Biological skin is effective in restoring the missing
water vapor barrier and promoting healing in
burn wounds. Its effectiveness in
wound management has been limited, however, by its inherently limited antibacterial properties and the fact that it is sometimes rejected before healing is complete, even reversing previous beneficial effects. Limited availability and storage difficulties have posed further problems. Impregnation of
biological skin with
silver ions has been proven to provide a potent bactericidal effect directly at the
wound surface. We hypothesized that
aldehyde cross-linking of
silver-impregnated skin would mask the histocompatibility sites from the recipient's immune system. This has been demonstrated previously with
aldehyde cross-linking of allografts and xenografts, prolonging retention sufficiently to permit complete wound healing. Commercially available skin was treated with an
aldehyde compound and impregnated with
silver. Initial studies of this cross-linked skin for treatment of
burn wounds showed average retention to be between 117 and 161 days, far exceeding that of any untreated skin. It was subsequently found that the
aldehyde cross-linking permitted impregnation with higher concentrations of
silver than had previously been possible--2,600 to 2,830 ppm as compared to an average of 1,020 to 1,350 ppm in previously available
silver-impregnated skin. This results in a more potent, immediate antibacterial effect at the
wound surface and an extended period of time-release antibacterial action before the
silver is exhausted. The antibacterial properties of this
aldehyde cross-linked
silver-impregnated skin are effective in decontaminating even grossly infected
wounds and in protecting against contamination of clean
wounds from adjacent infected areas or external sources.(ABSTRACT TRUNCATED AT 250 WORDS)