Doctoral Programme in Health, Disability, Dependence, and Welfare, University of León, León, Spain.
Faculty of Nursing, Catholic University of Murcia (UCAM), Cartagena, Murcia, Spain.
Front Public Health. 2024 Feb 21;12:1331753. doi: 10.3389/fpubh.2024.1331753. eCollection 2024.
Silver-releasing dressings are used in the treatment of infected wounds. Despite their widespread use, neither the amount of silver released nor the potential toxicity is known. The aim of this study was to evaluate the cytotoxic effects and the amount of silver released from commercially available dressings with infected wounds.
The review was conducted according to the PRISMA statement. The Web of Science, PubMed, Embase, Scopus, and CINAHL databases were searched for studies from 2002 through December 2022. The criteria were as follows: population (human patients with infected wounds); intervention (commercial dressings with clinical silver authorized for use in humans); and outcomes (concentrations of silver ions released into tissues and plasma). Any study based on silver-free dressings, experimental dressings, or dressings not for clinical use in humans should be excluded. According to the type of study, systematic reviews, experimental, quasi-experimental, and observational studies in English, Spanish, or Portuguese were considered. The quality of the selected studies was assessed using the JBI critical appraisal tools. Studies that assessed at least 65% of the included items were included. Data were extracted independently by two reviewers.
740 articles were found and five were finally selected (all of them quasi-experimental). Heterogeneity was found in terms of study design, application of silver dressings, and methods of assessment, which limited the comparability between studies.
comparative studies of clinical dressings for control of infection lack a standardized methodology that allows observation of all the variables of silver performance at local and systemic levels, as well as evaluation of its cytotoxicity. It cannot be concluded whether the assessed concentrations of released silver in commercial dressings for the topical treatment of infected wounds are cytotoxic to skin cells.
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022351041, PROSPERO [CRD42022351041].
银释放敷料用于治疗感染性伤口。尽管它们被广泛使用，但释放的银量及其潜在毒性都不得而知。本研究旨在评估具有感染性伤口的市售敷料的细胞毒性作用和银释放量。
本综述按照 PRISMA 声明进行。在 2002 年至 2022 年 12 月期间，我们在 Web of Science、PubMed、Embase、Scopus 和 CINAHL 数据库中搜索了具有感染性伤口的人群（人类患者）接受商业敷料（经临床授权使用的含临床银的商业敷料）干预以及组织和血浆中释放的银离子浓度等结局的研究。任何基于无银敷料、实验敷料或不适用于人类临床的敷料的研究都应被排除。根据研究类型，纳入了英语、西班牙语或葡萄牙语的系统评价、实验、准实验和观察性研究。使用 JBI 批判性评估工具评估选定研究的质量。评估了至少 65%包含项目的研究被纳入。数据由两位审阅者独立提取。
共发现 740 篇文章，最终选定了 5 篇（均为准实验研究）。由于研究设计、银敷料的应用以及评估方法的不同，研究之间存在异质性，限制了研究之间的可比性。
在控制感染方面，用于临床的敷料比较研究缺乏标准化的方法学，无法观察局部和全身各级别银的所有性能变量，也无法评估其细胞毒性。不能得出结论认为评估的商业感染性伤口局部治疗用敷料释放的银浓度对皮肤细胞是否具有细胞毒性。
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022351041，PROSPERO [CRD42022351041]。
