The truth about silver

Interest in silver as a topical agent in wound healing is undergoing a renaissance. Having basic information regarding silver's chemical properties and potential actions in the wound bed is important to its appropriate clinical use. Such information is also relevant to the interpretation of silver's in vitro antimicrobial (antiseptic) effects, which in turn relate to issues involved in the evaluation of the clinical effects of silver in vivo. Gaining an understanding of the basic science of silver products and the different challenges inherent to in vitro versus in vivo antimicrobial evaluations will allow clinicians to address several key questions inherent when considering the use of silver as a topical antimicrobial: 1) Are there different forms of silver? 2) How does the amount of silver released into the wound environment correlate with clinical benefit? 3) How does the rate of silver release correlate with clinical benefit?