This case series was conducted at the Clinical Research Limb Preservation and Wound Care Department, Department of Surgery, Boston University Medical Center, in collaboration with the Boston University School of Medicine. The study evaluated the application of a silver‐ion solution (SilverStream) in the management of chronic ulcers in patients with complex medical histories, demonstrating promising results in wound healing and biofilm reduction.

This case series highlights the efficacy of SilverStream, a hypertonic wound care solution developed by SilverStream Medical Ltd., Israel, in managing chronic ulcers. SilverStream combines menthol, low concentrations of silver ions, and surfactants, offering a unique approach to reducing biofilm and promoting wound healing. Four patients with multiple comorbidities and chronic venous or diabetic foot ulcers, each persisting for over 5 years, were treated after failing to respond to various advanced wound care modalities.

Application: SilverStream Solution as a cleanser

Patients applied SilverStream by saturating sterile gauze with the solution and placing it on the wound for 15 minutes daily before their dressing changes.

Over a 10-week period, they were monitored every 10 days for wound measurements, pain levels, wound characteristics, and tissue biopsies.

The results were promising:

• A reduction in wound area and fibrotic tissue.
• A decrease in exudates and pain, improving patient comfort.
• An increase in granulation tissue, supporting tissue regeneration.

Conclusion:

Application of SilverStream was shown to decrease wound area, fibrotic tissue, dressing change frequency, and pain and can
increase granulation tissue.