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‡ In these countries please contact our distributor

ACTICOAT

Antimicrobial Barrier Dressing

ACTICOAT

What is ACTICOAT? 

ACTICOAT is a range of flexible and conformable wound dressings 1,2 that utilses the antimicrobial properties of silver to provide an efficient and effective barrier to bacterial penetration 3. ACTICOAT is different, for both patients and budgets. 

ACTICOAT for Patients

ACTICOAT Patient ImageThe ACTICOAT range assists faster wound healing and is proven in over 10 years of clinical trials 4,5,6. Patients benefit from a dressing that has a rapid antimicrobial action 7,8,9,10shown to be effective (in-vitro) against a broad spectrum of Gram positive and Gram negative bacteria and fungal wound pathogens 11,12.

In a comparison study of silver containing dressings on infected chronic wounds, patients experienced a faster rate of healing when treated with ACTICOAT compared to other silver dressings 13.

Wound odour can have profound psychological effects on the patient 15, ACTICOAT has also been shown to have the ability to decrease the number of odour causing bacteria (in-vitro) 14.

Studies have shown patients with acute wounds facing less wound complications when ACTICOAT is used 12,16 and, in some cases, faster rates of wound healing 17.

ACTICOAT is widely reviewed in the burns arena with studies showing decreased pain vs SSD, 18,23 less dressing changes vs traditional approaches 19,20 and reduced complication rates 21. A 2006 study in Western Australia showed ACTICOAT as a contributing factor to burns patients having a shorter length of stay 22 and reduced antibiotic usage vs SSD 22.

 

ACTICOAT for Budgets


ACTICOAT Flex on handAs well as providing the patient with a comfortable and effective dressing, the ACTICOAT range also benefits the clinicians that work with it and the Health Care Systems that pay for it and associated treatment.


ACTICOAT is easy to apply and remove making dressing changes easier for both clinicians and patients 23. The sustained silver release (in-vitro24,25 means that the dressing can act as a long lasting antimicrobial barrier 24,25 and, in the case of ACTICOAT 7 and ACTICOAT Flex 7, can remain in place for up to 7 days 24,25 (demonstrated in-vitro).

ACTICOAT has been shown to promote faster healing through its ability to maintain a moist wound environment 26 coupled with a fast 7,8,9,10 and effective 11,12 antibacterial action (demonstrated in-vitro). ACTICOAT has been shown to shorten in-patient stay compared to SSD 21. The resulting decrease in bed time and subsequent nursing time means that ACTICOAT has been demonstrated to lower overall treatment costs compared to SSD in the high cost burns arena 27. ACTICOAT has also been shown to be more effective in a chronic setting by promoting faster wound healing compared to competitors 13. In a comparative study ACTICOAT was shown to not only result in faster time to resolution of infection 28 but also a decreased overall cost compared to competitors.

 

ACTICOAT for Today

The combined benefits of ACTICOAT make it the obvious choice of antimicrobial dressing for today. With an effective 11,12 and fast 7,8,9,10 speed of kill combined with useable and conformable 1,2 dressing varieties†, ACTICOAT benefits both patients and budgets.

† ACTICOAT Flex 3 and ACTICOAT Flex 7.

 

 

References

1. ACTICOAT Flex 7 - Evaluation of Extensibility, report reference DS.08.123.R1 (in-vitro)
2. Smith & Nephew Data on File Report - 0403002 (in-vitro)
3. Burrell RE, et al. 'Efficacy of Silver-Coated Dressings as Bacterial Barriers in a Rodent Burn Sepsis Model', WOUNDS 1999; 11(4):64-71.
4. Haung Y, et al. A randomised comparative trial between ACTICOAT and SD-Ag in the treatment of residual burn wounds, including safety analysis. Burns 2007. 33(2):161-166
5. Vlachou E, et al. The safety of nanocrystalline silver dressings on burns: A study of systemic absorption. Burns 2007. 33(8):979-85
6. Moieman NS, et al. ACTICOAT dressings and major burns: Systemic silver absorption. Burns 2010. 37(1):27-35 (in-vitro)
7. Smith & Nephew Data on file report 0810018 (in-vitro)
8. Smith & Nephew Data on file report 0810014 (in-vitro)
9. Smith & Nephew report reference DS/08/078/R2 (in-vitro)
10. Smith & Nephew report reference DS/08/062/R2 (in-vitro)
11. In-vitro study data on file: Scientific Background #0109003
12. Wright JB, Lam K, Hansen D, Burrell RE. Efficacy of topical silver against fungal burn wound pathogens. Am J Infect Control. 1999;27:344-350
13. Gago M, et al., A comparison of three silver-containing dressings in the treatment of infected, chronic wounds. Wounds 2008; 20 (10): 273-278
14. Westaim (Sherritt) Report Ref: 93/001 'Broad Spectrum Efficacy' (in-vitro)
15. Thomas S, Treating malodorous wounds. Community Outlook, October 1989 27-30
16. Childress BB, Berceli SA, Nelson PR, Lee WA, Ozaki CK. (2007) Impact of an absorbent silver-eluting dressing system on lower extremity revascularization wound complications. Annals of Vascular Surgery. 21(5): 598-602.
17. Wright JB, Lam K, Olson ME and Burrell RE. (2003) Is antimicrobial efficacy sufficient? A question concerning the benefits of new dressings. Wound. 15(5): 132-144
18. Muangman P, et al. (2006) Comparison of efficacy of 1% Silver Sulphadiazine and ACTICOAT for the treatment of partial thickness burn wounds.Journal of the Medical Association of Thailand. 89(7):953-8
19. Cuttle L. Naidu S. Mill J. Hoskins W. Das K. and Kimble R. (2007) a retrospective cohort study of ACTICOAT versus Silvazine in a paediatric population. Burns. 33 (6): 701-7
20. Silver S, et al. (2007) A silver-coated antimicrobial barrier dressing used postoperatively on meshed autografts: A dressing comparison study. Journal of Burn Care and Research. 28(5):715-719
21. Peters D, Verchere C. Healing at home: Comparing Cohorts of children with medium-sized burns treated as outpatients with in-hospital applied ACTICOAT to those children treated as inpatients with silver sulfadiazine. Journal of Burn Care &Research 2006; 27(2):198-201.
22. Tonkin C and Wood F. (2006). Nanocrystalline silver reduces the need for antibiotic therapy in burn wounds. Primary Intention. 13(4): 163-168
23. Tredget EE, et al. 'A Matched-Pair, Randomized Study Evaluating the Efficacy and Safety of ACTICOAT Silver-Coated Dressing for the Treatment of Burn Wounds', Journal of Burn Care & Rehabilitation 1998; 19(6): 531-537
24. Westaim Report Ref. #001213 'Long Term Comparative Evaluation of SilverlonTM and ACTICOAT 7 Dressings' Activities Against MRSA' (in-vitro)
25. Westaim Report Ref. #010322 'Seven Day Efficacy of ACTICOAT 7 Dressings Against Multiple Organisms' (in-vitro)
26. Myers D. (2006) The clinical and physical properties of ACTICOAT dressing and the moist wound environment
27. Fong J, Wood F, Fowler B. A silver coated dressing reduces the incidence of early burn wound cellulitis and associatedcosts of inpatient treatment: Comparative patient care audits. Burns 31 (2005)562-567. Burn Care Res 2006;27:198-201
28. Searle R and Bielby A. (2010) Dressing strategies for the management of infected wounds in community wound care: impacts and implications. Poster at Wounds UK, Harrogate Nov 2010
29. Russell AD, Hugo WB. Antimicrobial activity and action of silver. Prog Med Chem 1994; 31: 351-71
30. Kelly J. Addressing the problem of increased antibiotic resistance. Prof Nurs 2001; 17(1): 56-9
31. Hamilton-Miller JMT, Shah S, Smith C. Silver sulphadiazine: a comprehensive in-vitro reassessment. Chemotherapy 1993; 39: 405-9
32. Maillard J-Y and Denyer SP. 2006. Focus on Silver. EWMA JournalV6(1)
33. Warriner R and Burrell R. Infection and the chronic wound - a focus on silver. Advances in Skin and Wound Care Vol 18 (Supp. 1) Oct 2005
34. Varas RP, et al. (2005). A prospective, randomized trial of ACTICOAT versus silver sulfadiazine in the treatment of partial-thickness burns: which method is less painful? Journal of Burn Care and Rehabilitation. 26, 4: 344-347
35. Sibbald R G, Browne A C, Coutts P, Queen D, 'A Screening Evaluation of an Ionized Nanocrystalline Silver Dressing in Chronic Wound Care'. Ostomy Wound Management 2001; 47(10): 38-4
36. Singer AJ et al 'Persistent wound infection delays epidermal maturation and increases scarring in thermal burns' Wound Repair and Regeneration Vol 10. No. 6 372-377
37. Ovington L.G., Update on Today's Tissue Healing Technologies,www.surgicenteronline.com/articles/331feat6.html
38. Bowler PG, 'Wound pathophysiology, infection and therapeutic options' Ann Med 2002; 34: 419-427
39. Wright JB, et al. 'Wound Management in an era of increasing bacterial antibiotic resistance: A role for topical silver treatment', American Journal of Infection Control 1998; 26(6): 572-577
40. Yin HQ, et al. 'Comparative evaluation of the antimicrobial activity of ACTICOAT Antimicrobial barrier dressing. Journal of Burn care and rehabilitation. 1999; 20(3): 195-200
41. Wright JB, et al. 'The Comparative Efficacy of Two Antimicrobial Barrier Dressings: In-Vitro Examination of Two Controlled Release of Silver Dressings', WOUNDS 1998; 10(6): 179-188
42. Chopra I. (2007) The increasing use of silver based products as antimicrobial agents: a useful development or a cause of concern. Journal of Antimicrobial Chemotherapy 59, 587-590

ACTICOAT Technology

ACTICOAT Technology 

Silver as an Antimicrobial

The antimicrobial properties of Silver have been exploited for centuries 29; there is now a deeper understanding of the mechanism behind this protection and how we can optimise it to benefit patients and Clinicians.

The increasing problems of antibiotic resistance 30, along with concerns about the safety and toxicity of topical antiseptics, has resulted in the need for an agent that can be used to treat colonised and infected wounds effectively.

Silver is a powerful broad spectrum antimicrobial when it is delivered at the right concentration over an appropriate time period 30,31.

Silver exerts its antimicrobial action in its ionic form (Ag +32.

Ag + works by

  • inhibiting cellular respiration 33
  • denaturing nucleic acids 33
  • altering cellular membrane permeability 33

 

 ACTICOAT Antimicrobial diagram  Number 1 Destroys proteins and enzymes
 Number 2 Changes DNA
 Number 3 Blocks “breathing“ of cell

This multi-way action is one of the reasons that resistance is not developing against silver.

SILCRYST◊ Nanocrystalline Silver

How is ACTICOAT different? A patient with an ACTICOAT dressing can expect a faster rate of healing, as seen in the 2007 RCT in burns patients 4, a less painful dressing change compared to SSD 17,34, a decrease in odour causing bacteria ( in-vitro14 and fewer complications (as per the 2006 study by Peters and Verchere) 21. All a result of the way ACTICOAT deals with infection using SILCRYST technology, so what makes SILCRYST Silver unique?

ACTICOAT Flex MagnifiedDressings in the ACTICOAT product range have a metallic silver coating comprising column-shaped crystals which are deposited on the dressing surface by a physical vapour deposition process. This process creates a surface topography with features on the nano-scale.

Image: Nanocrystalline structure increases the surface area of ACTICOAT

The key to a successful silver antimicrobial dressing is four-fold; it must exert an action that is:

  • Effective (silver available at therapeutic levels, broad spectrum action against a wide range of bacteria)
  • Rapid (have a rapid onset of action)
  • Have sustained efficacy for the duration of the dressing wear time
  • Easy to use

Based on "Characteristics of an ideal silver dressing, Burrell R. WUWHS Conference, Paris, July 2004. 

ACTICOAT with SILCRYST Nanocrystalline silver possesses all of these key characteristics:

ACTICOAT is effectiveDressings in the ACTICOAT product range have a metallic silver coating comprising column-shaped crystals which are deposited on the dressing surface by a physical vapour deposition process. This process creates a surface topography with features on the nano-scale. This specialist structure presents a larger surface area to volume ratio compared to other silver presentations.

ACTICOAT Magnified 
Magnification of nancrystalline silver Magnification of normal silver

ACTICOAT has been proven, in vitro, to be effective against a broad spectrum of over 150 wound pathogens - Gram positive, Gram-negative, anaerobic and resistant bacteria 11, including multiple MRSA strains 39 ACTICOAT dressings have been shown to reduce bacterial load in the wound which is a causative factor of prolonged inflammation and increased MMP levels 35,36,37,38.

ACTICOAT is rapid: its structure consists of small clusters of water soluble crystals; when moistened these atomic clusters, which are very porous, rapidly release and replenish concentrations of silver ions at sufficient levels ( in-vitro10. ACTICOAT is proven ( in-vitro), to begin working within 30 minutes‡ 7,8,12,39,40,41. This rapid action gives the bacteria very little time to multiply and allows control to be exerted faster.

ACTICOAT PatientsACTICOAT is sustained: whilst many silver dressings have a rapid release of silver initially, SILCRYST nanocrystalline silver technology enables a sustained release of silver. In the presence of solution (e.g. water or wound exudate), the nanocrystalline coating of ACTICOAT releases silver ions which can exert an antimicrobial effect.The surface topography described above gives ACTICOAT a larger surface area to volume ratio when compared to other silver presentations (see magnification images), enabling a more rapid and sustained release of Ag + versus other silver-containing dressings.

ACTICOAT is easy to use: the ACTICOAT range of dressings are available in a variety of forms including ACTICOAT Flex; a conformable wound contact layer, ACTICOAT Site specifically designed for percutaneous device sites, ACTICOAT Moisture Control; a foam based dressing and ACTICOAT Absorbent; a calcium alginate dressing. This wide range of dressing types ensures that the appropriate form can be selected.

‡ACTICOAT, ACTICOAT 7, ACTICOAT Flex 3, ACTICOAT Flex 7

References

1. ACTICOAT Flex 7 - Evaluation of Extensibility, report reference DS.08.123.R1 (in-vitro)
2. Smith & Nephew Data on File Report - 0403002 (in-vitro)
3. Burrell RE, et al. 'Efficacy of Silver-Coated Dressings as Bacterial Barriers in a Rodent Burn Sepsis Model', WOUNDS 1999; 11(4):64-71.
4. Haung Y, et al. A randomised comparative trial between ACTICOAT and SD-Ag in the treatment of residual burn wounds, including safety analysis. Burns 2007. 33(2):161-166
5. Vlachou E, et al. The safety of nanocrystalline silver dressings on burns: A study of systemic absorption. Burns 2007. 33(8):979-85
6. Moieman NS, et al. ACTICOAT dressings and major burns: Systemic silver absorption. Burns 2010. 37(1):27-35 (in-vitro)
7. Smith & Nephew Data on file report 0810018 (in-vitro)
8. Smith & Nephew Data on file report 0810014 (in-vitro)
9. Smith & Nephew report reference DS/08/078/R2 (in-vitro)
10. Smith & Nephew report reference DS/08/062/R2 (in-vitro)
11. In-vitro study data on file: Scientific Background #0109003
12. Wright JB, Lam K, Hansen D, Burrell RE. Efficacy of topical silver against fungal burn wound pathogens. Am J Infect Control. 1999;27:344-350
13. Gago M, et al., A comparison of three silver-containing dressings in the treatment of infected, chronic wounds. Wounds 2008; 20 (10): 273-278
14. Westaim (Sherritt) Report Ref: 93/001 'Broad Spectrum Efficacy' (in-vitro)
15. Thomas S, Treating malodorous wounds. Community Outlook, October 1989 27-30
16. Childress BB, Berceli SA, Nelson PR, Lee WA, Ozaki CK. (2007) Impact of an absorbent silver-eluting dressing system on lower extremity revascularization wound complications. Annals of Vascular Surgery. 21(5): 598-602.
17. Wright JB, Lam K, Olson ME and Burrell RE. (2003) Is antimicrobial efficacy sufficient? A question concerning the benefits of new dressings. Wound. 15(5): 132-144
18. Muangman P, et al. (2006) Comparison of efficacy of 1% Silver Sulphadiazine and ACTICOAT for the treatment of partial thickness burn wounds.Journal of the Medical Association of Thailand. 89(7):953-8
19. Cuttle L. Naidu S. Mill J. Hoskins W. Das K. and Kimble R. (2007) a retrospective cohort study of ACTICOAT versus Silvazine in a paediatric population. Burns. 33 (6): 701-7
20. Silver S, et al. (2007) A silver-coated antimicrobial barrier dressing used postoperatively on meshed autografts: A dressing comparison study. Journal of Burn Care and Research. 28(5):715-719
21. Peters D, Verchere C. Healing at home: Comparing Cohorts of children with medium-sized burns treated as outpatients with in-hospital applied ACTICOAT to those children treated as inpatients with silver sulfadiazine. Journal of Burn Care &Research 2006; 27(2):198-201.
22. Tonkin C and Wood F. (2006). Nanocrystalline silver reduces the need for antibiotic therapy in burn wounds. Primary Intention. 13(4): 163-168
23. Tredget EE, et al. 'A Matched-Pair, Randomized Study Evaluating the Efficacy and Safety of ACTICOAT Silver-Coated Dressing for the Treatment of Burn Wounds', Journal of Burn Care & Rehabilitation 1998; 19(6): 531-537
24. Westaim Report Ref. #001213 'Long Term Comparative Evaluation of SilverlonTM and ACTICOAT 7 Dressings' Activities Against MRSA' (in-vitro)
25. Westaim Report Ref. #010322 'Seven Day Efficacy of ACTICOAT 7 Dressings Against Multiple Organisms' (in-vitro)
26. Myers D. (2006) The clinical and physical properties of ACTICOAT dressing and the moist wound environment
27. Fong J, Wood F, Fowler B. A silver coated dressing reduces the incidence of early burn wound cellulitis and associatedcosts of inpatient treatment: Comparative patient care audits. Burns 31 (2005)562-567. Burn Care Res 2006;27:198-201
28. Searle R and Bielby A. (2010) Dressing strategies for the management of infected wounds in community wound care: impacts and implications. Poster at Wounds UK, Harrogate Nov 2010
29. Russell AD, Hugo WB. Antimicrobial activity and action of silver. Prog Med Chem 1994; 31: 351-71
30. Kelly J. Addressing the problem of increased antibiotic resistance. Prof Nurs 2001; 17(1): 56-9
31. Hamilton-Miller JMT, Shah S, Smith C. Silver sulphadiazine: a comprehensive in-vitro reassessment. Chemotherapy 1993; 39: 405-9
32. Maillard J-Y and Denyer SP. 2006. Focus on Silver. EWMA JournalV6(1)
33. Warriner R and Burrell R. Infection and the chronic wound - a focus on silver. Advances in Skin and Wound Care Vol 18 (Supp. 1) Oct 2005
34. Varas RP, et al. (2005). A prospective, randomized trial of ACTICOAT versus silver sulfadiazine in the treatment of partial-thickness burns: which method is less painful? Journal of Burn Care and Rehabilitation. 26, 4: 344-347
35. Sibbald R G, Browne A C, Coutts P, Queen D, 'A Screening Evaluation of an Ionized Nanocrystalline Silver Dressing in Chronic Wound Care'. Ostomy Wound Management 2001; 47(10): 38-4
36. Singer AJ et al 'Persistent wound infection delays epidermal maturation and increases scarring in thermal burns' Wound Repair and Regeneration Vol 10. No. 6 372-377
37. Ovington L.G., Update on Today's Tissue Healing Technologies,www.surgicenteronline.com/articles/331feat6.html
38. Bowler PG, 'Wound pathophysiology, infection and therapeutic options' Ann Med 2002; 34: 419-427
39. Wright JB, et al. 'Wound Management in an era of increasing bacterial antibiotic resistance: A role for topical silver treatment', American Journal of Infection Control 1998; 26(6): 572-577
40. Yin HQ, et al. 'Comparative evaluation of the antimicrobial activity of ACTICOAT Antimicrobial barrier dressing. Journal of Burn care and rehabilitation. 1999; 20(3): 195-200
41. Wright JB, et al. 'The Comparative Efficacy of Two Antimicrobial Barrier Dressings: In-Vitro Examination of Two Controlled Release of Silver Dressings', WOUNDS 1998; 10(6): 179-188
42. Chopra I. (2007) The increasing use of silver based products as antimicrobial agents: a useful development or a cause of concern. Journal of Antimicrobial Chemotherapy 59, 587-590

ACTICOAT Product guide

Product Guide 

ACTICOAT Product

ACTICOAT
ACTICOAT 7

ACTICOAT 7
ACTICOAT Flex
ACTICOAT Flex 3

ACTICOAT Flex 7Flex 3

ACTICOAT Flex 7

ACTICOAT Site

ACTICOAT Site

ACTICOAT Surgical

ACTICOAT Surgical

ACTICOAT Moisture Control

ACTICOAT Moisture Control


 

 

ACTICOAT

ACTICOATAn antimicrobial barrier dressing with an absorbent inner core utilising SILCRYST nanocrystalline silver technology to facilitate an effective bacterial kill in as little as 30 minutes2,3,4,5 ACTICOAT provides a sustained release of silver for at least 3 days 6 and helps in the maintenance of a moist wound environment in the presence of exudate 7.

ACTICOAT is indicated for:

Burns, Recipient Graft Sites, IV Sites, Venous Leg Ulcers, Pressure Ulcers, Diabetic Foot Ulcers


ACTICOAT 7

ACTICOAT 7A longer lasting antimicrobial barrier dressing, ACTICOAT 7 has an effective, fast acting antimicrobial action utilising SILCRYST nanocrystalline silver technology to kill a broad spectrum of Gram positive and Gram negative bacteria 8 in as little as 30 minutes 2,3,4,5. ACTICOAT 7 provides a sustained release of silver for up to 7 days ( in-vitro ) 9,10. With a five layer construction ACTICOAT 7 aids in the maintenance of a moist wound environment in the presence of exudate 11 and in effective wound bed preparation 12,13.

Indicated for:

Burns, Recipient Graft Sites, Venous Leg Ulcers, Pressure Ulcers, Diabetic Foot Ulcers


ACTICOAT Flex 3


ACTICOAT FlexA conformable and flexible 14 antimicrobial barrier dressing 1,15,16,17 utilising SILCRYST nanocrystalline silver technology to facilitate a rapid 17 and effective 15,16 bacterial kill. ACTICOAT Flex 3 remains effective for at least 3 days 15,16 and is suitable for use under NPWT for up to 3 days 18,19,20.


Ideal for packing, filling and conforming to difficult anatomical areas.

Indicated for:

Burns, Recipient Graft Sites, Surgical Sites, Venous Leg Ulcers, Pressure Ulcers, Diabetic Foot Ulcers


ACTICOAT Flex 7

ACTICOAT Flex 7A longer lasting flexible and conformable 14 antimicrobial dressing utilising SILCRYST nanocrystalline silver technology to facilitate a rapid 21 and effective 22,23 bacterial kill. ACTICOAT Flex 7 remains effective for up to 7 days ( in-vitro) 23, and is suitable for use under NPWT for up to 3 days 18,19,20.

Ideal for packing, filling wounds and conforming to difficult anatomical areas.

Indicated for:

Burns, Recipient Graft Sites, Surgical Sites, Venous Leg Ulcers, Pressure Ulcers, Diabetic Foot Ulcers


ACTICOAT Moisture Control 

ACTICOAT Moisture ControlACTICOAT Moisture Control provides all of the benefits of ACTICOAT in highly absorbent foam 29. Utilising SILCRYST nanocrystalline silver technology to facilitate a fast bacterial kill in as little as 2 hours ( in-vitro ) 30 ACTICOAT Moisture Control reduces the risk of infection 1,27,30,31,32,33 and its antimicrobial barrier properties remain effective for up to 7 days 34.

ACTICOAT Moisture Control is indicated for use on partial and full thickness moderately to highly exuding wounds, it can also be used under compression 31.

Indicated for:

Burns, Recipient Graft Sites, Donor Sites, Venous Leg Ulcers, Pressure Ulcers, Diabetic Foot Ulcers


ACTICOAT Surgical

 
ACTICOAT SurgicalACTICOAT Surgical is a white foam pad with SILCRYST nanocrystalline silver-coated polyurethane wound contact layer, backed by an adhesive coated waterproof film layer. The foam and wound contact layer are fenestrated for flexibility. 

ACTICOAT Surgical is designed for use on surgical incision sites. The wound contact layer is coated with SILCRYST nanocrystalline silver, providing the antimicrobial benefits of ACTICOAT including a rapid bacterial kill 40 and antimicrobial barrier properties 41,42 to reduce the risk of infection 1,27,31,33,40

ACTICOAT Absorbent has been shown to reduce rates of surgical site infection versus previous standard of care 16. ACTICOAT Surgical utilises the same SILCRYST nanocrystalline silver technology as ACTICOAT Absorbent and is indicated for surgical wounds, it may be used on infected wounds as per local clinical protocol. 


ACTICOAT Site

ACTICOAT SiteACTICOAT site is an absorbent foam dressing designed to fit in intimate contact with vascular and non-vascular percutaneous device sites. The wound contact layer is coated with SILCRYST nanocrystalline silver, providing the antimicrobial benefits of ACTICOAT including a rapid bacterial kill and antimicrobial barrier properties 34,36,37 to reduce the risk of infection 3,38,39.

Indicated for use around vascular and non-vascular percutaneous device sites e.g. intravenous catheter insertion and external fixation sites. ACTICOAT Site may be used on infected insertion sites as per local clinical protocols. 

References

1. ACTICOAT Flex 7 - Evaluation of Extensibility, report reference DS.08.123.R1 (in-vitro)
2. Smith & Nephew Data on File Report - 0403002 (in-vitro)
3. Burrell RE, et al. 'Efficacy of Silver-Coated Dressings as Bacterial Barriers in a Rodent Burn Sepsis Model', WOUNDS 1999; 11(4):64-71.
4. Haung Y, et al. A randomised comparative trial between ACTICOAT and SD-Ag in the treatment of residual burn wounds, including safety analysis. Burns 2007. 33(2):161-166
5. Vlachou E, et al. The safety of nanocrystalline silver dressings on burns: A study of systemic absorption. Burns 2007. 33(8):979-85
6. Moieman NS, et al. ACTICOAT dressings and major burns: Systemic silver absorption. Burns 2010. 37(1):27-35 (in-vitro)
7. Smith & Nephew Data on file report 0810018 (in-vitro)
8. Smith & Nephew Data on file report 0810014 (in-vitro)
9. Smith & Nephew report reference DS/08/078/R2 (in-vitro)
10. Smith & Nephew report reference DS/08/062/R2 (in-vitro)
11. In-vitro study data on file: Scientific Background #0109003
12. Wright JB, Lam K, Hansen D, Burrell RE. Efficacy of topical silver against fungal burn wound pathogens. Am J Infect Control. 1999;27:344-350
13. Gago M, et al., A comparison of three silver-containing dressings in the treatment of infected, chronic wounds. Wounds 2008; 20 (10): 273-278
14. Westaim (Sherritt) Report Ref: 93/001 'Broad Spectrum Efficacy' (in-vitro)
15. Thomas S, Treating malodorous wounds. Community Outlook, October 1989 27-30
16. Childress BB, Berceli SA, Nelson PR, Lee WA, Ozaki CK. (2007) Impact of an absorbent silver-eluting dressing system on lower extremity revascularization wound complications. Annals of Vascular Surgery. 21(5): 598-602.
17. Wright JB, Lam K, Olson ME and Burrell RE. (2003) Is antimicrobial efficacy sufficient? A question concerning the benefits of new dressings. Wound. 15(5): 132-144
18. Muangman P, et al. (2006) Comparison of efficacy of 1% Silver Sulphadiazine and ACTICOAT for the treatment of partial thickness burn wounds.Journal of the Medical Association of Thailand. 89(7):953-8
19. Cuttle L. Naidu S. Mill J. Hoskins W. Das K. and Kimble R. (2007) a retrospective cohort study of ACTICOAT versus Silvazine in a paediatric population. Burns. 33 (6): 701-7
20. Silver S, et al. (2007) A silver-coated antimicrobial barrier dressing used postoperatively on meshed autografts: A dressing comparison study. Journal of Burn Care and Research. 28(5):715-719
21. Peters D, Verchere C. Healing at home: Comparing Cohorts of children with medium-sized burns treated as outpatients with in-hospital applied ACTICOAT to those children treated as inpatients with silver sulfadiazine. Journal of Burn Care &Research 2006; 27(2):198-201.
22. Tonkin C and Wood F. (2006). Nanocrystalline silver reduces the need for antibiotic therapy in burn wounds. Primary Intention. 13(4): 163-168
23. Tredget EE, et al. 'A Matched-Pair, Randomized Study Evaluating the Efficacy and Safety of ACTICOAT Silver-Coated Dressing for the Treatment of Burn Wounds', Journal of Burn Care & Rehabilitation 1998; 19(6): 531-537
24. Westaim Report Ref. #001213 'Long Term Comparative Evaluation of SilverlonTM and ACTICOAT 7 Dressings' Activities Against MRSA' (in-vitro)
25. Westaim Report Ref. #010322 'Seven Day Efficacy of ACTICOAT 7 Dressings Against Multiple Organisms' (in-vitro)
26. Myers D. (2006) The clinical and physical properties of ACTICOAT dressing and the moist wound environment
27. Fong J, Wood F, Fowler B. A silver coated dressing reduces the incidence of early burn wound cellulitis and associatedcosts of inpatient treatment: Comparative patient care audits. Burns 31 (2005)562-567. Burn Care Res 2006;27:198-201
28. Searle R and Bielby A. (2010) Dressing strategies for the management of infected wounds in community wound care: impacts and implications. Poster at Wounds UK, Harrogate Nov 2010
29. Russell AD, Hugo WB. Antimicrobial activity and action of silver. Prog Med Chem 1994; 31: 351-71
30. Kelly J. Addressing the problem of increased antibiotic resistance. Prof Nurs 2001; 17(1): 56-9
31. Hamilton-Miller JMT, Shah S, Smith C. Silver sulphadiazine: a comprehensive in-vitro reassessment. Chemotherapy 1993; 39: 405-9
32. Maillard J-Y and Denyer SP. 2006. Focus on Silver. EWMA JournalV6(1)
33. Warriner R and Burrell R. Infection and the chronic wound - a focus on silver. Advances in Skin and Wound Care Vol 18 (Supp. 1) Oct 2005
34. Varas RP, et al. (2005). A prospective, randomized trial of ACTICOAT versus silver sulfadiazine in the treatment of partial-thickness burns: which method is less painful? Journal of Burn Care and Rehabilitation. 26, 4: 344-347
35. Sibbald R G, Browne A C, Coutts P, Queen D, 'A Screening Evaluation of an Ionized Nanocrystalline Silver Dressing in Chronic Wound Care'. Ostomy Wound Management 2001; 47(10): 38-4
36. Singer AJ et al 'Persistent wound infection delays epidermal maturation and increases scarring in thermal burns' Wound Repair and Regeneration Vol 10. No. 6 372-377
37. Ovington L.G., Update on Today's Tissue Healing Technologies,www.surgicenteronline.com/articles/331feat6.html
38. Bowler PG, 'Wound pathophysiology, infection and therapeutic options' Ann Med 2002; 34: 419-427
39. Wright JB, et al. 'Wound Management in an era of increasing bacterial antibiotic resistance: A role for topical silver treatment', American Journal of Infection Control 1998; 26(6): 572-577
40. Yin HQ, et al. 'Comparative evaluation of the antimicrobial activity of ACTICOAT Antimicrobial barrier dressing. Journal of Burn care and rehabilitation. 1999; 20(3): 195-200
41. Wright JB, et al. 'The Comparative Efficacy of Two Antimicrobial Barrier Dressings: In-Vitro Examination of Two Controlled Release of Silver Dressings', WOUNDS 1998; 10(6): 179-188
42. Chopra I. (2007) The increasing use of silver based products as antimicrobial agents: a useful development or a cause of concern. Journal of Antimicrobial Chemotherapy 59, 587-590

ACTICOAT Evidence

    In Vitro Evidence     Case Studies

ACTICOAT Clinical Evidence 

ACTICOAT is supported by a wide range of evidence from a meta-analysis, randomised controlled trials (RCTs), other clinical trials and case studies to in-vitro data. The clinical evidence surrounding ACTICOAT is compelling and high quality and covers a wide range of areas from infection prevention, managing infection and pain to health economics and the budgetary benefits of ACTICOAT. Based on the SIGN 1 criteria here we list the evidence rated from the highest 1++ rating to 3 rating encompassing the major meta-analysis and RCTs involving ACTICOAT. With RCT evidence showing the benefits of ACTICOAT in the clinical setting across a range of wound types we believe that ACTICOAT is the most well evidenced dressing in its class.

 

Key-Blue

Manage Infection

 Key-Yellow Infection Prevention  Key-Green Healing

ACTICOAT Orange key

Health Economics

 Key-Purple Pain  Key-Red Toxicity

 

Title Includes
1++ High quality meta analyses with a very low risk of bias and a high probability that the relationship is causal

Gravante G, et al. (2009) Nanocrystalline Silver. A systematic review of randomized trials conducted on burned patients and an evidence based assessment of potential advantages over old silver formulations. Annals of Plastic Surgery, 63 (2): 201-204 Read More>

 

Key-YellowKey-Purple
1+ Well conducted RCTs with a low risk of bias

Huang Y, et al. (2007) A randomized comparative trial between ACTICOAT and SD-Ag in the treatment of residual burn wounds, including safety analysis. Burns. 33(2):161-166 Read More>

 

Key-GreenKey-BlueKey-Red

Muangman P, et al. (2006) Comparison of efficacy of 1% Silver Sulphadiazine and ACTICOAT for treatment of partial thickness burn wounds. Journal of the Medical Association of Thailand 87(7): 953-958Read More>

 

ACTICOAT Orange keyKey-YellowKey-Purple

Silver ,et al. (2007). A silver coated antimicrobial barrier dressing used post-operatively on meshed autografts: A dressing comparison study. Journal of Burn Care and Research. 28(5):198-201 Read More>

 

ACTICOAT Orange key

Tredget et al. (1998). A matched-pair, randomized study evaluating the efficacy and safety of ACTICOAT silver-coated dressing for the treatment of burn wounds. Journal of Burn Care and Rehabilitation. 19(6): 531-537Read More>

 

Key-YellowKey-Purple

Varas RP, et al. (2006) A prospective, randomized trial of ACTICOAT versus silver sulfadiazine in the treatment of partial-thickness burns: which method is less painful. Journal of Burn Care and Rehabilitation. 26(4) 344-347 Read More>
 

 

Key-Purple
2++ High quality case- control or cohort studies with a very low risk of confounding, bias, or chance and a high probability that the relationship is causal

Cuttle L, et al. (2002) A retrospective cohort study of ACTICOAT versus Silvazine in a paediatric population. Burns. 33(6): 701-707 Read More>

 

ACTICOAT Orange keyKey-Green

Fong J, et al . (2005) A silver coated dressing reduces the incidence of early burn wound cellulitis and associated costs of inpatient treatment: Comparative patient care audits. Burns. 31(5): 562-567 Read More>

 

ACTICOAT Orange keyKey-Yellow

Peters DA and Verchere C (2006) Healing at home: comparing cohorts of children with medium sized burns treated as outpatients with in-hospital applied ACTICOAT to those children treated as inpatients with Silver Sulfadiazine. Journal of Burn Care and Research. 28(5): 715-719 Read More>

 

ACTICOAT Orange keyKey-Yellow

Tonkin C and Wood F, (2006) Nanocrystalline silver reduces the need for antibiotic therapy in burn wounds. Primary Intention. 13(4): 163-168 Read More >

 

ACTICOAT Orange keyKey-Yellow

Gago M, et al. (2008) A comparison of three silver-containing dressings in the treatment of infected chronic wounds. Wounds. 20(10): 273-278 Read More>

 

Key-BlueKey-Green

Childress BB, et al. (2007) Impact of an absorbent silver-eluting dressing system on lower extremity revascularisation wound complications. Annals of Vascular Surgery. 21(5):298-602 Read More>

 

ACTICOAT Orange keyKey-Yellow
3 Non-analytic studies

Vlachou E, et al . (2007). The safety of nanocrystalline silver dressings on burns: a study of systemic absorption. Burns; 33(8):979-985 Read More>

 

Key-Red

Strohal R, et al. (2005) Nanocrystalline silver dressings as an efficient anti MRSA barrier: a new solution to an increasing problem. Journal of Hospital Infection; 60:226-230 Read More>

 

Key-Blue

Moiemen NS, et al. (2010) ACTICOAT Dressings and Major Burns: Systemic Silver Absorption. Burns; 37(1) Read More>
 

 

Key-Red

Sibbald RG, Browne AC, Coutts P, Queen D. Screening evaluation of an ionized nanocrystalline silver dressing in chronic wound care. Ostomy/Wound Management. 2001;47:38-43. Read More>

 

Key-PurpleKey-Green

 

References:

 

1 SIGN (Scottish Intercollegiate Guidelines Network grading system) (http://www.sign.ac.uk/guidelines/fulltext/50/annexb.html)

 

™ All trademarks acknowledged

ACTICOAT FAQs

FAQs

ACTICOAT and ACTICOAT 7 have a blue side and a silver side, which side should be in contact with the wound bed?

Either side can be placed in contact with the wound bed, there is no difference in efficacy.

Why should ACTICOAT be moistened with water and not saline?

The chloride ions in saline have the potential to neutralise released Ag + ions so to prevent this, water is the best wetting agent.

What is the minimum age a patient should be for ACTICOAT application?

ACTICOAT should only be used in premature infants (<37 weeks gestation) when clinical benefits outweigh any potential patient risks. No clinical data is available in this age group and only limited data is available for use in neonates.

How long can ACTICOAT be used for?

ACTICOAT should not be required for more than 4-6 weeks on wounds showing signs and symptoms of infection. Progress should be assessed every 2 weeks to help dictate forward strategies in terms of therapeutic options. In certain "at risk" wound types (including surgical incisions) ACTICOAT use can be part of a preventative strategy even though the signs and symptoms of infection are absent. Use over extended time periods should be based on a clinical and microbiological justification.

Is silver toxic?

A study of silver levels in patients dressed with ACTICOAT for skin grafts, and residual burn sites showed that the levels of serum silver for ACTICOAT were less than the maximal level reported in the literature for patients treated with SSD cream 1. The authors concluded that the use of ACTICOAT was not associated with clinical, biochemical or haematological signs of toxicity 1. Another study found no significant difference between ACTICOAT and SSD with routine blood tests, liver and renal function tests. Additionally, no side effects were found relating to the use of ACTICOAT 2. In relation to chronic wounds, blood testing of a cohort of venous leg ulcer patients showed no clinically relevant changes in serum silver concentrations, haematology or biochemistry results following ACTICOAT usage 3

ACTICOAT contains nanocrystalline silver, aren't nanoparticles dangerous?

A nanoparticle and the nanocrystalline structure of ACTICOAT are very different. ACTICOAT does not contain nanoparticles. The word nanocrystalline refers to the structure of the silver and its ability to have a high surface area in contact with the wound bed and wound fluid. The silver released into the wound is Ag + ions, which is the same antimicrobial agent that is released from other silver containing dressings. Silver release from ACTICOAT does not involve the release of free nanoparticles.

Why are the levels of silver release higher with ACTICOAT compared to some other silver dressings? 

The level of silver released from ACTICOAT has been demonstrated to have bacteriocidal effects ( in-vitro) against a broad spectrum of over 150 Gram positive and Gram negative bacteria and fungal wound pathogens 14,22,4. It is also effective ( in-vitro) against Antibiotic- resistant bacteria such as Pseudomonas, Methicillin-resistant Staphylococcus aureus (MRSA) and Vancomycin-Resistant Enterococcus (VRE) 21.  In the clinical setting ACTICOAT has been demonstrated to be more effective than competitor silver dressings including faster resolution of the signs of infection and faster healing 5.

How are the high levels of silver release maintained compared to some other silver dressings?

The higher levels of silver at the wound when ACTICOAT is applied occur due to its efficient and prolonged release of silver ions. This is due to its nanocrystalline structure formed from column-shaped crystals which are deposited on the dressing surface by a physical vapour deposition process. This process creates a surface topography with features on the nano-scale. This specialist structure presents a larger surface compared to other silver presentations.  The SILCRYST nanocrystalline structure consists of small clusters of water soluble crystals; when moistened these atomic clusters, which are very porous, rapidly release and replenish concentrations of silver ions at sufficient levels ( in-vitro6

What about silver resistance?

Unlike antibiotics, which tend to act on a single target within the bacteria, silver acts on multiple targets. These include the respiratory action in cytochromes, components of the microbial electron transport system and DNA replication 7.  Chopra (2007) describes how faster acting antimicrobial dressings will present less risk of resistance developing as organisms are more likely to be killed, removing the chance of a build-up of the resistant population 8. The author also states that the multi-faceted mode of action of silver means that resistance is unlikely. SILCRYST Silver provides a sustained release of silver with a rapid action due to its nanocrystalline structure.

Why is speed of kill so important?

Bacteria reproduce very rapidly. For example, E.coli reproduces about every ~20 minutes (depending on the strain) 9 and with each new generation, mutations are possible. The longer a given microbe is allowed to live and multiply in the presence of an antimicrobial agent, the greater the chances for selection of resistance to that agent. Guarding against resistance is a huge benefit of a rapid kill rate (for any antimicrobial agent).  In addition, preventing biofilm formation (under appropriate conditions, biofilms can begin to form rapidly) 10 is another potential advantage of a quick acting agent.

What makes SILCRYST nanocrystalline silver different from other silvers? 

The SILCRYST nanocrystalline silver utilised in the ACTICOAT range is unique in that it is formed from column-shaped crystals which are deposited on the dressing surface by a physical vapour deposition process. This process creates a surface topography with features on the nano-scale. This specialist structure presents a larger surface area to volume ratio compared to other silver presentations.  This structure enables the rapidly release and replenish concentrations of silver ions at sufficient levels ( in-vitro11 ACTICOAT is proven ( in-vitro), to begin working within 30 minutes‡. 11,12,13,14,15,22. This rapid action gives the bacteria very little time to multiply.

Isn't silver expensive?

The unit cost for an ACTICOAT dressing may be greater than a non-antimicrobial but the benefits to both the patient and the overall care budget outweigh this difference.  ACTICOAT has been shown to decrease the length of inpatient stay and has been demonstrated to lower overall treatment costs compared to SSD in the high cost burns arena 16.  ACTICOAT has also been shown to be more effective in a chronic setting by promoting faster wound healing compared to competitors 5. In a comparative study ACTICOAT was shown to not only result in faster time to resolution of infection 17 but also a decreased overall cost compared to competitors.  In terms of the total cost of wound care it is the complications such as infection that drive up costs. For example infection may cause an increase in bed days, increased antibiotic use and increased clinician time. So an interventional, fast acting product with improved outcomes can easily justify a higher price.

How long does it take ACTICOAT to have an effect?

ACTICOAT has been shown ( in-vitro) to kill bacteria in as little as 30 minutes 13,14,15,16,17,18,‡.

What microbes is ACTICOAT effective against?

ACTICOAT is effective ( in-vitro) against a broad spectrum of over 150 Gram positive and Gram negative bacteria and fungal wound pathogens 14,21,22. It is also effective ( in-vitro) against Antibiotic- resistant bacteria such as Pseudomonas, Methicillin-resistant Staphylococcus aureus (MRSA) and Vancomycin-Resistant Enterococcus (VRE) 6. ACTICOAT has been shown, in a 2010 study, to reduce MRSA bacteraemias 19

How long does ACTICOAT remain active for?

ACTICOAT and ACTICOAT Flex 3 both have a sustained release of silver (in-vitro) for up to 3 days 20 and have been shown to maintain antimicrobial barrier efficacy for 3 days ( in-vitro) 25. Other variants including ACTICOAT 721,22, ACTICOAT Flex 7 23,24,25, ACTICOAT Moisture Control 26 and ACTICOAT Absorbent 27 maintain antimicrobial barrier efficacy for up to 7 days.

When should ACTICOAT dressings be changed?

ACTICOAT dressings have recommended wear times of between 3 and 7 days depending on the variant (please refer to dressing specific insert leaflet), appropriate clinical protocols and judgement should always be used when deciding on dressing change timings.

Can I use ACTICOAT under NPWT?

ACTICOAT and ACTICOAT Flex are both indicated for use under negative pressure devices. ACTICOAT requires fenestration before application whilst the mesh structure of ACTICOAT Flex gives fluid transfer properties for use as an antimicrobial layer under NPWT 28,29,30 and can be used for up to 3 days.

Why should I use ACTICOAT compared to other silver dressings? 

When compared to other silver dressings or traditional dressing protocols studies have shown ACTICOAT to provide a) faster healing 2,1,31 , b) faster time to resolution of infection 20 , c) a decrease in odour causing bacteria 23,32 , d) decreased pain (compared to SSD) 33,34 , e) a reduced number of dressing changes 35,36 , f) decreased in-patient stay 37 and g) decreased antibiotic usage 42

‡ACTICOAT, ACTICOAT 7, ACTICOAT Flex 3, ACTICOAT Flex 7

 

References

1. Vlachou E, et al. The safety of nanocrystalline silver dressings on burns: A study of systemic absorption. Burns 2007. 33(8):979-85
2. Haung Y, et al. A randomised comparative trial between ACTICOAT and SD-Ag in the treatment of residual burn wounds, including safety analysis. Burns 2007. 33(2):161-166
3. Sibbald R G, Browne A C, Coutts P, Queen D, 'A Screening Evaluation of an Ionized Nanocrystalline Silver Dressing in Chronic Wound Care'. Ostomy Wound Management 2001; 47(10): 38-4
4. Westaim (Sherritt) Report Ref: 93/001 'Broad Spectrum Efficacy' (in-vitro)
5. Gago M, et al. A comparison of three silver-containing dressings in the treatment of infected chronic wounds.Wounds. 2008. 20(10) 273-278
6. Smith & Nephew report reference DS/08/062/R2 (in-vitro)
7. Warriner R. Infection and the chronic wound: A focus on silver. Advances in Skin and Wound Care. 2005 (18) Supp. 1
8. Chopra I. (2007) The increasing use of silver based products as antimicrobial agents: a useful development or a cause of concern. Journal of Antimicrobial Chemotherapy 59, 587-590
9. Caddow P. Microorganisms and their properties. In: Applied Microbiology. 1st ed. London, England: Scutari Press, 1989:17-42.
10. Harrison-Balestra C, Cazzaniga AL, Davis SC, et al. A Wound-Isolated Pseudomonas aeruginosa Grows a Biofilm in Vitro Within 10 Hours and Is Visualized by Light Microscopy. Dermatologic Surgery, 2003; 29(6): 631.
11. Smith & Nephew Data on file report 0810018 (in-vitro)
12. Smith & Nephew Data on file report 0810014 (in-vitro)
13. Wright JB, et al. 'Wound Management in an era of increasing bacterial antibiotic resistance: A role for topical silver treatment', American Journal of Infection Control 1998; 26(6): 572-577
14. Yin HQ, et al. 'Comparative evaluation of the antimicrobial activity of ACTICOAT Antimicrobial barrier dressing.Journal of Burn care and rehabilitation. 1999; 20(3): 195-200
15. Wright JB, et al. 'The Comparative Efficacy of Two Antimicrobial Barrier Dressings: In-Vitro Examination of Two Controlled Release of Silver Dressings', WOUNDS 1998; 10(6): 179-188
16. Fong J, Wood F, Fowler B. A silver coated dressing reduces the incidence of early burn wound cellulitis and associated costs of inpatient treatment: Comparative patient care audits. Burns 31 (2005)562-567. Burn Care Res 2006;27:198-201
17. Searle R and Bielby A. (2010) Dressing strategies for the management of infected wounds in community wound care: impacts and implications. Poster at Wounds UK, Harrogate Nov 2010
18. Wright JB, et al. 'Efficacy of topical silver against fungal burn wound pathogens', American Journal of Infection Control 1999; 27(4): 344-350.
19. Newton H. 2010; Reducing MRSA bacteraemias associated with wounds. Wounds UK (6) 1
20. Westaim Report Ref: #971030 'The Antimicrobial Activity of Westaim's ACTICOAT Silver Coated Dressing Against Clinically Relevant Organisms Over An Extended Period of Time' (in-vitro)
21. Westaim Report Ref. #001213 'Long Term Comparative Evaluation of SilverlonTM and ACTICOAT 7 Dressings' Activities Against MRSA' (in-vitro)
22. Westaim Report Ref. #010322 'Seven Day Efficacy of ACTICOAT 7 Dressings Against Multiple Organisms' (in-vitro)
23. Antimicrobial Activity of ACTICOAT Flex 7 against a Broad Spectrum of Wound Pathogens, Data on File reference 0810012 (in-vitro)
24. Antimicrobial Activity of ACTICOAT Flex 7 dressings in a 7 day Repeat Challenge Test, Data on File reference 0810013 (in-vitro)
25. Antimicrobial activity testing of ACTICOAT Flex 7 dressings against a broad spectrum of wound pathogens using log reduction, report reference WRP-TW141-022 (in-vitro)
26. Ref: 0503006 ACTICOAT™ Moisture Control Dressing - Corrected Zone of Inhibition Testing (in-vitro)
27. Data on File Report - 0403003.Acticoat Absorbent Dressing Corrected Zone of Inhibition (in-vitro)
28. Lumb, H; The Antimicrobial Activity of Acticoat and Acticoat Flex 3 while Under Negative Pressure, Data on File reference 0810010
29. Bannister N. (2009) Smith & Nephew ACTICOAT and NPWT Summary
30. Carpenter, S; Investigation into wound bed pressure under ACTICOAT using an in-vitro model, report reference DS/09/019/R1
31. Moiemen NS, et al. ACTICOAT dressings and major burns: Systemic silver absorption. Burns 2010. 37(1):27-35
32. Thomas S, Treating malodorous wounds. Community Outlook, October 1989 27-30
33. Muangman P, et al. (2006) Comparison of efficacy of 1% Silver Sulphadiazine and ACTICOAT for eth treatment of partial thickness burn wounds.Journal of the Medical Association of Thailand. 89(7):953-8
34. Tredget EE, et al. 'A Matched-Pair, Randomized Study Evaluating the Efficacy and Safety of Acticoat Silver-Coated Dressing for the Treatment of Burn Wounds', Journal of Burn Care & Rehabilitation 1998; 19(6): 531-537
35. Cuttle L. Naidu S. Mill J. Hoskins W. Das K. and Kimble R. (2007) a retrospective cohort study of ACTICOAT versus Silvazine in a paediatric population. Burns. 33 (6): 701-7
36. Silver S, et al. (2007) A silver-coated antimicrobial barrier dressing used postoperatively on meshed autografts: A dressing comparison study. Journal of Burn Care and Research. 28(5):715-719
37. Tonkin C and Wood F (2006). Nanocrystalline silver reduces the need for antibiotic therapy in burn wounds. Primary Intention. 13(4): 163-168

Patients

Smith & Nephew is providing information in this site for general educational use only, and does not intend for this to be construed as medical advice or used as a substitute for the advice of your physician. For questions or concerns about a previous or upcoming surgery, Smith & Nephew recommends that you contact your healthcare professional.