Wound Care InsiderAn educational resource from Gentell May 2020

Gentell leads the wound care industry in new product development and innovative cost-containment programs for hospitals, nursing homes and home health agencies. For more information, call 800-840-9041 or visit www.gentell.com.

Role of Silver in Wound Healing debris. However, excessive accumulation and activation of MMPs versus their inhibitors can compete with cell proliferation, angiogenesis and matrix proteins necessary for cell migration. Bacteria in chronic wounds also produce MMPs that may be responsible for the increasing tissue damage that can progress from critical colonization to infection. By reducing the number of bacteria and the associated inflammatory response it creates, a dressing containing silver may facilitate wound healing.

Gentell’s Calcium Aliginate Ag (Silver) is recommended as a primary dressing for all wound depths with moderate to heavy exudate. It is highly absorbent, reduces odor and helps manage bacterial burden. It does not cause burning like other antiseptics. Because of its versatility and cost-effectiveness, this is a useful wound dressing for a variety of wounds.

Long term use of silver on wounds is not recommended because the same antimicrobial activity that prohibits infection can also impair healing by exerting toxic effects on the beneficial keratinocytes and fibroblasts. And for clean wounds and closed surgical incisions, silver confers no benefit.

Use of silver in wound healing requires ongoing assessment of a patient’s wound healing process, as well as their wound care management and needs. Silver is more effective in treating some wounds than others, so it is important to assess the benefits of using silver on a case-by-case basis.

A key component of wound management is the prevention of infection. The antimicrobial effect of silver can play an important role of wound healing through the control of bacterial colonization.

Silver has a long history in wound healing. In his writing, the ancient Greek physician Hippocrates — frequently described as the “Father of Medicine” — discusses the effects of silver, while as early as 1850 BC, Egyptians applied silver to wounds for infection prevention and healing purposes. In the early 20th century, surgeons used silver in surgery for infection prevention. During World War I, soldiers would place silver coins in the infected wounds to assist with wound healing. While the increased use of antibiotics emerged over time as an additional option, silver continues to play a key role in wound healing. The effectiveness of silver dressings has been well-documented in clinical trials, but it is important to be cautious nonetheless, as many of these studies have been unable to confirm silver’s success in treating chronic wounds.

Silver can be utilized in wound healing for antimicrobial resistance on cells, and as such, it can decrease bacterial resistance and control of bio burden. This is precisely why silver wound dressings continue to be a treatment option: silver has terrific antimicrobial properties while still being versatile and safe to use. Silver’s application utilized in wound healing is carried out by a controlled release of silver in its ionic form of Ag+. These ions are highly reactive and can multiply in bacterial sites, causing bacterial cell death in the wound. The antimicrobial activity of Ag+ ions is generally attributed to four mechanisms:

• Blinds to the bacterial cell membrane, damaging it and interfering with various receptors.

• Disrupts bacterial electron transport, impeding the production of adenosine triphosphate.

• Impairs cell replication by binding to bacterial DNA.

• Triggers the intracellular formation of insoluble compounds with certain nucleotides, proteins and the amino acid histidine, making them unavail-able as intracellular building blocks.

Importantly, silver can also decrease matrix metalloproteinases (MMPs) on the surface of wounds. This results in an increase in surface calcium, an enhancement of microbial effects and a decrease of inflammation within the wound. As we know, the proteolytic property of the MMPs is essential during wound healing to facilitate cell migration and remove

Types Of Wounds Silver Dressings Can Benefit

Important Note:Long term use of silver is not recommended,

and it confers no benefit for clean wounds and closed incisions.

Diabetic Foot Ulcers

Leg Ulcers

Pressure Ulcers

Wound Care Insider

debris. However, excessive accumulation and activation of MMPs versus their inhibitors can compete with cell proliferation, angiogenesis and matrix proteins necessary for cell migration. Bacteria in chronic wounds also produce MMPs that may be responsible for the increasing tissue damage that can progress from critical colonization to infection. By reducing the number of bacteria and the associated inflammatory response it creates, a dressing containing silver may facilitate wound healing.

Gentell’s Calcium Aliginate Ag (Silver) is recommended as a primary dressing for all wound depths with moderate to heavy exudate. It is highly absorbent, reduces odor and helps manage bacterial burden. It does not cause burning like other antiseptics. Because of its versatility and cost-effectiveness, this is a useful wound dressing for a variety of wounds.

Long term use of silver on wounds is not recommended because the same antimicrobial activity that prohibits infection can also impair healing by exerting toxic effects on the beneficial keratinocytes and fibroblasts. And for clean wounds and closed surgical incisions, silver confers no benefit.

Use of silver in wound healing requires ongoing assessment of a patient’s wound healing process, as well as their wound care management and needs. Silver is more effective in treating some wounds than others, so it is important to assess the benefits of using silver on a case-by-case basis.

An educational resource from Gentell May 2020

A key component of wound management is the prevention of infection. The antimicrobial effect of silver can play an important role of wound healing through the control of bacterial colonization.

Silver has a long history in wound healing. In his writing, the ancient Greek physician Hippocrates — frequently described as the “Father of Medicine” — discusses the effects of silver, while as early as 1850 BC, Egyptians applied silver to wounds for infection prevention and healing purposes. In the early 20th century, surgeons used silver in surgery for infection prevention. During World War I, soldiers would place silver coins in the infected wounds to assist with wound healing. While the increased use of antibiotics emerged over time as an additional option, silver continues to play a key role in wound healing. The effectiveness of silver dressings has been well-documented in clinical trials, but it is important to be cautious nonetheless, as many of these studies have been unable to confirm silver’s success in treating chronic wounds.

Silver can be utilized in wound healing for antimicrobial resistance on cells, and as such, it can decrease bacterial resistance and control of bio burden. This is precisely why silver wound dressings continue to be a treatment option: silver has terrific antimicrobial properties while still being versatile and safe to use. Silver’s application utilized in wound healing is carried out by a controlled release of silver in its ionic form of Ag+. These ions are highly reactive and can multiply in bacterial sites, causing bacterial cell death in the wound. The antimicrobial activity of Ag+ ions is generally attributed to four mechanisms:

• Blinds to the bacterial cell membrane, damaging it and interfering with various receptors.

• Disrupts bacterial electron transport, impeding the production of adenosine triphosphate.

• Impairs cell replication by binding to bacterial DNA.

• Triggers the intracellular formation of insoluble compounds with certain nucleotides, proteins and the amino acid histidine, making them unavail-able as intracellular building blocks.

Importantly, silver can also decrease matrix metalloproteinases (MMPs) on the surface of wounds. This results in an increase in surface calcium, an enhancement of microbial effects and a decrease of inflammation within the wound. As we know, the proteolytic property of the MMPs is essential during wound healing to facilitate cell migration and remove

Gentell leads the wound care industry in new product development and innovative cost-containment programs for hospitals, nursing homes and home health agencies. For more information, call 800-840-9041 or visit www.gentell.com.

Sources: Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio. Published online 9 August 2019. Moore R, Liedl D, Jenkins S, Andrews K. Using a silver-coated polymeric substrate for the management of chronic ulcerations: the initial Mayo Clinic experience. Adv Skin Wound Care 2008; 21(11):517-20. Hermans, MH. Silver-containing dressings and the need for evidence. Adv Skin Wound Care 2007; 20(3):166-173. Lipsky, BA, Hoey, C. Topical antimicrobial therapy for treating chronic wounds. Clin Infect Dis 2009; 49(10):1541-9. 5Gravante G, Caruso R, Sorge R, Nicoli F, Gentile P, Cervelli V. Nanocrystalline silver: a systematic review of randomized trials conducted on burned patients and an evidence-based assessment of potential advantages over older silver formulations. Ann Plast Surg 2009; 63(2):201-5. Granick M, Gamelli R: Surgical wound healing and management. In: Mosti G, Mattaliano V (eds.): The Debride-ment of Chronic Vascular Leg Ulcers. Ch. 12, Informa Healthcare Inc., 2007, pp. 120-121. Sibbald RG, Contreras-Ruiz J, Coutts P, Fierheller M, Rothman A, Woo, K. Bacteriology, inflammation, and healing: a study of nanocrystalline silver dressings in chronic venous leg ulcers. Advances Skin Wound Care 2007; 20(10):549-557 .Fong J, Wood F. Nanocrystalline silver dressings in wound management: a review. Int J Nanomedicine 2006; 1(4):441-8. 9. Percival SL, Woods E, Nutekpor M, Bowler P, Radford A, Cochrane C. Prevalence of silver resistance in bacteria isolated from diabetic foot ulcers and efficacy of silver-containing wound dressings. Ostomy Wound Manage. 2008;54(3):30-40.