The rate of re-epithelialization across meshed skin grafts is increased with exposure to silver.
The objective in this study was to determine whether exposure to pure silver increases the rate of re-epithelialization across a partial thickness wound. A meshed skin graft, placed on an excised burn wound was used as a healing model.


METHODS
The rate of meshed skin graft epithelial closure on an exposed burn using a moist healing environment was shown. A moistened silver delivery system (Acticoat) was compared with a standard xeroform and eight ply gauze dressing continually moistened with a 0.01% neomycin and polymyxin solution (NP). Twenty burn patients with deep burns of over 15% of TBS were excised and grafted with 2:1 meshed grafts. One graft area was treated with the antibiotic solution and another with the silver delivery. The meshed graft was performed within 3 days of injury.


RESULTS
No infections were noted and quantitative swab cultures gave less than 10(2) bacteria in all cases at wound closure. At day 7, re-epithelialization was complete with silver and 55% closed with NP solution. Wound closure was complete in the NP solution group at day 10. Silver increased re-epithelialization rate by over 40%, a significant increase. Graft take was over 95% in both groups.


CONCLUSIONS
Silver released in a moist wound surface environment significantly increases the rate of re-epithelialization compared to a standard antibiotic solution.
Demling
Robert H
RH
Department of Surgery, Trauma and Burn Center, Brigham & Women's Hospital, 75 Francis Street, PBB-B4, Boston, MA 02115, USA. rhdemling@partners.org
Leslie DeSanti
M D
MD
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001458:Bandages; D002056:Burns / Q000188:drug therapy* / Q000503:physiopathology; D006085:Graft Survival; D006801:Humans; D009355:Neomycin / Q000627:therapeutic use*; D011091:Polyesters / Q000627:therapeutic use*; D011095:Polyethylenes / Q000627:therapeutic use*; D012834:Silver / Q000627:therapeutic use*; D016038:Skin Transplantation; D014945:Wound Healing / Q000187:drug effects*
C117408:Acticoat; D000900:Anti-Bacterial Agents; D011091:Polyesters; D011095:Polyethylenes; D012834:Silver; D009355:Neomycin