523 Silkworm Silk as an Alternative to Two Common Epidermal Substitutes for the Treatment of Acute Superficial Burns

Abstract

Abstract Introduction During the treatment of superficial burn injuries patients are often confronted with painful dressing changes. Therefore we usually treat these wounds with materials that can stay on the wound and slowly peel off during re-epithelialization. Since 2013 we started using pure silk as cost efficient alternative for the treatment of these wounds. Therefore we wanted to compare it directly with the other dressings. Methods In a prospective intra-individual design we evaluated the wound healing of 50 patients with superficial burn injuries. Hereof 30 patients received both silk and Nylon mesh with collagen and 20 further patients received silk and a synthetic epidermal substitute for the treatment of their burn injuries. Following a standardized case report form, we monitored pain, active bleeding, exudation, dressing change and inflammation. Furthermore we evaluated scar quality objectively with the Cutometer, Mexameter and Tewameter as well as subjectively with the patient and observer scar scale (POSAS) and the Vancouver scar scale (VSS). Results During wound healing no significant differences could be found regarding wound closure, inflammation and acute bleeding. Pain levels fell fast during after dressing application and during wound healing. Long-term results in functional and aesthetic outcome were similar. High satisfaction rates were reported for all dressings, with different individual preferences. Conclusions All three dressings provided a safe and effective healing environment, with low complication rates in regard to infection and exudation. Additionally, no significant differences regarding scarring could be found with an overall pleasing aesthetic outcome. Applicability of Research to Practice Silkworm silk is now the standard of care in our clinic for superficial burns.