Wounds International, Vol 1, Issue 5Product reviewsProduct focus: Reduced cellular toxicity and clinical performance of Atrauman® Ag

Product focus: Reduced cellular toxicity and clinical performance of Atrauman® Ag

15/11/10 | Complex wounds, Infection, Skin integrity, Wellbeing and concordance | David Gray

Product focus: Reduced cellular toxicity and clinical performance of Atrauman® AgThere is currently a wide range of silver-containing dressings available for the treatment of critically colonised and infected wounds. As released silver ions are known to be cytotoxic to human cells, the ideal antimicrobial dressing should balance sustained antimicrobial activity against cytotoxicity. It will also have other desirable features such as minimising trauma on application and removal, and conformability to the wound bed. Atrauman® Ag (Hartmann) non-adherent primary contact wound dressing is one such dressing. Its properties and their supporting evidence will be detailed in this article.


Silver is well known for its antimicrobial properties and there are now several silver-containing dressings available for the topical management of patients with critically colonised and infected wounds.  

This availability is encouraging a wider application of silver-containing dressings in acute and chronic wounds, and now they are used extensively for wound management, particularly in burn wounds[1,2], chronic leg ulcers[3], diabetic wounds[4] and traumatic injuries.

The extensive use of silver dressings is reflected in the increased NHS expenditure; £25 million or a quarter of the total cost of all dressings in 2006/7 was spent on silver-containing wound dressings[5].

This recent renewed interest possibly arises from advances in impregnation techniques and polymer technologies, coupled with the increase in prevalence of bacterial resistance to antibiotics.

The dressings available vary widely in structure, formulation and concentration of silver used. The carrier dressing component can also differ, and may be made from a variety of materials including nylon, mesh, hydrocolloid or methylcellulose.

The increased use of silver-containing dressings is largely attributed to their bactericidal efficacy at low concentration, and their relatively limited toxicity to human cells. However, efficacy and toxicity can vary between dressings and this should be considered when selecting a product.

The ideal silver-containing dressing should release as many silver ions into the environment as are necessary to produce an effective bactericidal action, while having limited cell toxicity[6,7]. It should also:

  • Have sustained antimicrobial activity
  • Provide a moist wound healing environment
  • Allow consistent delivery over the entire surface area of the wound
  • Allow monitoring of the wound with minimum interference
  • Manage exudate if appropriate
  • Be comfortable during wear time
  • Conform to the wound bed
  • Provide an effective microbial barrier
  • Absorb and retain bacteria
  • Avoid wound trauma on removal[8].

Atrauman® Ag (Hartmann) is a silver-containing dressing that has these key attributes and is used for the atraumatic treatment of colonised and critically colonised wounds.