Trials in a war zone and a bacteria-detecting camera are helping decide whether treating burns with silver is appropriate.

How do silver dressings perform in practice? Colonel Steve Jeffery, a consultant plastic surgeon at the UK’s biggest burns unit in Birmingham and a serving army surgeon, says: “Burns can destroy the skin’s ability to keep out bacteria, so big burns usually lead to infection, which is a major killer in burns patients.

“Silver stops bacteria getting into wounds from outside and neutralises any bacteria that remain inside the wound, so silver dressings and silver-based spray can be valuable in treating burns,” says Jeffery.


Using silver at Camp Bastion


Jeffery says: “We use silver dressings every day in treatments and reconstruction in Birmingham University Hospital’s burns unit, but I also used silver to treat injured soldiers at Camp Bastion in Afghanistan.”

He says: “From 2007 on, soldiers were coming in with large wounds caused by improvised explosive devices (IEDs). Typically the wounds were contaminated with soil and dust, which posed a huge infection risk, so we often used silver dressings to reduce the chances of infection. Treatment with silver dressings also reduced the levels of the foul odour associated with large wounds.”

He adds: “Silver dressings are also better at stopping bacteria getting into smaller, relatively uncontaminated wounds from the outside.”


Developing silver dressings


Given the additional cost of silver dressings, and the (so far undetected) possibility that bacteria might build up resistance to silver, Jeffery says it must be used appropriately.

Now a new device can help medical staff make more accurate decisions about whether to use silver dressings.
Jeffery says: “In Birmingham we are involved in trials of a new camera that can reveal the presence of bacteria in burn wounds. Often bacteria are not where we expect them to be, and in some burns patients, there are none.

“The camera helps us make decisions. Used in the right circumstances silver will save money, because infected wounds are costlier to treat – every extra day spent in a hospital bed, especially in a burns unit, is expensive.”