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Cytotoxicity of silver dressings on diabetic fibroblasts
Shi-Bo Zou1, Won-Young Yoon, Seung-Kyu Han
1Burn and Reconstruction Dept., The First Affiliated Hospital of Zhengzhou University, ZhengZhou, HeNan, China.
Abstract:
A large number of silver-based dressings are commonly used in the management of chronic wounds that are at risk of infection, including diabetic foot ulcers. However, there are still controversies regarding the toxicity of silver dressings on wound healing. The purpose of this study was to objectively test the cytotoxicity of silver dressings on human diabetic fibroblasts. Human diabetic fibroblasts were obtained from the foot skin of four diabetic foot ulcer patients and cultured. The effect of five silver-containing dressing products (Aquacel Ag, Acticoat*Absorbent, Medifoam Ag, Biatain Ag and PolyMem Ag) and their comparable silver-free dressing products on morphology, proliferation and collagen synthesis of the cultured human diabetic fibroblasts were compared in vitro. In addition, extracts of each dressing were tested in order to examine the effect of other chemical components found in the dressings on cytotoxicity. The diabetic fibroblasts cultured with each silver-free dressing adopted the typical dendritic and fusiform shape. On the other hand, the diabetic fibroblasts did not adopt this typical morphology when treated with the different silver dressings. All silver dressings tested in the study reduced the viability of the diabetic fibroblasts and collagen synthesis by 54-70 and 48-68%, respectively, when compared to silver-free dressings. Silver dressings significantly changed the cell morphology and decreased cell proliferation and collagen synthesis of diabetic fibroblasts. Therefore, silver dressings should be used with caution when treating diabetic wounds.
Insights
Silver dressings, commonly used for diabetic foot ulcers, may harm wound healing. This study found silver dressings significantly reduced diabetic fibroblast viability and collagen synthesis in vitro, suggesting cautious use.
Area of Science:
- Biomedical Engineering
- Wound Care
- Cell Biology
Background:
- Silver-based dressings are widely used for chronic wounds, particularly diabetic foot ulcers, to prevent infection.
- Concerns exist regarding the potential cytotoxic effects of silver dressings on wound healing processes.
Purpose of the Study:
- To objectively evaluate the in vitro cytotoxicity of common silver-based wound dressings on human diabetic fibroblasts.
- To compare the effects of silver dressings versus their silver-free counterparts on fibroblast morphology, proliferation, and collagen synthesis.
Main Methods:
- Human diabetic fibroblasts were cultured from four diabetic foot ulcer patients.
- Five silver-containing dressings and their silver-free analogues were tested for effects on cell morphology, proliferation, and collagen synthesis.
- Dressing extracts were analyzed to assess the cytotoxicity of other chemical components.
Main Results:
- Silver-free dressings maintained typical fibroblast morphology, while silver dressings altered it.
- All tested silver dressings significantly reduced diabetic fibroblast viability (54-70%) and collagen synthesis (48-68%) compared to silver-free controls.
- Silver dressings demonstrated significant negative impacts on cell morphology, proliferation, and collagen synthesis.
Conclusions:
- Silver-based wound dressings exhibit significant cytotoxicity towards human diabetic fibroblasts in vitro.
- The use of silver dressings in managing diabetic wounds warrants caution due to their potential adverse effects on key healing parameters.
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