Silver Dressing: Proving the Efficacy Through Clinical Trials
The wound care market has been in existence since the longest of time and it has undergone significant changes while moving from traditional to bioactive wound dressings and the next stop is active wound dressings. As the disposable income increased, it had a major impact on the lifestyle across developed countries such as U.S. and China. With the changes in lifestyle, the incidence of chronic diseases such as Diabetes came into picture. There are nearly 25 Million people affected with diabetes globally. According to statistics, 25% the diabetic population is prone to developing diabetic foot ulcers in their lifetime. This gave rise to the introduction of bioactive wound dressings in the late 1980’s and they continue to serve patients worldwide. While the earlier dressings included hydrocolloids, honey and semi-permeable films; the focus slowly shifted towards silver.
Silver dressings are being manufactured and used to treat chronic and acute wounds with companies such as Smith & Nephew plc, 3M Healthcare and Convatec Inc. leading from the front. Silver dressings are known to be expensive as compared to other bioactive wound dressings. It is important to understand the cost-benefit relationship for silver dressings and is the high price justified. Silver is known to have antimicrobial properties and the earliest example is of using silver sulphadiazine cream (SDC) to treat burns. Unfortunately, the cream was not able to solve the purpose completely and thus went out of the market.
Today, the silver dressings are being used across North America and Europe. However, to prove that silver dressings are better than other dressings and there is strong benefit associated with its use, there is a need of ‘Gold Standard’ proof. There is a need for randomized trial which can demonstrate the positive effect of silver dressings based on certain parameters such as healing time and percentage healing achieved. These trials should be conducted across different type of wounds these dressings intend to heal. The time duration is another important consideration. While some wounds may heal slowly and some may heal faster, the trial should be conducted for at least 12 weeks in the case of chronic wounds.
There have been randomized and non-randomized trials conducted to understand the efficacy associated with silver dressings and the results have been positive. An average of 56% reduction in the ulcer has been recorded which proves the advantage of using silver to an extent. However, the cost-benefit analysis can’t be completely dependent upon the healing time and the cost associated. There is a need to understand the specific type of wounds which will respond positively to these dressings. There are other issues of small time-frame, sample size and the dosage of silver ions.
Theoretically, these dressings are able to heal wounds faster and contain antimicrobial properties, but there have been few trials to validate the theory. Silver dressings are being used like never before with clinical efficacy still falling short. The physicians need to understand and make accurate diagnosis to prescribe silver dressings. Silver dressings currently exist in the market and they will continue to remain commercial in the future.
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