silver-impregnated dressings

silver-impregnated dressings

wound dressings incorporating silver (1 part per million); used to treat meticillin-resistant Staphylococcus aureus (MRSA)-infected ulcers (see Table 1)
Table 1: Types of wound dressings and indications for their use
Dressing TypeFeaturesIndicated Use
Primary Wound-Dressing Films
Semi-permeable adhesive filmNon-absorbent
Non-adherent to wound surface
Gas and water vapour permeable, but impermeable to water
Non-shedding
Transparent, allowing observation of wound
Low exudating wounds
Perforated film, absorbentLow adherence (absorbent pad covered by perforated film)
Low exudating wounds
Low-adherent Wound Contact Layers
Unmedicated viscoseNon-absorbent; non-sheddingNon-adherent primary dressing
Medicated tulleLow-adherent polyethylene glycol or paraffin impregnated tulle incorporating an antiseptic (e.g.: chlorhexidine gluconate; iodine)Topical antisepsis
Semi-permeable hydrogelsHydrophilic polymers in either sheet or amorphous formulations
Highly absorbent
Gas permeable, but impermeable to water
Dressing surface may dry out, and thus requires rehydration with saline
Removal of slough
Rehydration of dry, necrotic tissue to allow its later sharp debridement
Absorption of heavy exudation
Carrier of topical antimicrobials (e.g.: metronidazole)
HydrocolloidsInteractive (form a gel when in contact with wound surface)
Usually formulated with an occlusive, water-repellent backing
Promote an acidic and hypoxic wound environment, and facilitates neoangiogenesis
Not suitable for infected wounds
Maintain a moist, temperature controlled wound environment
AlginatesSeaweed derivatives which form a hydrophilic gel in contact with the wound surface
Require irrigation to remove from wound surface
Absorption of exudation
Moisten with saline before application
Polyurethane foamsSmooth low-adherent wound contact layer backed with hydrophobic foam
Highly gas-permeable
Maintain a moist wound environment and good thermal insulation
Absorption of moderate exudation
Outer layer prevents 'strike through'
Silver agentsSilver ions impregnated into dressing
Antibacterial action
Topical antisepsis, including resistant forms
References in periodicals archive ?
On the other hand, other clinical studies concluded that silver-impregnated dressings are associated with an improvement in the quality of life, expressed in a higher rate of healing, decrease in the ooze, less pain and longer interval between surgical cleanings, etc.
Brown-Etris reported a decrease in the healing time of previously colonized wounds when treated with silver-impregnated dressings (33).
This study presents evidence in favor of the use of silver-impregnated dressings in patients with contaminated wounds with and an effectiveness similar to saline gauzes, but with a clear delay in the occurrence of the SSI.
In one study out of Albert Einstein College of Medicine, silver-impregnated dressings outperformed gauze dressings in a group of patients undergoing laminectomies.
Silverlon appears to out-perform both gauze dressings and other silver-impregnated dressings.
Do silver-impregnated dressings limit infections after lumbar laminectomy with instrumented fusion," Surgical Neurology 68 (2007).
Some silver-impregnated dressings are meant to be worn for up to several days.
The silver-impregnated dressings effectively reduce the bacterial counts in such cases, thus allowing the wounds to heal.