Medicine

Silver ions and silver compounds show a toxic effect on some bacteria, viruses, algae and fungi, typical for heavy metals like lead or mercury, but without the high toxicity to humans that are normally associated with these other metals. Its germicidal effects kill many microbial organisms in vitro, but testing and standardization of silver products is difficult.[17] Hippocrates, the father of modern medicine, wrote that silver had beneficial healing and anti-disease properties, and the Phoenicians used to store water, wine, and vinegar in silver bottles to prevent spoiling. In the early 1900s people would put silver dollars in milk bottles to prolong the milk's freshness.[18] Its germicidal effects increase its value in utensils and as jewellery. The exact process of silver's germicidal effect is still not well understood, although theories exist. One of these is the oligodynamic effect, which explains the effect on microorganisms but would not explain antiviral effects. Silver compounds were used to prevent infection in World War I before the advent of antibiotics. Silver nitrate solution was a standard of care but was largely replaced by silver sulfadiazine cream (SSD Cream),[19] which was generally the "standard of care" for the antibacterial and antibiotic treatment of serious burns until the late 1990s.[20] Now, other options, such as silver-coated dressings (activated silver dressings), are used in addition to SSD cream. However, the evidence for the effectiveness of such silver-treated dressings is mixed and although the evidence is promising it is marred by the poor quality of the trials used to assess these products.[21] Consequently a major systematic review by the Cochrane Collaboration found insufficient evidence to recommend the use of silver-treated dressings to treat infected wounds.[21] The widespread use of silver went out of fashion with the development of modern antibiotics. However, recently there has been renewed interest in silver as a broad-spectrum antimicrobial. In particular, silver is being used with alginate, a naturally occurring biopolymer derived from seaweed, in a range of products designed to prevent infections as part of wound management procedures, particularly applicable to burn victims.[22] In 2007, AGC Flat Glass Europe introduced the first antibacterial glass to fight hospital-caught infection: it is covered with a thin layer of silver.[23] In addition, the U.S. Food and Drug Administration (FDA) has recently approved an endotracheal breathing tube with a fine coat of silver for use in mechanical ventilation, after studies found it reduced the risk of ventilator-associated pneumonia.[24] It has long been known that antibacterial action of silver is enhanced by the presence of an electric field. Applying a few volts of electricity across silver electrodes drastically enhances the rate that bacteria in solution are killed. It was found recently that the antibacterial action of silver electrodes is greatly improved if the electrodes are covered with silver nanorods.[25] [edit] Medication Today, various kinds of silver compounds, or devices to make solutions or colloids containing silver, are sold as remedies for a wide variety of diseases. Although most colloidal silver preparations are harmless, some people using these home-made solutions excessively have developed argyria over a period of months or years.[26] High doses of colloidal silver can result in coma, pleural edema, and hemolysis.[27] Silver is widely used in topical gels and impregnated into bandages because of its wide-spectrum antimicrobial activity. The anti-microbial properties of silver stem from the chemical properties of its ionized form, Ag+. This ion forms strong molecular bonds with other substances used by bacteria to respire, such as molecules containing sulfur, nitrogen, and oxygen.[28] Once the Ag+ ion complexes with these molecules, they are rendered unusable by the bacteria, depriving it of necessary compounds and eventually leading to the bacteria's death. [edit] Food Silver is now considered to be a bioaccumulating carcinogen and thus its use in food is not advised.[citation needed] In India and Pakistan, foods, especially sweets, can be found decorated with a thin layer of silver known as vark. Silver as a food additive is given the E number E174 and is classed as a food coloring. It is used solely for external decoration, such as on chocolate confectionery, in the covering of dragées and the decoration of sugar-coated flour confectionery. In Australia, it is banned as a food additive. [edit] Clothing Silver inhibits the growth of bacteria and fungi. It keeps odor to a minimum and reduces the risk of bacterial and fungal infection. In clothing, the combination of silver and moisture movement (wicking) may help to reduce the harmful effects of prolonged use in active and humid conditions. Silver is used in clothing in two main forms: A form in which silver ions are integrated into the polymer from which yarns are made (a form of nanotechnology) A form in which the silver is coated onto the yarns. In both cases the silver prevents the growth of a broad spectrum of bacteria and fungi. Recorded use of silver to prevent infection dates to ancient Greece and Rome, it was rediscovered in the Middle Ages, where it was used for several purposes, such as to disinfect water and food during storage, and also for the treatment of burns and wounds as wound dressing. In the 19th century, sailors on long ocean voyages would put silver coins in barrels of water and wine to keep the liquid pure. Pioneers in America used the same idea as they made their journey from coast to coast. Silver solutions were approved in the 1920s by the US Food and Drug Administration for use as antibacterial agents. Today, wound dressings containing silver are well established for clinical wound care and have recently been introduced in consumer products such as sticking plasters.[29]