USE OF SILVER NANOPARTICLES IN TREATMENT OF

CHRONIC WOUNDS
Hafza Afzal, SID: 530438472

ABSTRACT
Chronic wounds pose significant challenges in healthcare due to their high prevalence, negative impact on patients' well-
being, and economic burden. Conventional therapeutic approaches often fall short in addressing the complexities of chronic
wounds, such as microbial infection, prolonged inflammation, and antibiotic resistance. Silver nanoparticles (Ag-NPs) have
emerged as a promising solution for chronic wound treatment, leveraging their enhanced antimicrobial properties. However,
commercially available dressings incorporating Ag-NPs face limitations, including side effects, toxicity, and resistance.
Experimental trials explore solutions such as combining Ag-NPs with curcumin, studying anti-inflammatory effects, and
tackling bacterial biofilms. Further research is needed to understand bacterial resistance and ensure responsible Ag-NP use
to avoid antibiotic resistance. Addressing these challenges will enhance the effectiveness and safety of Ag-NPs in combating
chronic wound complications.

I. INTRODUCTION AND BACKGROUND have received regulatory approval for therapeutic use. The
table represent a selection of commercially accessible
Chronic wounds present a significant healthcare challenge,
wound dressings that integrate silver nanoparticles within
characterized by impaired healing and a prolonged inability
their composition.
to heal within the expected timeframe. These wounds
disrupt the precise sequence of events involved in the
Table I. some examples of clinically available chronic
healing process, including homeostasis, inflammation, and
wound dressings incorporating silver nanoparticles. [3]
proliferation [8]. Their escalating prevalence has Chronic Developed description
detrimental impact on patients' well-being, and the wound by
substantial economic burden they impose have brought dressing
chronic wounds to the forefront of healthcare concerns. containing
Medicare data reveals that approximately 8.2 million AgNPs
Medicare patients suffer from chronic wounds, resulting in Acticoat® Smith & durable and fast-acting
staggering costs ranging from 28.1 to 96.8 billion. Chronic Nephew antimicrobial barrier
wounds create an environment conducive to the growth of SilvaSorb® Medline long-lasting antibacterial
diverse microorganisms, leading to the formation of Industries, barrier utilizes
disruptive biofilms. Managing and treating these wounds Inc. MicroLatticeTM technology
effectively is challenging due to the presence of these to enable sustained release of
microbial communities [1]. Thus, antimicrobial therapy silver
plays a vital role in achieving successful healing. Aquacel® Ag ConvaTec AgNPs synergized with
Extra™ Hydrofiber™ technology
Conventional therapeutic approaches have proven contributing to pain
inadequate in addressing the intricate complexities of alleviation and managing
chronic wounds, primarily stemming from microbial exude release
infections, persistent inflammation, and the alarming rise of PolyMem Aspen incorporates nanocrystalline
antibiotic resistance [2]. As such, innovative solutions are Silver™ Medical silver particles within a
urgently required to tackle these challenges and advance hydrophilic polyurethane
the field of chronic wound management. foam providing potent
antimicrobial activity
Use of silver compounds in wound healing dates to 1970s Silver nanoparticles offer several advantages over other
due to their antibacterial properties. Silver nanoparticles, dressings in the treatment of chronic wounds. Their
with enhanced physicochemical properties, offer a superior antimicrobial properties stem from their small size and large
approach for treating chronic wounds. Retaining silver's surface area, facilitating enhanced interactions with
bioactive properties, they exhibit stronger antimicrobial microbial pathogens. This has been demonstrated by
effects due to their increased surface area for binding [1]. experiments such as the one conducted by Reddy et al. In
their study, diabetic rats treated with gallocatechin (GC)-
II. CURRENT STATUS
AgNPs cotton gauze patches exhibited higher wound
Silver has been widely recognized as a promising candidate healing rates compared to the control group, highlighting the
for chronic wound dressings due to its unique properties. superior effectiveness of silver nanoparticles in promoting
Numerous studies have demonstrated its effectiveness in wound healing [4].
wound healing and antimicrobial activity. For instance, in a Numerous studies have investigated the effectiveness of
study conducted by Konop et al. AgNPs exhibited strong AgNP dressings in promoting wound healing. For instance,
antimicrobial effects, inhibiting the growth of bacteria such in a study by Johnson et al. AgNP dressings were found to
as E. coli and S. aureus [4]. accelerate wound closure and reduce bacterial colonization
Promising results from preclinical experiments have been in patients with chronic ulcers. Similarly, a randomized
further validated through various stages of clinical studies. controlled trial by Chen et al. demonstrated that AgNP
Hence, several dressings containing silver nanoparticles dressings significantly improved wound healing outcomes,
including reduced wound size and increased granulation However, their ability to penetrate established biofilms
tissue formation [4]. remains a challenge.
To improve the efficacy of AgNPs in wound healing several
novel dressings are being researched by combining AgNPs IV. OVERCOMING THE CHALLENGES
with other compounds to achieve synergistic effects. For
To mitigate the side effects associated with silver,
example, combining silver AgNPs with curcumin
researchers are actively exploring the combination of these
demonstrated synergistic effects in terms of antibacterial
substances with other compounds that exhibit a synergistic
activity, accelerated wound contraction, and improved
effect.
wound healing compared to commercially available silver
New studies show promise when using anti-biofilm
dressings and chitosan nanofibers, similarly a conductive
hydrofiber (ABSH) dressings in treating deep-partial
hydrogel fabricated developed by Zhao et al. from
thickness wounds using porcine models to address the issue
polydopamine-decorated AgNPs, exhibited broad
of biofilm penetration [4].
antibacterial activity, promoted angiogenesis, accelerated
The combination of AgNPs with compounds such as
collagen deposition, and controlled wound infection [4].
Polyethylene glycol (PEG), Chitosan, and
Polyvinylpyrrolidone (PVP) can reduce cytotoxicity and
Moreover, the combination of AgNPs with biomaterials or
improve biocompatibility [5].
growth factors has shown promising results in promoting
Further research is needed to optimize silver nanoparticles'
wound healing. In a study by Gupta et al. AgNP-
ability to penetrate and eradicate existing biofilms by
incorporated chitosan hydrogels exhibited enhanced wound
developing enhanced formulations, determining optimal
closure rates and improved collagen deposition compared to
concentration and dosage, and exploring synergistic effects
conventional dressings. Additionally, the combination of
with other substances such as enzymes.
AgNPs with growth factors, such as epidermal growth factor
Further clinical trials with various AgNP combinations are
(EGF), has demonstrated accelerated wound healing and
necessary to prevent the emergence of resistant bacteria and
improved tissue regeneration in animal models [4].
determine the optimal formulation for clinical application,
involving different combinations and types of AgNPs
Synthesis methods affect AgNP properties and their
administered in vivo, aiming to identify the optimal AgNP
effectiveness in wound treatment. Mohanta et al. showed
formulation for clinical use. Additional trials are needed to
that AgNPs synthesized from Erythrina suberosa leaves had
determine the optimal concentration, dosage, and timing of
antioxidant properties and improved free radical scavenging
AgNP-coated dressings for effective application.
ability [4]. Optimizing synthesis methods can enhance the
Experimental evidence suggests that the effects of AgNPs
antioxidant activity of AgNPs, thereby enhancing the
vary depending on the dosage and duration of application
effectiveness of dressings.
[10]. Further research is required to determine optimal
III. REMAINING CHALLENGES
dosage and application protocols for silver nanoparticles
There are three main challenges that are associated with the (AgNPs) and evaluate their in vivo toxicity, facilitating their
current use of silver nanoparticles in wound dressings of broad implementation across diverse applications.
chronic wounds: side effects of silver, toxicity of silver and
V. CONCLUSIONS
resistance of bacteria to silver ions. Since some recent
reports have presented experimental evidence suggesting the In conclusion, silver nanoparticles (AgNPs) offer promising
development of bacterial resistance or reduced susceptibility potential for the treatment of chronic wounds, addressing
to Ag-NPs and this is supported by an intriguing mechanism challenges such as microbial infection and antibiotic
by Panáček et al. through which bacteria can develop resistance. However, their commercial use in dressings is
resistance to toxic effects of silver. [7] Moreover, the limited due to side effects, toxicity concerns, and the
accumulation of silver can lead to Argyria which manifests possibility of bacterial resistance. Combining AgNPs with
as a chromatic alteration of the skin, leading to a bluish-grey other compounds and optimizing their concentration and
hue. Infrequent adverse effects of silver treatment application regimen through clinical trials can enhance their
encompass renal and hepatic dysfunction, as well as efficacy. Thorough evaluation of AgNP toxicity and
hematological disorders. Silver, as a metal, possesses bioaccumulation is crucial to ensure safe utilization. Further
inherent toxic properties, the potential toxicity of silver is a research is needed to determine the optimal AgNP
significant concern for human cells and tissues. However, it formulations and dosage for clinical use. By overcoming
is important to note that the extent of silver's toxicity can these challenges, AgNPs can significantly improve chronic
vary based on its specific form and the route through which wound management and patient outcomes.
it is administered. [1]. This was demonstrated by zebrafish
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Acknowledgement : ChatGPT has been used for grammar

and to concise some imformation.