Comparison of Silver-containing Hydrofiber Dressing and Hydrophobic Dressing for Effects on MRSA-infected Full Thickness Skin Defect in the Rat.

Lee, Hun Joo; Kang, So Ra; Kim, Yang Woo

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Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2011;38(4):359-368.
Published online July 1, 2011.

Comparison of Silver-containing Hydrofiber Dressing and Hydrophobic Dressing for Effects on MRSA-infected Full Thickness Skin Defect in the Rat.

Hun Joo Lee, So Ra Kang, Yang Woo Kim

Department of Plastic and Reconstructive Surgery, Ewha Womans University, School of Medicine, Seoul, Korea. yangwkim@ewha.ac.kr

Abstract

PURPOSE
Aquacel Ag(R) is a hydrofiber wound dressing integrated with ionic silver. Sorbact(R) is a hydrophobic-coated dressing that uses the hydrophobic interaction with microbes. In this study, we compared the wound healing effects and the antibacterial effects of Medifoam(R), Betadine soaked, Aquacel Ag(R) and Sorbact(R) dressings against MRSA-infected wounds. METHODS: Eighty rats were divided into four groups: Medifoam(R); Betadine soaked; Aquacel Ag(R); and Sorbact(R). A 1.5 x 1.5 cm square full-thickness wound was made on the dorsum of each rat and infected with MRSA. Twenty-four hours thereafter, each dressing was applied to the wound and changed every other day. One, 3, 7, 11 and 15 days after the wound infection, swab culture grade, wound bed appearance score, and wound defect size change were evaluated, and 7 and 15 days after, histologic evaluation was compared between the groups.
RESULTS
The bacteria load of wounds in the Sorbact(R) group decreased earlier than in the other groups. The wound bed appearance score of the Sorbact(R) group also increased quicker, compared with the other groups. However, the size of wounds of the Aquacel Ag(R) group decreased more rapidly, compared with other groups. From the histologic point of view, there was no significant difference between Betadine soaked, Aquacel Ag(R) and Sorbact(R) groups.
CONCLUSION
The hydrophobic dressing using Sorbact(R) showed a more rapid reduction in the MRSA load and an elevation in the wound bed appearance score, but a slower decrease in wound size change due to detachment of wound bed tissue when the dressing was eliminated in the low exudate wound. The silver-containing hydrofiber dressing using Aquacel Ag(R) was more effective in ultimate wound size reduction, but some debris was trapped in the wound tissue and induced foreign body reaction in the high exudate wound. Thus, ongoing selection process of treatment based on the evaluation of the infectious wound state will be very important.

Keywords: MRSA; Skin defect; Wound infection; Aquacel Ag; Sorbact

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