CDRM Corporate presentation, history of the company, patients successes stories, compression therapy, wound care, Silver, Keloid Gel, Great Burn Unit, Burn Centers

1. Our know-how at your service
13/02/13 Québec, Canada

2. DRM Silver Products
MC
Overview
• History
• Product list
• Regulatory Status Worldwide
• Description/Composition
• Mechanism of action
• Indications (Specialty &Application)
• Advantages (Therapeutic, Economic, Practical)
• Contact Wound Dressing forms
• Product information & Instruction for use
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3. History – Silver as a medical element used in
different types all over the word since 2000
• For ages, world wide Silver as a metal has been used by humans
in medical applications.
• 2000 Romans used vessels made of silver to keep their drinking
water fresh longer.
• 912-983 Surgeon Spain /Arab born at Cordoba Al-Zehraoui.
Created surgical instrument in Silver and found a reduction of
infections.
• 1800 Many physicians discover silver is an antibacterial.
• 1852 Dr M.J. Murano used a silver thread for sutures.
• 1881 M. Carl Crede use silver nitrate for new born eyes.
• 1893 M. Von Naegeli and his team discover ion transfer.
• 1900 Dr Halsteasd use Silver sheet as a dressing.
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4. History Silver Laminated
1920-1955 M. Albert Barns, a business man,
sold Argyroll for over 10 million
1950 New product call antibiotic easy, clean, sure and efficient
1970 Cie Swith Metalizing introduce laminated Silver on nylon Fabric.
Drs Becker, Marino and Sparado are modern pioneers in study of
treatments using silver against infection.
1973 Flamazine cream (and similar products) are used since .
2000 Different laminations on fabric or polymer for silver (including wet
process with chemical product, nanocristalization technology on
different methods)
2005 Improvement from DRM - Nanocristalization silver and laminated on
different fabrics
2012Many different deposition on different fabric, some fabric are not
conductor
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5. In 2005 DRM introduces the revolutionary DRM Silver
impregnated fabrics that can be used as dressing, as garment
dressing and/or pressure garment. All used to kill bacteria,
thus dramatically accelerating healing of many wounds such as
burn, ulcer and to prevent infection of these wounds
• Rapidement l’application de
No penetration l’argent est devenue désuète
avec l’explosion des
No deposit antibiotiques après la deuxième
No secondary guerre mondiale. Pratique,
rapide, propre, efficace etc.
effect
• Les chercheurs n’abandonnent
pas…
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6. DRM list of product
DRM Silver ( burns and wounds )
DRM Pressure Garment ( controlled and digressive )
DRM Silicone ( Hypertrophic scars and cicatrization )
DRM Instruction sheet, rules of healing (home return )
 DRM Hip Pad ( ex. Pro hip) as Hip protector
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7. DRM Silver Products
Sector of Applications
• Plastic surgery
• Vascular surgery
• General surgery
• Dermatology
• Orthopedy
• Cardiology
• Gynecology
• Oncology
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8. DRM Certificate
 Health Canada
Manufacturer Certificate to cover exports and Medical Device
 ISO Medical 13485 (2003)
Laboratory SM Inc. ( independent test atcc 148-1998 )
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9. DRM Silver
 BURN (different degrees)
 Radio dermatitis (suint)
 All kinds of wounds
-Chronic wounds, Bed sores, Diabetic foot
-Skin grafts & donor site
-Ulcers (Venous, arterial, mixed )
-Open wounds in surgical & orthopedic surgeries
-
Silver Ion (Nanocristalline technology)
One nanometer equals one thousandth of a micrometer
With 99.99% + Purity
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10. DRM Silver Products
Contact Wound Dressing Forms
Available in three categories:
"Light", "Plus"
Light Plus
Running wounds Burns & non-running
Wound
Dressing & garment dressing
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11. DRM Silver mechanism of action
Silver ions are
transferred to the the Nanocritalisation Silver ions
intracellular space and allows the inhibit
act directly on the multiplication of the proteinases
energy system of the Silver Ions to transfer activity
bacteria cell into the wound
Anti-bacterial, Anti-fugal
Enhance the Clear
Analgesic & Haemostatic wound healing healing
effect
Reduce the inflammation
13/02/13 Analgesic & faster healing 11

12. Silver Ion process
0-24 H 24-72 H 72H & on
1st reaction 2nd reaction 3rd reaction
Silver ions
Silver Ions Silver ions associate with
associate with collagen fibers
combine with the mature fibroblast (Silver-Collagen
proteins & peptides & epithelial cells Complex)
Bactericide, Bacteriostatic de-differentiation activation of de-
into differentiated cells
Biocide
embryonic cells re-differentiate to form
for positive & negative gram specific types of cells
types
Also MRSA restore the region to its
13/02/13 pre-injured state
12

13. DRM Silver Products
Advantages
1.It is not necessary to replace daily. It is applied on the wound/burn for
up to 7 days. Saves time and is less painful for patient
2. No need for systemic medications such as antibiotics, antiseptics and
analgesics. (This recommendation applies for non-systemic wounds)
3. Maintains the wound, burn or ulcer clean (helps in skin cell regeneration
and reconstruction)
4. Helps in blood revascularization even for very old ulcerations (over 10
years)
5. Reduced treatment time to 30-40% which makes the Burn and Wound
healing exemplary
6. Restores blood re-equilibration in burn sites (e.g. burned face)
7. Helps in wound & burn debriding (such an operation is painful if it is
performed by the physician. Sometimes, it requires local or total anesthesia)
8. Malleability is very high: have the possibility to cut and make garments
(Tubes, Gloves, socks and vests)
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14. DRM Silver in Operation Room
Available in standard size for dressing, garment
dressing, tubes, gloves, socks and vests
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15. Burns & Plastic Surgery
University Center McGill – Side Montreal Children
• DRM Silver is applied the
first dressing after debriding,
•Dressing should be changed
after 2 to 3 days. Doctors can
decide for surgery or
continuing DRM Silver
•Treatment up to 5 or 7 days.
Flame Burn - 65% TSBA
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16. Burns & Plastic Surgery
McGill University Montreal Children hospital
After
5 months
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Flame Burn - 65% TSBA 16

17. Debriding - Treated with Silver glove
Without hospitalization
Day 0 Day 21
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18. Help in burn debriding
Damascus Hospital
Day 0 Day 5
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19. Reduce the healing time
Statistics from the "Centre Supra Regional des Grands Brulés de l'Université de
Montréal, Pavillon Hotel Dieu" from Montreal
Duration of Open Wound Percentage Risk for Hypertrophic scar
7 days negligible
14 days 35%
21 days 85%
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In 3 weeks 19

20. Burns & Plastic Surgery
Bactericide – Pseudomonas
Damascus Hospital
13/02/13
Flame Burn - 50% TSBA 20

21. Burns & Plastic Surgery
Study of the Bacteriostatic properties of DRM Silverclear
Damascus Hospital – Burn Section
After 24 Hours
After 72 Hours
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22. Burns & Plastic Surgery
Latakieh, More flexibility –
Reduce re-adaptation time
Day 0 After 1 month
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Flame Burn 22

23. MOH- Damascus Hospital
Car Accident
Day 17
Day 0
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24. MOH- Damascus Hospital
Car Accident
Day 64
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25. Maintains the wound clean
Even for MRSA
University Hosp. - Mouassat - Accident
Day 14
Day 0
Day 6
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26. Maintains the wound clean
Gram positive & negative
Day 0
Day 12
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Day 19 26

27. Maintains the wound clean
Homs – Dr. Khancan
Day 37
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28. Maintains the wound clean
Homs – Dr. Khancan
Day 0 Day 37
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29. Maintains the wound clean
Homs
Day 0
Day 14
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Day 37 29

30. Maintains the wound clean
Day 14 Day 37
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31. Very old ulcerations (over 10 years)
in 6 months
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32. Phlebitis – Varicose Ulcer
Since 10 years (Aleppo)
Day 0
Day 20
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33. Orthopedic
Derra – Fracture wound
Day 1 Day 27
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34. General Surgery
Diabetic Foot
Derra – Syria - Dr. Deiri
Day 0 After 3 months
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35. General Surgery
Diabetic Foot & Necroses
Dr. Atalla - Lebanon
After 5 months
13/02/13
Day 0 35

36. General Surgery
Diabetic Foot
Derra -Dr. Abd Moula Hassan
Day 0 Day 70
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37. General Surgery
Pressure Ulcer – Bed Sore
Derra -Dr. Abd Moula Hassan
Day 0 Day 9
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38. Plastic surgery - Dermatology
Slcérodermie diffuse
Hospital Maisoneuve Rosemont
Day 0 5 months
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Chronic wound 38

39. Plastic surgery - Dermatology
Epidermolyse bulleuse
Centre Hospitalier St. Justine
Day 0 Day 27
Chronic wounds and incurable disease
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40. Oncology – Radiotherapy
DRM Silver is approved by Health Canada
which can be used during Radiotherapy treatment
Day 0 Day 7
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41. Oncology – Radiotherapy
Center Hospitalier Universitaire de l’Universite de
Montreal
Day 0 Day 7
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42. Oncology – Radiotherapy
Latakieh – Dr. Mhanna
Day 0 Day 10
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43. General Surgery
Scalven mal treated
Day 0 Day 15
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44. DRM Silver Products
Product Information & Instruction
for Use
 Product Information Published
 DRM Silver products, the safe and effective way
to administer the benefits of silver treatment
without wound contamination, side effects or
toxicity problems
 Utilization protocol on the wound and burn
available
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45. Our know-how at your service
Controlled Pressure Garment
Health Canada – Medical Instrument Class I
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46. For over a year now, DRM made to measure pressure garments are
available in Syria through MedHosp. All garment designs are
verified in Canada by DRM for proper evaluation.
Our technicians have been trained in Canada at DRM's head office
for proper measurement technique and manufacturing procedure.
The severity of some burn cases that we have seen here during the
last year, made us decide to offer DRM's uvex masks and other
thermoforming products for scar management. Our local
technicians will be trained to offer these products as soon as
possible.
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47. Furthermore, we will soon offer a brochure to guide you through
the steps to take when returning home after severe burn injury.
This brochure will explain what to do and how to wear the pressure
garment. We will also talk about actions that can accelerate healing,
(daily massage, exercise etc…) In fact, healing is a combination of
many complimentary actions.
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48. Controlled & Degressive Pressure Garment
on Measures & Standards
Supplied in standard sizes:
 Post Cosmetic Pressure
Garment
 Transit Gloves
 Transit Medical Gloves
(available for Middle East
countries only)
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49. Our garments are designed according to the
Prescription and recommendations of the Health
Specialist .
We have Measure
sheet for every part
of the body: Head,
Hands, Torso, Legs
and Feet.
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50. We apply the requested contention
according to your Prescription
Or
according to the Diagnostic (if the
mmHg is not stated).
Several fabric choices are available
according to the diagnostic
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51. Rules to follow for the
pressure garment to be adequate
•It must exceed of about 15 cm the scar in proximity.
•Provide a Glove or a Sock if the scar is in the forearm or
leg to avoid swelling.
•It is possible to Reduce the Pressure to avoid swelling in
the extremities.
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52. Our technicians are trained to take the measures and also to
Evaluate the Needs.
We adapt & personalize our garment to the Condition of your
Patient so he can benefit entirely from the treatment
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53. Many of our technicians had received their
training in our Service Center in Canada
Made to measure, personalized and adapted to patient condition
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54. Controlled & Degressive Pressure Garment
for Different Diagnostics
.
•Burns
After 4.5 months
A mould could be placed to
assure a full contention in a
Scald Burn, middle/lower back
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55. The human body is not made of flat surfaces, curves form convex
and concave areas all over the body. In order to manufacture
efficient pressure garments, one has to consider this fact, thus
making the design of such garment a highly sophisticated task.
Using the science of pressure vessel, laws of physics and a vast
experience, DRM has developed sophisticated pressure garments
adapted to the patient's particular condition.
i.e.: When the palm face of the hand is burned, CDRM has
developed the "lateral thumb" glove that will open the hand in a
star shape thus providing pressure on the injured area. For other
parts of the body, DRM has developed a technique using pockets
and cushions built-in the garment.
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56. Controlled & Degressive Pressure Garment
for Different Diagnostics
•Reconstructive Surgery .
(gloves with zipper and web spacer)
Electrical burn, after 2.5 months
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57. Controlled & Degressive Pressure Garment
for Different Diagnostics
.
•Corrective Surgery
Correct a Retracted Scar
4 months
after skin
graft
Vest with Sleeves with splint of
abduction for 10-15 hours per day.
Silicone sheet 2 months later.
The mobility in extension was complete
13/02/13 57
in 3 months

58. Controlled & Degressive Pressure Garment
for Different Diagnostics
.
•Cosmetic Surgery
Chin strap
Breast implant & reduction
Liposuction & abdomino-plasty
3 months
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59. Controlled & Degressive Pressure Garment
for Different Diagnostics
.
•Lymphoedema
Primary: Congenital
Puberty
Tarda
Secondary: Surgery
Cancer
Trauma
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60. Controlled & Degressive Pressure Garment
.
for Different Diagnostics
•Venous malformations,
•Venous Insufficiency, We can add
Zippers and
Anti-slip Elastic
in order to
facilitate daily
wearing.
Phlebitis
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61. Controlled & Degressive Pressure Garment
for Different Diagnostics
.
•Cheloïds
After 1 year of wearing the
garment of the American company:
the garment conception (design)
was not adapted to the condition of
the patient. The scars were very
red, thick and stiff.
16 months
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62. Controlled & Degressive Pressure Garment
for Different Diagnostics
.
•Cheloïds
3 months
University Center
McGill
Children Hospital
of Montreal -
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Pavillon

63. Every case is unique.
We take into consideration all the
rehabilitee
so the patient can benefit entirely
From the prescription
Several fabric choices are available
according to the diagnostic
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64. Every case is unique.
A Controlled Pressure
Stocking of 10-15 mmHg was
prescribed to maintain in place
an elastomer mould which
preserved the space acquired
through surgery.
12 months.
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University Center of Montreal. Pavillon Ste Justine .

65. Pressure Garments for special cases
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66. 10 - 15 mm Hg
Light Support
For Therapeutic Support
Transit gloves Garments:
The patient is used to a light
compression in waiting the regular
garment.
Transit medical Gloves:
(different fabric)
Relieves the pain caused by the
swelling of tired hands and legs
13/02/13 66

67. 20 - 25 mm Hg
Light surgical
For patient sensitive to the
Pressure as 1st garment in
order to let them used to a
stronger pressure,
(Burns in children and elderly).
It is possible to adjust later
Relieve the pain caused by
phlebitis, edema and severe
varicose vein.
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68. 40 mm Hg and more
Very firm Surgical
lymphoedema
After
corrective surgical
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69. Lymphoedema
40 mm Hg and more
Severe lymphoedema, venous
malformations, vicious scars
13/02/13
(cheloids local compression only) 69

70. Many options may be added
DRM Silver Zipper
Silicone
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Anti-Slip Padding (Mould) 70

71. Uvex Mask -
12 months
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72. Silicone DRM
•For cicatrization control.
•Supplied in:
–1MM sheet ( adherent non adherent).
–3MM sheet (adherent).
–6MM sheet (adherent)..
The estimate life time of our Sheet is 4 to 8 months
(following instructions for care)
The silicone sheet must exceed the shape of the
scar for a minimum of 1 centimeter
–Gel, ideal for hand and face.
(apply 3 times/day minimum)
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73. In the Scars Healing
In Burns, corrective surgery of Hyperthrophic Scars,
The garments are not the sole Warranty of success.
The cooperation of the patient
&
The continuous daily wearing
Is an important part of the treatment.
14 months
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74. Not following the daily wearing results
After 3 months
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75. The cooperation of the patient
&
The continuous following
Mask in Uvex
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76. 13/02/13 76

77. For other diagnostics such as Venous
Malformation or Venous Insufficiency
Daily wearing of the garments
helps relieve and improve life.
This will contribute to reducing the risks
of worsening the illness.
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78. Thank you for your attention,
in case you need other information,
please do not hesitate to contact us.
CDRM
Québec, Canada
13/02/13 78

79. Publications
1. MacKeen, P.C., Person, S. Warner, S.C., Snipes, W., and Stevens, S.E.,
• Silver-coated Nylon Fiber as an Antibacterial Agent.,
• Antimicrob. Agents Chemother., 31, 93, 1987.
2. Deitch, E.A., Marino, A.A., Gillespie, T.E., and Albright, J.A.,
• SilverNylon: A New Antimicrobial Agent.,
• Antimicrob. Agents Chemother. 23, 356,1983.
3. Maniro, A.A., Deitch, E.A. Malakanok, V., Albright, J.A., and Specian, R.D.,
• Electrical Augmentation of the Antimicrobial Activititv of Silver-Nylon Fabrics, J. Biol.
• Phys., 12, 93, 1984.
4. Marino, A.A., Malakanok, V., Deitch, E.A., and Albright, J.
• Electrical properties of silver-nylon.
• Third Annual BRAGS, Sans Francisco, CA. Oct. 2-5, 36, 1983.
5. Deitch, E. A., Marino, A.A., Malakeonok, V., and Albright, J.A.,
• Silver Nylon Cloth: In vitro and In Vivo Evaluation of Antimicrobial Activity,
• J. rauma, 27, 301, 1987.
6. Deitch, E.A., Marino, A.A., Malaleonok, V., and Albright, J.A.,
• Silver nylon cloth: in vitro and in vivo evaluation of antimicrobial activity.
• J. Trauma, 27, 301, 1987.
13/02/13 79

80. Suite…
7. Barranco, S.D., Spadaro, J.A., Berger, T.J., and Becker, R.O.,
• In vitro Effect of Weak Direct Current on Staphlococcus aureus.
• Clinical Orthopaedics, 100, 250, 1974.
• Note: Identical results were published by Barranco in: Barranco, S.D. and Colmano, G.
• Electrical. Inhibition of Staphlococcus aureus.
• Virginia Medical 646, 1976
8. Berger, T.J., Spadaro, J.A., Chapin, S.E., and Becker, R.O.,
• Electrically Generated Silver Ions: Quantitative Effects on Bacterial and Mammalian
Cells.
• Antimicrob. Agents Chemother., 9, 357, 1976.
8. Berger, T.J., Spadaro, J.A., Chapin, S.E., and Becker, R.O.,
• Electrically Generated Silver Ions: Quantitative Effects on Bacterial and Mammalian
Cells.
• Antimicrob. Agents Chemother., 9, 357, 1976.
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81. Suite…
9. Berger, T.J., Spadaro, J.A., Bierman, R., Chapin, S.E., and Becker, R.O.,
• Antifungal Properties of Electrically Generated Metallic Ions.
• Antimicrob. Agents Chemother., 0, 856,1976.
10. Chu, C.S., Mc McManus, A.T., Pruitt B. A., et al
• Therapeutic effects of silver nylon dressing with weak direct current on
Pseudomonas aeruginosa infected burn wounds.
• J. Trauma 28:1488, 1988.
11. Chu, C.C., Tsai, W.C., Yao, J. Y., and Chiu, S.S.,
• Newly made anti-bacterial braided nylonsutures. I. In vitro qualitative and in vivo
preliminary biocompatibility study.
• J. Biomed. Mater. Res., 21, 1281, 1987.
12. Berger, T.J., Spadaro, J.A., Chapin, S.E., and Becker, R.O.,
• Electrically generated silver ions : quantitative effects on bacterial and mammalian
cells,
• Antimicrob. Agents Chemother., 9, 357, 1976.
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82. Suite…
13. Brown MRW, Anderson R.A., :
• The bactericidal effect of silver ions on Pseudomonas aeruginosa:
• J. Pham Pharmacol 20:15, 1968.
14. Colmano, G., and Barranco, S.D.,
• Inhibition of staphylococcus aureus on a contaminated electrode in the femur of
the rabbit by low electrical current and its relation to stress,
• Biophys. J., 15, 28a, 1975.
15. Falcone, A.E., and Spadaro, J.A.,
• Inhibitory effects of electrically acrivated silver material on cutaneous wound
bacteria,
• Plast.Reconstruc. Surg., 77, 455, 1986.
16. Marino, A.A., Malakonok, V., Albright, J.A., Deitch, E.A. and Special R.D.,
• Electrochemical Properties of Silver-nylon Fabrics
• J. Electrochem. Soc., 132, 68, 1985.
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83. Suite…
17. Marino, A.A., Deitch, E.A. and Albright, J.A.,
• Electric Silver Antisepsis
• IEEE Trans. Biomed. Eng., BME-323, 336, 1985.
18. Marino, A.A., Deitch, E.A., Malakanok, V., Albright, J.A., and Special, R.D.
• Electrical Augmentation of the Antimicrobial Activity of Silver Nylon Fabrics
• J. Biol. Phys., 12, 93, 1984.
19.Mackeen, P.C., Person, S., Warner, S.C., Snipes, W., ad Stevens, S.E.,
• Silver-coated nylon fiber as an antibacterial agent
• Antimicrob. Agents Chemother., 31, 93, 1987.
• DS. Dysenteriae, S. Marulene, and P. mirabalis. The commerciasize 2/0 Murolon
suture from Ethicon served as the control. A weak DC potential ranging from 0,4 to
400 uA was applied to the cultures. It was found that the Silverlon suture exhibited
very goodl to moderate bactericidal property toward the seven bacterial species.
Application of DC enhanced the antibacterial property and the degree of
enhancement depended on the level of DC passed. A preliminary biocompatibility
study of the Silverlon suture material in rate gluteal muscle indicted that the
Silverlon suture caused less inflammatory reaction that the control Nurolon suture
up to 60 days after implantation.
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84. Suite…
• J Trauma 1995 Aug;39(2):273-7; discussion 277-8 Related Articles, Books,
• LinkOut
• Enhanced survival of autoepidermal-allodermal composite grafts in
• allosensitized animals by use of silver-nylon dressings and direct current.
• Chu CS, McManus AT, Matylevich NP, Mason AD Jr, Pruitt BA Jr.
• U.S. Army Institute of Surgical Research, Fort Sam Houston, Texas
• 78234-6315, USA.
• 1: J Trauma 1997 Nov;43(5):804-11; discussion 812 Related Articles, Books,
• LinkOut
• Optimized mesh expansion of composite skin grafts in rats treated with
• direct current.
• Chu CS, Matylevich NP, McManus AT, Pruitt BA Jr, Goodwin CW.
• U.S. Army Institute of Surgical Research, Fort Sam Houston, Texas
• 78234-6315, USA.
• 1: Eur J Surg 2000 Jun;166(6):486-9 Related Articles, Books, LinkOut
• Healing of porcine donor sites covered with silver-coated dressings.
• Olson ME, Wright JB, Lam K, Burrell RE.
• LESARC, University of Calgary, AB, Canada.
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