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Evidence summaries

Topical Silver for Treating Infected Wounds

There is insufficient evidence to recommend the use of silver-containing dressings or topical agents for treatment of infected or contaminated chronic wounds. Level of evidence: "D"

A Cochrane review [Abstract] 1 included 3 studies with a total of 847 subjects:

  • comparison of silver-containing foam (Contreet® ) with hydrocellular foam (Allevyn® ) in patients with leg ulcers (n=129) or with best local practice in patients with chronic wounds (n=619).
  • comparison of a silver-containing alginate (Silvercel® ) with an alginate alone (Algosteril® ; n=99).

Silver-containing foam dressings did not significantly increase complete ulcer healing as compared with standard foam dressings or best local practice after up to four weeks of follow-up, although a greater reduction of ulcer size was observed with the silver-containing foam. Data on pain, patient satisfaction, length of hospital stay, and costs were limited and showed no differences. Leakage occurred significantly less frequently in patients with leg ulcers and chronic wounds treated with a silver dressing than with a standard foam dressing or best local practice.

Comment: The quality of evidence is downgraded by imprecise results (limited study size for each comparison), by limitations in study quality (short follow-up, inadequate reporting) and by inconsistency (heterogeneity in interventions and outcomes). .

    References

    • Vermeulen H, van Hattem JM, Storm-Versloot MN, Ubbink DT. Topical silver for treating infected wounds. Cochrane Database Syst Rev 2007 Jan 24;(1):CD005486. [PubMed]

Primary/Secondary Keywords