Cerium nitrate hexahydrate 22mg/g / Sulfadiazine silver 10mg/g cream

Silver-releasing materials used for wound dressing have anti-inflammatory, re- epithelizing and antihaemorrhagic properties. Commonly used in topical burn man- agement, silver sulfadiazine (Ag-SD) is a useful antibacterial agent for treating burn wound. The action of silver sulphadiazine has been extensively studied. Since silver sul- phadiazine alone was found to be insufficient in preventing or retarding the growth of gram-negative bacteria in patients with burns covering more than 50% of body surface, the use of cerium nitrate in combination with the former was introduced by Monafo and colleagues in 1976. In recent years, a range of wound dressings have been marketed con- taining slow-release Ag compounds. The application of nanotechology in burn injury treatment is gaining considerable impetus in the century due to its metal nanosizing po- tential. Metallic silver, in the form of nanoparticles, has made a remarkable comeback as a potential antimicrobial agent.

Abstract licence: CC BY-NC-ND

Ventilator-associated pneumonia (VAP) is a consequence of intubation and mechanical ventilation. Bacteria colonize the inner-lumen of endotracheal tubes (ETT) and develop into a biofilm. One method to reduce/eliminate the develop of biofilms within the ETT is lining the inner-lumen with silver-sulfadiazine. A systematic review was conducted to evaluate the effectiveness of silver-coated ETTs for patients that develop VAP. Multiple databases were searched to identify key literature related to silver-coated ETTs and VAP. Inclusion and exclusion criteria were identified to finalize the studies that were included in this systematic review. Five key studies were included in this review. Studies were further evaluated with PRISMA, a data collection table, the Critical Appraisal Skills Programme (CASP) and the Critical Appraisal for Summaries of Evidence (CASE) worksheet. All studies found either a reduction or elimination of bacteria within the ETT, breathing circuit, or lungs of the study subjects. In addition to the reduced colonization found across the studies, one study found a reduction in the mortality rate for the intervention group following a diagnosis of VAP. Certified Registered Nurse Anesthetists (CRNA) play an important role in educating staff about the impact silver-coated ETTs have on patient outcomes throughout periods of intubation and mechanical ventilation. Additionally, CRNAs are well positioned to identify patients pre-operatively that may require prolonged intubation following surgery. By advocating for silver-coated ETTs for these patients, CRNAs can improve patient outcomes by reducing the likelihood of these patients developing VAP.

Abstract licence: CC BY-NC-ND