Silver dressings – advanced wound care
By Dr. Sergio Mazzei, General Surgeon
Topical antimicrobial dressings, including silver dressings, are used to prevent or manage infection in a wide range of wounds.
Until recently, local wound infection has been a challenge with few management options. The advent of advanced wound dressings containing topical antimicrobial agents, such as silver, has provided a new approach to the controlling of wound pathogens.
Silver dressings are the up-to-date wound care products intended to manage bioburden in acute and chronic wounds.
The new class of dressings is designed to provide the antimicrobial activity of topical silver in a more convenient application. However, the dressings differ considerably regarding their silver content and in their physical and chemical properties.
Silver dressings are recommended for acute or chronic wounds with, or at risk of, a high level of bioburden or local infection. The wound infection continuum that describes the stages of impact microbes have on a wound proposes silver dressings for wounds that present localized (overt or covert), spreading, or systemic infection.
Silver dressings have a great role in
- reducing bioburden in infected or colonized wounds, and
- acting as an antimicrobial barrier for wounds at high risk of infection or re-infection and not to directly promote the healing of the wound.
The use of silver dressings should also be combined with other aspects of standard wound care protocols.
Antimicrobial dressings were recommended initially for two weeks, to be followed by an extensive assessment of the wound and the patient to adapt further wound management.
If after two weeks
- the wound has improved, but there are still signs of infection, it may be clinically legitimate to continue the application of silver dressings with further regular assessment
- the wound has improved and there aren’t any signs or symptoms of wound infection, the treatment with silver dressing should be stopped
- no improvement in the wound has been observed, the silver-dressing treatment should be stopped and alternative treatment with a different antimicrobial agent considered.
The experience of many clinicians, and more recent systematic reviews and meta-analyses, have confirmed positive effects of silver dressings when used appropriately.
Silver dressings should not be used on wounds where bioburden is not a problem, i.e. they should be reserved for use in wounds with or at risk of high bioburden or local infection.