Eficacia de la aplicación de la plata nanocristalina (Acticoat®) frente a sulfadiazina de plata en el tratamiento de quemaduras

  1. Felipez Agrelo, Iria María
  2. García Zurita, Abelardo
  3. Souto Trillo, Marina Rosalía
Revista:
Metas de enfermería

ISSN: 1138-7262

Ano de publicación: 2014

Volume: 17

Número: 5

Tipo: Artigo

Outras publicacións en: Metas de enfermería

Resumo

Objective: to determine the level of evidence available in literature regarding the efficacy of nanocrystalline silver (Acticoat®) for the treatment of patients with burns, compared with silver sulfadiazine at 1%. Method: narrative review, where a bibliographic search in literature is conducted, through standard protocol, in the Medline, PubMed, SciELO, Cuiden and Cochrane Library databases. The key terms �burns�, �second degree burn�, �silver dressing�, �sulfadiazine� and �nanocrystalline silver dressing� were used, with the boolean operators OR and AND. The studies were assigned a level of evidence adapted from the Oxford Centre for Evidence-based Medicine. Results: from the union of problem and intervention through the boolean operator AND, 11 articles were obtained, though two of them were not taken into account because they had been conducted in animals, and another one was assessed for conclusions, but did not become part of the analysis, as it was a literature review. The analysis of the selected articles demonstrated that Acticoat®, compared with the other silver dressing available, controls bacterial load and pain better, reduces the number of dressing changes and times for healing, has fewer adverse effects, and its clinical efficacy is higher. Conclusions: although the comparative analysis between both products shows clear results about the efficacy and cost-effectiveness of nanocrystalline silver, both in clinical management of the burn wound and its cost-benefit relationship, it is by no means less true that there are not enough studies to declare categorically that there is complete efficacy with said nanocrystalline silver marketed under the brand Acticoat®. It would be necessary, therefore, to conduct well-designed randomized and controlled clinical trials, in order to confirm said efficacy, and to make informed clinical decisions.

Referencias bibliográficas

  • Glen Mayhall C. The Epidemiology on Burn Wound Infections: Then and now. Clinical Infectious Diseases (CID) 2003; 37(4):543-550.
  • Bostok J, Riley HT (traducts). Pliny the Elder. The Natural History. London: Taylor and Francis; 1855.
  • Selcuk CT, Durgun M, Ozalp B, Tekin A, Tekin R, Akcay C, et al. Comparison of the antibacterial effect of silver sulfadiazine 1%, mupirocin 2%, Acticoat and octenidine dihydrochloride in a full-thickness rat burn model contaminated with multi drug resistant Acinetobacter baumannii. Burns 2012; 38(8):1204-1209.
  • Ulkür E, Oncul O, Karagoz H, Yeniz E, Celiköz B. Comparison of silver-coated dressing (Acticoat®), chlorhexidine acetate 0.5% (Bactigras®), and fusidic acid 2% (Fucidin®) for topical antibacterial effect in methicillin-resistant Staphylococci-contaminated, full-skin thickness rat burn wounds. Burns 2005; 31(7):874-877.
  • Khundkar R, Malic C, Burge T. Use of acticoat dressings in burns: what is the evidence? Burns 2010; 36(6):751-758.
  • Huang Y, Li X, Liao Z, Zhang G, Liu Q, Tang J, et al. A randomized comparative trial between Acticoat® and SD-Ag in the treatment of residual burn wounds, including safety analysis. Burns 2007; 33(2):161-166.
  • Muangman P, Chuntrasakul C, Silthram S, Suvanchote S, Benjathanung R, Kittidacha S, et al. Comparison of efficacy of 1% silver sulfadiazine and Acticoat® for treatment of partial-thickness burn wounds. J Med Assoc Thai 2006; 89(7):953-958.
  • Salvador Sanz JF, Novo Torres A, Lorda Barraguer E, Castillo F, Torra i Bou JE, Torregrosa Ramos MJ. Estudio comparativo de efectividad de un apósito de plata nanocristalina frente a sulfadiazina argéntica en el tratamiento de pacientes quemados. Cir plást Iberolatinoam 2011; 37(3): 253-266.
  • Cuttle L, Naidu S, Mill J, Hoskins W, Das K, Kimble RM. A retrospective cohort study of Acticoat® versus silvazine in a pediatric population. Burns 2007; 33(6):701-707.
  • Abedini F, Ahmadi A, Yavari A, Hosseini V, Mousavi S. Comparison of silver nylon wound dressing and silver sulfadiazine in partial burn wound therapy. International Wound Journal 2013; 10(5):573-578.
  • Moiemen NS, Esquisto E, Drysdale KJ, Smith G, Wilson YT, Papini R. Acticoat® dressings and major burns: Systemic silver absorption. Burns 2011; 37(1):27-35.
  • Cox SG, Cullingworth L, Rode H. Treatment of paediatric burns with a nanocrystalline silver dressing compared with standard wound care in a burns unit: a cost analysis. S Afr Med J 2011; 101(10):728-731.
  • Varas RP, O’Keeffe T, Namias N, Pizano LR, Quintana OD, Herrero Tellachea M, et al. A prospective, randomized trial of Acticoat® versus silver sulfadiazine in the treatment of partial-thickness burns: which method is less painful? J Burn Care Rehabil 2005; 26(4):344-347.