A new
silver-coating technology was developed to prevent
wound adhesion, limit
nosocomial infection, control bacterial growth, and facilitate
burn wound care through a
silver-coated dressing material. For the purposes of this article,
Acticoat (Westaim Biomedical Inc, Fort Saskatchawan, Alberta, Canada)
silver-coated dressing was used. After in vitro and in vivo studies, a randomized, prospective clinical study was performed to assess the efficacy and ease of use of
Acticoat dressing as compared with the efficacy and ease of our institution's standard
burn wound care. Thirty
burn patients with symmetric
wounds were randomized to be treated with either 0.5%
silver nitrate solution or
Acticoat silver-coated dressing. The dressing was evaluated on the basis of overall patient comfort, ease of use for the
wound care provider, and level of antimicrobial effectiveness.
Wound pain was rated by the patient using a visual analog scale during dressing removal, application, and 2 hours after application. Ease of use was rated by the nurse providing
wound care. Antimicrobial effectiveness was evaluated by quantitative
burn wound biopsies performed before and at the end of treatment. Patients found dressing removal less painful with
Acticoat than with
silver nitrate, but they found the
pain to be comparable during application and 2 hours after application. According to the nurses, there was no statistically significant difference in the ease of use. The frequency of
burn wound sepsis (> 10(5) organisms per gram of tissue) was less in
Acticoat-treated
wounds than in those treated with
silver nitrate (5 vs 16). Secondary
bacteremias arising from infected
burn wounds were also less frequent with
Acticoat than with
silver nitrate-treated
wounds (1 vs 5).
Acticoat dressing offers a new form of dressing for the
burn wound, but it requires further investigation with greater numbers of patients in a larger number of centers and in different phases of
burn wound care.