Evidence-based review of silver dressing use on chronic wounds.

PURPOSE: Use of silver containing dressings has become prevalent in clinical practice to manage chronic wounds at risk for infections. This literature review examines the evidence for the efficacy of using silver dressings in the chronic wound management. DATA SOURCES: Relevant in vitro articles on antimicrobial activity of silver dressings, relevant randomized controlled studies (RCTs), and one retrospective cohort study were selected to assess the effectiveness of silver dressings on human chronic wounds. CONCLUSIONS: The emerging evidence base for this use of silver dressings in clinical practice on chronic wounds does not provide absolute evidence of antimicrobial efficacy because there are limited large, well-designed RCTs. To supplement this gap, more rigorously controlled long-term, randomized studies of human subjects with chronic wounds are needed. IMPLICATIONS FOR PRACTICE: It is essential that advanced practice nurses (APNs) be knowledgeable of the wound bacterial balance continuum. For deciding appropriate wound healing strategies, they also need to critically appraise the current literature as it changes for the latest information on antimicrobial efficacy of silver dressings. Until research clarifies the inconclusive evidence, APNs must provide holistic and accurate assessments of both the patient and the wound before selecting silver dressings.