Silver Dressings Cut Healing Time More Than Iodine in Wounds, suggests study
Researchers have found that silver dressings significantly shorten wound healing time compared to iodine dressings, according to a recent systematic review and meta-analysis published in BMJ Open journal. The review, which considered 17 randomized controlled trials (in 18 articles) with human subjects, sought to assess the relative effectiveness of silver and iodine dressings in different wound care outcomes like healing time, rate of healing, pain, control of exudate, and anti-infective activity. The study was conducted by Yan Jiang and colleagues.
This systematic review consisted of data from a number of prominent databases such as PubMed, Cochrane Library, Embase, Web of Science, and CINAHL, all screened through to May 2024. It only included randomized controlled trials of silver versus iodine dressings. The data were extracted independently by two reviewers, and the risk of bias was assessed through the Cochrane tool. Quality of evidence was assessed using the GRADE approach. A statistical meta-analysis and narrative synthesis based on Review Manager V.5.4 was applied to obtain standardised mean differences (SMDs) for time to heal and relative risks (RRs) for rates of healing.
Key Findings
• The meta-analysis found that silver dressings cut down wound healing time considerably compared to iodine dressings by a standardised mean difference of -0.95 (95% Confidence Interval [CI] −1.62 to −0.28; I² = 92%; p = 0.005), which represents a moderate quality of evidence.
• But there was no significant difference in the healing rate between the two groups (RR = 1.29, 95% CI 0.90 to 1.85; I² = 91%; p = 0.16), according to low-quality evidence.
• For exudate control, of 3 studies that reported data, 66.7% (2/3) supported silver dressings for improved fluid management.
• Pain outcomes were inconsistent. Of 7 studies, 4 (57.1%) reported no significant difference in pain relief between the two dressings, whereas 3 (42.9%) reported silver dressings to produce better pain reduction.
• Anti-infective effectiveness was examined in 11 out of 13 studies included. Under this category, 6 studies (54.5%) found that silver and iodine dressings were equally effective in infection prevention. On the other hand, 4 studies (36.4%) advocated for enhanced antibacterial efficacy of silver dressings.
Silver dressings reduce healing time more than iodine dressings without sacrificing healing rate or infection control. Although for some secondary outcomes there is limited and low-quality evidence, the results lean towards silver dressings as a possibly more effective option in wound management. High-quality randomized trials are required to validate these results across different types of wounds and populations.
Reference:
Jiang, Y., Zhang, Q., Wang, H., Välimäki, M., Zhou, Q., Dai, W., & Guo, J. (2024). Effectiveness of silver and iodine dressings on wound healing: a systematic review and meta-analysis. BMJ Open, 14(8), e077902. https://doi.org/10.1136/bmjopen-2023-077902
