title: The effect of a silver-containing Hydrofiber dressing on superficial wound bed and bacterial balance of chronic wounds.
abstract: The treatment of chronic wounds represents a major cost to society and has a profound effect on the participant's quality of life. Chronic wounds may have an increased bacterial burden that can impair healing without all the clinical signs of infection. Silver dressings may provide an alternative topical method to control bacterial burden. The primary aim of this study was to evaluate the clinical improvement in chronic wounds through the effect on wound size, maceration, resolution of surface slough and conversion to healthy granulation during a 4-week application of the silver-containing Hydrofiber dressing. This was a single centre, open-label case series study which included a total of 30 evaluable participants: four with diabetic neuropathic foot ulcers, 13 venous stasis ulcers, four pressure ulcers and nine miscellaneous wounds that did not fit any of the previous categories. All participants had adequate vascular supply, indicating the potential to heal. The wounds were stalled or had the signs and symptoms consistent with critical colonisation. The underlying cause of the ulceration was identified and corrected, or the symptoms and signs were treated. This was followed by the application of silver-containing Hydrofiber dressings for a period of 4 weeks. The majority of wounds treated decreased in size (70%) with decreased exudate, decreased purulence and resolution of surface slough (75%). There was an increased quality and quantity of healthy granulation tissue. Unlike some silver dressings, the Hydrofiber and silver combination dressing was unlikely to cause burning and stinging on application. Peri-wound maceration was present in 54% of participants at baseline, and 85% of these resolved with this dressing. A desloughing action was seen in those patients with pre-existing slough at baseline and its removal will lower the bacterial burden of the wound.
authors.affiliation: Toronto Wound Healing Clinics, Toronto, Ontario, Canada.
authors.forename: Pat
authors.initials: P
authors.lastname: Coutts
authors.forename: R Gary
authors.initials: RG
authors.lastname: Sibbald
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000008:administration & dosage*; D047070:Bandages, Hydrocolloid; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012834:Silver / Q000008:administration & dosage*; D012883:Skin Ulcer / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome; D014945:Wound Healing; D014946:Wound Infection / Q000517:prevention & control; D014947:Wounds and Injuries / Q000473:pathology / Q000628:therapy*
chemical_list: D000890:Anti-Infective Agents; D012834:Silver