Silver treatments and silver-impregnated dressings for the healing of leg wounds and ulcers: A systematic review and meta-analysis

Previous systematic reviews of silver-impregnated dressings have been contradictory regarding the healing of leg wounds/ulcers. Our systematic review was restricted to randomized controlled trials. Cochrane Library, Scopus, and MEDLINE databases were searched using the term “silver” in combination w...

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Bibliographic Details
Published in:Journal of the American Academy of Dermatology 2010-10, Vol.63 (4), p.668-679
Main Authors: Carter, Marissa J., PhD, MA, Tingley-Kelley, Kimberly, MS, Warriner, Robert A., MD, FACA, FCCP, FCCWS
Format: Article
Language:English
Subjects:
Administration, Topical
Anti-Infective Agents, Local - therapeutic use
Biological and medical sciences
Dermatology
Female
Humans
Leg Ulcer - diagnosis
Leg Ulcer - therapy
Male
Medical sciences
meta-analysis
Occlusive Dressings
Prognosis
Randomized Controlled Trials as Topic
Severity of Illness Index
Silver Compounds - therapeutic use
Silver Nitrate - therapeutic use
Silver Sulfadiazine - therapeutic use
silver treatment
silver-impregnated dressing
subgroup analysis
systematic review
Treatment Outcome
Wound Healing - drug effects
Wound Healing - physiology
Wound Infection - prevention & control
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Summary:Previous systematic reviews of silver-impregnated dressings have been contradictory regarding the healing of leg wounds/ulcers. Our systematic review was restricted to randomized controlled trials. Cochrane Library, Scopus, and MEDLINE databases were searched using the term “silver” in combination with “wound” or “ulcer” (and plural versions) without date/language restriction. Study quality was assessed and meta-analysis conducted for complete wound healing, wound size reduction, and healing rates. Overall study quality was fair with most studies having some bias. Evidence for wound healing using individual studies was poor. Meta-analyses found strong evidence for wound healing based on wound size reduction but no evidence based on complete wound-healing or healing rates. Although our results provide some evidence that silver-impregnated dressings improve the short-term healing of wounds and ulcers, long-term effects remain unclear. Clinical trial data with longer follow-up times are needed to address these issues.
ISSN:0190-9622
1097-6787
DOI:10.1016/j.jaad.2009.09.007