 Ionic silver dressing. Silver, in its common ionic active form Ag, is particularly attractive as an antibacterial agent because it can be readily incorporated into dressing materials. When the materials contact an aqueous environment, the silver complex contained in them is dissociated Ovington 2004, White Cutting 2006. The mechanism of action for Ag is that it binds to bacterial cell DNA, and enzymes, and proteins in the cell wall. Once the silver cation attaches to these sites, it alters their structure, resulting in structural and functional changes in the bacterial cell Ovington 2004.It is suggested by numerous authors that silver dressings should be utilized when critical colonization within a wound occurs Ovington 2004, White Cutting 2006, Lo et al 2008. Therefore, this study research questions is 1What are the effects of ionic silver dressing AQUACEL Agin head and neck patients with malignant fungating wound, as compared to hydrofiber dressingAQUACEL, on the individual perception subjective quality of life?2 What are the effects of ionic silver dressing AQUACEL Ag in head and neck patients with malignant fungating wound, as compared to hydrofiber dressing AQUACEL alone, on the symptom distress and wound bed changed of patients receiving ionic silver dressing AQUACEL Ag for cancer patients? 