Silver based dressings versus non-silver based dressings in treating chronic wounds.

Abstract

The use of silver has long been reported for various purposes such as food preservation, as currency, for decorative purposes, as utensils and jewellery and even to treat wounds. In the 19th century the antimicrobial effects of silver were recognised and silver started to be used to manage open wounds. Considering the large number of bacteria discovered and the resistance developed versus different antibiotics in these last 8 years use of silver dressings gained popularity worldwide. This preference for silver dressings to treat wounds was felt locally too. The objective of this dissertation is to analyse the effectiveness that silver based dressings compared with non-silver based dressings have on the chronic wound healing process. To locate the evidence electronic searching in databases and website, and manual searching in libraries was undertaken. Additionally, the representatives of the dressings companies locally were asked for any studies. The retrieved evidence was then selected following the inclusion and exclusion criteria. To analyse the viability, reliability and trustworthiness of the selected evidence the assessment tool developed by the Centre for Evidence-Based Medicine was used. Furthermore, the findings of the retrieved evidence were analysed concluding that silver dressings were effective in treating chronic wounds during the first weeks of treatment. However, these findings were based on a very small number of studies since most of the other studies resulted in inconclusive findings. To avoid confusion that might rise among the health professionals regarding which evidence to follow when choosing a dressing to treat chronic wounds recommendations were being proposed for implementation locally, in research, education and practice, based on the findings of the selected studies. The most relevant keywords used were silver dressings, silver impregnated dressings, antimicrobial dressings, infected wounds, chronic wounds, and bacterial load.