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Efficacy of a Silver-Containing Foam Dressing in the Management of Partial-Thickness Burns Advances
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It is estimated that burn injuries are the cause of 180,000 deaths across the globe each year. As many as 410,000 burn injuries have been reported in the United States annually and nearly 10% of those required hospitalization (World Health Organization, 2018). These numbers represent a major cost to the nation’s healthcare system and an ongoing challenge for care providers.
Typically categorized based on depth, burns may be classified as superficial (first-degree), partial thickness (second-degree), or full thickness (third-degree and beyond). Full-thickness burn wounds usually require skin grafts for healing but burns of lesser severity can respond to a variety of standard and advanced treatments. Still, burns can be prone to slow healing, infection, excessive exudate, and hypertrophic scarring. To achieve healing and minimize the risk of complications, clinicians must be thoughtful about choosing a wound dressing that effectively addresses as many of these concerns as possible.
In a literature review published by Wounds International, Ulana Pawlak and Philip Davies of Mölnlycke Health Care examined studies that compared one particular advanced wound care dressing, Mepilex Ag (Mölnlycke Health Care), to other treatments in terms of progression of healing burn wounds, reducing overall treatment costs, and improving the treatment experience for both patients and providers. Mepilex Ag was found to have multiple advantages when compared against other treatments.
Silver-containing dressings are used on wounds at increased risk of infection to manage localized wound infection and, in conjunction with systemic antibiotics, to treat local spreading or systemic wound infection. Studies have shown that silver-containing dressings are associated with shorter hospital stays, reduced dressing change frequency, and reduced need for analgesia during dressing change.
Mepilex Ag is a soft foam dressing impregnated with silver and featuring a wound contact layer based around soft silicone (Safetac), a material that enables the dressing to adhere gently to dry skin without adhering to the wound tissue as well as a vapor-permeable outer film. The silver sulfate found in the dressing’s polyurethane foam is the key to its antimicrobial effects. Ionized silver has broad-spectrum activity against microorganisms, while not causing toxicity.
In vitro, studies have shown Mepilex Ag to be effective against a broad spectrum of bacteria and fungi within 30 minutes of application and for up to 7 days.
The dressing’s soft silicone layer allows for easy adherence to dry skin without causing damage to the wound surface or surrounding compromised tissue. Additionally, each dressing may be left in place up to 7 days.
As seen in the results from Pawlak and Davies, several studies demonstrated burn wounds with Mepilex Ag experienced benefits compared with other interventions, including a silver-containing hydrofiber dressing, a nanocrystalline silver-containing absorbent dressing, a biosynthetic dressing, a porcine xenograft, and silver sulfadiazine.
Moreover, the ease of application and removal led to lower pain severity scores at application and during removal, when compared with alternative dressing regimes. Notably, infection rates among burn wounds in the Mepilex Ag groups were zero to low across most of the studies. Importantly, cost effectiveness was also an area in which this foam dressing outperformed other interventions studied. Mepilex Ag was highly rated by both patients and clinicians for its ease and speed of application and removal, as well as fewer dressing changes needed, and showed no difference in physical function during wear time compared with other dressings studied.
In conclusion, Pawlak and Davis found from their review that the use of Mepilex Ag resulted in fewer dressing changes, reduced pain during dressing changes, notable cost savings associated with achieving the goals of the patient's care against their study comparators, including silver sulfadiazine.
Reference:
Pawlak U, Davies P. Mepilex® Ag in the management of partial-thickness burns: a review of the clinical evidence. Wounds International. 2022.