Three Years' Experience of a Novel Biosynthetic Cellulose Dressing in Burns.

Matilda Karlsson,Folke Sjöberg,Ingrid Steinvall,Johan Thorfinn,Moustafa Elmasry,Pia Olofsson

doi:10.1089/wound.2018.0790

Matilda Karlsson, Folke Sjöberg + Show 4 more

Open Access

https://doi.org/10.1089/wound.2018.0790

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Abstract

Objective: The use of porcine xenograft (PX) is widely spread in burn care. However, it may cause immunologic responses and other ethical and cultural considerations in different cultures. Therefore, there is a need for alternatives. The aim of this work is to test a novel biosynthetic cellulose dressing (Epiprotect®) on burn patients.Approach: Charts from 38 patients with superficial burns (SBs) (n = 18) or excised burns (n = 20) that got biosynthetic cellulose dressing instead of PX at a national burn center during 3 years were reviewed. Time to healing, length of stay, and wound infection were extracted from the medical records.Results: SBs hospitalization time was 11 days comparable to PXs reported by others. In the excised group, median duration of hospital stay was 35 days. Time to healing was 28 days. Seven wound infections were confirmed in the superficial group (39%) and 11 infections in the excised group (61%). Patients with superficial wounds reported pain relief on application.Innovation: A dressing (17 × 21 cm) consisting of biosynthetic cellulose replacing PX.Conclusion: Outcome of treatment of SBs or temporary coverage of excised deep burns with biosynthetic cellulose is comparable to treatment with PX. However, biosynthetic cellulose has benefits such as providing pain relief on application and ethical or cultural issues with the material is nonexistent.

Highlights

In our burn center, biological membranous dressings, such as porcine xenografts (PXs), play an essential role in burn care either as temporary wound coverage or as a dressing for conservatively treated superficial wounds
In 18 patients, the biosynthetic cellulose was applied on a superficial wound bed that was cleaned but not excised (SB group) (Fig. 1)
The data reported in this retrospective case series show the potential of biosynthetic cellulose (EpiprotectÒ) for acute burns

Summary

Introduction

Biological membranous dressings, such as porcine xenografts (PXs), play an essential role in burn care either as temporary wound coverage or as a dressing for conservatively treated superficial wounds. In temporary covering, they serve as an effective option for wound protection in situations where the placement of autograft needs to be delayed such as unstable patient, lack of donor sites, heavily infected wounds, or awaiting demarcation. The biological dressing aims to protect the wound during healing by keeping a moist wound environment and posing a barrier against infection.[1,2] it has been reported that PXs may prevent heat-, fluid- and protein loss.[3,4,5].

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