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Chapter 5

Silver in Medical Devices: Technology and Antimicrobial Efficacy

Silver has a fascinating history of use in medical devices dating from 15th Century surgeons. The technology employed nowadays in impregnating or coating medical devices with silver or silver salt attempts to maximise release of antimicrobial levels of Ag+ in a sustained fashion for the expected lifetime of the product. Whilst underlying antimicrobial principles are observed in production of wound dressings, in-dwelling catheters, cardiovascular devices, bone cements etc, selection of metallic silver or soluble silver salt vary according to the type of device, the duration of use and form of clinical application. The special risks of immuno-suppression in burn wounds are overcome by use of silver sulphadiazine with 2.2% cerium nitrate.

Antibiotic efficacy is measured in terms of control of pathogenic infection and alleviation of patient distress. Sequential improvements in silver technology and understanding of the role of infection in delayed wound repair or impaired device function have led to new concepts in silver technology with attention to risk: benefit assessment. Whilst there is satisfactory evidence that silver is efficacious in controlling the bacterial balance in wounds leading to excellent prognosis, less satisfactory observations have been experienced in the use of silver-treated urinary catheters and cardiovascular devices subject to recurrent biofilm formation. Innovations in biomaterials including Bioglass®-Ag may hold promise for alleviating infections associated with wound sutures, bone cements and dental fillings. This is a fertile research field.

Print publication date: 07 May 2010
Copyright year: 2010
Print ISBN: 978-1-84973-006-8
PDF eISBN: 978-1-84973-179-9
From the book series:
Issues in Toxicology