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Silver & Antimicrobial Dressings

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Silver & Antimicrobial Dressings

Antimicrobial dressings are for wounds where infection is present or the risk is high. They are not a routine dressing, and using them as one drives cost up without improving outcomes. BIOFAST supplies silver and antimicrobial wound dressings to clinics, hospitals, aged care facilities and NDIS providers across Australia.

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When to use an antimicrobial dressing

Use one where there are local signs of infection, where a wound is critically colonised and has stalled, or where the patient carries a high risk of infection, such as a diabetic foot ulcer or an immunocompromised patient. Use it for a defined period with a planned review, typically a couple of weeks, then reassess. If the wound has improved, step down to a non-antimicrobial dressing. If it has not, the dressing is not the problem and the wound needs review.

Antimicrobial dressings are not indicated for clean, granulating wounds that are healing normally, and prolonged unnecessary use is discouraged.

Types

Ionic silver. Silver ions are released into the wound bed as the dressing absorbs exudate, giving sustained broad-spectrum antimicrobial action. Available on hydrofiber, alginate, foam and contact-layer backings, so you can match the silver to the exudate level rather than choosing one over the other. Not for patients with known silver sensitivity.

DACC-coated dressings. These work physically rather than chemically. The coating is hydrophobic, so bacteria and fungi bind to the dressing surface and are lifted out at each dressing change. Nothing is released into the wound, which makes them a useful option where a medicated dressing is unsuitable, including on patients where silver is contraindicated.

Iodine dressings. Broad-spectrum, with a visible colour change as the iodine is released, which tells you when to change the dressing. Check thyroid and sensitivity contraindications before use.

Hypochlorous and super-oxidised solutions. Used for cleansing and irrigation of contaminated and infected wounds, and as an adjunct alongside a dressing rather than a replacement for one.

Choosing the backing

The antimicrobial decides whether the dressing manages bioburden. The backing decides whether it manages exudate. A silver hydrofiber or alginate suits moderate to heavy exudate and cavity wounds; a silver foam adds absorbency and cushioning; a silver contact layer suits a shallow wound under a separate absorbent dressing.

Common uses

Infected or at-risk diabetic foot ulcers, venous and arterial leg ulcers, pressure injuries, surgical wounds healing by secondary intention, donor sites and partial thickness burns.

Selection and duration should be directed by a qualified clinician based on the individual wound and the patient's history.

Related Categories

See also alginate and gelling fibre dressings, foam dressings and antiseptics and wound cleansing, or browse the full wound care range.

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