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Objective: This study aimed to compare the outcomes of the use of polyurethane boric acid sponges and sponges containing silver nitrate over the negative pressure wound treatment.
Materials and methods: The patients were separated as Group 1 (n:30) treated with boric acid group, and Group 2 (n:34) treated with silver nitrate group (Group 2). The wound healing of each patient was evaluated quantitatively on a cellular basis from a table of macroscopic and histopathological scoring.
Results: No statistically significant difference was determined between the groups applied with boric acid and silver nitrate in respect of the culture results from the first visit (p:0.705). In the final evaluation of wound dimensions on day 21, a significant reduction was seen in wound width (p=0.001), wound length (p=0.003), and wound depth (p<0.001) in the boric acid group, and no significant results were obtained in the silver nitrate group. In the quantitative cellular evaluations, a statistically significant difference was determined in favor of the boric acid group in respect of inflammatory cell count, angiogenesis, granulation, and re-epithelialization (p<0.001 for all).
Conclusion: Sponges with boric acid can have a positive effect on chronic wound recovery by improving cellular proliferation, cellular differentiation and cellular migration in addition to antimicrobial properties when used in combination with the negative pressure wound treatment system. Therefore, boric acid sponges seem to be a good alternative to silver nitrate sponges.
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2. Gaisford S, Beezer A, Bishop A, Walker M, Parsons D. An in vitro method for the quantitative determination of the antimicrobial efficacy of silver-containing wound dressings. International journal of pharmaceutics. 2009;366(1-2):111.
3. McDonnell G, Russell AD. Antiseptics and Disinfectants: Activity, Action, and Resistance. Clinical Microbiology Reviews. 1999;12(1):147.
4. Siegel HJ, Herrera DF, Gay J. Silver Negative Pressure Dressing With Vacuum-assisted Closure of Massive Pelvic and Extremity Wounds. Clinical Orthopaedics and Related Research. 2014;472(3):830.
5. Borrelly J, Blech M, Grosdidier G, Martin-Thomas C, Hartemann P, editors. Contribution of a 3% solution of boric acid in the treatment of deep wounds with loss of substance. Annales de chirurgie plastique et esthetique; 1991.
6. Nzietchueng R, Dousset B, Franck P, Benderdour M, Nabet P, Hess K. Mechanisms implicated in the effects of boron on wound healing. Journal of trace elements in medicine and biology: organ of the Society for Minerals and Trace Elements (GMS). 2002;16(4):239.
7. Tepedelen B, Soya E, Korkmaz M. Boric Acid Reduces the Formation of DNA Double Strand Breaks and Accelerates Wound Healing Process. Biological trace element research. 2016;174(2):309.
8. Samman S, Foster M, Hunter D. The Role of Boron in Human Nutrition and Metabolism. Boron Science: New Technologies and Applications. 2016:73.
9. Gupta A, Kumar P. Assessment of the histological state of the healing wound. 2015.
10. Armstrong D, Wrobel J, Robbins J. Guest Editorial: are diabetes-related wounds and amputations worse than cancer? International wound journal. 2007;4(4):286.
11. Hopman W, Harrison M, Coo H, Friedberg E, Buchanan M, VanDenKerkhof E. Associations between chronic disease, age and physical and mental health status. Chronic diseases in Canada. 2009;29(3):108.
12. Bickers DR, Lim HW, Margolis D, Weinstock MA, Goodman C, Faulkner E, et al. The burden of skin diseases: 2004: A joint project of the American Academy of Dermatology Association and the Society for Investigative Dermatology. Journal of the American Academy of Dermatology. 2006;55(3):490-500.
13. Kapukaya R, Ciloglu O. Treatment of tibial intercalary defects secondary to tumour with modified fibular flap technique. European Journal of Plastic Surgery.1-8.
14. Orgill D, Manders E, Sumpio B, Lee R, Attinger C, Gurtner G, et al. The mechanisms of action of vacuum assisted closure: more to learn. Surgery. 2009;146(1):40.
15. Wu M, Sun M, Dai H, Xu J, Guo R, Wang Y, et al. Negative-pressure wound therapy: An effective adjunctive treatment to assist flap survival and wound closure. Journal of plastic, reconstructive & aesthetic surgery: JPRAS. 2018;71(11):1664.
16. Sudmann E, Vik H, Rait M, Todnem K, Andersen K, Julsham K, et al. Systemic and local silver accumulation after total hip replacement using silver-impregnated bone cement. Medical progress through technology. 1994;20(3-4):179.
17. Trop M, Novak M, Rodl S, Hellbom B, Kroell W, Goessler W. Silver-coated dressing acticoat caused raised liver enzymes and argyria-like symptoms in burn patient. The Journal of trauma. 2006;60(3):648.
18. Chung I, Lee M, Shin D, Jung H. Three systemic argyria cases after ingestion of colloidal silver solution. International journal of dermatology. 2010;49(10):1175-7.
19. Wan A, Conyers R, Coombs C, Masterton J. Determination of silver in blood, urine, and tissues of volunteers and burn patients. Clinical chemistry. 1991;37(10 Pt 1):1683.
20. Drake P, Hazelwood K. Exposure-related health effects of silver and silver compounds: a review. The Annals of occupational hygiene. 2005;49(7):575.
21. Özcan KM, Sitesi Y, Blok A. The efficacy of boric acid in otomycosis: an in vitro study. Mediterr J Otol. 2005;2:00-.
22. Yilmaz MT. Minimum inhibitory and minimum bactericidal concentrations of boron compounds against several bacterial strains. Turkish Journal of Medical Sciences. 2012;42(Sup. 2):1423-9.
23. Kapukaya R, Ciloglu O. Treatment of chronic wounds with polyurethane sponges impregnated with boric acid particles: A randomised controlled trial. International Wound Journal. 2020;17(5):1159-65.
24. Doğan A, Demirci S, Cağlayan A, Kılıç E, Günal M, Uslu U, et al. Sodium pentaborate pentahydrate and pluronic containing hydrogel increases cutaneous wound healing in vitro and in vivo. Biological trace element research. 2014;162(1-3):72.
25. Demirci S, Doğan A, Karakuş E, Halıcı Z, Topçu A, Demirci E, et al. Boron and Poloxamer (F68 and F127) Containing Hydrogel Formulation for Burn Wound Healing. Biological trace element research. 2015;168(1):169.
26. Demirci S, Doğan A, Aydın S, Dülger E, Şahin F. Boron promotes streptozotocin-induced diabetic wound healing: roles in cell proliferation and migration, growth factor expression, and inflammation. Molecular and cellular biochemistry. 2016;417(1-2):119.