Non-healing wounds are a significant burden to healthcare systems, where it is estimated that 4-5% of the adult population has a problem wound at any one time (Guest et al, 2017). The development of wound infection can have potentially serious complications for patients. As well as delaying healing, wounds can rapidly deteriorate and, if left untreated, patients are at risk of septicaemia and death (Newton, 2010).

Accurate wound assessment is essential to detect early changes within the wound, surrounding skin, which may indicate a rise in bacterial levels. Infection is apparent when the sum of bacterial load and the virulence factors the bacteria produce are greater than the host’s immune defences, resulting in harm to the host. These are seen as the classic signs of infection (Swanson et al, 2014).

Topical antimicrobial silver has been used for hundreds of years in wound care. Topical antiseptics, such as silver, differ from antibiotics as they have multiple sites of antimicrobial action on target cells and therefore a low risk of bacterial resistance (Wounds International, 2012).

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