Các hợp chất bạc và bạc, được biết đến với tác dụng kháng khuẩn của họ, đã được sử dụng trong y học từ thế kỷ thứ mười chín [37, 38]. Bạc nitrat và sau đó sulfadiazine bạc đã được sử dụng trong những thập kỷ gần đây như các phương pháp điều trị của sự lựa chọn cho bỏng | 154 Chapter 11 Silver General Comments Silver and silver compounds known for their antibacterial effect have been used in medicine since the nineteenth century 37 38 . Silver nitrate and later silver sulfadiazine have been used in recent decades as the treatments of choice for burns. The bacteriostatic properties of silver ions were evaluated in vitro by Deltch et al. 39 using a woven nylon cloth coated with metallic silver. The antibacterial effects were shown to be proportional to the concentration of silver ions around the organisms tested. In vivo tests 40-42 have demonstrated the antibacterial effect of silver in a variety of organisms including Staphylococcus aureus Esherichia coli Pseudomonas aeruginosa and Proteus mirabi-lis. The bacteriocidal action of silver is proportional to the amount of silver and its rate of release 38 . Silver denatures nucleic acids thereby inhibiting bacterial replication 43 44 . Compared to the situation with antibiotic substances bacteria show a relatively low tendency to develop resistance to silver or silver compounds 45 46 . Furthermore silver is effective against Candida species 38 47 by interfering with the normal synthesis of the yeast cell wall. Wright et al. reported the effectiveness of topical silver against fungal infections in burns 48 . There is also evidence that silver ions can damage host tissue by interfering with fibroblast proliferation thus possibly impairing wound-healing processes 49-51 . Data on the possible toxicity of silver sulfadiazine are discussed below. Currently silver compounds may be used in the treatment of cutaneous ulcers in the form of silver sulfadiazine. Novel modes of dressings incorporating silver have been introduced such as Actisorb discussed in Chap. 8 . Silver Sulfadiazine Silver sulfadiazine SSD is prepared as a watersoluble cream in a concentration of 1 . It is Topical Antibacterial Agents composed of silver nitrate and sodium sulfadiazine both having .
