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

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

Authorship SCIMAGO INSTITUTIONS RANKINGS

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*	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*	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*	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*	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*	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*	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*	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*	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*	G2>G3
	14	1 (0-1)	1 (1-2)	0 (0-0)	0 (0-0)	0 (0-1)	0 (0-1)	0.002*	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*	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*	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*	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*	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*	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*	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*	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*	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*	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*	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*	G2>G1; G3>G1; G3>G6; G4>G1; G4>G6; G5>G1; G5>G6; G6>G1

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[1] DAI – days after injury induction; n – number of animals per group; Min - minimum value; max – maximum value. Statistical analysis: Kruskal-Wallis followed by Dunn`s post-test.

[TFN01] ^*
- statistical significance.