Silver wound dressings 'difficult to justify'

Silver is known to have anti-microbial properties and is used in many types of dressings for wounds, ulcers and burns. How it works is unknown, but silver is thought to stop microbes from being able to spread.

The amount of NHS money spent on such products has risen in recent years from about 23m in 2005 to 25m in 2006/7, according to today's Drug and Therapeutics Bulletin.

The latest figure is a quarter of all the money spent on wound dressings in that year, with silver dressings accounting for a seventh of the total number of dressings. In today's article, experts said the evidence backing the use of silver dressings was not robust enough.

Trials on effectiveness have featured small sample sizes and have failed to assess how well the dressings work over a long period. However, patients do not report many, if any, side-effects.

Nevertheless, their high cost is "difficult to justify" while evidence that they work considerably better than cheaper dressings is so scarce.

The authors concluded: "We believe the routine use of silver dressings is not justified on clinical or cost-effectiveness grounds as treatment for uncomplicated leg ulcers, when simple dressings and compression bandaging are more appropriate."