Silver - donating antimicrobial dressings for venous leg ulcers

• there is evidence that silver dressings are no more effective than unmedicated low-adherence dressings for treating leg ulcers (1)
  • the VULCAN trial was a large randomized controlled trial that investigated the use of silver dressings for venous ulceration
    • analysis of trial data showed that the application of silver dressings beneath compression did not improve venous ulcer healing. There were no significant differences between the use of silver-donating antimicrobial dressings and non-adherent dressings without any silver or antimicrobial agent, in either the primary or secondary endpoints
    • findings in relation to the lack of benefit from silver antimicrobial dressings were robust, with no suggestion of benefit for particular dressing types or population subgroups
  • a MeReC bulletin concluded that..."routine use of silver-containing dressings under multilayer compression bandaging is not recommended for the treatment of leg ulcers. In the absence of any evidence for a clinical benefit or cost-effectiveness advantage, healthcare professionals should not use them ahead of less-expensive non-silver wound dressings.." (2)

Reference:

• 1) Michaels JA, Campbells B, King B, et al. Randomized controlled trial and cost-effectiveness analysis of silver-donating antimicrobial dressings for venous leg ulcers (VULCAN trial). Br J Surg 2009;96:1147–56
• 2) MeReC Monthly No.22 January 2010