In-vitro Comparison of Antimicrobial Efficacy of Various Wound Dressing Materials
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Many new antimicrobial dressings have been used for the treatment of or protection against wound infection since the early 1980s. There are many different wound dressings such as silver, povidone iodine, and chlorhexidine impregnated materials on the market today. Various manufacturers assert that their dressings are the most effective and therefore should be preferentially employed. However, it is difficult to find a study that clearly identifies the most effective antimicrobial wound dressing. Methods. Eight different commercially available wound dressing materials were compared in terms of their antimicrobial effectiveness on 18 different microorganisms via disk diffusion test (Kirby-Bauer Method) on Mueller-Hinton (MH) agar. Among the 16 bacterial and 2 yeast species grown on MH agar plates, Contreet was the most effective antimicrobial dressing tested (P < 0.001). Results. A statistical difference was not found concerning efficacy against gram-positive and -negative bacteria among any of the materials except for Aquacel Ag and Inadine, the activity of which were found to be higher on gram-positive bacteria compared to gram-negative bacteria (P = 0.029, P = 0.030). In-vitro data suggest that Contreet is the most effective for topical treatment of contaminated wounds. Conclusion. Further methods of assessment, including the use of infected animal models and clinical studies, will be necessary to better understand the antimicrobial efficacy of these dressings.
Exposed subcutaneous tissue provides a favorable medium for microorganisms to contaminate and colonize. The conditions become optimal for microbial growth if the involved tissue is devitalized and/or the host immunity is compromised. This situation presents a considerable problem for both the patient and caregiver. Oral and systemic antibiotics are often used to control infection. While systemic antibiotheraphy is mandatory for advanced skin infections, from a basic wound management perspective, the three methods of eliminating a local wound infection are debridement, wound cleansing, and topical antimicrobial application.1,2 Many different topical antimicrobial agents are available such as silver, povidone iodine, chlorhexidine, and honey.
Silver has been used as an antimicrobial for thousands of years either as liquid, cream, or more recently, silver-coated wound dressings. Its antimicrobial activity is attributed to its ability to block the transmembranous energy metabolism in bacteria.3 Chlorhexidine is a persistent antimicrobial agent that is active against a wide range of gram-positive and gram-negative bacteria. It has been widely used for surgical hand and skin antisepsis. Povidone iodine is another commonly used antimicrobial agent, which has been demonstrated to be effective in killing a broad range of the microorganisms typically associated with wound infection.4 The antimicrobial properties of honey in relation to wound management date back to ancient times. Recently, studies have been published regarding the antimicrobial activity of honey against methicillin-resistant Staphylococcus aureus (MRSA) and Psuedomonas aeruginosa.5,6