Clinical efficacy and safety of a silver ion-releasing foam dressing on hard-to-heal wounds: a meta-analysis

• Published in: Journal of wound care Vol. 33; no. 10; p. 726
• Main Authors: Münter, Karl-Christian, Lázaro-Martínez, José Luis, Kanya, Susanne, Sawade, Linda, Schwenke, Carsten, Pegalajar-Jurado, Adoracion, Swanson, Terry, Leaper, David
• Format: Journal Article
• Language: English
• Published: England 02.10.2024
• Subjects: Bandages; Humans; Randomized Controlled Trials as Topic; Silver - pharmacology; Silver - therapeutic use; Treatment Outcome; Wound Healing - drug effects; Wounds and Injuries - therapy; wound; wound care; wound healing; chronic venous leg ulcer; wound dressing; wound infection; silver dressings; meta-analysis; delayed wound healing; hard-to-heal wounds
• ISSN: 0969-0700
• DOI: 10.12968/jowc.2024.0149

Delayed or stalled healing in open wounds can result from persisting chronic inflammation related to infection and/or persistent bacterial colonisation and biofilm. Treatment of hard-to-heal wounds focuses on debridement and exudate management, but also on infection prevention and control. Silver dressings have been evaluated in randomised clinical trials (RCTs); this meta-analysis evaluated the efficacy and safety of a silver ion-releasing foam dressing (Biatain Ag; Coloplast A/S, Denmark) to treat hard-to-heal wounds. Literature databases (PubMed and Cochrane Library) were searched for studies on silver ion-releasing foam dressings in the treatment of hard-to-heal wounds. Individual patient data from four RCTs were obtained and included in the meta-analysis. Findings showed that treatment with the silver ion-releasing foam dressing was associated with a significantly higher relative reduction in wound area after four (least squares-mean difference (LS-MD): -12.55%, 95% confidence interval (CI): (-15.95, -9.16); p<0.01) and six weeks of treatment (LS-MD: -11.94%, 95%CI: (-17.21, -6.68); p<0.01) compared with controls. Significant benefits were also observed for time to disappearance of odour (hazard ratio: 1.61, 95%CI: (1.31, 1.98); p<0.01), relative reduction of exudate (LS-MD: -5.15, 95%CI: (-7.36, -2.94); p<0.01), proportion of patients with periwound erythema (relative risk (RR): 0.81, 95%CI: (0.69; 0.94); p<0.01), and less pain at dressing removal (LS-MD: -0.35, 95%CI: (-0.63, -0.06); p=0.02). No differences regarding safety outcomes were identified. This meta-analysis has demonstrated beneficial outcomes and a good tolerability profile for silver ion-releasing foam dressings in the treatment of moderate-to-highly exuding wounds with delayed healing compared with control dressings.