Therapeutic Effect of Silver Nanoparticles in the Management of Diabetic Ulcers: A Systematic Review and Meta-Analysis on RCTs

Aims The skin, as the body's largest organ, plays vital roles in sensory functions, temperature regulation, and protection against pathogens and injuries. Skin wounds, which disrupt its integrity, can result from various factors, including diseases such as diabetes. Diabetic foot ulcers are a severe complication of diabetes, often leading to amputations. This systematic review explores the therapeutic potential of silver nanoparticles in the management of diabetic ulcers.Methods Seven studies published between 2016 and 2023 were included in this review. Also, 4 studies were included in the meta-analysis. These studies investigated the application of silver nanoparticles, primarily in dressing forms, for diabetic ulcer treatment. A systematic search strategy was employed, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed.Results The results show that silver nanoparticles do not have a significant difference in improving DFU healing rates. SilvrSTAT Gel, a dressing containing silver nanoparticles, outperformed traditional dressings, leading to a substantial percentage of ulcers healing within weeks. Comparative studies also indicated that silver nanoparticles were at least as effective as alternative treatments, such as nano-chitosan dressings, and showed potential for combination therapy with growth factors.Discussion This review underscores the promise of silver nanoparticles, a nanotechnology-based approach, in accelerating the healing of diabetic ulcers while providing antimicrobial benefits. Despite some limitations, including variations in treatment regimens and a lack of long-term outcome data, these findings show there is no clinical evidence for using Nanosilver for the healing process of DFU.Conclusion Silver nanoparticles currently do not have sufficient clinical evidence for healing the DFU; however, in some studies, they had noticeable effects on the rate of wound healing.