Objective

To evaluate the effectiveness of silver nitrate solution dressings (SilverStream) compared to conventional dressings in managing chronic lower limb ulcers, with the aim of identifying a standardized, efficient treatment approach.

Background

Chronic leg ulcers pose a significant health burden in developing countries like India, contributing to high healthcare costs and loss of productivity. Although advanced treatments such as vacuum-assisted closure and nanosilver dressings are available, foot ulcers remain a major cause of morbidity.

This study focuses on comparing the outcomes of silver nitrate solution dressings against conventional dressings to determine their effectiveness in promoting healing and reducing complications.

Methods

A prospective, comparative study was conducted from September 2018 to September 2019 at a tertiary care hospital, involving 160 patients with chronic lower limb ulcers.

• Group A: Treated with silver nitrate solution dressings.
• Group B: Treated with conventional dressings. Patients were treated until wound healing occurred, either spontaneously or surgically. Data on wound size, culture sensitivity, number of dressings, and hospital stay were analyzed.

Results

1. Patient Demographics:
   • Male: 80%, Female: 20%.
   • Common causes: Diabetes (53.12%) and trauma (21.87%).
   • Most frequent ulcer location: Leg (63.12%).
2. Wound Healing:
   • Initial wound size (mean): Group A (8.06±1.76 cm²), Group B (7.79±1.75 cm²).
   • Final wound size (mean): Group A (1.94 cm²), Group B (3.84 cm²).
3. Treatment Metrics:
   • Mean number of dressings: Group A (22.65), Group B (27.30).
   • Negative culture sensitivity at day 14: Group A (75%), Group B (34%).
   • Mean hospital stay: Group A (25.35 days), Group B (35.91 days).

Conclusion

Silver nitrate solution dressings are significantly more effective than conventional dressings for managing chronic lower limb ulcers.

Patients treated with silver nitrate experienced faster wound size reduction, improved infection control, shorter hospital stays, and earlier return to work.

This study underscores the potential of silver nitrate solution as a superior treatment modality for chronic ulcers.