Yiyao Du, Jianyu Lu, Xinya Guo, Zhaofan Xia, Shizhao Ji
The urgent need for silver-based antibacterial agents in clinical settings has driven the diversification of their delivery systems, evolving from traditional silver salt preparations to new silver nanoparticles (AgNPs) and silver-based composite functional materials. Research and application of various carrier systems have established a solid foundation for the clinical translation of silver. However, it is important to recognize that the clinical use of silver-based materials still faces several key challenges: one is the potential risk of cytotoxicity, another is the growing trend of bacterial resistance to silver, and the third is the heterogeneity of antibacterial properties in different wound microenvironments. Additionally, this study thoroughly examines the significant gap between basic research and clinical application of silver-based materials, highlighting that the lack of standardized clinical endpoint indicators and high-quality clinical research evidence are the main barriers to its standardized use. Future research should focus on four key areas: developing precise targeted delivery systems, creating combined treatments with silver and other antibacterial agents, enhancing biosafety through material engineering, and establishing a unified framework for clinical efficacy evaluation. Through systematic innovation and evidence-based clinical implementation, silver-based technologies hold broad potential and significant clinical value for addressing complex wound infections and alleviating the global antibiotic resistance crisis.