Silver dressings – do they work?

Despite a limited number of controversial studies suggesting that silver-dressings are not cost-effective, such antimicrobial dressings continue to be used widely in clinical practice, indicating that they are generally accepted as efficacious. The present study aims to provide clinical evidence to support the appropriate use of silver-dressings.

Clinical studies included: a post-marketing surveillance study involving patients with pressure sores/venous leg ulcers/diabetic foot ulcers/traumatic wounds (n=12,400) treated with an activated charcoal dressing with silver; a randomised control trial (RCT) involving patients with diabetic foot ulcers (n=40) treated with collagen/oxidised regenerated cellulose (ORC)/silver or the standard of care; a RCT involving patients with venous leg ulcers/pressure ulcers (n=99) treated with an antimicrobial alginate dressing with silver or a calcium-alginate dressing; and a clinical study involving 20 patients with chronic wounds treated with a non-adherent antimicrobial alginate dressing with silver.

Results from the post-marketing surveillance study showed that the overall healing rate was 35.5% and 49.3% for 6 and 12 weeks treatment with the activated charcoal dressing with silver, respectively. In the RCT with collagen/ ORC/silver, all patients were protected from infection compared with the control group, where 33% patients were withdrawn due to infection (p=0.012). Of the patients in the RCT receiving the antimicrobial alginate dressing with silver, the 4-week closure rate was greater than for the control group (0.32 +/- 0.5cm² vs 0.16 +/- 0.40cm²; p=0.024). Patients receiving the non-adherent antimicrobial alginate dressing with silver experienced less pain at dressing change than those receiving the control (0/10 vs 9/10).

There is a wealth of clinical evidence to support the efficacy of silver-dressings in wound management. Silver-dressings can assist wound healing and enhance patient quality of life by controlling infection, odour and pain.