Nanosilver Dressing in Treating Deep II Degree Burn Wound Infection in Patients with Clinical Studies.

BACKGROUND: Patients' clinical antibiotic treatment of deep II degree burns usually fails to achieve the ideal effect; in order to avoid the late result in pigmentation, scarring, and even limb dysfunction, it also needs to deal effectively with burn wounds. AIM: The purpose of this study is to evaluate nanosilver dressing in treating deep II degree burn wound infection in patients with clinical studies. MATERIALS AND METHODS: 106 burn patients were classified into the Sulfadiazine Silver Cream (SSC) group (n = 53) and the Nanosilver Burn Dressing (NSBD) group (n = 53). Both of them received basic wound treatment, and wound healing time and pigmentation fading away time of all patients were recorded. And the wound healing rate of the patients was calculated. Serum levels of tumor necrosis factor alpha (TNF-α) and interleukin-1beta (IL-1ß) were detected pre- and posttreatment. RESULTS: After basic treatment for all patients, Sulfadiazine Silver Cream was used in the SSC group, and Nanosilver Burn Dressing was used in the NSBD group. It was observed that after treatment, compared with the SSC group, there was significant efficiency; wound healing rate, healing time, and pigmentation fading away time were shortened in the NSBD group, and IL-1ß levels were decreased, and the positive rate of bacterial culture was decreased (all P < 0.05). CONCLUSION: Nanosilver Burn Dressing in treating deep II degree burns can effectively reduce the wound infection and promote wound healing. The curative effect was distinct, which was worthy of popularization and application.

Novel chitosan and bacterial cellulose biocomposites tailored with polymeric nanoparticles for modern wound dressing development.

Dressing biomaterials play a key role in wound management keeping a moisture medium and protecting against external factors. Natural and synthetic materials could be used as dressings where chitosan and bacterial cellulose is one of the most important solutions. These biopolymers have been used for wound dressing based on their non-toxic, biodegradable, and biocompatible features. In this study, biocomposites based on bacterial cellulose and chitosan membranes tailored with antimicrobial loaded poly(N-isopropylacrylamide)/polyvinyl alcohol nanoparticles were prepared. Core-shell polymeric nanoparticles, bacterial cellulose/chitosan membranes, and biocomposites were independently loaded with silver sulfadiazine, a well-known sulfonamide antibacterial agent used in the therapy of mild-to-moderate infections for sensitive organisms. The chemistry, structure, morphology, and size distribution were investigated by Fourier transformed infrared spectroscopy (FTIR-ATR), RAMAN spectroscopy, Scanning electron (SEM) and Transmission electron microscopy (TEM), and Dynamic light scattering (DLS). In vitro release behaviors of silver sulfadiazine from polymeric nanoparticles and biocomposites were investigated. The biological investigations revealed good biocompatibility of both the nanoparticles and the biocomposites in terms of human dermal fibroblasts viability and proliferation potential. Finally, the drug-loaded polymeric biomaterials showed promising characteristics, proving their high potential as an alternative support to develop a biocompatible and antibacterial wound dressing.

Evaluating the Efficacy, Safety, and Tolerance of Silver Sulfadiazine Dressings Once Daily Versus Twice Daily in the Treatment of Burn Wounds.

Topical silver sulfadiazine (SSD) is an effective antimicrobial therapy used to prevent burn wound infection and promote healing, but the frequency of application has not been previously examined. This study compares once versus twice daily dressing changes with SSD, focusing on development of wound infections, incidence of hospital acquired complications, patient pain scores, and length of stay. The objective of this study was to evaluate whether a once-daily or twice-daily application of SSD impacts burn wound healing outcomes. Our institution maintained a twice-daily dressing change standard of care until January 1, 2019. Patients admitted after that date had their dressing changed once daily. We performed a noninferiority analysis which indicated that a sample size of 75 per group would be sufficient to detect a significant difference with a power of 0.80. Our goal is to review outcomes for 75 patients before the change-of-practice and 75 patients after. Our main outcomes recorded are wound infection, average pain scores, average daily narcotic requirements, and length-of-stay. Results from 75 pre-change-of-practice and 75 post-change-of-practice patients showed slightly better outcomes in the post-change-of-practice group. The wound-infection rates were the same for both groups (pre = 5.33%, post = 5.33%), average daily pain levels for the pre-change group were slightly higher but the difference was negligible and not statistically significant (pre = 5.27, post = 5.25), hospital-related complication rates (unrelated to wound care) were higher pre-change (pre = 10.67%, post = 6.67%), and length-of-stay, was longer in the pre-change group (pre = 11.97, post = 10.31). The amount average amount of SSD (g/day) used per patient per hospital stay was higher as well (pre = 320.14, post = 202.12). Further statistical analysis of the results, particularly in the distribution of burn type, age, and burn depth showed no discrepancy and a generalized decreased length-of-stay with once-daily SSD dressing change. Our results show that once-daily dressing changes of SSD in burn wounds have no negative impact on wound outcomes. However, it is associated with a decreased length-of-stay, decreased pain levels, and less hospital-acquired complications. A decreased length-of-stay means reduced medical expenses for the patient and the hospital. In addition, less hospital-acquired complications result in better patient recovery. Since the difference in wound outcomes is negligible and statistically insignificant, changing the standard-of-care to once daily could prove beneficial.

Application Of Cling Film Over Burn Wounds (Occlusive Wound Dressing): Our Experience.

BACKGROUND: This study shares our experience and review the outcome of the use of cling film with silver sulfadiazine cream in terms of healing time, and patient's satisfaction score. METHODS: It was a descriptive case series conducted at Jinnah Burn and Reconstructive Surgery Center, Lahore, from March 2018 to February 2019. In this study, a thick layer of silver sulfadiazine was applied and then wrapped with cling film on 35 patients sustained mix thickness burns on the trunk and limbs. Dressing was done daily after wound wash with normal saline. Consultant Plastic surgeon assessed the wound healing by observation and serial photographs. Duration of wound healing and complications were noted. RESULTS: Complete wound healing was achieved in 25 (71.4%) patients with mean healing time of 13.3 days (range 11-15 days). The wound infection was seen in 5 (14.2%) patients, that were diagnosed by change in colour of wound edges and patients with signs of sepsis (ABA scoring). Sepsis was treated in 5 patients with debridement and culture specific antibiotics. split skin graft done in 8 (22.8%) cases. CONCLUSIONS: Moist wound dressing with Silver Sulfadiazine and cling film is cost effective, easy to apply with good visibility of the wound and has good patient satisfaction, but is labour intensive.

USE OF TOPICAL TREATMENTS AND EFFECTS OF WATER TEMPERATURE ON WOUND HEALING IN COMMON CARP (CYPRINUS CARPIO).

Skin lesions are frequently diagnosed in fish medicine. Although systemic fish treatments exist, little is known about the efficacy of topical drugs on fish skin lesions. This study aimed to investigate the efficacy of medical-grade honey and silver sulfadiazine on skin lesions using common carp (Cyprinus carpio) as a model. Additionally, the effect of temperature on the wound healing process was evaluated. Punch biopsies were generated on six fish per treatment group under anesthesia. Treatment groups received one of the following topical medications after wounding: Dr. Nordyke's Wound Honey, MicroLyte Ag Vet, or SilvaSorb Gel. Nontreated positive control groups were similarly wounded but did not receive topical treatment. Fish were housed at 10°C to 13°C or 18°C to 21°C for 29 days. Macroscopic evaluation and image collection of wounds were performed on days 0, 4, 8, 12, 21, and 29 after wounding to compare changes in wound areas and inflammation over time. On day 29, tissue samples were collected for histologic analysis. From day 12 after wounding onward, wounds in positive controls maintained at 18°C to 21°C were significantly smaller (days 12, 21, and 29: P < 0.0001) compared with positive controls kept at 10°C to 13°C. There was an overall improvement in macroscopic appearance in honey-treated groups compared with positive controls on day 12 after wounding at 18°C to 21°C (P = 0.001), whereas with the use of Microlyte and Silvasorb, wounds had increased inflammation grades (P < 0.0001 and P < 0.0001, respectively) with enlarged wound areas (P < 0.0001 and P < 0.001, respectively) in comparison with positive controls on day 12 after wounding at 18°C to 21°C. This study suggests that topical use of medical-grade honey produces positive effects on wound healing in the carp model and higher water temperatures enhance the effects, whereas the use of silver sulfadiazine and lower water temperatures delays or worsens the wound healing process.

Evaluation of the efficacy of platelet-rich plasma on healing of clean diabetic foot ulcers: A randomized clinical trial in Tehran, Iran.

BACKGROUND AND AIMS: Diabetic foot ulcers (DFUs) are among challenging hurdles both for the patient and the physician. There is a recent trend toward finding novel and clinically efficient modalities to treat this potentially hazardous complication of diabetes mellitus in a timely manner. Herein, we aim to appraise the efficacy of platelet-rich plasma (PRP) in healing of clean DFUs. METHODS: 90 patients with clean DFUs consisting of 56 (62.2%) males and 34 (37.8%) females with mean age (±standard deviation) of 56.52 (±7.14) years were enrolled in this study between June 2017 and December 2018. They were randomly allocated into control group (47 patients who received conventional dressing along with silver sulfadiazine ointment twice daily), and case group (43 patients who received PRP gel twice weekly for 3 weeks). All the patients were followed up for 6 months. RESULTS: Our study showed that PRP significantly increased the healing rate of DFUs regardless of the age (p-value: 0.0), gender (p-value: 0.0), or smoking (p-value: 0.0) and blood pressure (p-value: 0.0) status of patients, but it did not have a significant impact on the need for amputation (p-value: 0.11), level of amputation (p-value: 0.16), or the need for further treatments such as graft or angioplasty (p-value: 0.52). CONCLUSION: Regardless of the age, gender, or smoking and blood pressure status of patients, PRP can be efficiently used in diabetic patients to accelerate the healing rate of foot ulcers.

Effects of Carnosine, Ankaferd, and Silver Sulfadiazine on an Experimental Burn Model: Roles of Irisin and HSP70.

In this study, the effects of carnosine, ankaferd, and 1% silver sulfadiazine applied topically on second-degree burns were investigated and the roles of irisin and Heat shock protein 70 (HSP70) in this healing process were evaluated. Ninety male albino rats were used and divided into five groups. The groups were classified as control, burn, burn + carnosine (CAR), burn + ankaferd (ABS), and burn + silver sulfadiazine (SS). It was found that level of irisin increased in the first week and decreased in the second week in the burn and CAR groups. In the ABS and SS groups, the level of irisin was determined that started to increase in the first week and continued to increase in the second week. The level of HSP70 was found to increased in the first week in burn and CAR groups and decreased in the second week, but started to increase in the second week in ABS and SS groups. Both levels of irisin and HSP70 were observed to decreased in all treatment groups in the third week. In this study, it was shown that ankaferd and silver sülfadiazine treatments cause an increase in the irisin levels in the early period and a gradually increase in HSP70 levels in the later period in burns. The inflammatory response was observed to be limited in the early period in the ankaferd and sulfadiazin groups. It was concluded that these findings were effective in early wound healing in burns.

Comparison Between Two Strategies of Topical Treatment in Tar Burn: A Case Report.

The management of tar burns presents a wide range of possible approaches, and several strategies can be used to reduce the damage regarding the removal of tar adhered to the patient's skin. Tar residues should preferably be emulsified with solvent solutions. Due to the low incidence of tar burns, it has not yet been possible to select the appropriate agent for the removal of the adhered tar. In this article, we reported a case of a 47-year-old man with a tar burn in his forehead region and his both upper limbs treated with two different approaches and the outcomes. In the right upper limb, the removal of tar with oil-based on essential fatty acids was attempted at the time of hospital admission, whereas in the left upper limb, he was treated with 1% silver sulfadiazine cream, sterile gauze, and bandage. On the right upper limb, the treatment was eventually performed with debridement and split-thickness skin grafting. On the left upper limb, there was complete re-epithelialization of the burns. The more conservative approach of keeping a dressing with 1% silver sulfadiazine on the tar itself, followed by removing the material in the dressing changes was considered better than the immediate removal of tar with an oily solution, especially about pain. Our impression was that the application of 1% silver sulfadiazine cream at the time of the admission, as well as in the following days, may be beneficial for the removal of the tar in close contact with the skin. Possibly, this approach leads to less trauma to the skin and, eventually, simplifies the treatment of burns by hot tar.

Effects of blood flow on the antibacterial efficacy of chlorhexidine and silver sulfadiazine coated central venous catheter: A simulation-based pilot study.

BACKGROUND: Chlorhexidine and silver sulfadiazine coated central venous catheters (CSS-CVC) may cause loss of antimicrobial efficacy due to friction between the CVC surface and sheer stress caused by the blood flow. Therefore, the aim of this study was to investigate the antibacterial efficacy of CSS-CVC at various flow rates using a bloodstream model. METHODS: Each CVC was subjected to various flow rates (0.5, 1, 2, and 4 L/min) and wear-out times (0, 24, 48, 72, 96, and 120 hours), and the optical density (OD) 600 after a Staphylococcus aureus incubation test was used to determine the antibacterial effect of CSS-CVC. RESULTS: In the 0.5 L/min group, there was no significant change in the OD600 value up to 120 hours compared with the baseline OD600 value for CSS-CVC (P > .467). However, the OD600 values of CSS-CVC in the 1 L/min (P < .001) and 2 L/min (P < .001) groups were significantly reduced up to 72 hours, while that in the 4 L/min (p < 0.001) group decreased rapidly up to 48 hours. CONCLUSION: This study suggests that there is a doubt whether sufficient antibacterial function can be maintained with prolonged duration of catheter placement.

Silver sulfadiazine-loaded electrospun ethyl cellulose/polylactic acid/collagen nanofibrous mats with antibacterial properties for wound healing.

Recently, the electrospun nanofiber mats with appropriate properties for applications in the biomedical area has been more considered. In this regard, we successfully fabricated a novel antibacterial nanofiber mat (ethyl cellulose/poly lactic acid/collagen) (EC/PLA/collagen) incorporated with silver sulfadiazine (AgSD) and then analyzed with the required tests. AgSD was loaded in the developed mats with different contents (0.25%, 0.5% and 0.75%) and then electrospun to prepare nanofiber mats. To check the chemical structure of the developed mat, Fourier transform infrared spectroscopy (FTIR) was assessed. Surface morphological studies were performed by Scanning Electron Microscopy (SEM), which displayed uniform nanofiber mats without any bead formation. When the hydrophilicity was enhanced by decreasing the blending ratios of EC/PLA, the thermal stability of the nanofibers was reduced. The water contact angle (WCA) of NFs enhanced by decreasing the blending ratios of EC/PLA. The antibacterial properties showed the inhibition activity against Bacillus (9.71 ± 1.15 mm) and E. coli (12.46 ± 1.31 mm) bacteria. Besides, nanofibers have improved cell proliferation and adhesion with any cytotoxic effect on NIH 3T3 fibroblast cells. According these results, it seems that the developed mats would be effective scaffold for application in wound dressings.

Efficacy of Topical Antimicrobial Agents Against Bacterial Isolates From Burn Wounds.

Topically applied antimicrobials are key to the prevention of infection and mortality in the acute burn population. The purpose of this study was to determine the in vitro effectiveness of commercially available topical antimicrobials, as well as topical preparations that were compounded in our burn care institution. One-hundred twenty microorganisms were tested against these topical antimicrobials and in vitro effectiveness was observed. Results showed that compounded preparations of 1:1:1 + Double Antibiotic (1 part bacitracin: 1 part silver sulfadiazine: 100,000 units/g nystatin + 5 mg/g neomycin sulfate + 500 units/g polymyxin B) and 3:1 + Double Antibiotic (3 part bacitracin: 1 part silver sulfadiazine + 5mg/g neomycin sulfate + 500 units/g polymyxin B) were effective against 100% of the isolates tested. Other topical agents showed moderate effectiveness, thus demonstrating the need for multiple topical agents to reach a broad spectrum of microorganisms. However, the development of topical antimicrobial resistance needs further study.

Management of otitis externa with an led-illuminated gel: a randomized controlled clinical trial in dogs.

BACKGROUND: Canine otitis externa is a painful condition which can be challenging to treat due to difficulties in the administration of otic medication. This can be due to lack of owner compliance in the application of ear drops or due to the resentment that some dogs demonstrate when attempts are made to administer topical medication into a sensitive ear canal. The aim of the study was to assess the efficacy of a topical LED-illuminated gel (LIG) in canine otitis externa in comparison to standard of care therapy. Dogs with spontaneous otitis externa were randomly allocated in three groups: groups QW received LIG once weekly; BW received LIG twice weekly; group C received enrofloxacin and silver sulfadiazine twice daily. LIG consists of a topical application of a gel containing chromophores that, when illuminated by a LED lamp, re-emit fluorescent light which can stimulate physiological responses, promoting healing and controlling bacteria. The evaluation protocol (T0 to T5) considered clinical assessment (OTIS-3-index-scoring-system; pruritus-severity-scale; pain-severity-score; aural temperature), cytological scoring system, quali-quantitative bacteriologic assessment. RESULTS: All groups (QW, n = 21; BW, n = 23; C, n = 20) showed improvement during the study (QW: P < 0.02 for cytological and pain scores, P < 0.003 for bacteriologic assessment, P < 10- 4 for pruritus, total OTIS-3 and temperature assessments; BW: P < 10- 4 for all clinical, cytological and bacteriologic assessments; C: P < 0.02 for all clinical and cytological assessments, P < 10- 4 for bacteriologic assessment). The highest clinical score reduction occurred in Group BW (P < 0.014 in T3; P < 0.001 in T4 and P < 10- 4 in T5). BW reached the clinically relevant effect level at T3 (- 3.26 ± 1.21 levels), QW reached it at T4 (- 3.24 ± 0.99), C did not reach it. No differences between groups were seen in the reduction of CFU/mL (T0-T5). CONCLUSIONS: All treatment groups showed a positive clinical effect. LIG administered twice-a-week was the most favourable protocol of the study. LIG may be considered beneficial in the management of canine otitis externa; it seems to be effective in controlling the clinical condition, including the signs of inflammation and local pain, the bacterial growth, and it may help increasing treatment compliance.

Acute Radiation Therapy-related Dermatitis.

Radiation therapy (RT) following breast-conserving surgical excision of cancer reduces cancer-related mortality and recurrence.1 However, most patients experience acute radiation dermatitis (ARD) within weeks after beginning RT2; symptoms of ARD, including severe skin erythema, dryness, moist or dry desquamation, and/or ulceration, may interrupt radiotherapy. This can negatively affect patient quality of life (QoL) and cancer outcomes. Acute radiation dermatitis is not to be confused with chronic radiation dermatitis, which can lead to fibrosis, skin atrophy, pigmentation, and telangiectasia months to years after RT.3 Evidence-based guidelines4 to both prevent and treat ARD recommend the application of 1 of 2 topical interventions during and/or after RT: (1) corticosteroids to improve ARD-related discomfort and itching5 or (2) 1% silver sulfadiazine (SSD) cream to reduce ARD-related dermatitis scores.6 This Evidence Corner reviews evidence supporting the 2 aforementioned topical interventions for patients undergoing RT for breast cancer.

The Optimal Treatment for Partial Thickness Burns: A Cost-Utility Analysis of Skin Allograft vs. Topical Silver Dressings.

INTRODUCTION: Partial thickness burns not undergoing surgical excision are treated with topical silver products including silver sulfadiazine (SSD) and Mepilex Ag. Skin allograft is a more costly alternative that acts as definitive wound coverage until autogenous epithelialization. Economic constraints and the movement toward value-based care demand cost and outcome justification prior to adopting more costly products. METHODS: A cost-utility analysis was performed comparing skin allograft to SSD and Mepilex Ag using decision tree analysis. The base case modeled a superficial partial thickness 20% total body surface area burn. Utilities were derived from expert opinion on the basis of personal experience. Costs were derived from 2019 Medicare payments. Quality adjusted life years were calculated using rollback method assuming standard life expectancies in the United States. Probabilistic sensitivity analysis was performed to asses model robustness. RESULTS: The incremental costs of skin allograft to Mepilex Ag and SSD were $907.71 and $1257.86, respectively. The incremental quality adjusted life year (QALY) gains from allograft over Mepilex Ag and SSD were 0.011 and 0.016. This yielded an incremental cost-utility ratio for allograft vs. Mepilex Ag of $84,189.29/QALY compared with an incremental cost-utility ratio of $79,684.63/QALY for allograft vs. SSD. Assuming willingness-to-pay thresholds of $100,000/QALY, probabilistic sensitivity analysis demonstrated that allograft was cost effective to Mepilex Ag in 62.1% of scenarios, and cost effective to SSD in 64.9% of simulations. CONCLUSION: Skin allograft showed greater QALYs compared with topical silver dressings at a higher cost. Depending on willingness-to-pay thresholds, skin allograft may be a considered a cost-effective treatment of partial-thickness burns.

Dealing with biofilms of Pseudomonas aeruginosa and Staphylococcus aureus: In vitro evaluation of a novel aerosol formulation of silver sulfadiazine.

The risk of infection of skin and soft tissue chronic wounds by gram-negative and gram-positive pathogens growing in biofilms is a major health-care concern. In this study we test a formulation of silver sulfadiazine, vitamin A and lidocaine (AF-SSD) for aerosol administration against biofilms of Pseudomonas aeruginosa and biofilms of methicillin-resistant (MRSA) and methicillin-sensitive (MSSA) strains of Staphylococcus aureus. The aerosol allows the administration of AF-SSD without the direct contact with the wound and avoids contamination of the product after reiterative usage. We evaluated in vitro the anti-biofilm activity of AF-SSD by carrying out different technical approaches such as resazurin assays to measure metabolic activity/viability, crystal violet staining assays to determine biofilm biomass, counting of CFUs and live/dead staining for confocal microscopy analysis. AF-SSD clearly affected biofilm viability, biomass and structure, in the three bacterial strains tested. AF-SSD displayed a strong anti-biofilm effect, showing total bactericidal activity on biofilms of P. aeruginosa at a 400-fold dilution of the product, and after a 100-fold and 10-fold dilution for MRSA and MSSA, respectively. Considering the benefits of aerosol administration, our results support this kind of formulation as a potential improvement over conventional treatments with silver sulfadiazine.

O uso de alta frequência como recurso para cicatrização de queimaduras: Um estudo de caso / The use of high frequency as a resource for burn healing: A case study

OBJETIVO: Avaliar a eficácia da alta frequência na cicatrização de feridas por queimadura durante internação hospitalar. MÉTODO: Trata-se de um estudo de caso, realizado com uma voluntária do sexo feminino, 19 anos, em um hospital de pronto-socorro. Foram aplicados a alta frequência e curativos convencionais, com a amostra única sendo dividida em área de intervenção e área controle. Foram avaliados dados clínicos e sociodemográficos, registros fotográficos pré e pós as intervenções, dimensão da área da ferida por meio de planimetria digitalizada, aspecto da cicatriz através da Escala Vancouver e a qualidade de vida por meio do questionário Burn Specific Health Scale. RESULTADOS: A área da ferida teve redução de 54% na área de intervenção e 26% na área controle. Aspectos como vascularização e flexibilidade também apresentaram discreta melhora. O questionário de qualidade de vida reduziu dois pontos, relacionados à melhora da sensibilidade da pele e aos cuidados com a queimadura. CONCLUSÃO: A utilização de alta frequência combinada com uso de curativos durante a internação hospitalar mostrou resultados favoráveis em comparação a apenas o uso de curativos na cicatrização de feridas. Contudo, mais estudos são necessários.

OBJECTIVE: To evaluate the effectiveness of the high frequency in the healing of burn wounds during hospitalization. METHODS: This is a case study, conducted with a 19-year-old female volunteer, in an emergency room. The high frequency and conventional dressings were applied, with the single sample being divided into the intervention area and the control area. Clinical and sociodemographic data, photographic records before and after the interventions, dimension of the wound area through digitalized planimetry, the aspect of the scar through the Vancouver Scale and quality of life through the Burn Specific Health Scale questionnaire were evaluated. RESULTS: The wound area decreased 54% in the intervention area and 26% in the control area. Aspects such as vascularity and flexibility also showed a slight improvement. The quality of life questionnaire reduced two points, related to the improvement of skin sensitivity and care for burns. CONCLUSION: The use of the high frequency combined with the use of dressings during hospitalization showed favorable results compared to only the use of dressings in wound healing. However, more studies are needed.

Therapy for patients with burns - an integrating review.

OBJECTIVE: to identify, through an integrative review, national studies published over the last ten years highlighting products and therapies used in burns. METHODS: integrative research with studies published in the last ten years. Including clinical studies describing the use of the already established or innovative therapies in burns and the results obtained, published in national journals in the last ten years. Excluding articles published before 2007 and those that did not present results regarding the use of products in burns. RESULTS: ten articles that met the inclusion criteria were selected. Collagenase, 1% silver sulfadiazine, and porous cellulose membrane were some of the therapies cited. CONCLUSION: the casuistry was low; however, the good results obtained with porous cellulose membrane and silver nanocrystalline dressing are highlighted, since they were used in a larger number of patients in the studies evaluated.

Therapy for patients with burns - an integrating review

SUMMARY OBJECTIVE: to identify, through an integrative review, national studies published over the last ten years highlighting products and therapies used in burns. METHODS: integrative research with studies published in the last ten years. Including clinical studies describing the use of the already established or innovative therapies in burns and the results obtained, published in national journals in the last ten years. Excluding articles published before 2007 and those that did not present results regarding the use of products in burns. RESULTS: ten articles that met the inclusion criteria were selected. Collagenase, 1% silver sulfadiazine, and porous cellulose membrane were some of the therapies cited. CONCLUSION: the casuistry was low; however, the good results obtained with porous cellulose membrane and silver nanocrystalline dressing are highlighted, since they were used in a larger number of patients in the studies evaluated.

RESUMO OBJETIVO: Identificar, por meio de revisão integrativa, estudos nacionais publicados nos últimos dez anos que destaquem produtos e terapêuticas utilizados nas queimaduras. MÉTODOS: Pesquisa integrativa com estudos publicados nos últimos dez anos. Incluídos os estudos clínicos que descreveram a utilização de terapias já consagradas ou inovadoras em queimaduras e os resultados obtidos e publicados em periódicos nacionais nos últimos dez anos. Excluídos os artigos publicados antes de 2007 e os que não apresentaram resultados quanto ao uso de produtos nas queimaduras. RESULTADOS: Selecionados dez artigos que atenderam aos critérios de inclusão, sendo colagenase, sulfadiazina de prata 1% e membrana celulósica porosa algumas das terapias descritas. CONCLUSÕES: A casuística foi baixa, porém, ressaltam-se os bons resultados obtidos com a membrana celulósica porosa e o curativo com prata nanocristalina, em virtude de terem sido utilizados em um maior número de pacientes nos estudos avaliados.

"Smart" polymer enhances the efficacy of topical antimicrobial agents.

The delivery of antimicrobial agents to surface wounds has been shown to be of central importance to the wound healing process. In this work, we prepared film forming wound care formulations containing 3 polymers (FTP) that provide broad-spectrum antimicrobial protection for prolonged periods. FTP formulations comprises of a smart gel matrix comprising of pH-degradable and temperature responsive polyacetals (smart polymer) which allow for the FTP films to be hydrophobic at room temperature, preventing accidental rubbing off, and hydrophilic at lower temperatures, allowing for easy removal. Two FTP smart-antimicrobial films were evaluated in this work: FTP-AgSD (Silver sulfadiazine actives), and FTP-NP (Neosporin actives). The in vitro and ex vivo antimicrobial efficacy studies show that FTP-AgSD films are significantly more effective for longer durations against Staphylococcus aureus (3 days), Candida albicans (9 days) and Pseudomonas aeruginosa (4 days) when compared to the cream formulations containing antimicrobials. FTP-NP films showed significantly improved antimicrobial activity for a minimum of 3 days for all pathogens tested. Moreover, when tested ex vivo in porcine skin, FTP-AgSD and FTP-NP showed average improvements of 0.89 log10 and 1.66 log10 respectively over standard cream counterparts. Dermal toxicity studies were carried out in a rat skin excision model which showed a similar wound healing pattern to that in rats treated with standard cream formulations as represented by reduction in wound size, and increase in wound healing markers.