Silver Dressing (silver-coated dressings) is used in the management of minor abrasions, ulcers, and superficial wounds of first and second degrees.

Silver-containing dressings Uses:

• Wound management:

  • First- and second-degree burns and wounds, including abrasions, wounds from medical device insertion, lacerations, skin rips, superficial wounds, donor, graft, and operation sites, as well as diabetic, pressure, and stasis ulcers, are treated with topical anti-infectives.

Silver Nitrate; Uses, Dose, MOA, Brands, Side effects

Silver-dressings Dose in Adults

Silver-dressings Dose in the Wound Management:

Note:

• It is recommended to consult the manufacturer's labeling before using any anti-microbial dressings. If wound healing has not occurred within two weeks, consult a healthcare provider. When the infection has resolved, non-antimicrobial dressings should be applied.

Topical Silver Dressings:

• Acticoat, Acticoat 7:

  • Apply sterile water (not soap) to the wound and moisten it. Apply secondary dressing. The dressing should be kept dry and changed as necessary. 
  • The Acticoat 7 may be left on for a maximum of seven days. 

• Silver-seal dressings:

  • To keep the wound moist, apply right away and cover with a conventional dressing.
    Within seven days, change.

• Restore

  • Apply immediately to the wound, then dress it without an occlusive material. 

• Acticoat Flex:

  • Apply right away to the wound. Maintain a secondary dressing that is snug and wet as necessary. Use water to moisten the dressing if there is minimal exudate or the wound is severely dry.
    Acticoat Flex 3 can be left in place for three days. Acticoat Flex7 can dry for up to 7 days.

• 3M Tegaderm Ag Mesh:

  • • Apply sterile normal or sterile water to dry wounds.
    • Premoistening is not necessary for wounds that drain well.
    • In order to manage wound drainage, the wound may be dressed. You can put on a barrier dressing that holds moisture to keep the wound moist.
•  

• Acticoat Moisture Control, Acticoat Site, Acticoat Surgical:

  • You can change the dressing as often as you need; it may stay in place for up 7 days. For Acticoat Moisture Control and Acticoat Site, the supplementary dressing can be necessary.
  • Apply right to the injury. Apply to dress immediately. If the wound requires cleaning, you can use sterile water.

• SilverSTAT:

  • Apply right away, then cover with a standard dressing. Alternate daily or as often as necessary.

• Topical Gel:

• SilverMed

  • Apply a 1/4-inch-thick covering or a dressing to the wound to help it heal.

• Solox, RevitaDERM:

  • Cover the wound with 1/ 8 inches to 1/ 4 inches thick layers. Keep the wound moistened by changing as necessary.

Use in Children:

No dosage adjustment recommended in children by the manufacturer.

Use in Pregnancy and breastfeeding:

• Although there is limited systemic absorption after topical treatment, it is not advisable to use it while pregnant.

Silver use during breastfeeding:

• Despite the fact that there is not much systemic absorption after topical application, nursing mothers should not use it.

Dose in Kidney Disease:

There are no dosage adjustments provided in the manufacturer’s labeling. However, dosage adjustment is unlikely due to low systemic absorption.

Dose in Liver disease:

There are no dosage adjustments provided in the manufacturer’s labeling. However, dosage adjustment is unlikely due to low systemic absorption

Side effects of Silver dressings:

• Local:

  • Application site irritation

• Dermatologic:

  • Skin cyanosis
  • Localized colour change (temporary black discolouration at the application site)
  • Allergic skin reaction
  • Erythema

Contraindication to Silver dressings:

Hypersensitivity to any ingredient in the composition, including silver.

3M Tegaderm AG Mesh:

• Heightened sensitivity to cotton
• Use as a sponge for surgery.
• Employed for third-degree burns.

Acticoat Moisture Control:

• Use during MRI

Acticoat Flex 3, Acticoat Flex 3 & 7, Acticoat Surgical:

• for use during radiation treatment or magnetic resonance imaging (MRI)

Restore:

• Alginates are quite sensitive.
• Utilized for third-degree burns, surgical implants, severe bleeding management, and dry or hardly leaking wounds.

Acticoat Site:

• Hypersensitivity of polyurethane during MRI

Silver-seal Hydrogel:

• Hypersensitivity towards nylon and used with cardiac defibrillators

Warnings and Precautions

• Agents for enzymatic debridement
  • Silver bandages should not be used on wounds that are coagulating enzymatically.

Monitoring Parameters:

• Monitor the wound for healing and secondary infections.
• Consult a healthcare provider if there is excessive exudation, redness, swelling, or fever.

How to administer Arida (Silver-containing dressings)?

It is only meant to be used outside. Clean wounds should have dressings placed on them. The manufacturer's labelling should be consulted for advice on the best secondary dressings.When dressings that have adhered to the wound surface have softened from being soaked in sterile water or sterile normal saline, they can be gently removed. Never use Acticoat (all products) with saline solution prior to application.

Mechanism of action of Silver-dressings:

• When exposed to wound exudate, elemental silver becomes positively charged. 
• After being ionised, silver is antibacterial. In doing so, it breaks bacterial cell walls and binds to their membranes, leading to cell leakage.

Absorption:

• Very little drug is systemically absorbed.

Excretion:

• The drug is not absorbed systemically. Minute amounts of absorbed silver is either excreted via feces or urine.

International Brand Names of Silver-containing dressings:

• Aceso Ag
• Arida
• Elta SilverGel
• Silverseal Hydrogel Dressing
• Solox
• Acticoat
• Acticoat Flex

Silver-containing dressings Brand Names in Pakistan:

No Brands Available in Pakistan.