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Topical silver for treating infected wounds.
Cochrane Database Syst Rev 2007; (1):CD005486CD

Abstract

BACKGROUND

Topical silver treatments and silver dressings are increasingly used for the local treatment of contaminated or infected wounds, however, there is a lack of clarity regarding the evidence for their effectiveness.

OBJECTIVES

To evaluate the effects on wound healing of topical silver and silver dressings in the treatment of contaminated and infected acute or chronic wounds.

SEARCH STRATEGY

We sought relevant trials from the Cochrane Central Register of Controlled Trials (CENTRAL), the Cochrane Wounds Group Specialised Register in March 2006 and in MEDLINE, EMBASE, CINAHL, and digital dissertations databases up to September 2006. In addition, we contacted companies, manufacturers and distributors for information to identify relevant trials.

SELECTION CRITERIA

Randomised controlled trials (RCTs) assessing the effectiveness of topical silver in the treatment of contaminated and infected acute or chronic wounds.

DATA COLLECTION AND ANALYSIS

Eligibility of trials, assessment of trial quality and data extraction were undertaken by two authors independently. Disagreements were referred to a third author.

MAIN RESULTS

Three RCTs were identified, comprising a total of 847 participants. One trial compared silver-containing foam (Contreet) with hydrocellular foam (Allevyn) in patients with leg ulcers. The second trial compared a silver-containing alginate (Silvercel) with an alginate alone (Algosteril). The third trial compared a silver-containing foam dressing (Contreet)) with best local practice in patients with chronic wounds.The data from these trials show that silver-containing foam dressings did not significantly increase complete ulcer healing as compared with standard foam dressings or best local practice after up to four weeks of follow-up, although a greater reduction of ulcer size was observed with the silver-containing foam. The use of antibiotics was assessed in two trials, but no significant differences were found. Data on pain, patient satisfaction, length of hospital stay, and costs were limited and showed no differences. Leakage occurred significantly less frequently in patients with leg ulcers and chronic wounds treated with a silver dressing than with a standard foam dressing or best local practice in one trial.

AUTHORS' CONCLUSIONS

Only three trials with a short follow-up duration were found. There is insufficient evidence to recommend the use of silver-containing dressings or topical agents for treatment of infected or contaminated chronic wounds.

Authors+Show Affiliations

Academic Medical Centre, University of Amsterdam, Department of Surgery, Meibergdreef 9, PO Box 22700, Amsterdam, Netherlands, 1100 DE. h.vermeulen@amc.uva.nlNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

17253557

Citation

Vermeulen, H, et al. "Topical Silver for Treating Infected Wounds." The Cochrane Database of Systematic Reviews, 2007, p. CD005486.
Vermeulen H, van Hattem JM, Storm-Versloot MN, et al. Topical silver for treating infected wounds. Cochrane Database Syst Rev. 2007.
Vermeulen, H., van Hattem, J. M., Storm-Versloot, M. N., & Ubbink, D. T. (2007). Topical silver for treating infected wounds. The Cochrane Database of Systematic Reviews, (1), p. CD005486.
Vermeulen H, et al. Topical Silver for Treating Infected Wounds. Cochrane Database Syst Rev. 2007 Jan 24;(1)CD005486. PubMed PMID: 17253557.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Topical silver for treating infected wounds. AU - Vermeulen,H, AU - van Hattem,J M, AU - Storm-Versloot,M N, AU - Ubbink,D T, Y1 - 2007/01/24/ PY - 2007/1/27/pubmed PY - 2007/5/9/medline PY - 2007/1/27/entrez SP - CD005486 EP - CD005486 JF - The Cochrane database of systematic reviews JO - Cochrane Database Syst Rev IS - 1 N2 - BACKGROUND: Topical silver treatments and silver dressings are increasingly used for the local treatment of contaminated or infected wounds, however, there is a lack of clarity regarding the evidence for their effectiveness. OBJECTIVES: To evaluate the effects on wound healing of topical silver and silver dressings in the treatment of contaminated and infected acute or chronic wounds. SEARCH STRATEGY: We sought relevant trials from the Cochrane Central Register of Controlled Trials (CENTRAL), the Cochrane Wounds Group Specialised Register in March 2006 and in MEDLINE, EMBASE, CINAHL, and digital dissertations databases up to September 2006. In addition, we contacted companies, manufacturers and distributors for information to identify relevant trials. SELECTION CRITERIA: Randomised controlled trials (RCTs) assessing the effectiveness of topical silver in the treatment of contaminated and infected acute or chronic wounds. DATA COLLECTION AND ANALYSIS: Eligibility of trials, assessment of trial quality and data extraction were undertaken by two authors independently. Disagreements were referred to a third author. MAIN RESULTS: Three RCTs were identified, comprising a total of 847 participants. One trial compared silver-containing foam (Contreet) with hydrocellular foam (Allevyn) in patients with leg ulcers. The second trial compared a silver-containing alginate (Silvercel) with an alginate alone (Algosteril). The third trial compared a silver-containing foam dressing (Contreet)) with best local practice in patients with chronic wounds.The data from these trials show that silver-containing foam dressings did not significantly increase complete ulcer healing as compared with standard foam dressings or best local practice after up to four weeks of follow-up, although a greater reduction of ulcer size was observed with the silver-containing foam. The use of antibiotics was assessed in two trials, but no significant differences were found. Data on pain, patient satisfaction, length of hospital stay, and costs were limited and showed no differences. Leakage occurred significantly less frequently in patients with leg ulcers and chronic wounds treated with a silver dressing than with a standard foam dressing or best local practice in one trial. AUTHORS' CONCLUSIONS: Only three trials with a short follow-up duration were found. There is insufficient evidence to recommend the use of silver-containing dressings or topical agents for treatment of infected or contaminated chronic wounds. SN - 1469-493X UR - https://www.unboundmedicine.com/medline/citation/17253557/Topical_silver_for_treating_infected_wounds_ L2 - https://doi.org/10.1002/14651858.CD005486.pub2 DB - PRIME DP - Unbound Medicine ER -