Nanosilver dressing use was associated with greater 12-week complete healing and shorter time to closure in this matched tertiary-care cohort; prospective multicenter validation is required.
Key Findings
Results
Nanosilver dressings were associated with significantly higher rates of complete wound healing at 12 weeks compared to alginate dressings in propensity score-matched diabetic foot ulcer patients.
Complete healing occurred in 87 of 115 patients (75.7%) receiving nanosilver versus 65 of 115 (56.5%) receiving alginate dressings.
Matched odds ratio was 2.47 (95% CI, 1.32–4.84; P = 0.003).
Matched relative risk was 1.34 (95% CI, 1.11–1.62).
The study used 1:1 propensity-score matching generating 115 matched pairs from an unmatched cohort of 361 patients (121 nanosilver, 240 alginate).
Results
Nanosilver dressings were associated with faster early wound-area reduction, with more patients achieving at least 50% wound-area reduction by week 4.
At least 50% wound-area reduction at week 4 occurred in 82.6% of nanosilver-treated patients versus 67.0% of alginate-treated patients.
Matched OR was 2.80 (95% CI, 1.32–6.46; Holm-adjusted P = 0.015).
This outcome was classified as a secondary/exploratory endpoint.
Results
Median time to complete healing was shorter in the nanosilver group compared to the alginate group.
Median time to complete healing was 45 days for nanosilver versus 58 days for alginate dressings.
Hazard ratio for time to complete healing was 1.58 (95% CI, 1.22–2.05; Holm-adjusted P < 0.004).
This outcome was a secondary exploratory endpoint.
Results
The primary association between nanosilver dressings and complete healing remained consistent in sensitivity analyses accounting for measured confounding.
In the extended measured-confounding sensitivity analysis, the adjusted OR was 2.31 (95% CI, 1.17–4.56).
The similarity between the primary matched OR (2.47) and the sensitivity-adjusted OR (2.31) suggests robustness of the association to additional covariate adjustment.
The study was a single-center retrospective cohort conducted between January 2020 and December 2023.
Methods
The study screened 393 patients, of whom 361 formed the unmatched cohort treated within a multidisciplinary diabetic-foot program.
393 patients were screened; 361 formed the unmatched cohort.
The unmatched cohort included 121 patients treated with nanosilver and 240 with alginate dressings.
Propensity-score matching produced 115 matched pairs for the primary analysis.
The study was conducted at a single tertiary-care center.
Results
Other clinical and safety outcomes beyond the primary healing endpoint were characterized as exploratory rather than confirmatory.
The single primary endpoint was complete wound healing at week 12.
Secondary outcomes including early wound-area reduction and time to healing were described as exploratory.
Safety outcomes were also classified as exploratory.
The authors noted that prospective multicenter validation is required.
What This Means
This research suggests that nanosilver wound dressings may help diabetic foot ulcers heal faster and more completely than alginate dressings, which are a commonly used alternative. The study looked back at records from 361 patients treated at a single hospital between 2020 and 2023. To make a fair comparison, the researchers used a statistical technique called propensity score matching to create two groups of 115 patients each that were similar in key characteristics. In the nanosilver group, about 76% of patients had their wounds fully healed by 12 weeks, compared to about 57% in the alginate group. Patients using nanosilver dressings also showed faster early progress — more of them had their wound size cut in half within the first four weeks — and their wounds fully closed about two weeks sooner on average (45 days versus 58 days).
Diabetic foot ulcers are a serious and common complication of diabetes that can lead to infections, hospitalizations, and in severe cases, amputations. Finding dressings that promote faster healing is clinically important because longer-lasting wounds carry higher risks of complications. Nanosilver dressings contain tiny silver particles believed to have antimicrobial properties that may help control infection and support wound healing. This research suggests nanosilver dressings could offer a meaningful advantage over alginate dressings in this setting.
However, the authors emphasize important limitations: this was a retrospective (looking backward) study at a single center, which means it cannot definitively prove that nanosilver caused better healing — only that there was an association. Unmeasured differences between patient groups could still influence the results. The authors call for prospective, multicenter clinical trials to confirm these findings before broader clinical recommendations can be made.
Liu Z, Sun H. (2026). Nanosilver Dressings and 12-Week Healing in Diabetic Foot Ulcers: A Retrospective Propensity Score-Matched Study.. Journal of visualized experiments : JoVE. https://doi.org/10.3791/73306