Chronic wounds have a high prevalence and wound care, treatment, and prevention consume large quantities of resources. Chronic wounds are a growing challenge for clinicians. A prospective randomized pilot study was conducted to assess the effectiveness in terms of reduction in area and safety of the combined use of negative-pressure wound therapy and nanocrystalline silver dressings as compared to negative pressure wound therapy (NPWT) alone in the management of outpatients with chronic wounds. A total of 17 patients were included in the study, 10 were treated with the combined method and 7 with NPWT. Patients were followed for 6 weeks, with a final assessment at 3 months. Clinical improvement, microbiologic data, and toxicity of silver were evaluated. The antibacterial effects of ionic silver together with the development of granulation tissue promoted by NPWT reduced significantly the median extension of the wound between weeks 3 and 6 of treatment. The combination with silver also reduced bacterial colonization with Pseudomonas aeruginosa and the bacterial load on the surface of the wound. The silver levels correlated positively with the extension of the wound, although in none of the patients' toxic levels were reached. The combination of NPWT with nanocrystalline silver dressings was safe and as effective as NPWT alone.

Therapeutic measures should be primarily directed to promote healing, but also to improve or at least to maintain HRQoL. This prospective randomized pilot study was conducted to assess the impact on HRQoL of negative pressure wound therapy (NPWT) combined with nanocrystalline silver dressings in outpatients with chronic nonhealing ulcers. A total of 17 patients were included in the study, 10 of which were treated with the combined method and 7 with NPWT only. Patients were followed for 6 weeks. The 36-item short-form (SF-36) questionnaire was administered to at baseline and at the end of treatment. Patients included in the study had multiple concomitant pathological conditions and a mean age of 70 years. Significant changes in different domains of the SF-36 questionnaire, including physical functioning, role limitations (physical), vitality, mental health, social functioning, bodily pain, and general health, before and after treatment were not found. The mean (standard deviation, SD) score of social functioning was 53.1 (31.8) before treatment and 66.3 (23.6) after treatment (P = 0.09). The application of NPWT with nanocrystalline silver dressings or NPWT alone for 6 weeks was effective in wound healing promotion. The impact on HRQoL was non-significant except for somewhat better benefits in the social domain in patients treated with NPWT and silver dressings. The present preliminary data could be the basis for the design of future, more robust clinical studies.