How I Use Silver Dressings in Wound Management

Silver compounds have long been used as topical agents for wound care. In human medicine topical silversulfadiazine agents have been used for decades in burn units with the expressed aim of dealing with resistant bacteria particularly Pseudomonas aeruginosa and Methicillin resistant Staphylococcus aureus (MRSA) species. Silver-containing dressings are widely used to assist with management of infected wounds and those at risk of infection by Physicians and we are beginning to use them in veterinary medicine. These dressings have varied responses in clinical use due to technological differences in the nature of their silver content and release and in properties of the dressings themselves. Seven proprietary silvercontaining dressings in use for people include AQUACEL ® Ag Hydrofiber ® ; nonwoven dressing; Acticoat™ Absorbent alginate; dressing, SILVERCEL™ alginate-carboxymethylcellulose nylon blended fibers; Contreet ® Foam nonadhesive; foam PolyMem ® ;Silver ;Urgotul ® S.Ag gauze, and SilvaSorb ® hydrogel.

Of the above dressings we have the most clinical experience with Acticoat 7 ™ (Smith and Nephew Wound Care St Petersburg Fl 33716). This is a nanocrystalline silver impregnated dressing that is placed in the wound and hydrated with tap water before being covered with a water impervious outer dressing that can be left on for up to 7 days. Nanocrystalline silver as a source of ionic silver is an effective broad spectrum antimicrobial agent. In contact with wound exudate, silver ions are released in the dressing and kill microbes by disrupting their cell walls and interacting with intracellular components to create an antimicrobial barrier within the dressing. The antimicrobial technology used in Acticoat 7 produced silver-coated polyethylene films that can release an effective concentration of silver over several days. Thus, as silver ions are consumed, additional silver is released from the dressing to provide an effective antimicrobial barrier. This technology was first applied to burn wound dressings because burns present a very severe risk of infection. This silver dressing not only has profound antibacterial properties but promotes granulation tissue formation. Human laboratory studies show that the ACTICOAT ◊ 7 dressing kills micro-organisms faster than conventional products such as silver sulfadiazine (1 percent cream) or silver nitrate (0.5%) solution. It has also been shown in-vitro to provide protection against more than 100 pathogens. The pathogens tested in people include very resistant strains of bacteria such as antibiotic-resistant strains of Pseudomonas, methicillinresistant Staphylococcus aureus, vancomycin-resistant Enterococcus and fungi.  […]