A 2024 systematic review examined silver-ion release and cytotoxicity from commercially available silver dressings used in human wounds.
The evidence base was surprisingly small.
740 articles identified.
5 studies included.
113 patients in total.
All five studies were quasi-experimental, with no control groups.
The studies also differed substantially in wound type, silver formulation, application and measurement methods, limiting comparison between them.
Silver was detected systemically, with measured blood concentrations varying according to the type of silver dressing. Mean dressing exposure across the included studies was 13.5 days, ranging from 3 to 28 days.
Importantly, none of the included studies directly demonstrated cytotoxicity. The review reports that four of the five studies exceeded the blood concentration the authors cite as a cytotoxic range (>0.01 ppm), yet no clinical cytotoxicity was reported.
The authors’ conclusion is appropriately cautious:
Current in-vivo evidence is too heterogeneous and methodologically limited to determine whether silver concentrations released from commercial wound dressings are cytotoxic to skin cells.
That is the finding.
Not evidence that silver is toxic.
Not evidence that it is harmless.
Evidence that we still do not have a clear answer.
Reference
Sánchez-Gálvez, J., Martínez-Isasi, S., Gómez-Salgado, J., Rumbo-Prieto, J. M., Sobrido-Prieto, M., Sánchez-Hernández, M., García-Martínez, M., & Fernández-García, D. (2024). Cytotoxicity and concentration of silver ions released from dressings in the treatment of infected wounds: a systematic review. Frontiers in public health, 12, 1331753. https://lnkd.in/dQ5wAzEa
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