Efficacy of Novel Blue Silver Nanoparticles Hydrogel versus Reference Hydrogel: a Prospective Randomized Controlled Trial for Acute and Chronic Wound Management Blue AgNPs hydrogel wound treatment
Article Sidebar
Main Article Content
Abstract
OBJECTIVE: Hydrogel dressings are commonly used as wound dressings and provide a moist environment in the wound area. Silver nanoparticles (AgNPs) are widely considered as useful therapeutic agents for the prevention and eradication of wound colonization by microorganisms. Recently, there has been a hydrogel dressing that consists of carboxymethyl cellulose hydrogel with blue AgNPs. It provides a moist and optimal healing environment for pain relief and protection from infection. This study aimed to evaluate the use of blue AgNPs hydrogel in acute and chronic wound care.
METHODS: From September 2017 to September 2018, 62 wound sites from 39 patients were randomized to receive daily application of either the blue AgNPs hydrogel (31 wound sites from 20 patients) or a commercially available reference hydrogel (31 wound sites from 19 patients). The primary outcome was wound area reduction, expressed as the wound healing rate; secondary outcomes included pain intensity and infection prevention.
RESULTS: The blue AgNPs and reference hydrogels were comparable in terms of wound area reduction and pain scores during the changing of wound dressings, with no significant differences (p > 0.05). Patients in the blue AgNPs hydrogel group showed low rates of bacterial infection for both gram-negative and gram-positive strains; in particular, there was almost complete prevention of infection by gram-positive strains at day 21 after treatment initiation.
CONCLUSION: The blue AgNPs hydrogel may be effective in preventing bacterial infections of both gram-negative and gram-positive strains at 14–21 days. Thus, the blue AgNPs hydrogel is a promising material for therapeutic applications in wound care.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
Gonzalez AC, Costa TF, Andrade ZA, Medrado AR. Wound healing - a literature review. An Bras Dermatol 2016;91(5):614-20.
Frykberg RG, Banks J. Challenges in the treatment of chronic wounds. Adv Wound Care (New Rochelle) 2015;4(9):560-82.
Sood A, Granick MS, Tomaselli NL. Wound dressings and comparative effectiveness data. Adv Wound Care (New Rochelle) 2014;3(8):511-29.
Kamoun EA, Kenawy ES, Chen X. A review on polymeric hydrogel membranes for wound dressing applications: PVA-based hydrogel dressings. J Adv Res 2017;8(3):217-33.
Aswathy SH, Narendrakumar U, Manjubala I. Commercial hydrogels for biomedical applications. Heliyon 2020;6(4):e03719.
Ahmed EM. Hydrogel: preparation, characterization, and applications: a review. J Adv Res 2015;6(2):105-21.
Dumville JC, O’Meara S, Deshpande S, Speak K. Hydrogel dressings for healing diabetic foot ulcers. Cochrane Database Syst Rev 2013;2013(7): CD009101.
Shu W, Wang Y, Zhang X, Li C, Le H, Chang F. Functional hydrogel dressings for treatment of burn wounds. Front Bioeng Biotechnol 2021;9:788461.
Dakal TC, Kumar A, Majumdar RS, Yadav V. Mechanistic basis of antimicrobial actions of silver nanoparticles. Front Microbiol 2016;7:1831-48.
Qing Y, Cheng L, Li R, Liu G, Zhang Y, Tang X, et al. Potential antibacterial mechanism of silver nanoparticles and the optimization of orthopedic implants by advanced modification technologies. Int J Nanomedicine 2018;13:3311-27.
Haidari H, Goswami N, Bright R, Kopecki Z, Cowin AJ, Garg S, et al. The interplay between size and valence state on the antibacterial activity of sub-10 nm silver nanoparticles. Nanoscale Adv 2019;1:2365-71.
Zhang L, Wu L, Si Y, Shu K. Size-dependent cytotoxicity of silver nanoparticles to Azotobacter vinelandii: growth inhibition, cell injury, oxidative stress and internalization. PLoS One 2018;13(12):e0209020.
Kim DH, Park JC, Jeon GE, Kim CS, Seo JH. Effect of the size and shape of silver nanoparticles on bacterial growth and metabolism by monitoring optical density and fluorescence intensity. Biotechnol Bioproc 2017;22(2):210-7.
Masood N, Ahmed R, Tariq M, Ahmed Z, Masoud MS, Ali I, et al. Silver nanoparticle impregnated chitosan-PEG hydrogel enhances wound healing in diabetes induced rabbits. Int J Pharm 2019;559:23-36.
Lee YH, Hong YL, Wu TL. Novel silver and nanoparticle-encapsulated growth factor co-loaded chitosan composite hydrogel with sustained antimicrobility and promoted biological properties for diabetic wound healing. Mater Sci Eng C Mater Biol Appl 2021;118:111385.
Martínez-Higuera A, Rodríguez-Beas C, Villalobos-Noriega JMA, Arizmendi-Grijalva A, Ochoa-Sánchez C, Larios-Rodríguez E, et al. Hydrogel with silver nanoparticles synthesized by Mimosa tenuiflora for seconddegree-burns treatment. Sci Rep 2021;11(1): 11312.
Holbert MD, Griffin BR, McPhail SM, Ware RS, Foster K, Bertoni DC, et al. Effectiveness of a hydrogel dressing as an analgesic adjunct to first aid for the treatment of acute paediatric thermal burn injuries: study protocol for a randomised controlled trial. Trials 2019; 20(1):13.
Abboud EC, Legare TB, Settle JC, Boubekri AM, Barillo DJ, Marcet JE, et al. Do silver-based wound dressings reduce pain? A prospective study and review of the literature. Burns 2014;40 Suppl 1:S40-7.
Wongravee K, Parnklang T, Pienpinijtham P, Lertvachirapaiboon Ch, Ozaki Y, Thammacharoen C, et al. Chemometric analysis of spectroscopic data on shape evolution of silver nanoparticles induced by hydrogen peroxide. Phys Chem Chem Phys 2013;15(12):4183-9.
Williams C. Intrasite gel: a hydrogel dressing. Br J Nurs 1994;3(16):843-6.
Masson-Meyers DS, Andrade TAM, Caetano GF, Guimaraes FR, Leite MN, Leite SN, et al. Experimental models and methods for cutaneous wound healing assessment. Int J Exp Pathol 2020;101(1-2):21-37.
Burusapat C, Supawan M, Pruksapong C, Pitiseree A, Suwantemee C. Topical aloe vera gel for accelerated wound healing of split-thickness skin graft donor sites: a double-blind, randomized, controlled trial and systematic review. Plast Reconstr Surg 2018;142(1):217-26.
Nunes JPS, Dias AAM. ImageJ macros for the user-friendly analysis of soft-agar and wound healing assays. Biotechniques 2017;62(4):175-9.
Aragón-Sánchez J, Quintana-Marrero Y, Aragón-Hernández C, Hernández-Herero MJ. ImageJ: a free, easy, and reliable method to measure leg ulcers using digital pictures. Int J Low Extrem Wounds 2017;16(4):269-73.
Karcioglu O, Topacoglu H, Dikme O, Dikme O. A systematic review of the pain scales in adults: which to use? Am J Emerg Med 2018; 36(4):707-14.
Bowler PG, Duerden BI, Armstrong DG. Wound microbiology and associated approaches to wound management. Clin Microbiol Rev 2001;14(2):244-69.
Thomson PD, Smith DJ Jr. What is infection? Am J Surg 1994;167(1A):7S-10S.
Dreifke MB, Jayasuriya AA, Jayasuriya AC. Current wound healing procedures and potential care. Mater Sci Eng C Mater Biol Appl 2015;48:651-62.
Xie Y, Liao X, Zhang J, Yang F, Fan Z. Novel chitosan hydrogels reinforced by silver nanoparticles with ultrahigh mechanical and high antibacterial properties for accelerating wound healing. Int J Biol Macromol 2018;119:402-12.
Xiang J, Shen L, Hong Y. Status and future scope of hydrogels in wound healing: synthesis, materials and evaluation. Eur Polym J 2020; 130(9):109609.
Mir M, Ali MN, Barakullah A, Gulzar A, Arshad M, Fatima S, et al. Synthetic polymeric biomaterials for wound healing: a review. Prog Biomater 2018;7(1):1-21.
Silverstein P, Heimbach D, Meites H, Latenser B, Mozingo D, Mullins F, et al. An open, parallel, randomized, comparative, multicenter study to evaluate the cost-effectiveness, performance, tolerance, and safety of a silver-containing soft silicone foam dressing (intervention) vs silver sulfadiazine cream. J Burn Care Res 2011;32(6):617-26.
Shukla D, Tripathi AK, Agrawal S, Ansari MA, Rastogi A, Shukla VK. Pain in acute and chronic wounds: a descriptive study. Ostomy Wound Manage 2005;51(11):47-51.
Bechert K, Abraham SE. Pain management and wound care. J Am Col Certif Wound Spec 2009;1(2):65-71.
Veiga AS, Schneider JP. Antimicrobial hydrogels for the treatment of infection. Biopolymers 2013;100(6):637-44.
Panacek A, Kvítek L, Prucek R, Kolar M, Vecerova R, Pizúrova N, et al. Silver colloid nanoparticles: synthesis, characterization, and their antibacterial activity. J Phys Chem B 2006;110(33):16248-53.
Morones JR, Elechiguerra JL, Camacho A, Holt K, Kouri JB, Ramírez JT, et al. The bactericidal effect of silver nanoparticles. Nanotechnology 2005;16(10):2346-53.
Serra R, Grande R, Butrico L, Rossi A, Settimio UF, Caroleo B, et al. Chronic wound infections: the role of Pseudomonas aeruginosa and Staphylococcus aureus. Expert Rev Anti Infect Ther 2015;13(5):605-13.