Bioelectric Silver-Zinc Dressing Equally Effective to Chlorhexidine in Reducing Skin Bacterial Load in Healthy Volunteers

Arthroscopy. 2018 Oct;34(10):2886-2891. doi: 10.1016/j.arthro.2018.05.046. Epub 2018 Sep 5.

Abstract

Purpose: The aim of the present study was to evaluate and compare the effectiveness of the silver-zinc bioelectric dressing as compared with skin preparation with 2% chlorhexidine or 4% chlorhexidine in reducing the bacterial count on the knee.

Methods: Three groups consisting of 48 healthy volunteers were included. Age range was 23 to 54 years old and 60% of participants were male. Each subject had 1 knee serve as the test and the contralateral as the control. The test site was prepared with either 2% chlorhexidine, 4% chlorhexidine, or a silver-zinc bioelectric dressing and after 24 hours skin cultures were taken and examined for bacterial growth.

Results: In the 2% chlorhexidine group 23 of 48 unprepped knees had positive cultures, compared with 9 of 48 prepped knees (P = .003; risk reduction, 4.0 times). In the 4% chlorhexidine group 25 of 48 unprepped knees had positive cultures, compared with 14 of 48 prepped knees (P = .027; risk reduction, 2.6 times). In the silver-zinc bioelectric dressing group 29 of 48 unprepped knees had positive cultures, compared with 7 of 48 prepped knees (P < .001; risk reduction, 8.9 times). There was no difference in the positive skin culture rate between the 3 methods.

Conclusions: Application of the silver-zinc bioelectric dressing was equally effective at reducing skin bacterial load when compared with skin preparation with 2% chlorhexidine or 4% chlorhexidine in healthy volunteers.

Level of evidence: Basic Science - Microbiology.

Clinical relevance: The findings of this study indicate that the use of a bioelectric dressing after knee surgery can match the standard of care of preparing the skin with an antiseptic before surgery.

MeSH terms

  • Adult
  • Anti-Infective Agents, Local / therapeutic use*
  • Bacterial Load / drug effects*
  • Bandages*
  • Bioelectric Energy Sources*
  • Chlorhexidine / therapeutic use*
  • Electric Stimulation / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Silver / therapeutic use*
  • Skin / microbiology*
  • Wound Infection / prevention & control
  • Young Adult
  • Zinc / therapeutic use*

Substances

  • Anti-Infective Agents, Local
  • Silver
  • Zinc
  • Chlorhexidine