Silver-containing dressings are used for managing wound bioburden and are available as alginates, foams, films, hydrocolloids, hydrogels, contact layers, and collagens. Typically, a silver dressing is chosen because 1) the wound is at risk for infection, 2) the wound demonstrates signs of infection (and systemic antibiotic therapy has been instituted), or 3) the wound shows no signs of improvement after 14 days of other dressing use.

     Dressings containing silver often are more expensive than others in the same dressing category — thus, it is important to ensure full use of each dressing, take pro-active steps to avoid premature dressing removal or loss, and discontinue use of the silver dressing and step down to a dressing without silver when appropriate.

     At our facilities, clinicians take special precautions to ensure all dressings stay in place for the longest appropriate wear time using a five-step approach to applying the outermost dressing:

     1. Apply skin prep around all periwound skin.
     2. Allow the skin prep dry completely.
     3. Reinforce the edges of the dressing with a conformable nonwoven or cloth tape.
     4. Cover the entire dressing with the appropriate width silk-type tape to ensure the dressing slides easily against the patient’s clothes and bedding.
     5. Have staff monitor the dressing regularly to avoid removal until it is replaced at the appropriate time.

     In addition, our clinicians closely monitor wound progress so a nonsilver dressing may be substituted judiciously. In order to best manage silver dressing costs, not only should clinicians make sure the dressing stays on the patient, but they also should use a silver dressing only as long as it benefits healing tissues.

     Pearls for Practice is made possible through the support of Ferris Mfg. Corp, Burr Ridge, IL (www.polymem.com). The opinions and statements of the clinicians providing Pearls for Practice are specific to the respective authors and are not necessarily those of Ferris Mfg. Corp., OWM, or HMP Communications. This article was not subject to the Ostomy Wound Management peer-review process.