Clinical Case Studies:

Efficacy of Silver Oxysalt Wound Dressing* Containing Higher Oxidation State Silver in Post-Operative Management
Eric J. Lullove, DPM, CWS FACCWS Boca Raton, FL

ABSTRACT
REFERENCES
*Exsalt SD-7 is a registered trademark with Exciton Technologies, Inc., Edmonton, Alberta, Canada.
CONCLUSIONS
The use of silver oxysalt wound dressings in post-operative surgical cases showed to
have a high probability of success. In the above clinical studies, patients positively
responded based on incision genealogy and locations. In severe diabetic patients,
silver oxysalts demonstrated a rapid antimicrobial environment which allowed the
surgical incisions to regranulate and resolve with minimal to no complications.
In more complicated surgical incisions, silver oxysalts have shown in the above
studies to have a more rapid effect on wound healing with quicker resolution due to
the ability of the wound to suppress chronic wound states and provide a more
homogenic healing scaffold.
1) Acel, D. The Oligodynamic Action of Metals, Biochem. Z., 1920: 112-23.
2) Goetz, A., Tracy, RL, Harris, FS, The Oligodynamic Effect of Silver In: Silver in Industry, Chapter 16, edited by
Lawrence Addicks, Reinhold Publishing Corp., NY, 1940; p. 403.
3) Antelman, M.S., N. Jonas & Co., Inc., US Patent 5.211.855
4) Dellasega, D., et al.; Nanotech., 2008, 19, 475602-475607.
5) Djokic, S.S., J. Electrochem. Soc., 2004, 151(6), C659-C364.

OBJECTIVE
Surgical wounds constitute a significant burden on patients and the
healthcare system. Silver containing dressings are commonly used in
clinical practice in order to manage post-operative infection and control
the bacterial bioburden in surgical wounds. A new lower cost Silver
Oxysalt Wound Dressing promises to provide effective treatment of
acute surgical wound management using remotely low silver
concentrations. Current silver products contain silver +1(Ag
+1
) ions
and/or metallic silver (Ag
0
). A major step was taken by Acel and Goetz,
who determined that the antimicrobial properties of silver were due to
the liberation of ionic silver (Ag
+1
), and not due to the metal (Ag
0
) itself.
1,2
The Silver Oxysalt Wound Dressing, unlike current silver dressings,
contains three silver oxidation states. These include the higher +3
(Ag
+3
) and +2 (Ag
+2
) oxidation states in addition to the commonly seen
+1(Ag
+1
) oxidation state. The higher oxidation state silver is more
efficacious than the +1(Ag
+1
) form, thus reducing the amount of silver
required compared to other silver dressings.
3-5
The concentration of
silver on the Silver Oxysalt Wound Dressing is approximately 0.4mg/cm
2

(2.5%) w/w.

In these case studies, it was demonstrated that the new higher oxidation
state Silver Wound Dressing was highly efficacious against common
wound pathogens including antibiotic-resistant strains. The use of the
higher oxidation silver wound dressing was used to accentuate wound
closure in post-operative foot surgery patients without staining. The
application of higher oxidation state silver also showed to decrease the
amount of post-operative wound dressing changes over the course of
management. In each case, the use of Oxysalt Silver allowed for more
rapid wound closure by directly reducing microbial contamination. Use
of more efficacious forms of silver of lower concentration is shown to be
one solution to providing a high standard of patient care while
controlling healthcare costs.
The objective of this presentation is to illustrate the use of a new
silver technology, silver oxysalts, as an advanced antimicrobial
dressing designed for complicated and uncomplicated wound
genealogies.
Case 1:
3 days post-op
10 days post-op
2.5 weeks post-op
65 y/o diabetic female presented to office with complaints
of severe contracture of 2
nd
and 3
rd
toes of left foot. The
second toe had previously been operated on 4 years ago
by another surgeon. Patient underwent arthrodesis of 2
nd

and 3
rd
toes with a distal 2
nd
metatarsal osteotomy to
correct MPJ predislocation.

Silver Oxysalt Wound Dressing used as primary post-
operative dressing until sutures removal at 10 days.
Approximation of incision line occurred 25% faster with
suture removal at 10 days instead of 14.
Case 2:

36 y/o non-diabetic female presented to office with
complaint of fracture 4
th
toe right foot with 6 month
history of non-treatment. Patient underwent
revision of non-union middle phalangeal fracture
with 4
th
toe arthrodesis with intermedullary fixation
screw.
Silver Oxysalt Wound Dressing used as primary
post-operative dressing until sutures removal at 10
days. Approximation of incision occurred 25%
faster with suture removal in 10 days instead of
14.


3 days post-op
10 days post-op
(prior to suture removal)
Case 3:

57 y/o diabetic male seen in hospital on consultation
with severely infected right hallux with associated
osteomyelitis of distal phalanx. Patient underwent
distal phalangeal amputation, I & D abcess and
rotational plantar flap.
Silver Oxysalt Wound Dressing was used as primary
post-operative dressing until suture removal at 14
days. Approximation of incision occurred 33% faster
with suture removal at 14 days instead of the initially
planned of 21.

14 days post-operative with
suture removal