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.