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Bibliographic details: Felipez Agrelo IM, Zurita AG, Souto Trillo MR.  [Efficacy of the application of nanocrystalline silver (Acticoat) vs silver sulfadiazine for the treatment of burns]. [Eficacia de la aplicación de la plata nanocristalina (Acticoat) frente a sulfadiazina de plata en el tratamiento de quemaduras.] Metas de Enfermeria 2014; 17(5): 22-26 Available from: http://dialnet.unirioja.es/servlet/articulo?codigo=4794040

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

Wound dressings and creams containing silver are widely used. It is thought that silver may help wounds to heal faster and prevent infection, but we did not know if this was true. This review identified 26 trials (involving 2066 participants) comparing silver‐containing dressings or creams against dressings or creams that did not contain silver. Twenty of the trials were on burn wounds, while the other trials were on a mixture of wound types. Most studies were small and of poor quality. After examining them all, the authors concluded that there is not enough evidence to support the use of silver‐containing dressings or creams, as generally these treatments did not promote wound healing or prevent wound infections. Some evidence from a number of small, poor‐quality studies suggested that one silver‐containing compound (silver sulphadiazine) has no effect on infection, and actually slows down healing in patients with partial‐thickness burns.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Burn injuries are a serious problem. They are associated with a significant incidence of death and disability, multiple surgical procedures, prolonged hospitalisation, and high costs of health care.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Aloe vera is a cactus‐like, succulent plant which grows in tropical climates. Aloe vera is widely used in a variety of cosmetics including creams and toiletries. Some studies conducted in animals have suggested that Aloe vera may help wound healing. Aloe vera can be applied topically as a cream or gel, or can be impregnated into a dressing and applied to the wound.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Pressure ulcers, also known as bedsores, decubitus ulcers and pressure injuries, are wounds involving the skin and sometimes the tissue that lies underneath. Pressure ulcers can be painful, may become infected, and so affect people's quality of life. People at risk of developing pressure ulcers include those with spinal cord injuries, and those who are immobile or who have limited mobility ‐ such as elderly people and people who are ill as a result of short‐term or long‐term medical conditions.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Superficial burns are those which involve the epidermal skin layer and partial thickness burns involve deeper damage to structures such as blood vessels and nerves. There are many dressing materials available to treat these burns but none has strong evidence to support their use. Evidence from poor quality, small trials, suggests that superficial and partial thickness burns heal more quickly with silicon‐coated nylon, silver containing dressings and biosynthetic dressings than with silver sulphadiazine cream. Burns treated with hydrogel dressings healed more quickly than those treated with usual care.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

The evidence for application of silver-containing dressings and topicals in the treatment of partial-thickness burns in pediatric patients is largely based on clinical trials involving adult patients despite the important differences between the skin of children and adults. A systematic review and meta-analysis was performed of all randomized controlled trials comparing nonsilver treatment with silver-containing dressings and silver topical agents in children with partial-thickness burns in the acute stage. Endpoints were wound healing, grafting, infection, pain, number of dressing changes, length of hospital stay, and scarring. Seven randomized controlled trials were included involving 473 participants. All trials used silver sulfadiazine as control in comparison with five different nonsilver treatments. Most trials were of moderate quality with high risk of bias. Use of nonsilver treatment led to shorter wound healing time (weighted mean difference: -3.43 days, 95% confidence interval: -4.78, -2.07), less dressing changes (weighted mean difference: -19.89 dressing changes, 95% confidence interval: -38.12, -1.66), and shorter length of hospital stay (weighted mean difference: -2.07 days, 95% confidence interval: -2.63, -1.50) compared with silver sulfadiazine treatment, but no difference in the incidence of wound infection or grafting was found. In conclusion, nonsilver treatment may be preferred over silver sulfadiazine, but high-quality randomized controlled trials are needed to validly confirm the effectiveness of silver containing preparations, in particular silver-containing dressings, above nonsilver treatments.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

To determine the quantity and quality of current research on the effectiveness of silver-based dressings and topical agents for the treatment of leg ulcers, this paper presents a systematic review of randomized controlled trials (RCTs) looking at the effects of silver-based dressings and topical agents on leg ulcer healing. Electronic databases were searched up to May 2006 for relevant randomized controlled trials. Journals and conference proceedings were also searched. The methodological quality of selected trials was assessed and statistical pooling of the results from similar studies undertaken. Rate of healing, proportion of ulcers completely healed and change in ulcer size were observed. Nine studies were considered eligible for inclusion. These studies varied in terms of the types of leg ulcers treated, interventions used, and outcomes assessed. Studies provided inconsistent evidence regarding the effects of silver-based dressings and topical agents on leg ulcer healing. Studies generally provided poor evidence due to a lack of statistical power, poor study designs, and incomplete reporting. In conclusion, the current evidence base on the use of these silver-based products on leg ulcers is limited, both in terms of the quantity available and the quality of the evidence. This review highlights the need for further, more rigorous research to be carried out before the use of these silver-based interventions in routine leg ulcer management is supported.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2007

This review found some evidence that sliver-impregnated dressings improved the short-term healing of leg wounds and ulcers, but long-term effects remained unclear. The authors' conclusions reflect the evidence presented but, given concerns about publication bias and included trial quality, the reliability of the conclusions is uncertain.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

The authors concluded that the silver dressings and topical agents were promising, safe and effective for wound care, but further research was needed. These conclusions reflect the evidence, but given the small samples, poor quality, and clinical variation between trials, as well as the lack of effect sizes, the findings may be overestimated.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

This review evaluated the use of central venous catheters (CVCs) impregnated with rifampicin-based antimicrobial combinations to prevent catheter-related bloodstream infections and CVC colonisation. The authors concluded that rifampicin and minocycline-impregnated CVCs appear safe and effective, but more research on the potential for microbial resistance is needed. These conclusions are likely to be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2007

This review assessed whether impregnated CVCs provide any advantage over standard CVCs in terms of CR-BSI or catheter colonisation. It concludes that heparin-coated or antibiotic-impregnated CVCs provide the optimal approach but that further research is needed to determine which is superior. The authors’ conclusions may be overly strong given the study numbers and quality, especially regarding heparin-coated CVCs.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2008

This review assessed the efficacy of antimicrobial central venous catheters in adults, concluding that chlorhexidine-silver sulfadiazine or minocycline-rifampicin central venous catheters can be considered when the baseline incidence of catheter-related bloodstream infections is above institutional goals. The authors’ conclusions reflect the limitations of the evidence and are likely to be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2008

The authors concluded that nanocrystalline silver for burn patients had a significantly stronger antimicrobial activity compared with older formulations, and that it also reduced dressing change frequency, which was probably responsible for decreased pain. The limited search for trials, coupled with the lack of reporting of trial quality, means the reliability of the authors' conclusions is uncertain.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2009

Pressure ulcers, also known as bedsores, decubitus ulcers and pressure injuries, are wounds involving the skin and often the tissue that lies underneath. Pressure ulcers can be painful, may become infected, and affect people’s quality of life. People at risk of developing pressure ulcers include those with spinal cord injuries, and those who are immobile or have limited mobility, such as elderly people and people who are ill.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

We reviewed the evidence about whether antiseptics are safe and effective for treating burn wounds.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2017

We reviewed the evidence about the effects of applying honey on the healing of any kind of wound. We found 26 studies involving 3011 people with many different kinds of wounds. Honey was compared with many different treatments in the included studies.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Chronic ulcers (i.e., ulcers that are unresponsive to initial therapy or that persist despite appropriate care) are estimated to affect over 6 million people in the United States. The incidence is expected to increase as the population ages and as the number of individuals with diabetes increases. Chronic ulcers negatively affect the quality of life and productivity of the patient and represent a substantial financial burden to the health care system.

Evidence-based Synthesis Program - Department of Veterans Affairs (US).

Version: November 2012

Prevention of pressure ulcers usually involves an assessment to identify people most at risk of pressure ulcers, such as elderly, immobile people or those with spinal cord injury. Assessments are most commonly carried out using specific pressure area risk scores (for example, the Braden or Waterlow scales for predicting pressure sore risk or the, Glamorgan scale for paediatric pressure ulcers).

NICE Clinical Guidelines - National Clinical Guideline Centre (UK).

Version: April 2014

Expert-reviewed information summary about the genetics of skin cancer — basal cell carcinoma, squamous cell carcinoma, and melanoma — including information about specific gene mutations and related cancer syndromes. The summary also contains information about interventions that may influence the risk of developing skin cancer in individuals who may be genetically susceptible to these syndromes.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: September 12, 2017

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