title: The efficacy of silver mesh dressing compared with silver sulfadiazine cream for the treatment of pressure ulcers.
abstract: BACKGROUND
  Controlling infection and promoting healing should be aims of pressure ulcer treatment along with improving a patient's general condition and relieving pressure. Many pressure ulcers present with cavities, tracks or a combination of these. A new silver mesh dressing (Tegaderm Ag Mesh dressing) has the ability to contour around and conform to irregular surfaces of a wound bed.
  
  
  OBJECTIVE
  To evaluate the efficacy of a silver mesh dressing compared with silver sulfadiazine cream for pressure ulcer treatment.
  
  
  METHODS
  A prospective, randomized, clinical trial was conducted in patients with pressure ulcers grade III or IV. The patients were divided randomly by computer into two 20 patient-groups. The study period was eight weeks for each patient. Demographic data, wound size, wound photography, and bacterial wound culture were recorded at the beginning of the study and every two weeks thereafter. Wound beds were covered with silver sulfadiazine cream in the control group and silver mesh dressing in the experimental group. Dressings were changed twice a day in the control group and every three days in the experimental group.
  
  
  RESULTS
  Forty-five patients enrolled in the present study but only 40 patients finished the study. Twenty patients in each group finished the eight-week study. The mean healing rates and the percentage of reduction in PUSH score at eight-week were better in the study group than in the control group but they were not statistically significant. Better changing in bacteriological study after the treatment was shown in both groups. The estimated average cost of the treatment in the mesh group was 263 USD per patient while it was 1812 USD in the cream one (p = 0.0001). Silver mesh dressing can be adapted very well on the bed, can control infection, and promote wound healing. Wound reduction was greater in the experimental group than the control group. The cost of treatment, using silver mesh was cheaper than using silver sulfadiazine cream significantly.
  
  
  CONCLUSIONS
  Silver mesh dressings is one of the choices for pressure ulcer treatment with good healing rate, minimal care and lower overall cost.
authors.affiliation: Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. apirag@gmail.com
authors.forename: Apirag
authors.initials: A
authors.lastname: Chuangsuwanich
authors.forename: Orawan
authors.initials: O
authors.lastname: Charnsanti
authors.forename: Visanu
authors.initials: V
authors.lastname: Lohsiriwat
authors.forename: Chupaporn
authors.initials: C
authors.lastname: Kangwanpoom
authors.forename: Narumol
authors.initials: N
authors.lastname: Thong-In
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000891:Anti-Infective Agents, Local / Q000191:economics / Q000627:therapeutic use*; D001458:Bandages; D003362:Cost-Benefit Analysis; D004643:Emollients / Q000008:administration & dosage*; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D003668:Pressure Ulcer / Q000188:drug therapy*; D011446:Prospective Studies; D018030:Silver Compounds / Q000008:administration & dosage*; D012837:Silver Sulfadiazine / Q000191:economics / Q000627:therapeutic use*; D013785:Thailand; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects
chemical_list: D000891:Anti-Infective Agents, Local; D004643:Emollients; D018030:Silver Compounds; D012837:Silver Sulfadiazine