I.  Introduction

With the improved resuscitation measures for burns developed in the 1960’s, infection became the predominant cause of morbidity and mortality.  Recognizing the potency of silver as an antimicrobial, Dr. Carl Moyer in 1965 introduced the use of a 0.5% silver nitrate solution for burn wound management.  The silver nitrate was a more stable compound and replaced colloidal silver.  During the same time period Dr. Charles Fox⁽⁷⁾ developed another silver compound for burns, silver sulfadiazine.  The sulfadiazine is  composed of propylene glycol, stearyl alcohol and iso propanolol.  This compound was formulated as a water soluble cream to be applied once or twice a day to the wound surface instead of a continuous soak required of silver nitrate for continued silver delivery.  Over the past 40 years silver sulfadiazine has become the most popular silver delivery system and antimicrobial for burns. 

Recent major nano-technological advances have resulted in the ability to crystallize silver in a nanocrystal form, which can release pure silver onto a wound surface in large quantities, using a stable delivery system.  

The new nanocrystalization technique for silver developed by Dr. Robert Burrell⁽⁸⁾ has led to an extremely effective pure silver ion delivery system to the burn wound (Acticoat).  This delivery system markedly increases the rate of pure silver ion release onto a wound surface, compared to any previous silver crystal delivery system.  This approach to providing silver is a major advance in burn wound care for a number of reasons, which will be described.