Evaluation of the penetration of nanocrystalline silver through various wound dressing mediums: An in vitro study

Background: The nanocrystalline silver (NCS) dressing Acticoat is commonly used in clinical practice for the treatment of burns and other open wounds as a topical antimicrobial. The dressing may dry resulting in traumatic dressing changes; hence the variety of contact layer dressings used in conjunction with it. Dressing combinations that do not permit NCS penetration are not cost effective and deprives the wound of the needed anti-microbial. Methods: Common wound pathogens were subjected to a variety of contact layer dressings underlying the NCS dressings. The zone of inhibition (ZOI) obtained was measured and compared to a control. Results: Intrasite gel demonstrated a synergistic effect with Acticoat. Iruxol exhibits antagonism by preventing penetration and is known to be partially deactivated by NCS. Intrasite conformable and Adaptic allowed partial penetration while the discs of Biobrane, unstretched/non-fenestrated Pelnac and Telfa transparent film did not allow for sufficient penetration to inhibit the underlying bacteria in this study. The cadaver skin from the South African skin bank (Tshwane university of Technology) displayed a greater antimicrobial effect than even the Acticoat control. Conclusion: Our results illustrate that we should perhaps reconsider dressing combination choices with Acticoat in view of their redundancy or synergistic effect. (C) 2017 Elsevier Ltd and ISBI. All rights reserved.