Use of a Bioresorbable Wound Matrix with a Polymeric Coating Containing Ionic and Metallic Silver in the Treatment of Diabetic Foot and Venous Leg Wounds

Wound healing is a complex, orderly process of cellular infiltrate and matrix deposition. Chronic wounds develop in patients with comorbidities and compromised immune systems. Infection and bacterial burden are major contributors to wound chronicity.

Silver is widely used as an antimicrobial addition to wound dressings due to its broad-spectrum antimicrobial properties against bacteria, yeast, and fungi common in wounds. Silver dressings have demonstrated activity against wound biofilm but intimate contact with the wound bed is required in order for them to be effective. Most dressings are effective at killing or inhibiting bacterial proliferation within the dressing. Few actually release silver ions into the wound fluid or have enough contact with the wound bed to have any effect on biofilms.

Argyria, or discoloration of the skin caused by deposition of silver particles in the skin, is frequently seen with long term use of silver dressings due to the high concentration of silver in the dressings. We present five cases in which a new antimicrobial wound matrix was used to improve healing and decrease bacterial burden in patients with chronic wounds. Upon application, the dressing immediately adheres to the wound surface and forms a bioactive gel that conforms to the irregular wound bed to stimulate granulation, reduce bacterial proliferation, and maintain a moist healing environment.

The matrix provides a template for cellular growth and is resorbed into the wound bed over three days. Silver in the matrix kills 99.99% of bacteria for 5–7 days, while employing up to 100 times less silver than conventional dressings or topical solutions. Low silver content reduces the risk of silver toxicity and staining and the inhibition of cell proliferation seen with high concentration alternatives. The dressing is safe for use for burns, donor sites, diabetic ulcers, and pressure sores.