Critical colonization and infection of wounds present a dual problem for clinicians. First, there is the possibility of delayed wound healing, particularly in the presence of a compromised immune system or where the wound is grossly contaminated or poorly perfused. Second, colonized and infected wounds are a potential source for cross-infection — a particular concern as the spread of antibiotic-resistant species continues. For patients, an infected wound can have additional consequences including increased pain and discomfort, a delay in return to normal activities, and the possibility of a life-threatening illness. For healthcare providers, there are increases in treatment costs and nursing time to consider.
Until recently, local wound infection has been a challenge with few management options. However, the advent of advanced wound dressings containing topical antimicrobial agents, such as silver, has provided a new approach to the control of wound pathogens.
Silver has proven antimicrobial activity that includes antibiotic-resistant bacteria, such as methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE). Its role as an antimicrobial agent is particularly attractive, as it has a broad spectrum of antimicrobial activity with minimal toxicity toward mammalian cells at low concentration and has a less likely tendency than antibiotics to induce resistance due to its activity at multiple bacterial target sites.
Topical creams or solutions containing silver have long been used as a mainstay of wound management in burn patients who are especially susceptible to infection.. A range of antimicrobial dressings containing silver either incorporated within or applied to the dressing are now available for clinical use. This new class of dressings is designed to provide the antimicrobial activity of topical silver in a more convenient application.