INTRODUCTION
WED, infected burn wounds
HAND INFECTION, ADVERSE EFFECTS, WOUND INFECTION, WED
Local management of infected burn wounds includes cleansing, debridement, topical antimicrobial agents (Ionic silver is bactericidal and a known inhibitor of microbes in the planktonic state.The ease of use, availability, and familiarity associated with such dressings has led to their common application in burn wound infection management, although the evidence to support their beneficial effect is not overwhelming. In 2010, a Cochrane study of 26 randomized controlled trials (RCTs) and 2066 subjects performed between 1980 and 2008 (13 trials on burn patients) concluded that there was insufficient evidence to support the use of silver-based dressings and creams.From the preclinical perspective, previous studies using a porcine burn biofilm model have shown that once biofilm is established, silver has limited benefit.The electrical basis of bacterial biology is an emergent discipline driven largely by the need for alternative methods of treating pathogenic strains.Furthermore, offense and defense mechanisms of microbial pathogens are dependent on electrical principles. For example, In 1992, it was first reported that killing of biofilm bacteria by antibiotics can be dramatically enhanced by relatively weak (1.5 V/cm and 15 μA/cmOur porcine studies where WED was tested on bacterial or fungal biofilm-infected burn wounds (10Preclinical studies demonstrating the safety and efficacy of WED against bacterial biofilmsA pilot clinical study using PED-10 demonstrated that this dressing could be safely used in human chronic wounds as wound dressing.Based on our published studies, we hypothesized that WED would reduce biofilm severity and infection load in clinically infected burn wounds. This first trial was designed to include a short-term treatment (1 week) with WED during which time SoC was withdrawn from the patient enrolled in a military burn center. This enabled testing of any potential adverse effects related to SoC withdrawal.