Departing on his white stallion, the Lone Ranger would shout, "Hi-Yo, Silver! Away!" As they galloped off, someone would ask, "Who was that masked man, anyway?" The masked crusader, his faithful horse and his Indian friend Tonto have become enduring icons of America's Old West. In modern America, another "silver" is fast becoming a beloved and enduring icon—in wound care.

Over the past three to five years, silver technology has increasingly become a mainstay in hospitals for wound care to help prevent and treat the alarming incidence of hospital-acquired infections, especially those caused by methicillin-resistant Staphylococcus aureus.

Unlike antibiotics, silver safely removes pathogens from leaking wounds. When moist, silver emits ions. These particles are bioactive and in sufficient concentration kill bacteria in external wounds. A Langhorne, PA-based biomedical company, Alliqua Biomedical, Inc., has created an interesting product based on this insight: SilverSeal®, a wound dressing with metallic silver-coated fibers. In addition to silver, SilverSeal offers another key feature: they incorporate hydrogels.

As Alliqua's CEO, David Johnson, explains, "Hydrogels are gel-like or colloidal substances made of water and solids. They can be created chemically, through a combination of ultraviolet cross-linking and chemical interface or by mixing polymer and water, and then exposing it to an electron beam, creating a 'sheet' of water. With patient comfort always of prime importance to our company, SilverSeal offers proven protection for wounds at risk of infection. The SilverSeal sheets conform well without sticking to the wound or patients' skin or hair. The dressings can be comfortably removed without causing additional trauma."

SilverSeal is approximately 93 percent water-based, meaning it provides a moist environment that is very favorable for wound healing, may enhance patient comfort by providing a cooling effect, and becomes active immediately after being placed on the wound. Although the sheets—which are available in 2"x3" and 4"x5" sizes—are flexible and conform to the wound well, they do not bond to the wound or skin, and thus can be removed without causing pain during dressing changes. And while many hydrogels are not highly absorbent, SilverSeal can absorb up to 2.0 times its weight in wound fluid. Finally, a single dressing can be worn for up to seven days, during which time silver ions are continuously released. In vitro studies have shown that the silver fiber in SilverSeal is effective in resisting the growth of bacteria. A recently presented in vivo study has supported these results.

As Johnson further reports, "What we assure in every sheet is the continuous, sustained release of silver cations—ions made of silver—for antimicrobial activity against a broad range of bacteria for a balanced healing process and enhanced patient comfort."

Tonto called the Lone Ranger "Ke-mo sah-bee," which meant "trusted friend." Today, when it comes to the heroic attributes of SilverSeal, perhaps it could stand for "trusted dressing!"

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