insufficiency weeks only 13 and 12 patients were
insufficiency and chronic pressure or
surgery. Even though antibacterial agents may control bacterial load and
prevent the development of infection, they may also be toxic to fibroblasts and
other viable cells.
Compared to other antiseptic
agents, silver has a very weak toxic potential and rarely induces microbial
resistance. Ancient Greeks and Romans used silver as a disinfectant. Many in vitro studies have demonstrated the
effectiveness of silver-based dressings against pathogenic bacteria. Hence, it
is beneficial to use silver-releasing dressings in conjugation with debridement
on wounds that are at a risk of developing infection. Development of very small
sized silver particles that have large surface area and imparts greater
antimicrobial efficacy has been made possible with nanotechnology. Also, it lowers
their toxicity to human tissue.
The study was conducted to compare the efficacy of
silver colloidal dressings versus conventional dressings in management of
diabetic foot ulcers.
This single-centre randomised control
study was conducted on 37 patients with diabetic foot over a period of one year
with Wagner Grade 1 and 2.
Patients with foot ulcer at least 2 cm2
falling under Wagner grade I and II of at least 30 days duration, and fasting blood glucose level more than 126
mg/dL or patients with known diabetes mellitus were included in the study.
Foot ulcer, which can be attributed to
other coexisting disease like paraplegia, varicose, vein etc, patients suffering
from carcinoma, vasculitis, connective tissue disease, an immune system
disorder, treatment with corticosteroids, immunosuppressive agents, radiation therapy,
chemotherapy and patients with known hypersensitivity to colloidal silver gel
were excluded from the study.
Patients were divided in to conventional
dressing group (n = 19) and silver colloidal dressing group (n = 18).
Conventional dressings group was managed
with debridement and povidone iodine/saline dressings, while silver colloidal
dressing group was managed with debridement and application of silver colloidal
Patients were managed and followed up
for 12 weeks at two weeks interval.
Almost all the patients enrolled in the
study were diabetic for 6-15 years. Five patients in the silver group and seven
patients in the conventional group were lost to follow up or opted out of the
At the end of 12 weeks only 13 and 12 patients
were left in each group. The mean age of silver group was 58.23 ± 11.59
(male-9, female-4) and in conventional group the mean age was 54.08±10.33 year
Mean wound area in silver and
conventional group on admission was 36.8 and 20.46 cm2 which
decreased to 5.28 and 6.42 cm2, respectively at 12 weeks (Table 1).
The percentage decrease in wound area after 12
weeks was more in silver group than conventional group (85.63% vs. 68.63%,