Excerpts From:
http://www.burnsurgery.org/Betaweb/Modules/silver/section1.htm
Authors: Robert H. Demling, M.D. | Leslie DeSanti, RN
| Dennis P. Orgill, M.D. PhD.
Silver has been used for centuries to prevent and
treat a variety of diseases, most notably infections.
It has been well documented that silver was used in
ancient Greece and Rome as a disinfectant for water
and other liquid storage. Silver coins were placed in
the jars of liquid to maintain sterility. The American
Settlers (1800s) routinely place a silver dollar in
barrels of liquids to avoid spoilage and more recently
NASA has used silver to maintain water purity on the
space shuttle. The free silver ion or radicals are
known to be the active agents of anti-microbial
silvers. Of interest is its extremely potent
antibacterial properties as only 1 part per 100
million of elemental silver is effective in a
solution. Silver ion kills micro-organisms instantly
by blocking the respiratory enzyme system (energy
production) while having no negative effect on human
cells.
In 1834 the German obstetrician F. Crede used a 1%
silver nitrate solution as eye drops in newborns,
eliminating blindness caused by post partum eye
infections. Numerous studies in the early 1900s
correlated low plasma silver levels with infections,
suggesting silver to be an essential micromineral
requiring replacement. Of significant importance is
that no known BACTERIAL RESISTANCE has developed to
the silver ion as opposed to current antibiotics.
Charged silver solutions (electro-colloidal) were
approved in the 1920s by the FDA for use as an
antibacterial agent.
In addition to its recognized antibacterial properties
silver solutions, especially (electro-colloidal
elemental silver) were reported to improve the healing
of "indolent wounds" and in the regeneration of
damaged tissue unrelated to its effects on infection.
The description of decreased rubor in wounds indicates
an anti-inflammatory property of silver.
Silver is completely non-toxic to local tissues and
painless upon application. This response must be
distinguished from the response of silver salts, many
of which are caustic to tissues, especially silver
nitrate, due to the potent oxidizing or cell damaging
effects of nitrate or nitrite. Virtually all of the
reports on the use of the pure elemental silver to
control infection or to increase healing occurred
prior to the 1940s after which antibiotics became
prevalent, decreasing the use of silver (except in
burns). With the recent introduction of a pure silver
delivery system for use in burns and wounds, new data
is being obtained which verifies these historical
concepts. Silver was commonly worn in the Greco-Roman
period because of its perceived qualities of
"maintaining health".
Section II.
WHAT ARE THE BIOLOGIC PROPERTIES OF SILVER RELATED TO
WOUND INFECTION CONTROL AND HEALING?
(THE FACTS ABOUT SILVER)
Silver has long been known to be a potent
antimicrobial agent and its beneficial effects on
wound biology have in general been overlooked until
recently. A description of what silver does and its
role in wound management will be presented briefly
with a more complete discussion in later sections.
ANTIMICROBIAL PROPERTIES:
The antimicrobial activity of silver ion is well
defined. Silver ion rapidly kills microbes by blocking
the cell respiration pathway. The speed of action is
almost instantaneous once the silver reaches the
microbe. The efficacy of microbe killing is based not
only on the amount of silver ion present, but likely
also the presence of other silver radicals generated
by a silver releasing product.
Because of mechanism of action, microbial resistance
to silver itself has not been reported. In addition,
silver has repeatedly been shown to be non-toxic to
human cells. Toxicity occurs from the complexes used
to deliver silver such as nitrate and sulfadiazine.
Section IV
IS SILVER TOXIC TO HUMAN TISSUE?
There are two well-described (but often
inappropriately interchangeable) forms of silver
toxicity. One is due to silver itself and the second
more severe complication is due to the attached
compound.
SILVER ION TOXICITY
(Systemic)
Although absorbed silver interacts with other metals
and tissue proteins, these interactions do not appear
to be harmful with the exception of the skin
discoloration known as ARGYRIA, a cosmetic problem.
Argyria is a process of silver granule deposition in
skin leading to a permanent blue/gray discoloration.
There is no tissue injury. The effect is a cosmetic
problem. The most common causes were not from
medicinal use of silver but rather the constant
exposure to silver either as a chemist, silver miner
or long term use of silver cups, plates, etc. Of
interest is the fact that the term "blue blood" used
to describe Royalty came from the finding of mild
argyria in European nobility from the constant use of
silver place setting, silverware, and silver cups,
along with the frequent ingestion of ground-up silver
metal powder (used as a microbial medicine), leading
to a bluish skin color. Silver granules can be found
in all organs including the skin indicating that the
silver aggregates are not cleared. It would therefore
appear that any form of silver if given in large
quantity can be a causative factor (at least 10 grams
needs to be absorbed).
Silver itself has been shown to be harmless to normal
human tissue. The toxicity results from the salt or
complexes that are used to deliver the silver. A pure
silver delivery would be the ideal approach to avoid
local toxicity.
(J Burn Care Rehabilitation 1999;20:195-200)
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