Appropriate use of dressings containing nanocrystalline silver to support antimicrobial stewardship in wounds

Emma J Woodmansey, Christopher D Roberts, Emma J Woodmansey, Christopher D Roberts

Abstract

Antimicrobial resistance is an ever-increasing global concern, with the era of untreatable infection becoming a reality. Wound care is no exception, with increasing issues of antibiotic-resistant infections across different wound types and care settings. Antibiotic resistance and stewardship have been the priority for most strategic interventions so far; however, in wound care, alternative or supplementary strategies using antiseptics should be considered. Antiseptics such as silver can provide effective cidal activity across a broad range of wound pathogens, assuming they are used at the correct level for an appropriate duration. Evidence summarised in this manuscript suggests that effective antiseptics, such as nanocrystalline silver, have an increasing body of evidence in support of their use to minimise transmission of antibiotic-resistant organisms as part of institutional infection control procedures and, in addition, through appropriate early use and stewardship on local wound infections, in conjunction with local procedures, to minimise the need for systemic antibiotic therapy. Engagement, alignment, and collaboration between wound care professionals and wider related teams and governments on antimicrobial stewardship, and the potential role of antiseptics within this, will help to generate further evidence for such interventions in the fight against antimicrobial-resistant infections in wound care.

Keywords: antimicrobial resistance; antimicrobial stewardship; antiseptics; efficacy; nanocrystalline silver.

© 2018 The Authors. International Wound Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Figures

Figure 1
Figure 1
Key factors encompassing infection prevention and control21, 44, 50, 51, 52 [Colour figure can be viewed at wileyonlinelibrary.com]
Figure 2
Figure 2
Topical silver dressing and antibiotic treatment recommendations along the wound infection continuum. * With the exception of high‐risk patients, modified from Ayello et al24 [Colour figure can be viewed at wileyonlinelibrary.com]

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