Comparison of the efficacies of silver-containing dressing materials for treating a full-thickness rodent wound infected by methicillin-resistant Staphylococcus aureus]

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 (R)), silver carboxymethylcellulose (Aquacel (R)-Ag), silver sulfadiazine (Medifoam silver (R)), nanocrystalline silver (PolyMem silver (R)), silver sulfadiazine (Ilvadon (R)), and 10% povidone iodide (Betadine (R)). 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 (R)>Aquacel (R)-Ag>PolyMem silver (R)>Medifoam silver (R)> Ilvadon (R)>Betadine (R). The histological findings revealed that the Acticoat (R) 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 (R)>Aquacel (R)-Ag>PolyMem silver (R)> Ilvadon (R)> Med Joam silver (R)> Betadine (R). The bacterial colony counts reduced in all the groups, except in the Medifoam silver (R) group. The order of the size of the inhibition zone was Acticoat (R)>Aquacel (R)-Ag>Ilvadon (R)>PolyMem silver (R)>Betadine (R)>Medifoam silver (R), 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 (R) should be preferentially used for the treatment of MRSA-infected skin wounds. (Korean J Lab Med 2010;30:20-7)