Presentation Authors: Matteo Balzarro*, Emanuele Rubilotta, Anna Marcer, Antonio Soldano, Nicolò Trabacchin, Verona, Italy, Vito Mancini, Foggia, Italy, Filippo Migliorini, Verona, Italy, Antonio Luigi Pastore, Antonio Carbone, Latina, Italy, Luigi Cormio, Giuseppe Carrieri, Foggia, Italy, Walter Artibani, Verona, Italy
Introduction: Silver nanoparticles (AgNPs) have bactericidal activity promoting wound healing through facilitated anti-inflammatory action, accelerating of the wound-healing process. This improves the tensile properties of the repaired skin. Aim of this study was to evaluate the early and late clinical safety, and efficacy of AgNPs in wound healing after circumcision.
Methods: This multicenter randomized prospective ongoing observational study compared the medication with gel containing AgNPs, titanium dioxide, hyaluronic acid, and aloe vera (PeonilÂ®) vs topical gentamicin cream (TGC) in males underwent circumcision. From January to September 2018 males were randomized in Group A (AgNPs) and control Group B (TGC). Exclusion criteria were: corticosteroids and/or other immunosuppressive therapies, diabetes, conditions causing immunosuppression. After circumcision all pts had a single prophylactic application of TGC. Medication was carried out 3 times a day, for 10 days. Follow-up included clinical objective evaluation at 10 and 30 days, and the following healing validated scales: â€¢ Southampton Scoring Systemâ€¢ Stony Brook Scar Evaluation Scale Good healing was considered at Southampton Scoring System the grade < 1 (normal healing or with mild bruising or erythema), and at the Stony Brook Scar Evaluation Scale a total score of 0 points.Statistical analysis was performed by Chi-square and Fisher exact test.
Results: In the study 186 patients were enrolled: Group A (92 pts) and B (94 pts) with similar demographic characteristics. Mean age was 34.2 years, standard deviation Â±18.4. Table 1 reports wound healing in the two groups. At 10 and 30 days we found not statistically significant difference in the groups. No major complications occurred, and none patient needed surgical wound revision. However, in Group B 7.4% of the males (7/94), at the 10 days follow-up, needed additional antibiotic therapy due to pus discharge associated to a < 1cm diastasis.
Conclusions: Topical use of AgNPs after circumcision was safe and effective with non-inferiority wound healing rate. The antibacterial efficacy of AgNPs was useful in avoiding the use of antibiotics.