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Abstract
Background:
Methicillin-resistant Staphylococcus aureus (MRSA) may cause infections during wound dressing. We aimed to compare the antibacterial activities and wound-healing effects of commercially available silver-coated or silver-impregnated wound dressings on MRSA-infected wounds.
Methods:
Full-thickness skin defects were made on the back of rats (N=108) and were infected with MRSA. The rats were divided into the following 6 groups according to the dressing used for the wounds: nanocrystalline silver (Acticoat®), silver carboxymethylcellulose (Aquacel®-Ag), silver sulfadiazine (Medifoam silver®), nanocrystalline silver (PolyMem silver®), silver sulfadiazine (Ilvadon®) and 10% povidone iodide (Betadine®). We analyzed the wound sizes, histological findings, and bacterial colony counts for the groups. We also inoculated the silver materials on Mueller-Hinton agar plates containing MRSA and compared the inhibition zones in the agar plates.
Results:
The order of the rate of wound-size decrease was Acticoat®>Aquacel®-Ag>PolyMem silver®>Medifoam silver®>Ilvadon®>Betadine®. The histological findings revealed that the Acticoat® showed more reepithelialization and granulation tissue formation and less inflammatory cell infiltration than the other materials. The order of the time required for wound healing was Acticoat®>Aquacel®-Ag>PolyMem silver®>Ilvadon®>Medifoam silver®>Betadine®. The bacterial colony counts reduced in all the groups, except in the Medifoam silver® group. The order of the size of the inhibition zone was Acticoat®>Aquacel®-Ag>Ilvadon®>PolyMem silver®>Betadine®>Medifoam silver®.
Conclusions:
Silver-coated or silver-impregnated wound dressings can be used for treating MRSA-infected wounds. Considering its superior efficacy in comparison to the efficacies of other silver-coated or silver-impregnated wound dressings, Acticoat® should be preferentially used for the treatment of MRSA-infected skin wounds.
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REFERENCES
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 | Fig. 1.Antibacterial effect of silver-based dressing materials in Mueller-Hinton agar. The antibacterial effect was evaluated by measuring the growth-inhibition zones on the agar plate. After 24 hr, additional inhibition zones were observed along the edges of the dressing material.
Abbreviations: Ac, Acticoat®; Aq, Aquacel®-Ag; P, PolyMem silver®; M, Medifoam silver®.
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 | Fig. 2.Error bars indicating the standard deviation for the antibacterial effects of silver dressing materials (Acticoat® [Ac], Aquacel®-Ag [Aq], PolyMem silver® [P], Medifoam silver® [M], Ilvadon® [I], and Betadine® [B] groups) in Mueller-Hinton agar. Statistically significant differences were observed among the groups (oneway ANOVA, P<0.001). |
 | Fig. 3.Error bars indicating the standard deviation for wound size change (%) according to the day and type of wound dressing (Acticoat® [Ac], Aquacel®-Ag [Aq], PolyMem silver® [P], Medifoam silver® [M], Ilvadon® [I], and Betadine® [B] groups). The differences among the groups were statistically significant (two-way ANOVA, P<0.001). |
 | Fig. 4.Histological findings in each group (hematoxylin and eosin stain, ×200) at 10 days . |
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