Silver Ion-releasing Dressing (CONTREET) Does Not Disturb Angiogenesis and Microvascularization In Vivo
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Disclosure: Coloplast GmbH Hamburg provided financial support and the dressings used in this study.
Disturbed development of new microvasculature may affect the wound healing process. Presently, dressing containing silver are widely used for wound management. Silver-based dressings, which release silver ions into the wound bed, are available in many varieties—particularly for the treatment of burns, chronic leg ulcers, and infected wounds. Some data seems to support the clinical use of these products.1 However, recent findings indicate that the silver may affect the wound healing process.2 Contreet® (Coloplast, Holtedam, Denmark) is one of the new silver-releasing wound dressings designed for restarting the healing process in
infected wounds. The active component of this foam dressing is ionized silver (silver/sodium/hydrogen/zirconium/phosphate). The silver compounds are homogeneously distributed within the polyurethane matrix. A sustained release of silver for up to 7 days is guaranteed.3 The silver-based dressing is supposed to possess antimicrobial activity and reduce infection in wounds. Preliminary clinical trials have found this silver-containing dressing promotes healing in infected chronic venous leg ulcers and diabetic foot ulcers.1,4–6 In addition, effectiveness against a wide range of microorganisms including methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) was reported. An induction of bacterial resistance was not detected in these in-vitro studies.2,7,8 Cost-effective faster wound healing in bacterially challenged, delayed healing leg ulcers was shown in a 4-week health economic analysis for Contreet as compared to alternative antiseptic dressings.9
Aside from the encouraging reports regarding this silver-based dressing in wound management, in-vivo studies concerning the impact of silver on microcirculation have not been performed as of yet. Despite extensive testing and clinical experience, not much is known about the effect of ionic silver on wound angiogenesis, therefore the influence of silver ions rebased from this product has only been explored here.
The aim of this study was to investigate the effects of a silver-based, polyurethane dressing (Contreet) versus silver-free polyurethane (Biatain™, Coloplast, Hotledam, Denmark) and alginate dressings (SeaSorb®, Coloplast, Hotledam, Denmark) on specific wound healing events, such as angiogenesis and vascularization. The investigations were performed in an established microcirculatory model using the dorsal skinfold chamber of BALB/c mice.
Materials and Methods
1. Lansdown AB, Jensen K, Jensen MQ. Contreet Foam and Contreet Hydrocolloid: an insight into two new
silver-containing dressings. J Wound Care. 2003;12(6):205–210.
2. Schaller M, Laude J, Bodewaldt H, Hamm G, Korting HC. Toxicity and antimicrobial activity of a hydrocolloid dressing containing silver particles in an ex vivo model of cutaneous infection. Skin Pharmacol Physiol. 2004;17(1):31–36.
3. Karlsmark T, Agerslev RH, Bendz SH, Larsen JR, Roed-Petersen J, Anderson KE. Clinical performance of a new silver dressing, Contreet Foam, for chronic exuding venous leg ulcers. J Wound Care. 2003;12(9):351–354.
4. Rayman G, Rayman A, Baker NR, et al. Sustained silver-releasing dressing in the treatment of diabetic foot ulcers. Br J Nurs. 2005;14(2):109–114.
5. Munter KC, Beele H, Russell L, et al. Effect of a sustained silver-releasing dressing on ulcers with delayed healing: the CONTOP study. J Wound Care. 2006;15(5):199–206.
6. Jorgensen B, Price P, Andersen KE, et al. The silver-releasing foam dressing, Contreet Foam, promotes faster healing of critically colonised venous leg ulcers: a randomised, controlled trial. Int Wound J. 2005;2(1):64–73.
7. Thomas S, McCubbin P. A comparison of the antimicrobial effects of four silver-containing dressings on three organisms. J Wound Care. 2003;12(3):101–107.
8. Ip M, Lui SL, Poon VK Lung I, Burd A. Antimicrobial activities of silver dressings: an in-vitro comparison. J Med Microbiol. 2006;55(Pt 1):59–63.
9. Scanlon E, Karlsmark T, Leaper DJ, et al. Cost-effective faster wound healing with a sustained silver-releasing foam dressing in delayed healing leg ulcers—a health-economic analysis. Int Wound J. 2005;2(2):150–160.
10. Menger MD, Steiner D, Messmer K. Microvascular ischemia-reperfusion injury in striated muscle:
significance of “no reflow.” Am J Physiol. 1992;263(6 Pt 2):H1892–1900.
11. Ring A, Langer S, Homann HH, et al. Analysis of neovascularization of PEGT/PBT-copolymer dermis substitutes in balb/c-mice. Burns. 2006;32(1):35–41.
12. Steinstraesser L, Ring A, Bals R, Steinau HU, Langer S. The human host defense peptide LL37/hCAP accelerates angiogenesis in PEGT/PBT biopolymers. Ann Plast Surg. 2006;56(1):93–98.
13. Langer S, Sinitsina I, Biberthaler P, Krombach F, Messmer K. Revascularization of transplanted adipose tissue: a study in the dorsal skinfold chamber of hamsters. Ann Plast Surg. 2002;48(1):53–59.
14. Lee AR, Moon HK. Effect of topically applied silver sulfadiazine on fibroblast cell proliferation and biomechanical properties of the wound. Arch Pharm Res. 2003;26(10):855–860.
15. Poon VK, Burd A. In vitro cytotoxicity of silver: implication for clinical wound care. Burns. 2004;30(2):140–147.
16. Lam PK, Chan ES, Ho WS, Liew CT. In vitro cytotoxicity testing of a nanocrystalline silver dressing (Acticoat) on cultured keratinocytes. Br J Biomed Sci. 2004;61(3):125–127.
17. Kraft CN, Hansis M, Arens S, Menger MD, Vollmar B. Striated muscle microvascular response to silver implants: a comparative in-vivo study with titanium and stainless steel. J Biomed Mater Res. 2000;49(2):192–199.
