Abstract

Chronic venous ulcers (CVU) of the lower limbs (LL) are common and cause psychological changes and significant social impact, as they make the patient susceptible to pain, absence from work and social bonds. Some materials are suggested as dressings for the treatment of CVU, but they are expensive and are generally not available for use in public health services. To evaluate the efficacy of the treatment for lower limbs (LL) chronic venous ulcer (CVU) using bacterial cellulose (BC), gel and multi-perforated film associated. A randomized controlled clinical-intervention study was performed among participants with LL CVU, divided into two groups: experimental (EG), treated with BC wound dressing and control (CG), treated with a cellulose acetate mesh impregnated with essential fatty acids (Rayon®). The participants were followed for 180 days, evaluated according to the MEASURE methodology. Thirty-nine patients were treated, 20 from the EG and 19 from the CG. In both groups, the wound area decreased significantly (p < 0.001), the healing rate was similar to the CG. The mean number of dressing changes in the SG was 18.33 ± 11.78, while in the CG it was 55.24 ± 25.81, p < 0.001. The healing dressing of bacterial cellulose, gel and associated film, when stimulating the epithelization of the lesions, showed a significant reduction in the initial area, with a percentage of cure similar to the Rayon® coverage. In addition to requiring less direct manipulation of ulcers.

Highlights

  • The treatment of chronic venous ulcers (CVU) is a challenge to health professionals [1]

  • Thirty-nine individuals with lower limbs (LL) Chronic Venous Ulcer (CVU) were submitted to intervention, being randomly allocated into two groups: experimental (EG) with 20 patients treated with Bacterial Cellulose (BC), gel and multi-perforated film associated (Fig. 1A, B) and control (CG) with 19 patients, treated with dressings made of a cellulose acetate mesh impregnated with essential fatty acids (RAYON®) (Fig. 1C)

  • For the treatment of comorbidities, most patients reported using antihypertensive pills (61.5%), oral hypoglycemic agents (15.4%) and medicines used for the treatment of Chronic Venous Insufficiency (CVI) 20.5%, being the distribution similar between the groups (p > 0.05), (Table 1)

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Summary

Introduction

The treatment of chronic venous ulcers (CVU) is a challenge to health professionals [1]. The high cost associated with its treatment does not reflect the effective cure of the disease, this can be explained by the absence of a therapeutic standardization [5]. Health professionals are responsible for choosing and evaluating the adequate dressing for CVU’s treatment [1]. Journal of Materials Science: Materials in Medicine (2021) 32:79 This choice is based on clinical characteristics of the ulcer, efficacy of the material, cost-benefit, practicality and availability of resources [1, 6, 7]. In this scenario, bioengineering gains space by associating the use of biomaterials, cell culture and growth factors in the production of instruments aimed at curing skin lesions [8]. Bacterial Cellulose (BC), a biomaterial produced from biotechnological synthesis, has gained prominence by achieving promising results when used as a dressing and biological graft [9, 10]

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