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Silver from Polyurethane Dressing Is Delivered by Gradient to Exudate, Tissue, and Serum of Patients Undergoing Negative-Pressure Wound Treatment

Abarca-Buis, René F. PhD; Munguía, Nadia M. BSc; Gonzalez, Juan Manuel Melchor MD; Solís-Arrieta, Lilia MSc; y Osorio, Liliana Saldivar PhD; Krötzsch, Edgar PhD

Advances in Skin & Wound Care: April 2014 - Volume 27 - Issue 4 - p 156–162
doi: 10.1097/01.ASW.0000444849.71374.bc
Features: Original Investigations

OBJECTIVE: This study aimed to evaluate the distribution and concentration of silver eluted from silver-coated polyurethane dressing (V.A.C. GranuFoam Silver Dressing; KCI, San Antonio, Texas) in vitro and in patients undergoing negative-pressure wound therapy (NPWT).

DESIGN: This was a descriptive study of the effect of silver-coated polyurethane dressing in patients undergoing NPWT.

PARTICIPANTS: Six patients with infected wounds undergoing NPWT using silver-coated polyurethane dressing.

INTERVENTIONS: To evaluate silver release in vitro, the authors soaked dressing fragments in water and human serum for different lengths of time and performed atomic absorption spectroscopy. For patient evaluation, the authors obtained exudate, serum, and wound tissue at different time points from 6 patients undergoing NPWT and measured silver levels by atomic absorption and dispersed x-ray spectroscopy.

MAIN RESULTS: Silver from the dressing was immediately released in vitro at a rate 3 times greater in serum than in water. In vivo, silver was delivered to wound exudate at rates 102 to 104 times greater than in corresponding serum. Few surface silver deposits were detected in treated tissue.

CONCLUSION: The high concentration of silver found in wound exudate reflects not only the affinity for silver in serum components and wound fluids, but also that most silver ions are not distributed systemically in the patient; instead, they are transported by the vacuum created by therapy.

René F. Abarca-Buis, PhD, is a Medical Science Researcher, Laboratory of Connective Tissue, Centro Nacional de Investigación y Atención de Quemados, Instituto Nacional de Rehabilitación, Mexico City. Nadia M. Munguía, BSc, is a Chemist, Department of Analytical Chemistry, Facultad de Química, Universidad Nacional Autónoma de México, Mexico City. Juan Manuel Melchor Gonzalez, MD, is a Surgeon, Department of Plastic Surgery, Instituto de Seguridad Social del Estado de México y Municipios, Estado de Mexico. Lilia Solís-Arrieta, MSc, is a Microscopist, Laboratory of Electronic Microscopy, Instituto Nacional de Rehabilitación, Mexico City. Liliana Saldivar y Osorio, PhD, is Chairman, Department of Analytical Chemistry, Facultad de Química, Universidad Nacional Autónoma de México, Mexico City. Edgar Krötzsch, PhD, is Chairman, Laboratory of Connective Tissue, Centro Nacional de Investigación y Atención de Quemados, Instituto Nacional de Rehabilitación, Mexico City. Acknowledgments: The authors thank Deepak Kilpadi, PhD, MBA, for a critical review of the manuscript, and Orna Wiseman from Write Science Right for English translation and editorial review. The authors have disclosed that they have no financial relationships related to this article. Submitted December 12, 2012; accepted in revised form May 8, 2013.

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