A systematic review and meta-analysis of clinical outcomes associated with nanocrystalline silver use compared to alternative silver delivery systems in the management of superficial and deep partial thickness burns.

Objective: The purpose of this systematic review and meta-analysis was to assess the clinical effectiveness of nanocrystalline silver compared to alternative silver delivery systems (silver sulphadiazine [SSD] and silver nitrate) in adults and children with superficial and deep partial thickness burns.

Methods: PubMed, EMBASE, Cochrane and other databases were searched to identify relevant randomised controlled trials and observational studies.

Results: Eight studies that assessed both nanocrystalline silver and SSD and one study that compared nanocrystalline silver vs. silver nitrate were identified. Nanocrystalline silver compared to SSD/silver nitrate was associated with a statistically significant reduction in infections (odds ratio [OR] 0.21, 95% CI 0.07-0.62, p=0.005), length of stay in hospital (mean difference -4.74 (95% CI -5.79 to -3.69, p=0.00001) and surgical procedures (OR 0.40, 95% CI 0.28-0.56, p=0.00001). Three studies that reported on pain had lower pain scores with nanocrystalline silver use than with SSD/silver nitrate; a high level of heterogeneity precluded pooling estimates.

Conclusion: This comprehensive systematic review and meta-analysis of the available evidence suggest that the use of nanocrystalline silver dressings results in shorter length of stay in hospital, less pain, fewer surgical procedures and reduced infection rates compared to silver sulphadiazine/silver nitrate.