Intervention Review

You have free access to this content

Topical silver for preventing wound infection

  1. Marja N Storm-Versloot1,*,
  2. Cornelis G Vos1,
  3. Dirk T Ubbink2,
  4. Hester Vermeulen2

Editorial Group: Cochrane Wounds Group

Published Online: 17 MAR 2010

Assessed as up-to-date: 1 NOV 2009

DOI: 10.1002/14651858.CD006478.pub2


How to Cite

Storm-Versloot MN, Vos CG, Ubbink DT, Vermeulen H. Topical silver for preventing wound infection. Cochrane Database of Systematic Reviews 2010, Issue 3. Art. No.: CD006478. DOI: 10.1002/14651858.CD006478.pub2.

Author Information

  1. 1

    Academic Medical Centre at the University of Amsterdam, Department of Surgery, Amsterdam, Netherlands

  2. 2

    Academic Medical Centre, University of Amsterdam, Quality Assurance & Process Innovation, Amsterdam, Netherlands

*Marja N Storm-Versloot, Department of Surgery, Academic Medical Centre at the University of Amsterdam, Meibergdreef 9, Amsterdam, 1105 AZ, Netherlands. m.n.storm@amc.uva.nl.

Publication History

  1. Publication Status: New
  2. Published Online: 17 MAR 2010

SEARCH

[Figure 1]
Figure 1. Flowchart
[Figure 2]
Figure 2. Methodological quality summary: review authors' judgements about each methodological quality item for each included study.
[Figure 3]
Figure 3. Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.
[Figure 4]
Figure 4. Funnel plot of comparison: 12 SSD/SILVER vs NO SILVER, outcome: 12.1 Number of patients developed wound infection.
[Analysis 1.1]
Analysis 1.1. Comparison 1 Silver sulfadiazine (SSD) cream (1%) vs biosynthetic dressing (Biobrane®), Outcome 1 Number of patients that developed wound infection.
[Analysis 1.2]
Analysis 1.2. Comparison 1 Silver sulfadiazine (SSD) cream (1%) vs biosynthetic dressing (Biobrane®), Outcome 2 Mean pain scores.
[Analysis 1.3]
Analysis 1.3. Comparison 1 Silver sulfadiazine (SSD) cream (1%) vs biosynthetic dressing (Biobrane®), Outcome 3 Costs based on hospital charges (US dollars).
[Analysis 2.1]
Analysis 2.1. Comparison 2 SSD cream (1%) vs biosynthetic dressing with skin substitute (Transcyte® on Biobrane® mesh), Outcome 1 Number of patients that developed wound infection.
[Analysis 3.1]
Analysis 3.1. Comparison 3 SSD cream (1%) with chlorhexidine-impregnated gauze (Bactigras®) vs hydrocolloid (Duoderm® Hydroactive), Outcome 1 Number of patients that developed wound infection.
[Analysis 4.1]
Analysis 4.1. Comparison 4 SSD cream (1%) vs hydrocolloid (Duoderm® Hydroactive), Outcome 1 Number of patients that developed wound infection.
[Analysis 4.2]
Analysis 4.2. Comparison 4 SSD cream (1%) vs hydrocolloid (Duoderm® Hydroactive), Outcome 2 Mean pain scores.
[Analysis 5.1]
Analysis 5.1. Comparison 5 SSD cream (1%) vs honey, Outcome 1 Number of patients with clinical evidence of wound infection.
[Analysis 5.2]
Analysis 5.2. Comparison 5 SSD cream (1%) vs honey, Outcome 2 Number of wounds completely healed.
[Analysis 5.3]
Analysis 5.3. Comparison 5 SSD cream (1%) vs honey, Outcome 3 Number of patients with clinical evidence of wound healing (day 21).
[Analysis 5.4]
Analysis 5.4. Comparison 5 SSD cream (1%) vs honey, Outcome 4 Number of patients reporting free of pain.
[Analysis 6.1]
Analysis 6.1. Comparison 6 SSD cream (1%) vs liposome hydrogel with polyvinyl-pyrrolidone iodine, Outcome 1 Number of patients that developed wound infection.
[Analysis 6.2]
Analysis 6.2. Comparison 6 SSD cream (1%) vs liposome hydrogel with polyvinyl-pyrrolidone iodine, Outcome 2 Number of patients with adverse effects.
[Analysis 6.3]
Analysis 6.3. Comparison 6 SSD cream (1%) vs liposome hydrogel with polyvinyl-pyrrolidone iodine, Outcome 3 Number of patients reporting wound pain.
[Analysis 7.1]
Analysis 7.1. Comparison 7 SSD cream (1%) vs collagenase ointment applied with polymyxin B sulfate/bacitrin (Santyl®), Outcome 1 Number of patients that developed wound infection.
[Analysis 7.2]
Analysis 7.2. Comparison 7 SSD cream (1%) vs collagenase ointment applied with polymyxin B sulfate/bacitrin (Santyl®), Outcome 2 Number of patients reporting pain.
[Analysis 8.1]
Analysis 8.1. Comparison 8 SSD cream (1%)/chlorhexidine (0.2%) (Silverex) vs diphenyldantoin (Phenytoin), Outcome 1 Number of patients with positive cultures (day 10).
[Analysis 8.2]
Analysis 8.2. Comparison 8 SSD cream (1%)/chlorhexidine (0.2%) (Silverex) vs diphenyldantoin (Phenytoin), Outcome 2 Number of wounds completely healed.
[Analysis 8.3]
Analysis 8.3. Comparison 8 SSD cream (1%)/chlorhexidine (0.2%) (Silverex) vs diphenyldantoin (Phenytoin), Outcome 3 Number of patients reporting moderate to severe pain.
[Analysis 9.1]
Analysis 9.1. Comparison 9 Nanocrystalline silver-coated dressing (Acticoat®) vs hydrophilic polyurethane dressing (Allevyn®), Outcome 1 Number of patients that developed wound infection.
[Analysis 9.2]
Analysis 9.2. Comparison 9 Nanocrystalline silver-coated dressing (Acticoat®) vs hydrophilic polyurethane dressing (Allevyn®), Outcome 2 Number of wounds healed by day of discharge.
[Analysis 10.1]
Analysis 10.1. Comparison 10 Silver nitrate (0.5%) vs Ringer's lactate, Outcome 1 Number of patients that developed wound infection.
[Analysis 11.1]
Analysis 11.1. Comparison 11 Silver nitrate (0.5%) vs neomycin with bacitracin, Outcome 1 Number of patients that developed wound infection.
[Analysis 12.1]
Analysis 12.1. Comparison 12 SSD/SILVER vs NO SILVER, Outcome 1 Number of patients that developed wound infection.
[Analysis 13.1]
Analysis 13.1. Comparison 13 SSD cream (1%) vs nanocrystalline silver-coated dressing (Acticoat®), Outcome 1 Number of patients that developed wound infection.
[Analysis 13.2]
Analysis 13.2. Comparison 13 SSD cream (1%) vs nanocrystalline silver-coated dressing (Acticoat®), Outcome 2 Mean background pain scores.
[Analysis 13.3]
Analysis 13.3. Comparison 13 SSD cream (1%) vs nanocrystalline silver-coated dressing (Acticoat®), Outcome 3 Mean length of hospital stay.
[Analysis 14.1]
Analysis 14.1. Comparison 14 SSD cream (1%) vs hydrofibre dressing containing ionic silver (Aquacel® Ag), Outcome 1 Number of patients that developed wound infection.
[Analysis 14.2]
Analysis 14.2. Comparison 14 SSD cream (1%) vs hydrofibre dressing containing ionic silver (Aquacel® Ag), Outcome 2 Number of patients with re-epithelialisation within 21 days.
[Analysis 14.3]
Analysis 14.3. Comparison 14 SSD cream (1%) vs hydrofibre dressing containing ionic silver (Aquacel® Ag), Outcome 3 Number of patients reporting adverse effects.
[Analysis 14.4]
Analysis 14.4. Comparison 14 SSD cream (1%) vs hydrofibre dressing containing ionic silver (Aquacel® Ag), Outcome 4 Number of patients using systemic antibiotics.
[Analysis 14.5]
Analysis 14.5. Comparison 14 SSD cream (1%) vs hydrofibre dressing containing ionic silver (Aquacel® Ag), Outcome 5 Total costs of clinical care (USD).
[Analysis 15.1]
Analysis 15.1. Comparison 15 SSD cream (1%) vs synthetic dressing containing silver (Hydron AgSD (1-3%)), Outcome 1 Number of patients with positive cultures.
[Analysis 16.1]
Analysis 16.1. Comparison 16 SSD cream (1%) (Flamazine®) vs SSD (1%) with 0.2% chlorhexidine digluconate cream (Silvazine®), Outcome 1 Number of patients that developed wound infection.
[Analysis 16.2]
Analysis 16.2. Comparison 16 SSD cream (1%) (Flamazine®) vs SSD (1%) with 0.2% chlorhexidine digluconate cream (Silvazine®), Outcome 2 Number of patients that received antibiotics.
[Analysis 16.3]
Analysis 16.3. Comparison 16 SSD cream (1%) (Flamazine®) vs SSD (1%) with 0.2% chlorhexidine digluconate cream (Silvazine®), Outcome 3 Number of patients reporting extreme pain at application.
[Analysis 17.1]
Analysis 17.1. Comparison 17 SSD cream (1%) (Flamazine®) vs SSD (1%) cerium nitrate (2.2%) (SSD-CN) (Flammacerium®), Outcome 1 Sepsis after 10 days.
[Analysis 17.2]
Analysis 17.2. Comparison 17 SSD cream (1%) (Flamazine®) vs SSD (1%) cerium nitrate (2.2%) (SSD-CN) (Flammacerium®), Outcome 2 Number of patients reporting subjective stinging effect.
[Analysis 17.3]
Analysis 17.3. Comparison 17 SSD cream (1%) (Flamazine®) vs SSD (1%) cerium nitrate (2.2%) (SSD-CN) (Flammacerium®), Outcome 3 Number of patients receiving systemic antibiotics for at least 7 days.
[Analysis 17.4]
Analysis 17.4. Comparison 17 SSD cream (1%) (Flamazine®) vs SSD (1%) cerium nitrate (2.2%) (SSD-CN) (Flammacerium®), Outcome 4 Mean length of hospital stay.
[Analysis 18.1]
Analysis 18.1. Comparison 18 SSD cream (1%) (Silvadene®) vs Dimac containing SSD (Sildimac®), Outcome 1 Number of patients that developed clinical wound sepsis.
[Analysis 18.2]
Analysis 18.2. Comparison 18 SSD cream (1%) (Silvadene®) vs Dimac containing SSD (Sildimac®), Outcome 2 Number of patients reporting local adverse effects.
[Analysis 19.1]
Analysis 19.1. Comparison 19 Nanocrystalline silver-coated dressing (Acticoat®) vs fine-mesh gauze with silver nitrate (0.5%), Outcome 1 Number of patients that developed wound infection.
[Analysis 19.2]
Analysis 19.2. Comparison 19 Nanocrystalline silver-coated dressing (Acticoat®) vs fine-mesh gauze with silver nitrate (0.5%), Outcome 2 Number of patients that developed bacteraemia.
[Analysis 19.3]
Analysis 19.3. Comparison 19 Nanocrystalline silver-coated dressing (Acticoat®) vs fine-mesh gauze with silver nitrate (0.5%), Outcome 3 Mean overall painscore.
[Analysis 20.1]
Analysis 20.1. Comparison 20 SSD cream (1%) vs bacitracin zinc ointment, Outcome 1 Number of patients that developed wound infection.
[Analysis 21.1]
Analysis 21.1. Comparison 21 SSD cream (1%) vs neomycin sulfate, Outcome 1 Number of patients that developed wound infection.
[Analysis 22.1]
Analysis 22.1. Comparison 22 SSD cream (1%) vs petrolatum, Outcome 1 Number of patients that developed wound infection.
[Analysis 23.1]
Analysis 23.1. Comparison 23 Hydrofibre dressing containing ionic silver (Aquacel® Ag) vs povidone iodine gauze, Outcome 1 Number of patients that developed wound infection.
[Analysis 23.2]
Analysis 23.2. Comparison 23 Hydrofibre dressing containing ionic silver (Aquacel® Ag) vs povidone iodine gauze, Outcome 2 Number of wounds completely healed at end of treatment.
[Analysis 23.3]
Analysis 23.3. Comparison 23 Hydrofibre dressing containing ionic silver (Aquacel® Ag) vs povidone iodine gauze, Outcome 3 Number of patients that reported adverse effects.
[Analysis 24.1]
Analysis 24.1. Comparison 24 SSD cream (1%) vs benzoic acid, salicylic acid and Quercus rubra extract (Bensal HP), Outcome 1 Number of wounds healed (6 weeks).
[Analysis 25.1]
Analysis 25.1. Comparison 25 Activated-charcoal dressing containing silver (Actisorb Plus®) vs conventional phase-adapted therapy using diverse topical modalities, Outcome 1 Number of wounds healed (6 weeks).
[Analysis 26.1]
Analysis 26.1. Comparison 26 Hydrofibre dressing containing ionic silver (Aquacel® Ag) vs calcium alginate dressing (Algosteril®), Outcome 1 Number of patients that developed wound infection.
[Analysis 26.2]
Analysis 26.2. Comparison 26 Hydrofibre dressing containing ionic silver (Aquacel® Ag) vs calcium alginate dressing (Algosteril®), Outcome 2 Time to complete healing.
[Analysis 26.3]
Analysis 26.3. Comparison 26 Hydrofibre dressing containing ionic silver (Aquacel® Ag) vs calcium alginate dressing (Algosteril®), Outcome 3 Number of wounds completely healed during study.
[Analysis 26.4]
Analysis 26.4. Comparison 26 Hydrofibre dressing containing ionic silver (Aquacel® Ag) vs calcium alginate dressing (Algosteril®), Outcome 4 Percentage ulcer area reduction in 8 weeks.
[Analysis 26.5]
Analysis 26.5. Comparison 26 Hydrofibre dressing containing ionic silver (Aquacel® Ag) vs calcium alginate dressing (Algosteril®), Outcome 5 Ulcer depth reduction in 8 weeks (cm).
[Analysis 26.6]
Analysis 26.6. Comparison 26 Hydrofibre dressing containing ionic silver (Aquacel® Ag) vs calcium alginate dressing (Algosteril®), Outcome 6 Number of patients that experienced adverse effects.
[Analysis 27.1]
Analysis 27.1. Comparison 27 SSD cream (1%)/hydrocolloid vs hydrocolloid, Outcome 1 Number of patients that developed wound infection.
[Analysis 28.1]
Analysis 28.1. Comparison 28 SSD cream (1%)/hydrocolloid vs non-occlusive paraffin-impregnated gauze, Outcome 1 Number of patients that developed wound infection.