title: Do silver-based wound dressings reduce pain? A prospective study and review of the literature.
abstract: Silver-containing dressings are a mainstay in the management of burn injury and acute and chronic wounds. In addition to antimicrobial activity, there is anecdotal evidence that silver dressings may modulate or reduce wound pain. Pain is subjective and difficult to quantify, and most studies of silver-containing dressings evaluate pain as a secondary rather than a primary outcome. Nevertheless, a dressing with a proven ability to reduce pain independent of systemic analgesics would have great utility. In this study, we compared patient-reported pain levels in patients previously randomized to receiving silver-nylon dressings vs. conventional gauze dressings in a study of surgical site infection. Compared to gauze dressings, patients in the silver dressing group reported less pain between postoperative days 0 and 9 (p<0.02). Post hoc analysis of analgesic use did not reach statistical significance between the groups. The study was completed with a literature review of the effect of silver on pain. Silver-based dressings may reduce wound pain by providing an occlusive barrier or by other as-yet undefined mechanisms. The role of silver in pain relief, however, cannot be definitively stated until well-designed prospective randomized studies evaluating pain as a primary endpoint are carried out.
authors.affiliation: University of South Florida, Department of Surgery, Morsani College of Medicine, Tampa, FL, USA. Electronic address: eabboud@health.usf.edu.
authors.forename: Elia Charbel
authors.initials: EC
authors.lastname: Abboud
authors.affiliation: University of South Florida, Department of Surgery, Morsani College of Medicine, Tampa, FL, USA.
authors.forename: Timothy B
authors.initials: TB
authors.lastname: Legare
authors.affiliation: University of South Florida, Department of Surgery, Morsani College of Medicine, Tampa, FL, USA.
authors.forename: Judson C
authors.initials: JC
authors.lastname: Settle
authors.affiliation: University of South Florida, Department of Surgery, Morsani College of Medicine, Tampa, FL, USA.
authors.forename: Amir M
authors.initials: AM
authors.lastname: Boubekri
authors.affiliation: Disaster Response/Critical Care Consultants, LLC, Mount Pleasant, SC, USA.
authors.forename: Dave J
authors.initials: DJ
authors.lastname: Barillo
authors.affiliation: University of South Florida, Department of Surgery, Morsani College of Medicine, Tampa, FL, USA.
authors.forename: Jorge E
authors.initials: JE
authors.lastname: Marcet
authors.affiliation: University of South Florida, Department of Surgery, Morsani College of Medicine, Tampa, FL, USA.
authors.forename: Jaime E
authors.initials: JE
authors.lastname: Sanchez
mesh_terms: D000890:Anti-Infective Agents / Q000627:therapeutic use*; D001458:Bandages; D002056:Burns / Q000628:therapy; D006801:Humans; D010149:Postoperative Pain / Q000188:drug therapy*; D011446:Prospective Studies; D012834:Silver / Q000627:therapeutic use*; D013530:Surgical Wound Infection / Q000517:prevention & control*
chemical_list: D000890:Anti-Infective Agents; D012834:Silver
keywords: Literature review; Reduce pain; Silver; Silver dressing; Silver study