Get access

The effectiveness of silver-releasing dressings in the management of non-healing chronic wounds: a meta-analysis

Authors

  • Shu-Fen Lo,

    1. Authors:Shu-Fen Lo, MSc, RN, CWCN, Assistant Professor, Department of Nursing, Tzu Chi College of Technology and Doctoral Program Student, School and Graduate Institute of Nursing, National Taiwan University, Taipei, Taiwan; Chee-Jen Chang, PhD, Professor, Graduate Institute of Basic Medical Science, Chang Gung University and Resource Center for Clinical Research, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Wen-Yu Hu, PhD, RN, Associate Professor, School of Nursing Science, College of Medicine and Hospital, National Taiwan University, Taipei, Taiwan; Mark Hayter, BA(Hons), MSc, PhD, RN, Senior Lecturer in Nursing, Centre for Health and Social Care Studies and Service Development, School of Nursing and Midwifery, University of Sheffield, Sheffield, UK; Yu-Ting Chang, MSc, RN, Lecturer, Department of Nursing, Tzu Chi College of Technology and Doctoral Program Student, School and Graduate Institute of Nursing, National Taiwan University, Taipei, Taiwan
    Search for more papers by this author
  • Chee-Jen Chang,

    1. Authors:Shu-Fen Lo, MSc, RN, CWCN, Assistant Professor, Department of Nursing, Tzu Chi College of Technology and Doctoral Program Student, School and Graduate Institute of Nursing, National Taiwan University, Taipei, Taiwan; Chee-Jen Chang, PhD, Professor, Graduate Institute of Basic Medical Science, Chang Gung University and Resource Center for Clinical Research, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Wen-Yu Hu, PhD, RN, Associate Professor, School of Nursing Science, College of Medicine and Hospital, National Taiwan University, Taipei, Taiwan; Mark Hayter, BA(Hons), MSc, PhD, RN, Senior Lecturer in Nursing, Centre for Health and Social Care Studies and Service Development, School of Nursing and Midwifery, University of Sheffield, Sheffield, UK; Yu-Ting Chang, MSc, RN, Lecturer, Department of Nursing, Tzu Chi College of Technology and Doctoral Program Student, School and Graduate Institute of Nursing, National Taiwan University, Taipei, Taiwan
    Search for more papers by this author
  • Wen-Yu Hu,

    1. Authors:Shu-Fen Lo, MSc, RN, CWCN, Assistant Professor, Department of Nursing, Tzu Chi College of Technology and Doctoral Program Student, School and Graduate Institute of Nursing, National Taiwan University, Taipei, Taiwan; Chee-Jen Chang, PhD, Professor, Graduate Institute of Basic Medical Science, Chang Gung University and Resource Center for Clinical Research, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Wen-Yu Hu, PhD, RN, Associate Professor, School of Nursing Science, College of Medicine and Hospital, National Taiwan University, Taipei, Taiwan; Mark Hayter, BA(Hons), MSc, PhD, RN, Senior Lecturer in Nursing, Centre for Health and Social Care Studies and Service Development, School of Nursing and Midwifery, University of Sheffield, Sheffield, UK; Yu-Ting Chang, MSc, RN, Lecturer, Department of Nursing, Tzu Chi College of Technology and Doctoral Program Student, School and Graduate Institute of Nursing, National Taiwan University, Taipei, Taiwan
    Search for more papers by this author
  • Mark Hayter,

    1. Authors:Shu-Fen Lo, MSc, RN, CWCN, Assistant Professor, Department of Nursing, Tzu Chi College of Technology and Doctoral Program Student, School and Graduate Institute of Nursing, National Taiwan University, Taipei, Taiwan; Chee-Jen Chang, PhD, Professor, Graduate Institute of Basic Medical Science, Chang Gung University and Resource Center for Clinical Research, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Wen-Yu Hu, PhD, RN, Associate Professor, School of Nursing Science, College of Medicine and Hospital, National Taiwan University, Taipei, Taiwan; Mark Hayter, BA(Hons), MSc, PhD, RN, Senior Lecturer in Nursing, Centre for Health and Social Care Studies and Service Development, School of Nursing and Midwifery, University of Sheffield, Sheffield, UK; Yu-Ting Chang, MSc, RN, Lecturer, Department of Nursing, Tzu Chi College of Technology and Doctoral Program Student, School and Graduate Institute of Nursing, National Taiwan University, Taipei, Taiwan
    Search for more papers by this author
  • Yu-Ting Chang

    1. Authors:Shu-Fen Lo, MSc, RN, CWCN, Assistant Professor, Department of Nursing, Tzu Chi College of Technology and Doctoral Program Student, School and Graduate Institute of Nursing, National Taiwan University, Taipei, Taiwan; Chee-Jen Chang, PhD, Professor, Graduate Institute of Basic Medical Science, Chang Gung University and Resource Center for Clinical Research, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Wen-Yu Hu, PhD, RN, Associate Professor, School of Nursing Science, College of Medicine and Hospital, National Taiwan University, Taipei, Taiwan; Mark Hayter, BA(Hons), MSc, PhD, RN, Senior Lecturer in Nursing, Centre for Health and Social Care Studies and Service Development, School of Nursing and Midwifery, University of Sheffield, Sheffield, UK; Yu-Ting Chang, MSc, RN, Lecturer, Department of Nursing, Tzu Chi College of Technology and Doctoral Program Student, School and Graduate Institute of Nursing, National Taiwan University, Taipei, Taiwan
    Search for more papers by this author

Chee-Jen Chang, Professor, Graduate Institute of Clinical Medical Science, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan, Taiwan, 333, R.O.C. Telephone: 386 3 218800 ext. 3573.
E-mail:cjchang@mail.cgu.edu.tw

Abstract

Aim.  The purpose of this study was to examine the efficacy of silver-releasing dressings in the management of non-healing chronic wounds.

Background.  Non-healing chronic wounds often have a negative physical impact on patients and place a financial burden on healthcare systems. Silver dressings are wound products designed to control infection and provide a wound environment conducive to healing. However, validation of the clinical efficacy of these dressings is lacking.

Design.  Systematic review and meta-analysis.

Methods.  A systematic search of the major electronic databases PubMed, CINAHL, Cochrane, MEDLINE, British Nursing Index, EBSCO, OCLC and Proquest between 1950–June 2007 was conducted. Hand searches of selected periodicals, textbooks and checking reference lists and contacting experts was also performed.

Results.  Eight studies were selected from a potentially relevant 1957 references screened. Analysis incorporated data from 1399 participants in the eight randomised control trials. We found that silver dressings significantly improved wound healing (CI95: 0·16–0·39, < 0·001), reduced odour (CI95: 0·24–0·52, < 0·001) and pain-related symptoms (CI95: 0·18–0·47, < 0·001), decreased wound exudates (CI95: 0·17–0·44, < 0·001) and had a prolonged dressing wear time (CI95: 0·19–0·48, = 0·028) when compared with alternative wound management approaches. An analysis of sensitivity in these studies by subgroup analysis generally supported these associations. Furthermore, studies indicated an improvement in quality of life (CI95: 0·04–0·33, = 0·013) using silver dressings in wound management with no associated severe adverse events.

Conclusion.  This meta-analysis confirms the effectiveness of silver dressings in wound healing and improving patients’ quality of life. However, it also highlights the need for additional well-designed randomised controlled trials to evaluate the effectiveness of silver-related dressings further.

Relevance to clinical practice.  The results of this study provide objective data on the effectiveness of silver-related dressing when applied to non-healing chronic wounds.

Ancillary