Silver is more than a decorative metal. For centuries physicians in the field of wound management have exploited its curative properties to assist in the healing of burns and chronic wounds.There are references to the use of silver in the treatment of chronic wounds dating back hundreds of years, where the metal was referred to as “infernal stone” and “lunar caustic.” Surgeons used silver regularly to open abscesses, to help heal leg ulcers, and to treat venereal swelling.
The 19th century saw a decline in the use of silver with the advent of antibiotics such as penicillin and sulphonamides. However, silver has been revived to treat wounds over the last fifty years, including venous leg ulcers, diabetic foot ulcers, and especially in the area of burn therapy.
In the 1960s, the late Dr. Carl Moyer, chairman of the Washington University School of surgery, explored silver’s role in burn therapy. Despite antibiotic use, he noticed that infection of burns remained a serious problem. He used silver nitrate solutions -- silver sulphadiazine (SSD) cream, and dressings containing elemental or ionized silver -- applied to thick cotton gauze dressings to heal burns as well as grafted skin.
Dr. Moyer noticed the approach was effective against several types of infection, and his work spawned many of the advances we have seen in the area of silver-based wound management.
Over the past few years, silver has further shown to be active against bacterial, fungal, and viral pathogens. It can be applied topically — in cream form or as a wound dressing — or used to treat wounds systemically, through the whole body. In cream and dressing form, the silver remains active within the wound for several days, thus avoiding the toxicity that results from immediate absorption.
There is significant evidence that topically applied silver is an effective antibacterial agent as well as a wound healer. The ideal silver dressing also has an odor-control function and sits comfortably when applied to the wound. Although the exact process through which silver fights infection is unknown, the most accepted theory is that it disables the specific enzyme that feeds the growth of many forms of bacteria, viruses and fungi.
Several silver-based dressings are in use today. See the table below for more information on some of these products.
| Product | Manufacturer | Of Note |
| Acticoat 7 | Smith & Nephew Healthcare | This dressing helps maintain a moist environment while
decreasing exudates (cellular debris) formation via its
antimicrobial properties. Especially valuable for burn wounds. Has a higher silver content than Arglaes. Acticoat 7 can be left on wounds for up to 7 days. |
| Actisorb Silver 220 | Johnson & Johnson Medical | Silver is impregnated onto an activated charcoal cloth within a nylon sleeve. This dressing absorbs liquid without dehydrating the wound, facilitating cell migration and proliferation. |
| Arglaes | Maersk Medical | Arglaes was developed in response to topical antibiotic misuse and theresultinge emergence of resistant organisms. The silver is released as it comes in contact with wound fluid. |
For more information on the companies highlighted in this article, visit their Web sites:
Smith & Nephew Health Care
Johnson & Johnson Medical
Maersk Medical
