Frequently Asked Questions
In some articles, it states not to get the silver nitrate on the PD catheter as it may damage the catheter. Other articles say it is not harmful. The PD catheters that we are using are made of translucent silicone rubber containing a radiopaque stripe. Do you have any information related to this?
As far as we know, silver nitrate will not damage a catheter nor radiopaque strips but it can stain them. It is not absorbed by, and does not affect, nonabsorbent surfaces such as stainless steel and glass. Slightly absorbent materials like plastic will therefore be stained after contact with silver nitrate but not harmed by it. Such a stain on a radiopaque strip should not affect the opacity of the strip to x-rays.
The instructions on the sticks say to moisten and then apply. Some of the nurses who have been using these sticks tell me that they do not have to moisten first as the area is also moist. Any comments related to this?
If there is sufficient body fluid already on the surface to be treated, there is no need to moisten the tip. The applicators are designed to be used in blood or mucous and in otherwise inaccessible body orifices (nose, mouth etc) without the addition of water. Saline solution (or water containing salt) should never be used because salt neutralises silver nitrate and stops the action of silver nitrate.
I have seen that 2-3 times per week application is recommended. Our patients are not seen that frequently in clinic so is it equally effective if only applied weekly? Eg weekly x 3 weeks vs 3 x/week for 1 week
This depends on the condition being treated and the judgement of the medical professional supervising the patient. Please consult the medical professional concerned.
After treatment, I noticed blood on the area treated. What should I do?
Silver nitrate contact with a small open wound in skin may cause stinging for a few seconds or minutes. It is important to make sure a solid piece of silver nitrate has not broken away from the pencil or applicator and become lodged in a wound or anywhere else. Pencil and applicator points are brittle and easily broken if force is used. Stinging suggests silver nitrate is still active which can be neutralised by flushing with saline. Contact with saline solution will prevent silver nitrate having any further effect.
If bleeding occurs during treatment, the wound should be allowed to dry. If bleeding continues after treatment, the blood flow could move active silver nitrate to other skin or clothing which could be stained.
Silver nitrate should not come into contact with eyes.
Silver nitrate stains on normal skin will disappear in a day or two through the normal process of exfoliation.
I would like to know the amount of silver nitrate released by the applicator with each application.
Up to an average maximum of 22.5mg from a standard 30mg applicator tip of strength 75% w/w silver nitrate. Silver nitrate can be released from the applicator by dissolving some of the tip in either water or available body fluid. The longer the tip is held in fluid, the more silver nitrate is released up to the maximum. In practice, only a small proportion of the 22.5mg makes contact with living tissue because a lot of the tip is unused and, if dissolved in water, much of the water holding silver nitrate is thrown away.