Silver is widely used in wound dressings and medical devices to control pathogenic infections which are recognised as causes of impaired healing, functional defects in orthopaedic fixation pins and patient distress. This review discusses new approaches and advances in silver technology in controlling infections associated with wound sutures, insertion points and in-dwelling catheters, gastonomy tubes and orthopaedic fixation pins. The author discusses silver-coated and silvercontaining sutures and considers efficacy, safety in use and the possibility of silver resistance.