The bactericidal activity of silver is well documented. Its benefit in reducing or preventing infection can be seen in several applications, including as a topical treatment for burns and chronic wounds and as a coating for both temporary and permanent medical devices. However, silver has been unsuccessful in certain settings, such as the failed silver-coated sewing ring of the Silzone heart valve, and its benefit remains unproved in other settings, such as orthopedic hardware coatings. Continued evaluation of such devices will be necessary to define further those areas in which silver confers benefit.
As new devices incorporating silver into their infection-prevention design are surfacing rapidly, an up-to-the minute tally is nearly impossible. This review aimed to cover the major areas in which silver has been used in medical applications. Whereas for some of these applications, other products have emerged with antibacterial properties, silver remains a reasonable addition to the armamentarium against infection and with relatively few side effects. However, one should weigh the benefits of silver-containing products against the known side effects and the other options available for the specific purpose in selecting the most appropriate therapy.