Efficacy Versus Cost of Different Types of Silver Dressings on Healing of Neuropathic Diabetic Foot Ulcers

Background: Wound care is essential in diabetic foot ulcers (DFUs) management. Different silver dressings are available at varied prices, but there is no agreement on which is the most cost-effective for DFU healing.
Objective: This study aimed to explore the cost efficacy of existing silver dressings in healing of neuropathic DFU.
Patients and methods: The study was a prospective, randomized, single center comparative, which included 60 patients with neuropathic DFUs. All patients received standard wound management. They were randomly distinct into two groups based on the type of dressing used: silver foam treatment (Mepilex^® Ag) or nanocrystalline silver spray (Silver Sol^®). Target was the percentage of ulcer surface area reduction after 12 weeks or complete healing.
Results: Sociodemographic data and ulcer characteristics were comparable in both groups. Initial median ulcer surface area was 2.33 cm² (0.25-5) vs. 3.0 cm² (0.72-6.0) in foam and spray groups respectively (p=0.127). After 12 weeks, the reduction of ulcer surface area was higher among foam group (43.9 % vs. 20.3 %) (p=0.049). Complete ulcer healing was considerably higher in the foam group, 66.7 % vs. 36.7% in spray group (p = 0.02). The mean total cost of dressings per patient was considerably lower in Mepilex^® group (368.0 ± 121.78 LE) than in Silver Sol^® group (950.0 ± 0.0 LE) (p <0.001).
Conclusions: Silver ions foam dressing is significantly more cost effective than nanocrystalline silver spray in healing of neuropathic DFUs.