Management of chronic wounds: the role of silver-containing dressings

• Non viable wound tissue (slough and/or necrosis). • Lack of healthy granulation tissue (wound tissue may be pale, greyish and avascular). • No reduction in wound size over time. • Recurrent wound breakdown. Numerous molecular and biochemical imbalances are found within the chronic wound environment, including elevated inflammatory cytokines, elevated matrix metalloproteinases (MMPs) and decreased tissue inhibitors of metalloproteinases (TIMPs) 1. The cells within the chronic wound exhibit low mitotic activity, senescence and decreased growth factor activity 1; chronic wounds are often referred to as being ‘stuck’ in the inflammatory or proliferative phases of wound healing 3.