Authors' objectives:

This report evaluates the role of Acticoat in the topical treatment of severe burns.

Authors' results and conclusions: This technical note deals exclusively with the treatment of burns, although Acticoat is also used in the clinical context to treat wounds. The reviewed literature presents certain limitations, related to study methodology, small sample sizes, and heterogeneity of the products to which Acticoat is compared, among others. It is also important to note a lack of clinical studies that compare Acticoat TM with similar silver-based dressings. Despite these limitations, studies show that Acticoat possesses effective antimicrobial activity in vitro and in vivo capable of reducing colonization and preventing contamination by micro-organisms. Its release mechanism ensures a continuous distribution of 70 to 100 mg/L of ionized silver over more than 48 hours and rapid start of action (within 30 minutes of application) in optimal moisture conditions. It also offers an alternative in the case of allergy to topical sulpha products. According to the results of three randomized controlled trials, Acticoat reduces pain. This benefit can be intensified if dressings are changed only every three days, as recommended by the manufacturer. According to consulted clinicians, the lower frequency of dressing changes for Acticoat, compared with 1% silver sulphadiazine cream for example, may reduce the workload of nursing staff, although this has not been formally evaluated. The superiority of Acticoat for burn infection control and healing over other topical silver agents, such as 0.5% silver nitrate solution or 1% silver sulphadiazine cream, has not been demonstrated in a statistically significant manner, although the observed effects are promising. The potential benefits of Acticoat for reducing hospital stays and other costs have not yet been put in evidence. To date one recent Canadian study suggests quicker hospital discharge for children with medium-sized burns.

Authors' recommendations: Given these results and the lack of clinical studies comparing Acticoat with similar silver-based dressings, AETMIS concludes that: 1) Acticoat is a therapeutic option for the treatment of severe burns. 2) The rationale for its use is based more on empirical results observed in the clinical setting than on published scientific evidence. 3) Burn care is an emerging field of research, and its development paves the way for additional, better-designed clinical studies - and especially cost-benefit analyses - capable of demonstrating the potential benefits of Acticoat in the care of burns.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.aetmis.gouv.qc.ca/

Year Published: 2006

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: Agence d'évaluation des technologies et des modes d'intervention en santé

Contact Address: 2021, avenue Union, Bureau 10.083,Montreal, Quebec H3A S29, Canada.Tel: +1 514 873 2563; Fax: +1 514 873 1369

Contact Name: demande@inesss.qc.ca

Contact Email: demande@inesss.qc.ca

Copyright: Agence d'Evaluation des Technologies et des Modes d'Intervention en Sante (AETMIS)