title: The safety of nanocrystalline silver dressings on burns: a study of systemic silver absorption.
abstract: BACKGROUND
  Wound dressings containing silver have been in widespread use for many years. However, there are few quantitative data on the systemic absorption of silver or whether there is associated clinical risk.
  
  
  OBJECTIVE
  To assess systemic silver levels when Acticoat dressings containing nanocrystalline silver were used, and to determine whether increases in such levels were associated with haematological or biochemical indicators of toxicity.
  
  
  METHODS
  A prospective, single-centre, open-label study of 30 patients with relatively small burns that required skin grafting. Serum silver levels were measured before, during and at discontinuation of the use of the Acticoat dressings, and again at 3 and 6 months following completion of treatment.
  
  
  RESULTS
  The median total postoperative wound size was 12% of the total body surface area. The median time to maximum silver levels was 9 days. The median maximum serum silver level was 56.8 microg/l. The median serum level at 6 months was 0.8 microg/l. There were no haematological or biochemical indicators of toxicity associated with the silver absorption observed in this study.
  
  
  CONCLUSIONS
  This study has confirmed our view that Acticoat products are safe for use on burns and they remain a standard part of treatment at our centre.
authors.affiliation: University Hospital Birmingham Foundation Trust, Birmingham, UK.
authors.forename: Evangelia
authors.initials: E
authors.lastname: Vlachou
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Chipp
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Shale
authors.forename: Yvonne T
authors.initials: YT
authors.lastname: Wilson
authors.forename: Remo
authors.initials: R
authors.lastname: Papini
authors.forename: Naiem S
authors.initials: NS
authors.lastname: Moiemen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001458:Bandages; D002056:Burns / Q000097:blood* / Q000473:pathology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D053768:Metal Nanoparticles / Q000009:adverse effects; D008875:Middle Aged; D011091:Polyesters / Q000009:adverse effects; D011095:Polyethylenes / Q000009:adverse effects; D011446:Prospective Studies; D012834:Silver / Q000009:adverse effects / Q000097:blood*; D016038:Skin Transplantation; D015599:Trauma Severity Indices
chemical_list: C117408:Acticoat; D011091:Polyesters; D011095:Polyethylenes; D012834:Silver