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Letters to the Editor

Study on Comparison of DNA Damage and Apoptosis is too Flawed to be Clinically Relevant

September 2018
1044-7946
Wounds 2018;30(9):282.

Dear Editor:

The June 2018 issue of Wounds featured a study by Choi et al,1 in which the authors hypothesized that nanosilver is less toxic than ionic silver — an intriguing theory. However, their study design was deeply flawed. The Abstract, Materials and Methods, and Results sections were muddled, and the results presented in the text are contradictory to what is reported in Table 3.1 In addition, they failed to recognize that PolyMem Silver (henceforth Product D; Ferris Mfg. Corp., Fort Worth, TX) is a fundamentally different dressing whose multiple components interact with the body to improve healing.2,3

Each of the 4 test dressings is unique with respect to silver delivery. Product D was the least toxic of the 4 dressings.1 Combining the toxicity scores of test dressings A & C and B & D in Table 4 served to obscure, rather than clarify, the study results. In fact, the reverse transcription polymerase chain reaction and Western Blot analysis results for each parameter appear completely random, with the control often testing as more toxic than some test dressings.1

When Product D’s “Instructions For Use” are followed, it balances wound moisture, continuously cleanses wounds, and alters the nociceptor response at the wound site to decrease pain and edema, all of which help prevent infection and speed healing.2 However, failing to change Product D when indicated undermines its ability to provide these benefits and may delay healing, making the study results clinically irrelevant. In vitro testing is clearly inappropriate for determining the toxicity and clinical benefits of these interactive wound dressings.4

In 2012, Greulich et al5 showed that both silver nanoparticles and ionic silver are toxic to human cells at concentrations sufficient to kill common wound bacteria, rendering the question of which is worse somewhat academic. Anticipating this problem, Product D is designed with a powerful, built-in wound cleansing system that draws contaminants up into the dressing, where silver locked into the dressing can kill the microbes without endangering the human cells in the wound bed.2-4

Sincerely,

Linda Benskin, PhD, RN, SRN (Ghana), CWCN, CWS, DAPWCA

Author Responses

The authors of the June 2018 article1 Dr. Benskin addresses declined to respond.

Acknowledgment

Independent Researcher for Wound Management in Rural Areas of Tropical Developing Countries and Clinical Research & Education Liaison, and Charity Liaison, Ferris Mfg. Corp., Fort Worth, TX

Disclosure: Dr. Benskin is a paid employee of Ferris Mfg. Corp. (Fort Worth, TX). She did not receive any special financial assistance from the company for this publication.

Retraction Notice

The Editor and Publisher regretfully retract the study Dr. Benskin addresses due to a faulty study design.

References

1. Choi YS, Gwak HC, Park JK, et al. Comparison of DNA damage and apoptosis induced by silver nanoparticle-containing dressing materials during wound healing. Wounds. 2018;30(6):147–153. 2. Benskin LL. Polymeric membrane dressings for topical wound management of patients with infected wounds in a challenging environment: a protocol with 3 case examples. Ostomy Wound Manage. 2016;62(6):42–50. 3. Dabiri G, Damstetter E, Phillips T. Choosing a wound dressing based on common wound characteristics. Adv Wound Care (New Rochelle). 2016;5(1):32–41. 4. Benskin LL. Limitations of in vitro antimicrobial dressings study. Burns. 2016;42(5):1147–1148. Response: Webber MA. Response to Letter to Editor: ‘Limitations of in vitro antimicrobial dressings study’. Burns. 2016;42(5):1148. 5. Greulich C, Braun D, Peetsch A, et al. The toxic effect of silver ions and silver nanoparticles towards bacteria and human cells occurs in the same concentration range. RSC Adv. 2012;2(17):6981–6987.

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