Treatment of experimentally induced partial-thickness burns in rats with different silver-impregnated dressings

Carvalho, Carolyna de Sousa; Bernardes, Milton Junio Cândido; Gonçalves, Randys Caldeira; Vilela, Marielle Sousa; Silva, Marcus Vinicius Meneses da; Oliveira, Vinicius da Silva; Rocha, Marcelo Ribeiro da; Vinaud, Marina Clare; Galdino Junio, Hélio; Lino Junior, Ruy de Souza

doi:10.1590/acb370801

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Acta Cirúrgica Brasileira

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ORIGINAL ARTICLE • Acta Cir. Bras. 37 (8) • 2022 • https://doi.org/10.1590/acb370801 copy

Treatment of experimentally induced partial-thickness burns in rats with different silver-impregnated dressings

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Purpose:

To evaluate the morphometric, macroscopic and microscopic aspects of experimentally induced partial-thickness burns in rats treated with different silver-based dressings.

Methods:

Wistar rats were used, divided into six treatments: saline (NaCl 0.9%); silver sulfadiazine 1%; Silvercel; Mepilex Ag; Aquacel Ag and Acticoat. The animals were monitored daily and euthanized at 7, 14 and 30 days after injury induction (DAI).

Results:

At 7 DAI, necrosis/crust was greater in control, silver sulfadiazine and Mepilex Ag treatments, granulation tissue was induced by Aquacel Ag, polymorphonuclear infiltrate (PMN) infiltration was intensified by Mepilex Ag; mononuclear infiltrate (MN) infiltration and angiogenesis were increased by Silvercel. At 14 DAI, hemorrhage was decreased by Silvercel and Mepilex Ag, PMN infiltration increased by Acticoat. At 30 DAI, angiogenesis was greater in the Acticoat treatment and fibroblasts were increased by Acticoat and Mepilex Ag. Collagen was induced at 14 DAI by silver sulfadiazine and Aquacel Ag and, at 30 DAI, by silver sulfadiazine and Silvercel treatments.

Conclusions:

Silvercel and Acticoat presented better results than the other products. However, all the dressings were better than the control at some point during the process, and may contribute to the healing of partial thickness burns. Silvercel and Aquacel Ag treatments induced better cosmetic outcomes regarding wound closure and scarring.

Key words
Burns; Bandages; Animals; Acticoat; Collagen

Pathologic process	DAI	G1 (n=15) Median (min-max)	G2 (n=15) Median (min-max)	G3 (n=15) Median (min-max)	G4 (n=15) Median (min-max)	G5 (n=15) Median (min-max)	G6 (n=15) Median (min-max)	p	Dunn’s
Necrosis/crust	7	(2-3)	3 (2-3)	2 (1-2)	3 (3-3)	0.5 (0-1)	1 (1-3)	0.001^* * - statistical significance.	G1>G3; G1>G5; G2>G3; G2>G5; G3>G5; G4>G3 G4>G5; G4>G6; G6>G5
	14	2 (1-3)	3 (0-3)	1 (0-2)	2 (2-3)	0 (0-1)	1 (0-3)	0.010^* * - statistical significance.	G4>G3; G4>G5
	30	2 (0-3)	0.5 (0-2)	0 (0-1)	2.5 (0-3)	0 (0-1)	0 (0-1)	0.008^* * - statistical significance.	G1>G3; G1>G5; G1>G6; G4>G2; G4>G3; G4>G5; G4>G6
Granulation tissue	7	2 (1-3)	1 (1-2)	2 (1-3)	1 (0-1)	3 (3-3)	1 (0-3)	0.001^* * - statistical significance.	G3>G4; G5>G1; G5>G2; G5>G4; G5>G6
	14	2.5 (2-3)	2 (1-3)	3 (2-3)	2 (1-3)	3 (2-3)	3 (1-3)	0.378
	30	0 (0-0)	0 (0-1)	0 (0-1)	0 (0-0)	0 (0-1)	1 (0-1)	0.07
Reepithelialization	7	0 (0-0)	0 (0-0)	0 (0-0)	0 (0-0)	0 (0-0)	0 (0-0)	1.000
	14	0.5 (0-2)	0 (0-2)	0 (0-2)	2 (0-2)	2 (2-2)	1 (0-1)	0.157
	30	3 (2-3)	3 (3-3)	3 (3-3)	2 (2-3)	3 (3-3)	3 (3-3)	0.012^* * - statistical significance.	G2>G4; G3>G4; G5>G4; G6>G4

Pathologic process	DAI	G1 (n=15) Median (min-max)	G2 (n=15) Median (min-max)	G3 (n=15) Median (min-max)	G4 (n=15) Median (min-max)	G5 (n=15) Median (min-max)	G6 (n=15) Median (min-max)	p	Dunn’s
Necrosis/Crust	7	2 (1-3)	1 (1-2)	2 (1-2)	3 (3-3)	2 (2-2)	2(2-3)	0.001^* * - statistical significance.	G4>G1; G4>G2; G4>G3; G4>G5; G6>G2
	14	1 (1-1)	2 (1-3)	1 (1-1)	2 (1-2)	1(1-2)	2(1-2)	0.025^* * - statistical significance.	G2>G1; G2>G3; G4>G1; G4>G3; G6>G1; G6>G3
	30	0 (0-1)	1 (0-1)	0 (0-1)	0 (0-1)	0(0-1)	0(0-1)	0.595
Hemorrhage	7	2 (0-3)	2 (1-2)	2 (1-3)	1 (1-2)	1(0-2)	2(1-3)	0.300
	14	0 (0-0)	1 (1-2)	0 (0-0)	0 (0-0)	1 (0-2)	2 (0-2)	0.001^* * - statistical significance.	G2>G1; G2>G3; G2>G4; G5>G1; G5>G3; G5>G4; G6>G1; G6>G3; G6>G4;
	30	0 (0-0)	0 (0-0)	0 (0-0)	0 (0-0)	0 (0-0)	0 (0-0)	1.000
Fibrin	7	1 (1-3)	2 (2-3)	1 (1-1)	1 (1-2)	2 (1-3)	2 (1-3)	0.017^* * - statistical significance.	G2>G3
	14	1 (0-1)	1 (1-2)	0 (0-0)	0 (0-0)	0 (0-1)	0 (0-1)	0.002^* * - statistical significance.	G2>G3; G2>G4; G2>G5; G2>G6
	30	0 (0-0)	0 (0-0)	0 (0-0)	0 (0-0)	0 (-0-0)	0 (0-0)	1.000
PMN	7	2 (1-3)	1 (1-2)	1,5 (1-2)	3 (3-3)	2 (1-2)	2 (2-3)	0.001^* * - statistical significance.	G4>G1; G4>G2; G4>G3; G4>G5; G4>G6
	14	1 (1-1)	2 (1-3)	1 (1-1)	2 (1-2)	1 (1-3)	2 (1-3)	0.016^* * - statistical significance.	G6>G1; G6>G3
	30	0 (0-1)	1 (0-1)	0 (0-1)	0 (0-1)	1 (0-1)	0 (0-1)	0.417
MN	7	2 (2-3)	3 (3-3)	3 (3-3)	2 (2-3)	2 (1-2)	1 (1-2)	0.001^* * - statistical significance.	G1>G5; G1>G6; G2>G4; G2>G5; G2>G6; G3>G4; G3>G5; G3>G6; G4>G6
	14	2 (2-3)	2 (2-2)	2 (2-2)	2 (2-2)	2 (2-3)	2 (2-3)	0.153
	30	1 (1-2)	2 (1-2)	1 (1-1)	2 (1-3)	1 (1-2)	1 (1-2)	0.106
Angiogenesis	7	3 (2-3)	3 (3-3)	3 (3-3)	2 (2-3)	3 (1-3)	2 (2-3)	0.002^* * - statistical significance.	G2>G4; G2>G6; G3>G4; G3>G6
	14	3 (2-3)	2 (2-2)	3 (3-3)	3 (2-3)	3 (3-3)	3 (3-3)	0.001^* * - statistical significance.	G1>G2; G3>G2; G4>G2; G5>G2; G6>G2
	30	1 (1-1)	1 (1-2)	1 (1-2)	1 (1-2)	2 (1-3)	2 (2-3)	0.011^* * - statistical significance.	G6>G1; G6>G2; G6>G3; G6>G4
Fibroblast	7	3 (3-3)	3 (3-3)	3 (3-3)	3 (3-3)	2 (1-2)	1 (1-3)	0.001^* * - statistical significance.	G1>G5; G1>G6; G2>G5; G2>G6; G3>G5; G3>G6; G4>G5; G4>G6
	14	3 (3-3)	3 (3-3)	3 (3-3)	3 (3-3)	3 (3-3)	3 (3-3)	1.000
	30	2 (2-3)	2 (2-2)	2 (2-2)	3 (2-3)	2 (1-3)	3 (2-3)	0.035^* * - statistical significance.	G4>G2; G4>G3; G4>G5; G6>G2; G6>G3; G6>G5

Wound closure	G1	G2	G3	G4	G5	G6	p
Total	5	5	5	5	5	5
Yes	4	4	5	2	1	1	1.00
No	1	1	0	3	4	4	1.00

DAI	G1 (n=15) Median (min-max)	G2 (n=15) Median (min-max)	G3 (n=15) Median (min-max)	G4 (n=15) Median (min-max)	G5 (n=15) Median (min-max)	G6 (n=15) Median (min-max)	p	Dunn’s
7	0.03 (0.00-1.51)	0.73 (0.00-9.55)	0.42 (0.00-9.90)	0.07 (0.00-0.19)	0.29 (0.02-9.69)	0.61 (0.02-7.31)	0.001^* * - statistical significance.	G2>G1; G2>G3; G2>G4; G2>G5; G3>G1; G3>G4; G5>G1; G5>G4; G6>G1; G6>G4
14	0.02 (0.00-5.02)	1.79 (0.02-15.62)	0.25 (0.06-4.98)	0.30 (0.02-6.37)	0.60 (0.03-9.80)	0.24 (0.05-5.93)	0.001^* * - statistical significance.	G2>G1; G2>G3; G2>G4; G2>G5; G2>G6; G3>G1; G4>G1; G5>G1; G5>G6; G6>G1
30	0.02 (0.00-4.25)	4.26 (0.12-18.73)	18.01 (1.17-57.00)	9.15 (1.36-46.67)	7.61 (0.26-45.70)	1.52 (0.12-36.61)	0.001^* * - statistical significance.	G2>G1; G3>G1; G3>G6; G4>G1; G4>G6; G5>G1; G5>G6; G6>G1

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[1] *Corresponding author: ruy@ufg.br | (55 62) 3209-6113