The Concept of Silver Dressing Modality - Essay Example

? Evidence Based Silver Dressing Modality Evidence based Modality Introduction This paper aims at discussing modality of silver dressing on a patient diagnosed with a non-healing ulcer on the right foot and type II diabetes. The case was reviewed for a period of three months in order to allow for an accurate follow-up of the case. This was done under the permision of the clinical educator in a clinial placement session whose objective was to assess this modality. The assesment was based on sessions conducted by a district nurse. In this paper, a brief descriptionof the case study format as well as some of the key issues underlying the modality will be provided. Sequentially, this study will also seek to evaluate the efficacy of the modality based on some of the research conducted in this field. Moreover, the clinical applicability of the modality will also be highlighted. Background The patient, Mr. Y, was a 44 year old male diagnosed with Type II diabetes. He has a history of a non-healing ulcer for seven years. The ulcer is on the superior aspect of Medial malleoli on his right foot, which also had a singficantly high exudate levels. The ulcer was as a result of an injury he sustained after falling down. His blood sugar was also considerably high at 15 Hbl Ac. As such, Mr. Y was not only reluctant in complying to the treatment requirements, but also he refused to attend his clinical schedules as required. Indeed, his condition was made even worse since he opted for self dressing than being assisted by a qualified nurse. A foul odour emanated from the ulcer, which had started to produce a coloured exudatate. A swab of the exudate was taken for analysis for the determination of the the degree of infection. In Alridge et.al (2002) opinion, Mr. Y was made aware of outcomes of the assesment so as to involve him in deciding the next course of action. This entailed explaining to him the need for strict adherance to medical prescriptions or otherwise risk an amputation. Silver dressing was opted for as the suitable modality for stoping the exudation and overall treatment of the infection. Maillard (2006) in his research reported that ionic silver has expansive antimicrobial properties capable of treating a wide range of biopathogenic infections. Contreat foam is one of such dressers. According to Rogers and Patel (2000), contreet form is considered safe and perfoms well when used in the treatment of delayed-healing chronic venous leg ulcer. It combines effective antibacterial properties with excellent exudate management. Еvidеncе for efficacy of thе trеatmеnt Lansdown (2003) present that silver coated dressing is regarded as the most efficacious against a wide range of bacteria. Butcher (2010) compared a sliver dressing changed daily, with the standard procedure of wound care and covering wounds with gauze daily and found that silver dressing caused significantly less pain on removal and had substantially less infection. Moreover, with silver dressing, the ulcer would only require attention every 24 hours and could have been left for 48 hours, reducing dressing time and costs. Integration of silver ion in dressing offers the capacity to hydrate the wound (Graham 2006). In terms of silver dressing antimicrobial effects and toxicity, Herman (2006) expresses there is no common wound pathogen that has demonstrated resistance to pure silver. This therefore becomes effective for treatment of pathogens that are resistant to methilicin (Tioet, 2002). Those that have exhibited some form of resistance are mainly non-wound pathogens such as the Salmonella strain. Morison et.al (2004) further postulates that silver dressing is quite efficient due to the absence of allergy associated with the same. The modality also reduces the healing time as postulated by Lansdown (2002) attributable to silver dressing capability to attack multi-site bacterial infection. The multi-site attack of the silver is accredited to its ability to bind to the membranes of the pathogens thereby inducing rupture and their subsequent death. Furthermore, silver also possesses the ability to induce some alterations to the functional protein component of the microrganisms. This in turn hinders further growth or multiplication of the pathogens (Lansdown 2002). In this way, Rogers et.al (2000) articulates that silver dressing has the potential to cut bacterial infestation on a wound by nearly 60%, whereas a single application of silver-based cream to the wound reduces the same by almost 10% on a single application to the dressing.. According to the National Healing Corporation, dressing using silver-release has been used and continues to be used in the treatment of a wide range of diseases and infections. They further conceive that the pure silver dressings have been shown to have potent antimicrobial activity as well as pro-healing and anti-inflammatory properties. Sustained release of silver is deemed critical to cutting down the bacterial burden from wounds. Leaper (2006) presents that when silver sulfadiazine cream was applied on a cancerous wound once to twice daily; it reacted with serous exudates to form a scar, which must be removed before application of the cream. On the negative note, when hyperosmolar creams that have a short period of silver activity were applied on a patient, it was established that they can also cause surface desiccation of wound (Leaper 2006). Nevertheless, Herman (2010) posits that evidence-based wound care modality is normally hampered by the fact that it is practically impossible to carry out double-blind trials, which in turn makes it difficult to carry out grade A studies. Relevance In the study, it is evident that the colour as well as the variation of the levels of exudation provide a means of assesing the degree of infection and in turn the efficacy of the modality, an idea that Jones et.al (2005) supports. In fact, Mr. Y’s ulcer significantly improved within five weeks especially with the continual use of Contreet foam. Karlsmark et.al (2003) Contreet foam is a sustained silver releasing dressing that combines antibacterial activity with effective exudate handling. Its antiseptic property is due to the preferential silver uptake by susceptible pathogenic organisms. In contreet foam, silver is an integral part of the mixture and is thus recommended for use on wound with high bacterial burden. The foam controls the mositure content of the wound bed and also releases silver ions regarded as promoters of epithelial generation. Conclusion As therefore seen, silver dressing is widely preferred due to a number of reasons; its little allergy effects, little resistance shown to it by most pathogens and its high potential of reducinh healing time. Research on related literature indicates that unique antimicrobial activity of silver enhances wound healing. For many silver-containng dressings, preclinical proof of antimicrobial efficacy has been established. References Armstrong, D.G. (2002) ‘The use of silver as a antimicribial. Alpha & Omega Worldwide. New Jersey: Somerset Aldridge, R., Jamali, M., Guffey, J. S., Yates, D. A. & Ward, M. (2002) Patient compliance: its relevance to the management of a patient with Charcot’s foot. The International Journal of Lower Extremity wound. 1(3), pp.179-183. Boulton, A. M. J., Vileikyte, L., Ragnarson-Tenvall, G. & Apelgvist, J. (2005) The global burden of diabetic foot disease. Lancet. 366, pp.1719-1724. Falanga, V. (2005) Wound healing and its impairment in the diabetic foot. Lancet. 366. pp.1736-1743. Graham, C. (2005) ‘The role of silver in wound healing.’ British Journal of Nursing. 14(19), pp.22-28. Hermans, M. H. (2010). Silver Containing Dressing and the Need for Evidence. Advances in skin and Wound care, 30(3), 166-173. Jones. S., Philip, G., Bowler, M. & Walker, M. (2005) ‘Antimicrobial activity of silver-containing dressings is influenced by dressing conformability with a wound surface.’ Wounds. 17(9), pp.263-270. Lansdown, A. (2002) ‘Silver 1: Its antibacterial properties and mechanism of action.’ Journal of Wound Care. 11(14), pp.125-9. Lansdown, A. B. G. (2003) ‘Contreet foam & Contreet Hydrocolloid: an insight into two new silver-containing dressings.’ Journal of Wound Care. 12, pp.205-210. Leaper, D. (2006) Silver dressings: their role in wound management. 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