A randomized comparison study of conventional normal saline and silver nanocrystalline gel as topical wound dressings in non-healing wounds

V. Mahadev


Background: Non-healing wounds and chronic ulcers are being consequence of the abnormality in healing process and disturbance in the recovery pathway. Picking an ideal choice of topical application and dressing helps in enhancing the wound heal in addition to the antibiotics administration. To identify the outcome of topical dressing in chronic ulcers by using, silver nanocrystalline gel dressing (AgNP) and conventional normal saline dressing (NS).

Methods: This study was an open label randomized study in patient with chronic non-healing wound. The wound healing outcomes of two different dressing methods were compared, which was evaluated by independent assessor. The primary outcome is area reduction of wound and duration of healing. The secondary outcome is the formation of healthy granulation, slough and discharge and wound site infection control.

Results: The outcome of AgNP and conventional NS dressing was compared. The 100 patients with non-healing wounds were randomized in the ratio of 1:1. The primary outcome was study group had better area of reduction of 41.97% (SD-7.41) with statistical significance (p<0.0001) and mean duration of healing, 15.64 weeks. The secondary outcome of healthy granulation tissue and reduced slough and discharge at the end of 3 weeks with topical silver nanocrystalline dressing was significant.        

Conclusions: Topical silver nanocrystalline dressing shall be an effective dressing option to achieve apposite recovery of healing process in non-healing wounds.       



Non-healing wounds, Chronic ulcer, NS, Silver nanocrystalline gel, Surgical dressings, Wagner’s ulcer grade

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Han G, Ceilley R. Chronic Wound Healing: A Review of Current Management and Treatments. Adv Ther. 2017;34(3):599-610.

Xu L, Wang YY, Huang J, Chen CY, Wang ZX, Xie H. Silver nanoparticles: Synthesis, medical applications and biosafety. Theranostics. 2020;10(20):8996-9031.

Robson MC, Steed DL, Franz MG. Wound healing: biologic features and approaches to maximize healing trajectories. Curr Probl Surg. 2001;38:72-140.

Storm-Versloot MN, Vos CG, Ubbink DT, Vermeulen H. Topical silver for preventing wound infection. Cochrane Database Syst Rev. 2010;1(3):CD006478.

Carter MJ, Warriner RA. Evidence-based medicine in wound care: time for a new paradigm. Adv Skin Wound Care. 2008;22(1):12-6.

Chaby G, Senet P, Vaneau M, Martel P, Guillaume JC, Meaume S et al. Dressings for acute and chronic wounds: a systematic review. Arch Dermatol. 2007;143(10):1297-304.

Lim JK, Saliba L, Smith MJ, McTavish J, Raine C, Curtin P. Normal saline wound dressing--is it really normal? Br J Plast Surg. 2000;53(1):42-5.

Diegelmann RF, Evans MC. Wound healing: an overview of acute fibrotic and delayed healing. Front Biosci. 2004;9:283-9.

Warriner R, Burrell R. Infection and the chronic wound: a focus on silver. Adv Skin Wound Care. 2005;18(1):2-12.

White R, Cutting K. Exploring the effects of silver in wound management-what is optimal? Wounds: Compend Clin Res Pract. 2006;18(11):307-14.

Khansa I, Schoenbrunner AR, Kraft CT, Janis JE. Silver in Wound Care-Friend or Foe? A Comprehensive Review. Plast Reconstr Surg Glob Open. 2019;7(8):e2390.

Fong J, Wood F. Nanocrystalline silver dressings in wound management: a review. Int J Nanomedicine. 2006;1(4):441-9.

Sibbald R, Raphael S, Rothman A. The selective anti-inflammatory activity of prolonged release nanocrystalline silver dressing (Acticoat 7) in the treatment of chronic venous leg ulcers. Wound Repair Regen. 2005;13(2):40.