗的伤口少（1例对5例）。Acticoat敷料为烧伤创面提供了一种新的敷料形式，但需要在更多中心、更多患者以及烧伤创面护理的不同阶段进行进一步研究。
