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A case report of the use of nanocrystalline silver dressing in the management of acute surgical site wound infected with MRSA to prevent cutaneous necrosis following revision surgery.

Abstract
The authors report the use of nanocrystalline silver (Acticoat 7, Smith and Nephew, London, UK) in an acute surgical wound to prevent localized skin necrosis due to infection, thereby avoiding skin grafting as a secondary procedure. Two patients were successfully treated with Acticoat 7 dressings without using systemic antimicrobials after developing methicillin-resistant Staphylococcus aureus infection in the surgical site. Despite a history of smoking and incision through scar tissues, the wound did not progress into deep infection nor was there recurrence of infection at 2 years follow-up. The intention was to use this particular dressing to assess the effect of silver on infected keratinocytes in an acute wound environment. It is possible that the use of Acticoat 7 may reduce the bacterial loading at the wound site, thereby decreasing a propensity for skin necrosis caused by the infective process. This case report demonstrates that the acute surgical wound with impending cutaneous necrosis due to localized infection may be treated without oral antimicrobials.
AuthorsMayukh Bhattacharyya, Helen Bradley
JournalThe international journal of lower extremity wounds (Int J Low Extrem Wounds) Vol. 7 Issue 1 Pg. 45-8 (Mar 2008) ISSN: 1534-7346 [Print] United States
PMID18372271 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Acticoat
  • Polyesters
  • Polyethylenes
Topics
  • Arthroplasty, Replacement, Knee
  • Bandages
  • Female
  • Humans
  • Methicillin Resistance
  • Middle Aged
  • Nanoparticles (therapeutic use)
  • Necrosis
  • Polyesters (therapeutic use)
  • Polyethylenes (therapeutic use)
  • Reoperation
  • Skin (pathology)
  • Smoking (epidemiology)
  • Staphylococcal Infections (therapy)
  • Surgical Wound Infection (microbiology, therapy)

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