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Nanomaterials 2021, 11, 96 18 of 19 References bacteria may form biofilms which may prove to be a bigger antimicrobial challenge for PVA-silver films. Additionally, it is possible that some silver-resistant bacteria might be encountered, again providing a more significant challenge. However, in Western hospitals silver based wound dressings are generally not intended for use over long time periods and it is assumed that, similarly, in African countries the extended use of these PVA films would be avoided. If extended residence times of PVA hydrogel films on wounds and burns was required it is hoped that the initial inhibition of bacterial growth and the hydrogel protection of the wound would still provide a better outcome for the patient. Previously, using antibiotic loaded PLGA nanofibers we developed a uniform animal orthopedic model for in vivo testing [31]. However, it is very difficult to create a uniform infected burn wound model. We felt it unnecessary to develop an anti-infective animal model because similar materials are already used in humans and controlled bacterial testing in vitro with both gram negative and positive bacteria establish that release profiles allow strong antibacterial effects in the presence of huge loads of bacteria. 5. Conclusions The use of silver as an antimicrobial additive in commercially available wound dress- ings is now well established in western countries and, amongst these dressings, there are products such as ActicoatTM 7 and ActicoatTM Moisture Control, which contain nanocrys- talline silver and rely on silver nanoparticles for their anti-infective activity. As discussed in this paper, we have discovered that by subjecting PVA films containing silver nitrate to a sequential oven-drying and heat curing treatment, it is possible to generate crosslinked PVA films with in situ creation of silver nanoparticles which exhibit delayed release prop- erties on exposure to water. Further, in the context of a burn wound dressing application, the use of 5% w/w loadings of silver nitrate combined with heat treatment at 140 ◦C for 90 min, may be optimal in terms of both insolubilizing PVA and delaying silver release. The presence of silver nanoparticles in the PVA films and release media and the potent silver based antimicrobial activity have been demonstrated in this study. We have therefore concluded that silver-cross-linked PVA film may be a suitable material as a basis for a simple and inexpensive burn wound dressing. Author Contributions: Conceptualization, J.J., H.B., R.E.; methodology, D.P., D.L., I.W.; formal analysis, J.J., I.W.; investigation, J.J., D.P., I.W., D.L.; writing—original draft preparation, J.J.; writing— review and editing, J.J., D.P., H.B.; visualization, J.J., R.E.; supervision, H.B.; project administration, R.E., H.B. All authors have read and agreed to the published version of the manuscript. Funding: These studies were supported by a grant from Grand Challenges Canada. Data Availability Statement: Data sharing not applicable. Acknowledgments: We gratefully acknowledge the assistance of Robin Stoodley and Anita Lam, both from the Department of Chemistry at the University of British Columbia, in providing access to atomic absorption spectroscopy and x-ray diffraction respectively. Gethin Owen from the Faculty of Dentistry at the University of British Columbia kindly provided SEM images of silver cross-linked PVA films. The assistance of Joey Lo in carrying out the antimicrobial activity testing at the UBC Department of Urologic Sciences is much appreciated. Financial support from Grand Challenges Canada is also gratefully acknowledged. Conflicts of Interest: The authors have no conflict of interest. 1. Albertyn, R.; Bickler, S.; Rode, H. Paediatric burn injuries in Sub Saharan Africa—An overview. Burns 2006, 32, 605–612. [CrossRef] [PubMed] 2. Rayner, R.; Prentice, J. Paediatric burns: A brief global review. Wound Pract. Res. 2011, 19, 39–46. 3. Klasen, H.J. A historical review of the use of silver in the treatment of burns. Part 1 early uses. Burns 2000, 30, 1–9. 4. Heggers, J.P.; Richard, J.W.; Spencer, B.A.; McCoy, L.F.; Carina, E.; Washington, J.; Edgar, P.; Rosenblatt, J.; Goodheart, R. Acticoat versus silver ion: The truth. J. Burn Care Rehabil. 2002, 23, S115. [CrossRef]PDF Image | Hydrogel Forming Dressings Containing Silver Nanoparticles
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