By Candy Lashkari
The use of expensive silver dressing in burn cases is being brought under the scanner by an editorial in the Drug and Therapeutics Bulletin. The NHS has increased its spending from £23 million in 2005 to around £25 million in 2006/7 on such products. The author asks if expensive silver dressing is really justified when cheaper alternatives are available.
"Silver dressings are expensive and there have been few high-quality clinical trials to establish whether they have advantages over other, cheaper, alternatives," says the Bulletin. “Most of the studies that have been conducted have had considerable methodological limitations.”
Dr Andrew Jull from New Zealand who is a clinical epidemiologist at the University of Auckland tends to agree with the evaluation. "This is a well reasoned description of the evidence base for silver dressings. Silver is anti-bacterial in bench-top terms but when it comes to real patients, the quality of evidence is very low" says Jull.
However Dr Jull also believes that silver dressings should not be used routinely in leg ulcers and diabetic foot ulcers. According to him it should be a second choice and not a first line treatment. Destruction of skin in serious burns may merit the use of silver dressings but he wonders if antibiotics may be as effective for the treatment of the burns.