An historical overview of the use of silver in wound management

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Abstract
While silver and its compounds have been medically used for thousands of years, the recent research focus on this element has led to a resurgence in interest, particularly in the field of wound care product development. The increasing problems of antibiotic resistance, combined with concerns over the safety and toxicity of topical antiseptics, has highlighted the need for a safe agent which can be used to treat colonized and infected wounds effectively. Wounds, notably chronic wounds, can support a wide variety of microorganisms, many of which are pathogens, and act as a source for cross-infection. While systemic antibiotics are justifiably recognized as the first-line treatment of choice for chronic wounds with spreading cellulitis and infected wounds in ‘at risk’ patients, not all infected wounds merit this treatment. There is now a rationale for the judicious use of suitable topical antisepsis in certain colonized, critically colonized, and infected wounds. The increasing evidence available on products containing silver suggests that this element can fulfil a valuable role in wound care. This review of the history of silver as an antibacterial covers the mode of action of preparations containing silver and concludes with a focus on silver as a component of the modern wound management products: Arglaes, Acticoat, Actisorb Silver 220 and Avance.