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I was looking through some researches done and there is still no reliable evidence regarding any silver dressings.
I have found the aquacell ag being the most effective in terems of antimicrobial activity and time effectiveness - as reducing the infection and therefore the healing time.
Is there any reliable source(s) to bring some good results or some new evidence regarding the silver dressings?
Any clue would be really appreciated.
Have you looked at the Diabetic Foot Journal for any articles published.Im certain....not 100% sure though that a few years ago when it became fashionable to use silver taht there were some research being bandied about.
On a personal note....I like silver dressings and have added them to my array of other dressings.For highly exudative wounds Aquacel Ag works really well.However I use Acticoat as well.So no preferance really...it depends on teh wound.I still use the old fashioned dressings such as Inadine and Iodoflex.
For any wound effective mangement begins with careful assessment and debridement etc and also teh otehr factors taht influence wound healing
Assessment of the antimicrobial effectiveness of a new silver alginate wound dressing: a RCT.
Trial C, Darbas H, Lavigne JP, Sotto A, Simoneau G, Tillet Y, Téot L. J Wound Care. 2010 Jan 14;19(1):20-26.
Quote:
Objective: To compare the efficacy and tolerability of a new ionic silver alginate matrix (Askina Calgitrol Ag) with that of a standard silver-free alginate dressing (Algosteril).
Method: Patients with locally infected chronic wounds (pressure ulcers, venous or mixed aetiology leg ulcers, diabetic foot ulcers) or acute wounds were eligible for this prospective, open-label, controlled and randomised trial. Patients were randomised to receive one of the two dressings for a two-week period. Criteria of efficacy were based on the evolution, from day 1 to day 15, of local signs of infection using a clinical score ranging from 0 to 18, and the evolution of the bacteriological status for each wound. The latter was determined by (blind) bacteriological examinations of results obtained from two biopsies performed at days 1 and 15. A three-point scale (deterioration, unchanged, improvement) was also used. Acceptability, usefulness and tolerance were also assessed.
Results: Forty-two patients (20 women and 22 men, 68.9 +/- 18.8 and 66.5 +/- 15.7 years old respectively) were randomly assigned to receive either Askina Calgitrol Ag (n=20) or Algosteril (n=22). Most had chronic wounds such as pressure ulcers (57%) or venous or mixed aetiology leg ulcers and diabetic foot ulcers (29%); few had acute wounds (14%). Clinical scores of infection were comparable in both groups at inclusion, 8.9 +/- 2.4 and 8.6 +/- 3.2 in the Askina Calgitrol Ag group and the Algosteril group respectively (not significant), but decreased significantly in both groups at day 15, 3.8 +/- 2.9 in the Askina Calgitrol Ag group (p=0.001) and 3.8 +/- 3.4 in the Algosteril group (p=0.007). There was no significant difference between the two groups at day 15. Although there was also no significant difference in bacteriological status between the treatment groups, a trend in favour of Askina Calgitrol Ag was found for the relative risk of improvement, especially in patients who were not treated with antibiotics either at the beginning of the study or during it. No differences between groups were observed regarding local tolerance, acceptability and usefulness of the dressings.
Conclusion: The regression of local signs of infection, local tolerance, acceptability and usefulness were similar for the two dressings. However, Askina Calgitrol Ag improved the bacteriological status of the wounds. Further trials are required to show that it has a positive impact on the healing process
BACKGROUND: Silver-containing treatments are popular and used in wound treatments to combat a broad spectrum of pathogens, but evidence of their effectiveness in preventing wound infection or promoting healing is lacking.
OBJECTIVES: To establish the effects of silver-containing wound dressings and topical agents in preventing wound infection and healing of wounds. SEARCH STRATEGY: We searched the Cochrane Wounds Group Specialised Register (6 May 2009); The Cochrane Central Register of Controlled Trials (CENTRAL) (2009 Issue 2); Ovid MEDLINE (1950 to April Week 4 2009); Ovid EMBASE (1980 to 2009 Week 18); EBSCO CINAHL (1982 to April Week 4 2009) and Digital Dissertations (to May 2009) for relevant trials. We contacted manufacturers and distributors.
SELECTION CRITERIA: Randomised controlled trials (RCTs) comparing silver-containing wound dressings and topical agents with silver-containing and non silver-containing comparators on uninfected wounds. DATA COLLECTION AND ANALYSIS: Two authors independently selected trials, assessed risk of bias, and extracted data.
MAIN RESULTS: We identified 26 RCTs (2066 patients). Heterogeneity of treatments and outcomes precluded meta-analysis. We grouped results according to wound type, and silver preparation.BurnsThirteen trials compared topical silver (in a variety of formulations - including silver sulphadiazine (SSD) cream) with non-silver dressings. One trial showed fewer infections with silver nitrate when compared with a non-silver dressing, but three trials showed significantly more infection with SSD than with the non-silver dressing.Six trials compared SSD cream with silver-containing dressings. One showed significantly fewer infections with the silver-containing dressing (Hydron AgSD) compared with SSD, the remaining five found no evidence of a difference.One trial compared two silver-containing dressings, and showed a significantly lower infection rate with silver-coated gauze (Acticoat(R)) than with silver nitrate gauze.Other woundsSix trials compared SSD/silver-containing dressings with non-silver dressings (nine dressings in total). Most comparisons (seven) found no significant differences in infection rates; one trial in a variety of wounds exhibited significantly fewer infections with SSD/hydrocolloid, but another, in acute wounds, found significantly more infections with SSD. Only one comparison showed a significant reduction in healing time associated with a silver-containing hydrofibre dressing in diabetic foot ulcers.
AUTHORS' CONCLUSIONS: There is insufficient evidence to establish whether silver-containing dressings or topical agents promote wound healing or prevent wound infection; some poor quality evidence for SSD suggests the opposite.
There has been a resurgence of silver dressings in wound care in recent years due to the antimicrobial activity of silver, its safety and a lack of resistance. Accordingly, this author discusses silver dressing selection, shares insights on nanocrystalline silver and assesses the current literature on silver in wound care.
Silver has inundated the field of wound care in the last decade in the form of different products and dressings. This resurgence can in part be attributed to the resistant strains of bacteria forming against commonly used antibiotics. We now know that even minute concentrations of silver have a bactericidal effect.1 This has prompted the development of multiple silver-containing wound care products such as hydrogels, hydrofibers, foams, hydrocolloids, gauze and alginates.
Silver Dressings -any evidence present?
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