There has been a vast increase in the last 5 years in the number of available silver-containing dressings. Their use has seen a corresponding rise in the number of publications referring to silver and its potential benefits. It is important that recognition is also given to the potential pitfalls of use, particularly in relation to toxicity. These factors have been recently reviewed. This article will explore what happens once the body absorbs silver, discuss the relevance of the carrier dressing to efficacy of silver, and review the clinical relevance of microbial kill time.

Pseudosyndactyly, a mitten deformity of the hand, is a serious problem that can arise in children with recessive dystrophic epidermolysis bullosa (EB). The authors present 2 cases of patients who developed significant contractures of their hands with limited functional use secondary to pseudosyndactyly. At the time of both initial operations, digit separation and contracture releases were performed, which resulted in large areas of denuded skin on the palmar and volar aspect of the fingers and hand. A biologic tissue matrix (Integra™ Bilayer Matrix Wound Dressing, Integra Lifesciences Corp., Plainsboro, NJ) was used initially to cover the wounds. Subsequently, a bioengineered skin equivalent (Apligraf™, Organogenesis Inc., Canton, Mass) was used for epidermal coverage. The biologic tissue matrix was selected because of its excellent tensile strength, flexible adherent covering, and success with decreasing the incidence of postoperative wound contracture, which the authors believed was

The effect of laser on wound healing is controversial. This study examines the effects of low-level gallium arsenide (904 nm) laser irradiation on the wound healing process in a rat model. Twenty-four rats were used. Paired wounds were made on the shaved dorsal skin on either side of the midline. The rats were randomly divided into 3 groups (n = 8 in each group). Using a gallium arsenide laser, Group 1, Group 2, and Group 3 were irradiated with 0.31 J/cm2, 2.48 J/cm2, and 19 J/cm2, respectively. The wound on the right side of each animal received laser irradiation for 7 consecutive days, and the left side wound served as a control. On Day 21, bilateral wounds were excised and processed for light microscopy examination. Impaired collagen synthesis, large defect areas, degeneration of skin appendages, and presence of dermal granulation tissue were observed in laser-treated groups, while normal wound healing was found in control wounds. High-dose gallium arsenide laser irradiation appears