Effectiveness of silver in wound care treatment

Abstract

Background: Topical treatments impregnated with silver are being increasingly used in the treatment of acute and chronic wounds; however, the evidence on the effectiveness of silver wound care treatment is in question. Objectives: To systematically review the literature examining the effectiveness of silver in wound care treatment. Methods: Research databases were consulted including the Cumulative Index to Nursing and Allied Health Literature (CINAHL), ProQuest, MEDLINE and the Cochrane Database of Systematic Reviews for relevant clinical trials from 2000 to 2009. Studies deemed to have met inclusion criteria were scored using the Physiotherapy Evidence Database (PEDro) scale and those scoring 4/10 or higher were included in this review. Results: Five clinical trials were identified including three randomized control trials including a total of 410 subjects. Methodological quality ranged from 4 to 10 out of 10. All five research studies showed positive effects of the use of silver dressings or topical agents. Conclusion: This literature review analyzed the effectiveness of sliver hydroalginate, Contreet foam, hydrofiber Ag dressings along with hyaluronic acid plus silver sulfadiazine and silver sulfadiazine topical agents in wound care. Second degree burns, venous leg ulcers, diabetic foot ulcers, pressure ulcers and open surgical and traumatic wounds were analyzed in the included studies. The results of this literature review demonstrate that silver dressings and topical agents are promising as safe and effective treatment methods for wound care patients throughout the treatment period in the selected studies. However, further research should be conducted to provide additional evidence on the effectiveness of silver dressings and topical agents.

Role of honey in modern medicine

“…Honey is effective on various kinds of wounds where other wound healing methods are unsuccessful ( Ligouri and Peters, 2010 ). Honey minimizes the risk of infection in wounds ( Moore and Young, 2011 , Wilkinson et al, 2011 ).…”

Methods for chronic wound research — A scoping systematic review of the recommendations, guidelines and standards

“…The recommendations include the need for research studies to include analysis of power size and calculation of sample size 22,25,41,45,57 . Trials should estimate and have adequate, appropriate and large enough sample sizes 32,43,44,[58][59][60][61] . They should be appropriately and adequately powered for clinically important primary outcome measures in order to detect significant treatment effects that are able to detect differences in wound healing rates, where sample size estimates 10,[19][20][21]31,33,34,36,39,40,[62][63][64][65][66][67][68] should be based on a priori sample size calculation 16,35,38,62 .…”

“…Trials should apply concealed allocation strategies, with effective blinding of participants (to study groups and outcome measures), personnel (where assessors should be blinded to treatment allocation), the data analyser and outcome assessment or measures; and these methods of blinding should be clearly reported 10,14,16,21,22,24,25,30,32,[35][36][37]40,43,45,46,57,60,62,63,72,73 . While blinding in some studies is difficult and would clearly be unethical, one of the main weaknesses reported for many RCTs was a lack of blinding 74 .…”

“…While there is little agreement in the literature regarding follow-up periods and they are likely to be different for different wounds, a recent review found that most studies used only a short follow-up period (that is, 14 days), and therefore concluded that longer follow-up periods were needed 59 . Long-term follow-up is needed to provide evidence on ulcer recurrence and the occurrence of lower limb amputations 73 and this includes long-term follow-up examinations after completion of the studies and reporting of this data 60 . A range of trial durations have been suggested including: 20 weeks to allow for comparisons to be made across trials, and provide a more robust evaluation of the benefits and harms of interventions 35 , at least six months 'was essential' for any wound healing effect to be detectable in chronic wounds 46 , and at least 30 days postoperatively was required to ensure all complications of surgical wounds were reported 57 .…”

Nano-silver stabilized Pickering emulsions and their antimicrobial electrospun fibrous matrices

“…Among various antimicrobial agents like chitosan, aloe-vera, curcumin and others, nano-silver has gained significant popularity because of its ease of production and profound antimicrobial efficacy [1]. Nano-silver based products showed biocidal activity against 12 species of bacteria and have effectively been used in catheters [2][3][4], wound care applications [5][6][7] and textile coatings [8][9][10][11][12]. Nano-silver or silver nanoparticles were reported to be synthesized by chemical reduction of silver nitrate (AgNO 3 ) in presence of various reducing agents including sodium borohydride (NaBH 4 ) [13], gum karaya [14], chitosan [15], glucose [16], solanum xanthocarpum berry extract [17], soluble starch [18] etc.…”