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Silver, critical colonization, randomized controlled trial, chronic wounds, critical colonization



  1. Woo, Kevin Y. PhD, RN, FAPWCA
  2. Coutts, Patricia M. RN
  3. Sibbald, R. Gary BSc, MD, Med, FRCPC(Med Derm), MACP, FAAD, MAPWCA


OBJECTIVE: The primary objective of this study was to evaluate if a topical silver dressing that consists of silver alginate powder is effective in managing chronic wounds that exhibit signs of critical colonization and promoting wound healing.


METHOD: This was a prospective, open-label, 4-week randomized controlled trial. The primary end points of the study were changes in signs associated with critical colonization and in wound surface areas. All subjects were evaluated at weeks 0, 2, and 4 at the end of the study.


SUBJECT AND SETTINGS: Participants between 18 and 85 years of age were recruited from 2 wound care clinics in Canada. The study was reviewed and approved by research ethics boards.


DATA ANALYSIS: Analyses of this study were carried out based on intent-to-treat principle; t tests were used to determine if the means were statistically different between treatment groups.


RESULTS: Thirty-four subjects participated and completed in the study. In the control group, the mean infection checklist score was 2.2 at baseline and 2.3 at week 4 (t9 = -0.36, P = .73). In the silver alginate powder group, the infection score reduced from 3.3 at baseline to 1.3 at week 4; the result was significant (t23 = 7.62, P < .00). The difference in average surface reduction over time between the 2 groups was statistically significant (t32 = 3.56, P < .001). Subjects randomized to the silver group achieved a greater surface reduction than those who were randomized to the use of foam dressing as the control.


CONCLUSION: Silver alginate powder is an effective treatment option for wounds with increased bacterial burden.