In vitro silver

22/06/04

9:52

Side 1

In vitro silver release profiles for various antimicrobial dressings

Dolmer, M., Larsen, K., Jensen, K. Coloplast A/S, Wound Care Business Unit, Humlebaek, Denmark

Conclusion
This in vitro study shows that Contreet Foam and Contreet Hydrocolloid provide sustained release. The rest of the silver dressings tested either release silver more rapidly or in negligible amounts. Contreet provides a smart sustained silver release system, as the rate of silver release is proportional to the rate of fluid uptake4 and an excellent absorption capacity, i.e. no need for a secondary absorbent dressing. Contreet offers a unique 2 in 1 solution.

Introduction
Various antimicrobial silver-containing wound dressings are available today. This in vitro study was aimed at investigating the silver release profiles and the total amount of silver released over time.

Methods
The product samples (34 mm) were mounted in modified Franz diffusion cells for seven days. The diffusion cells were kept at 37C and were continuously stirred. The release media consisted of an isotonic solution with equal amounts of sodium to serum and had a continuous flow rate of 1.4 ml/h. The amount of silver released from the products (g/cm2) was measured every four hours using an Atomic Absorption Spectrophotometer.

Results
The silver release is shown in different ways in figures 1-4, all based on the same data: According to the results in this in vitro study, the dressings can be divided into three categories: 1. Products with silver release, where a maximum 50% is released after 24 hours (fig. 3). Contreet Foam and Contreet Hydrocolloid fall into this category. 2. Products with silver release, where a minimum 50% is released within 12 hours (fig. 3). Acticoat, Acticoat 7, Aquacel Ag, Actisorb Silver 220, PolyMem Silver and Urgotul SSD fall into this category. 3. Products impossible to categorize due to measurement of silver release being below or near the detection limit (fig. 1b and 2). Avance falls into this category. Since absorption capacity and a sustained effective amount of silver release3 are two of the most important characteristics of an ideal silver dressing, a comparison between absorption capacity and accumulated silver release is illustrated in figure 4.
Figure 1A - In vitro silver release profiles for various antimicrobial dressings

References 1. Kolte, M.I., Nielsen, B., Dolmer, M. Exsudat-management mit silberhltigen Verbnden. Poster presented at the 7th conference of the Deutsche Gesellschaft fr Wundheilung und Wundbehandlung (DGfW), Augsburg, Germany, 2003 2. Kolte, M.I., Larsen-Jochumsen, U., Nielsen, B. Exudate management of silver containing dressings. Poster presented at the 12th conference of the European Wound Management Association (EWMA), Granada, Spain, 2002 3. White, R. (2001); British Journal of Nursing, The Silver supplement Part One, p. 3-8 4. Lansdown, A.B.G et al. (2003), J of Wound Care, Vol 12 (6)

Figure 2 - Accumulated in vitro silver release profiles for various antimicrobial dressings

1100 1000 900 800 700 600 500 400 300 200 100 0

Accumulated released silver (g/cm2)

24

48

72 96 Hours

120

144

168

Accumulated in vitro silver release results (g/cm2) (4-hour results accumulated).

Figure 3 - In vitro % silver release profiles for various antimicrobial dressings

Silver released (g/cm2)

700 600 500 400 300 200 100 0 0 24 48 72 96 120 144 168 % silver released 25 50 75 100 0 0 24 48

Hours 72 96

120

144

168

Hours
Amount of silver released (g/cm2) during each 4-hour period.

Percentage of total released silver during the study.

Figure 1B - In vitro silver release profiles for various antimicrobial dressings

Figure 4 - Absorption and accumulated silver release (5 days)

900 24 hours absorption (mg/cm2)

60 Silver released (g/cm2) 50 40 30 20 10 0 0 24 48 72 96 120 144 168 Hours

Amount of silver released (g/cm2) during each 4-hour period (same figure as 1a, but emphasizing 0-60 g/cm2 on the Y-axis).

450

0
2

500

1000

g/cm Ag released after 5 days

A comparison of the total amount of silver released (g/cm2) after 5 days combined with the absorption capacity (mg/cm2)1,2.

Recommendations concerning dressing wear-time and the use of secondary absorbent dressings according to the manufacturers instructions for use should be considered when interpreting data.

Presented at the 2nd WUWHS meeting, Paris, July 2004

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