17.3.3 Silver

Antimicrobial dressings containing silver should be used only when infection is suspected as a result of clinical signs or symptoms (BNF)

It is recommended that these dressings should not be used on acute wounds as there is some evidence to suggest they delay wound healing. There is little evidence of the efficacy of silver against anaerobes, although these are often present in chronic wounds.

There is no evidence to support the use of silver dressings under compression bandaging for the healing of venous leg ulcers when compared with non-silver low adherent dressings.

Silver-impregnated dressings should not be used routinely for the management of uncomplicated ulcers.

The two-week challenge

  • It is recommended that silver dressings should be used for no longer than two weeks initially and then the wound, the patient, and the management approach should be re-evaluated
  • If no improvement to the wound is noted within 2 weeks, then the silver products should be replaced by a non-silver product

Silver ions exert an antimicrobial effect in the presence of wound exudate; the volume of wound exudate as well as the presence of infection should be considered when selecting a silver-containing dressing.

High deposits of silver can have a toxic effect on internal organs and there is evidence for bacterial resistance.

Silver can permanently stain the skin (argyria) and will reduce keratinocyte (skin) production.

Hydrocolloid dressings

Aquacel® Ag + Extra

(Soft, sterile non-woven ribbon dressing impregnated with silver)

  • Dressing 5cm x 5cm (£1.95), 10cm x 10cm (£4.64), 15cm x 15cm (£8.75)


  1. Primary dressing for moderately to highly exuding wounds that are infected or show signs of infection
  2. Change frequency / wear time = every 3 to 4 days for up to 14 days

Desloughing dressings

UrgoClean® Ag

(Sterile, absorbent dressing made of polyabsorbent fibres impregnated with silver)

  • Dressing 6cm x 6cm (£1.96), 10cm x 10cm (£4.45), 15cm x 20cm (£8.39).


  1. Used when wound site requires debridement
  2. Change frequency / wear time = daily up to 7 days
Last updated: 29-07-2020


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