Silver and Non Healing Wounds

The injuries and its infections are the most painful form of trauma. Wound infections are the growth of microorganisms within the wound area. This infection causes the body's immune system, inflammation and damages the tissue within the wound site. Hence, there is an immense need to formulate new dressing materials for wound dressing application. To know more about new dressing material working it is need of time to study the mechanism of wound healing. Today's review focus on mechanism of wound healing, wound dressing, new dressing material and necessity of wound dressings.

Cutaneous wounds are known as the damages and injuries on the skin. Knowing the type of wound is very important before any kind of treatment or therapy being applied. Each type of wound is different from other due to the different structure, biology and pathophysiology, therefore, a kind of treatment for one wound cannot be specified for others. Considering the importance of types of wounds, these wounds are classified into different categories because of their different pathobiology. This manuscript would be a great piece of knowledge for the tissue engineer to develop specific skin substitute for specific wound which might help for the development of appropriate treatment strategies.

The current economic downturn in the UK and other countries has caused healthcare organisations to justify the costs of more advanced technologies. This is seen especially within the wound care discipline. The costs of healthcare account for a third of all UK government spend and with the prevalence of chronic wounds increasing, the cost of modern wound care is becoming more strained and open to scrutiny. Healthcare decision makers should not base their decisions on cost of dressings alone, but take into account the costs mitigated by using an advanced wound therapy. A clinical-economic assessment should be performed on a number of advanced therapies to assess if these are indeed more cost-effective long-term.

Several  natural  polymers  have  application  in  terms  of  therapeutic treatment of ailments. Chitosan, Aloe Vera and  Calendula officinalis have proven wound healing properties individually. It was theorized that a combination  of the biopolymer and the plant extract will show an improvement in wound healing properties. Thus, composite films of  Aloe  Vera  extract  in  Chitosan  and  C.  officinalis  petal  extract  in
Chitosan  were  prepared  and  evaluated  to  ascertain  the  applicability for  wound  healing.  The  chemical  composition  and  mechanical, morphological, and surface characteristics including the antibacterial activity were also evaluated. The optimum conditions for obtaining a maximum  percentage  of  composition  were  standardized.  Their mechanical  properties,  water  absorption  characteristics  and compatibility  were  analyzed  by  tensile  tester,  FTIR  and  SEM analyses. The composite films containing aloe vera had higher water absorption  capacity  and  antimicrobial  activity  as  compared  to those containing  C.  officinalis  petal  extract.  The  films  containing  C. officinalis petal extract showed higher tensile strength as compared to those containing Aloe Vera. With the above results, it was concluded that  a  composite  of  25%  Aloe  Vera  in  Chitosan  can  be  used  as  a wound dressing amongst all the combinations.

Throughout most of history, serious burns occupying a large percentage of body surface area were an almost certain death sentence because of subsequent infection. A number of factors such as disruption of the skin barrier, ready availability of bacterial nutrients in the burn milieu, destruction of the vascular supply to the burned skin, and systemic disturbances lead to immunosuppression combined together to make burns particularly susceptible to infection. In the 20th century the introduction of antibiotic and antifungal drugs, the use of topical antimicrobials that could be applied to burns, and widespread adoption of early excision and grafting all helped to dramatically increase survival. However the relentless increase in microbial resistance to antibiotics and other antimicrobials has led to a renewed search for alternative approaches to prevent and combat burn infections. This review will cover patented strategies that have been issued or filed with regard to new topical agents, preparations, and methods of combating burn infections. Animal models that are used in preclinical studies are discussed. Various silver preparations (nanocrystalline and slow release) are the mainstay of many approaches but antimicrobial peptides, topical photodynamic therapy, chitosan preparations, new iodine delivery formulations, phage therapy and natural products such as honey and essential oils have all been tested. This active area of research will continue to provide new topical antimicrobials for burns that will battle against growing multi-drug resistance.

Throughout most of history, serious burns occupying a large percentage of body surface area were an almost certain death sentence because of subsequent infection. A number of factors such as disruption of the skin barrier, ready availability of bacterial nutrients in the burn milieu, destruction of the vascular supply to the burned skin, and systemic disturbances lead to immunosuppression combined together to make burns particularly susceptible to infection. In the 20th century the introduction of antibiotic and antifungal drugs, the use of topical antimicrobials that could be applied to burns, and widespread adoption of early excision and grafting all helped to dramatically increase survival. However the relentless increase in microbial resistance to antibiotics and other antimicrobials has led to a renewed search for alternative approaches to prevent and combat burn infections. This review will cover patented strategies that have been issued or filed with regard to new topical agents, preparations, and methods of combating burn infections. Animal models that are used in preclinical studies are discussed. Various silver preparations (nanocrystalline and slow release) are the mainstay of many approaches but antimicrobial peptides, topical photodynamic therapy, chitosan preparations, new iodine delivery formulations, phage therapy and natural products such as honey and essential oils have all been tested. This active area of research will continue to provide new topical antimicrobials for burns that will battle against growing multi-drug resistance.

tMedical cotton is usually used to clean skin, pack wounds and in other surgical tasks. Such importantusages make imparting the antibacterial property to medical cotton is so essential research. The currentresearch focuses on functionalization of medical cotton by direct incorporation of silver nanoparticles(AgNPs) in two-step process namely, pre-alkalization followed by sorption. Decorative color and antibac-terial action were accomplished for medical cotton after in situ incorporation of AgNPs without usingany other external reducing agent. AgNPs were produced due to the reduction action of alcoholic andaldehydic groups of cotton’s skeletal blocks. Cotton fibers were acquired a decorative color attributedto surface plasmon resonance of AgNPs. The treated cotton was characterized by using electron micro-scope. Results showed that Ag0with size distribution of 0–160 nm was formed in the cotton fibers andtheir size majority (70%) was less than 80 nm. The reduction of Ag+to Ag0was confirmed by measuringthe carboxylic and aldehydic contents. The treated cotton exhibited excellent antibacterial action at lowsilver contents. The absorbency of cotton was not affected by treatment. The produced medical cottoncould be used to safe cleaning of wounds without getting any microbial infections

Burn injury is a major cause of death and disability worldwide. Healing of burn wounds still
remains a challenge to modern medicine. The aim of this study was to investigate the effects of  Dimethyl
sulfoxide (DMSO) on a second-degree burn wounds and compare it with that of silver sulfadiazine (SSD)
1% cream in dogs. A standard deep second-degree burn wound was produced, five dogs, each dog have
three groups, DMSO, SSD and control (untreated). The efficacy of treatment was assessed based on the
healing percentage of the wound, time to complete wound healing and the degree of inflammation.
Wound contraction was higher in the DMSO group than both SSD and the control group. It was
significantly higher in the DMSO group than the control group on days 21 and 24 (P < 0.05). The mean
times for wound complete closure were  24.4 ± 2.23 and 25.7 ± 2.31 days for DMSO and SSD,
respectively, being shorter for DMSO but not significantly (P> 0.05). Clinically, inflammatory reaction
was less in DMSO group than the control group. Topical application of DMSO has significant positive
effects on the healing of burn wounds in a dog model.

Throughout most of history, serious burns occupying a large percentage of body surface area were an almost certain death sentence because of subsequent infection. A number of factors such as disruption of the skin barrier, ready availability of bacterial nutrients in the burn milieu, destruction of the vascular supply to the burned skin, and systemic disturbances lead to immunosuppression combined together to make burns particularly susceptible to infection. In the 20th century the introduction of antibiotic and antifungal drugs, the use of topical antimicrobials that could be applied to burns, and widespread adoption of early excision and grafting all helped to dramatically increase survival. However the relentless increase in microbial resistance to antibiotics and other antimicrobials has led to a renewed search for alternative approaches to prevent and combat burn infections. This review will cover patented strategies that have been issued or filed with regard to new topical agents, preparations, and methods of combating burn infections. Animal models that are used in preclinical studies are discussed. Various silver preparations (nanocrystalline and slow release) are the mainstay of many approaches but antimicrobial peptides, topical photodynamic therapy, chitosan preparations, new iodine delivery formulations, phage therapy and natural products such as honey and essential oils have all been tested. This active area of research will continue to provide new topical antimicrobials for burns that will battle against growing multi-drug resistance.

The aim of this systematic review with meta-analysis was to compare the effect of Silver Sulfadiazine (SSD) with other new dressings, with or without silver, on healing and infection prevention in burns. The electronic search was carried out in the electronic databases of Pubmed, ScienceDirect, Lilacs and BVS. The articles included were randomized clinical trials about burn treatment with SSD, which evaluated the healing and infection of burn wounds in humans. The exclusion criteria included articles, editorials and letters published in the form of abstracts, unpublished reports and case series, cross-sectional, observational experimental studies, and the use of sulfadiazine for other types of wounds. The search identified 873 references, and 24 studies were included in accordance with the eligibility criteria. The results showed a statistically favorable difference related to the time of healing for silver dressings (p&lt;0.0001; MD 3.83; 95% CI 2.03-5.62) and dressings without sil...

Physical treatments such as therapeutic ultrasound and Laser are cited as important aides in wound management. This work expected to assess the role of ultrasound and laser on excisional wound healing progression in incited diabetic mice. Forty Swiss albino mice were divided into 2 groups; group I (diabetic free, 10mice) was used as a control group, while the other; group II(30 mice) was diabetic induced. Circular wounds were created on the dorsal fur of the animals. The wounds of laser treated group (N=10) were exposed to laser irradiation (830nm, 60mW), 5 minutes daily, 5 days/week until the wounds healed completely. The wounds of ultrasound treated group (N=10) were exposed to pulsed ultrasound (0.5 W/cm 2 , 1MHz) 5 minutes daily until the wounds healed completely. The untreated group (N=10) wound was left without treatment. The wounds for control group did not receive any type of treatment. The healing was noticed and assessed during the treatment period. Histological analysis of mice skin was accomplished at days 4, 10 and 15 post-wounding. Taking after healing period and determine the mechanical properties of healed skin. By looking at results acquired from various treatment modalities, we found that the two remedial devices encourage and quicken diabetic injury recuperating and enhancing scar quality yet with various degrees. Lighted injury with laser exhibited a more propelled recuperating process than ultrasound treated gathering. We can conclude that, both low-power laser and ultrasound treatments may quicken cutaneous injury mending in diabetic injury model. This finding may widen current treatment regimens

The present reaearch has been undertaken with the aim to fomulate and evaluate the herble gel containng alcoholic extract of Hollarrhena pubences(kurchi), Withania somnifera(ashwagandha), curcuma longa(turmeric)Azadiracht indica(neem). The gel formulation prepared by using various polymer bases(methyl cellulose). The stability study have carried as per ICH guideline. The result show that the gel formulation containing kurchi, ashwagandha, turmeric, neem has better stability than other. All formulation studied on animal model(rat).The present work justifies the use oh herbal gel containing ashwagandha, turmeric, neem, kurchi for wound healing.

Throughout most of history, serious burns occupying a large percentage of body surface area were an almost certain death sentence because of subsequent infection. A number of factors such as disruption of the skin barrier, ready availability of bacterial nutrients in the burn milieu, destruction of the vascular supply to the burned skin, and systemic disturbances lead to immunosuppression combined together to make burns particularly susceptible to infection. In the 20th century the introduction of antibiotic and antifungal drugs, the use of topical antimicrobials that could be applied to burns, and widespread adoption of early excision and grafting all helped to dramatically increase survival. However the relentless increase in microbial resistance to antibiotics and other antimicrobials has led to a renewed search for alternative approaches to prevent and combat burn infections. This review will cover patented strategies that have been issued or filed with regard to new topical agents, preparations, and methods of combating burn infections. Animal models that are used in preclinical studies are discussed. Various silver preparations (nanocrystalline and slow release) are the mainstay of many approaches but antimicrobial peptides, topical photodynamic therapy, chitosan preparations, new iodine delivery formulations, phage therapy and natural products such as honey and essential oils have all been tested. This active area of research will continue to provide new topical antimicrobials for burns that will battle against growing multi-drug resistance.

Silver is used widely in wound dressings and medical devices as a broad-spectrum antibiotic. Metallic silver and most inorganic silver compounds ionise in moisture, body fluids, and secretions to release biologically active Ag+. The ion is absorbed into the systemic circulation from the diet and drinking water, by inhalation and through intraparenteral administration. Percutaneous absorption of Ag+ through intact or damaged skin is low. Ag+ binds strongly to metallothionein, albumins, and macroglobulins and is metabolised to all tissues other than the brain and the central nervous system. Silver sulphide or silver selenide precipitates, bound lysosomally in soft tissues, are inert and not associated with an irreversible toxic change. Argyria and argyrosis are the principle effects associated with heavy deposition of insoluble silver precipitates in the dermis and cornea/conjunctiva. Whilst these changes may be profoundly disfiguring and persistent, they are not associated with pathological damage in any tissue. The present paper discusses the mechanisms of absorption and metabolism of silver in the human body, presumed mechanisms of argyria and argyrosis, and the elimination of silver-protein complexes in the bile and urine. Minimum blood silver levels consistent with early signs of argyria or argyrosis are not known. Silver allergy does occur but the extent of the problem is not known. Reference values for silver exposure are discussed.

Burn injury is a major cause of death and disability worldwide. Healing of burn wounds still remains a challenge to modern medicine. The aim of the present study was to evaluate the efficacy of Aloe vera (AV) gel in the treatment of deep second-degree burn wounds and compare its results with those of silver sulfadiazine (SSD) in dogs. A standard deep second-degree burn wound was produced, five dogs, each dog has three groups, AV gel, SSD 1% cream and control (no topical therapy at all). The efficacy of treatment was assessed based on the healing percentage of the wound, time to complete wound healing and the degree of inflammation and exudation. Wound contraction was higher in the AV group than both SSD and the control group. It was significantly higher in the AV group than the control group on days 18, 21 and 24, 27 while significantly higher than the SSD group on days 21 and 24. The mean times for wound complete closure were 22.9 ± 2.56 and 25.7 ± 2.31 days for AV and SSD, respect...

Physical treatments such as therapeutic ultrasound and Laser are cited as important aides in wound management. This work expected to assess the role of ultrasound and laser on excisional wound healing progression in incited diabetic mice. Forty Swiss albino mice were divided into 2 groups; group I (diabetic free, 10mice) was used as a control group, while the other; group II(30 mice) was diabetic induced. Circular wounds were created on the dorsal fur of the animals. The wounds of laser treated group (N=10) were exposed to laser irradiation (830nm, 60mW), 5 minutes daily, 5 days/week until the wounds healed completely. The wounds of ultrasound treated group (N=10) were exposed to pulsed ultrasound (0.5 W/cm 2 , 1MHz) 5 minutes daily until the wounds healed completely. The untreated group (N=10) wound was left without treatment. The wounds for control group did not receive any type of treatment. The healing was noticed and assessed during the treatment period. Histological analysis of mice skin was accomplished at days 4, 10 and 15 post-wounding. Taking after healing period and determine the mechanical properties of healed skin. By looking at results acquired from various treatment modalities, we found that the two remedial devices encourage and quicken diabetic injury recuperating and enhancing scar quality yet with various degrees. Lighted injury with laser exhibited a more propelled recuperating process than ultrasound treated gathering. We can conclude that, both low-power laser and ultrasound treatments may quicken cutaneous injury mending in diabetic injury model. This finding may widen current treatment regimens

Novel findings on fabrication techniques for bioactive materials, discovering further basic knowledge
about wound healing process, and availability of stem cells as alternative candidate for differentiated cells
have highly encouraged scientists for developing new bioengineered skin substitutes (BSS) that offer an
effective remedy for a specific wound type. However, technical, clinical, legislative and economic reasons
hamper wide-spread commercialization and clinical translation of BSS. Among the various types of
strategies that target skin repair and regeneration, tissue engineering with stem cells is most promising
route. Tissue engineering by cooperation of several disciplines forms a context on which the commercial
development of BSS is possible to provide benefits for patients who currently have limited or no cure
options. The principles of tissue engineering are to initiate cell cultures in vitro, grow them in monolayer
or on porous scaffolds and transplant the composite into a patient with a specific wound indication in vivo.
The potential for creating of custom-designed biomaterials and availability of stem cells from either
autologous or allogenic sources have helped to produce novel innovative BSS. Currently, wide range of
skin substitutes are already being fabricated for clinical use in different wound indications but not yet
definitively established. Therefore, many novel engineered constructs might be fabricated in the future.
In this review, we describe the progress that has been made to date in the field of skin substitutes and the
critical issues that are still hindering successful production and bench to bedside translation of BSS and
restricting the availability of these innovative therapeutic constructs. Integrity of the science and
technology, interdisciplinary expertise collaborations, and early interaction with regulatory entities such
as Food and Drug Administration (FDA) and European Medicines Agency (EMA), together with other
critical determinants, is vital to the successful commercialization of tissue engineering products into the
marketplace/clinic.

Throughout most of history, serious burns occupying a large percentage of body surface area were an almost certain death sentence because of subsequent infection. A number of factors such as disruption of the skin barrier, ready availability of bacterial nutrients in the burn milieu, destruction of the vascular supply to the burned skin, and systemic disturbances lead to immunosuppression combined together to make burns particularly susceptible to infection. In the 20th century the introduction of antibiotic and antifungal drugs, the use of topical antimicrobials that could be applied to burns, and widespread adoption of early excision and grafting all helped to dramatically increase survival. However the relentless increase in microbial resistance to antibiotics and other antimicrobials has led to a renewed search for alternative approaches to prevent and combat burn infections. This review will cover patented strategies that have been issued or filed with regard to new topical agents, preparations, and methods of combating burn infections. Animal models that are used in preclinical studies are discussed. Various silver preparations (nanocrystalline and slow release) are the mainstay of many approaches but antimicrobial peptides, topical photodynamic therapy, chitosan preparations, new iodine delivery formulations, phage therapy and natural products such as honey and essential oils have all been tested. This active area of research will continue to provide new topical antimicrobials for burns that will battle against growing multi-drug resistance.