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Biocompatibility Silver Wound
Dressing Studies

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Silverlon® Biocompatibility Studies  



1.  Sensitization Study of Silverlon®  

    

The Silverlon® fabric was tested by the ISO Sensitization Study in the Guinea Pig (Maximization Method of Magnusson and Kligman, 1970) to evaluate the potential for delayed dermal contact sensitization.  Studies were performed by North American Science Association Inc.

 

Method

             The Silverlon® material was extracted in 0.9% sodium chloride and cottonseed oil and intradermally injected and occlusively patched to ten test guinea pigs (per extract) in an attempt to induce sensitization.    Silverlon® was similarly injected and occlusively patched to five control guinea pigs.   Following a recovery period, the test and control animals received a challenge patch of the appropriate Silverlon® extract and the reagent control.  In addition the test article was applied to the same animal.   All sites were scored at 24, 48, and 72 hours after patch removal.

 

Results

               Silverlon® showed no evidence of causing delayed dermal contact sensitization in the guinea pig.

 

Interpretation

             Specific cells   (antigen-specific T cells) of the immune system react (the reaction is called delayed type hypersensitivity) to certain materials and substances that are foreign to the body.  Such a reaction results in what is commonly called an “allergic reaction”.  In order to determine if a material will react and cause an allergic reaction, this study was performed.   Since there was no evidence of delayed type hypersensitivity (delayed dermal contact sensitization), Silverlon® can be labeled hypoallergenic.

 

  2. Acute Intracutaneous Reactivity Study of Silverlon®


The Silverlon® fabric was tested by the Acute Intracutaneous Reactivity Study in the Rabbit to evaluate the local dermal irritant effects of leachables extracted from the Silverlon® following intracutaneous injection in rabbits.  Studies were performed by North American Science Association Inc.


Method
     The Silverlon® material was extracted in 0.9% sodium chloride and cottonseed oil and intradermally injected into five separate sites on the right side of the back of each rabbit.   Similarly, the corresponding reagent control was injected on the left side of the back of each rabbit.  The injection sites were observed immediately after injection.  Observations for erythema (redness) and edema (swelling) were conducted at 24, 48, and 72 hours after injection.

Results

     Silverlon® showed no evidence of significant irritation or toxicity from the extracts injected intracutaneously into the rabbits.  The Primary Irritation Index Characterization for the extracts were negligible.

Interpretation
     This study examined the local skin reactivity of any substances that were leachable from the Silverlon® material in water (0.9% sodium chloride) and in oil (cottonseed oil).  The study showed that there was no evidence of irritation or toxicity from the water or the oil extracts of Silverlon®. 

 

 

3.  Cytotoxicity Study of Silverlon®

 

     The objective of this study was to evaluate the cytotoxicity of Silverlon® using an ISO elution method in L-929 mouse fibroblast cell line in vitro based on the International Organization for Standardization (ISO) methodology.   Studies were performed by North American Science Association Inc.

 

Method

     The cytotoxicity was evaluated in a single strength minimum essential medium with Earle’s Salts (MEM) supplement with 5% serum supreme and 2% antibiotics.  Based on the USP ratio of 120 cm2 per 20 ml, a 54 cm2 portion of Silverlon® was covered with 9 ml of MEM. Triplicate preparations were prepared and extracted at 37oC for 24 hours.  A single culture well with a confluent L-929 mouse fibroblast monolayer was selected for each replicate and of each extracted preparation (test, negative control, reagent control, and positive control).  Twelve wells use used in this study.  The growth medium contained in the culture wells was discarded and the cells washed.  The medium was replaced with 2 ml of test extract, negative control, reagent control, or positive control preparation.  All test and control wells were incubated at 37oC in 5% CO2.  The cell cultures were examined microscopically at approximately 100X magnification and evaluated using the United States Pharmacopeia (USP) scoring guidelines.  Observations were conducted for the test extract, negative, positive, and reagent controls at 48 hours of incubation.

 

Results

     Under the conditions of this study, the MEM test extracts showed no evidence of causing cell lysis or toxicity.  The MEM extracts were not cytotoxic, and met the requirements of the test.  The negative controls, reagent controls and the positive controls preformed as anticipated.

 

Interpretation

     Silverlon® was not toxic to a line of cells called fibroblasts.  One can draw conclusions from this that Silverlon® is not toxic to cells in open wounds.

 

 

4. Hemolysis Study of Silverlon®

 

The objective of this study was to evaluate the presence of any leachable chemicals from Silverlon® that would cause in vitro red blood cell hemolysis. Studies were performed by North American Science Association Inc.

 

Method

             Silverlon® was prepared in duplicate and extracted in 0.9% sodium chloride USP solution at 700C for 24 hours.  Blood was obtained from 3 rabbits, pooled diluted and added to duplicate tubes of the test article extract.  A negative control article extract and USP Purified Water positive control were similarly prepared.  Each tube was inverted gently to uniformly mix the extract with the blood.  After 4 hours of incubation at 370C, the suspensions were centrifuged and the resulting supernatant was added to Drabkin’s reagent.   The percent transmission of the extract was spectrophotometrically measured at a wavelength of 540 nm.

 

Results

             The negative and positive controls performed as anticipated.  Under the conditions of this study, the mean hemolytic index for the test article was 4%.  The test article was slightly hemolytic.

 

Interpretation

             Hemolysis testing of medical device materials has historically been used to measure blood compatibility in vitro.  The extract from Silverlon® caused slight hemolysis (red blood cell death).  This was not considered significant.  If Silverlon® comes in direct contract with blood, no adverse effects are anticipated.

 

 

5. Muscle Implantation Study of Silverlon® 

    

The objective of this study was to evaluate the effect of implanting Silverlon® in muscle tissue of the rabbit.  The muscle tissue was evaluated for evidence of irritation or toxicity in accordance with the requirements of the International Organization for Standardization Part 6: Test for Local Effects after Implantation.  Studies were performed by  North American Science Association Inc.

 

Method

  

            Rabbits were anesthetized by subcutaneous injection of butorphanol (1mg/kg) and then sedated with acepromazine maleate (0.2 ml/kg dose).  After the muscle area was wiped clean with 70% alcohol, each paravertebral muscle was infiltrated with 1% lidocaine to achieve local anesthesia on both sides of the vertebral column.  A stylet was placed in the hub of a loaded needle.  The needle was inserted into the muscle at a 450 angle.  The needle was withdrawn over the stylet, leaving the sample in the paravertebral muscle.  Four pieces of Silverlon® were implanted in the right paravertebral muscle of each rabbit.   In the opposite muscle, four USP negative control strips were similarly implanted.  Rabbits were observed daily for general health.  At two weeks the rabbits were euthanatized by an intravenous injection of sodium pentobarbital based drug.  The paraveterbral muscles were dissected free and fixed in 10% neutral buffered formalin to facilitate cutting.  After fixation, the muscles were methodically cut to locate test and control article sites.  Capsul formation or other signs of irritation were scored and recorded.

 

Results

            All animals appeared clinically normal throughout the duration of the study.  Body weight data for individual rabbits were considered acceptable.   Macroscopically, there were no differences between the reactions of the test and control materials.  This resulted in a macroscpoic reaction of “Not significant” tissue contact irritation. Under the condition of this study, the macroscopic reaction was not significant as compared to the USP negative control implant material. Microscopically, the reaction was a slight irritant as compared to the USP negative control implant material.

 

Interpretation

             Silverlon® fabric, when implanted into a muscle, is safe with very little tissue reactivity.

 

6. Acute Systemic Toxicity Study of Silverlon® 

    

The objective of this study was to evaluate the acute systemic toxicity following injection of an extract of Silverlon® fabric extracted in an aqueous and an oil solvent.  These extracts were evaluated for systemic toxicity in accordance with the requirements of the International Organization: Biological Evaluation of Medical Devices, Part 11: Test for Systemic Toxicity.    Studies were preformed by North American Science Association Inc.

 

Method

     The aqueous vehicle was 0.9% sodium chloride and the oil vehicle was cottonseed oil.  A ratio of 120cm2:20 ml (surface area of test article to volume of vehicle) was used for each preparation.  The test article was extracted in the aqueous and oil solvents at 700C for 24 hours.  The extraction vehicles without test articles were similarly prepared to serve as reagent controls.  Five mice (per extract) were weighed and than each were injected with the test extract at a dose of 50ml/kg.   The corresponding extraction vehicles were similarly injected into five mice per control group.  The aqueous saline was injected by the intravenous route while the cottonseed oil was injected by the intraperitoneal route. The animals were observed immediately and at 4, 24, 48, and 72 hours after systemic injection.

 

Results

     Under the conditions of this study, there was no mortality or evidence of systemic toxicity from the aqueous or the oil extracts of Silverlon®.

 

Interpretation

This study revealed that aqueous and oil extracts of Silverlon® did not result in acute systemic toxic reactions.


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