As previously described, all the silver products except a pure silver delivery system (ACTICOAT) retard healing as a result of the complex attached to the silver. Most of the evidence to date is observational and will be presented in the next section.

To data, several studies on donor sites using ACTICOAT have been performed. The following study demonstrated a significant increase in healing with the silver delivery.

Objective - To compare rates of healing of donor sites in pigs between those dressed with silver-coated dressings and those dressed with petrolatum-impregnated absorbent gauze.

Design - Open study with each animal acting as its own control.

Setting - University research facility, Canada

Animals - 6 young specific-pathogen-free domestic pigs

Interventions - A total of 72 wounds about 1 cm x 2 cm x 0.4 mm were made in rows of eight on each pig with a dermatome. They were divided into three groups of 24, and dressed with petrolatum gauze, or silver-coated dressings moistened with sterile water either once only or daily for 10 days. All dressings were secured in plac with an elastic bandage.

Main outcome measures - Erythema, infection, epidermal migration, and healing.

Results - Wounds dressed with moistened silver-coated dressings re-epithelialized significantly more quickly. This resulted in complete re-epithelialization within 70% of the time taken by those wounds dressed with petrolatum gauze.

Conclusion - Silver-coated dressings provide a moist environment for the healing wound combined with an effective antimicrobial agent, and this significantly accelerates healing compared with wounds dressed with traditional petrolatum gauze dressings. (Europ J Surg In Press)

The following is a study designed to test the hypothesis that silver ion accelerates re-epithelialization on a burn wound: Effect of silver on re-epithelealization rate of burn wound meshed autografts

PURPOSE: To compare rate of re-epithealization with a moist closed wound technique using silver (Acticoat) or neomycin solution

-The methods were equivalent with silver being the variable tested

-The grafted wound was not infected, therefore, a direct wound healing effect would be tested.

METHODS: 9 patients who underwent excision of full thickness extremity burns (upper and/or lower) were studied. On the first excision, the wound was grafted with a 2:1 mesh autograft opened completely (12/1000^th inch thick) One extremity graft was covered with moist Acticoat and the other extremity with xeroform gauze followed by a constant moistened gauze (.01% neomycin solution). At least 95% mesh re-epithelialization rate was the endpoint.

CONCLUSION: Providing silver (Acticoat) to a moist wound environment accelerated re-epithelialization of a burn wound mesh graft.