Application of chitosan-based wound coatings ‘ChitoPran’ in the treatment of patients with burn trauma

Abstract

Introduction The analysis of clinical experience for using biodegradable wound coating based on «HitoPran» chitosan in treatment of patients with burn trauma is presented.Background Our work included an analysis of clinical experience for using a biodegradable wound coating based on «HitoPran» chitosan for surgical treatment in patients with local and common thermal burns.Material and Methods A treatment analysis was conducted in 46 male and female patients, aged from 1 to 63 years with thermal burns on an area of 5 to 56% of the body surface. All injured were given surgical treatment in the complex with the use of low-temperature air plasma of arc discharge with atmospheric pressure in the conditions of our burn center in 2017-2018. Depending on the area and depth of the lesion, the patients were divided into two clinical groups: with local burns of II degree and area to 5% of the body surface and common burns of II and III degree and body surface 10% and more. In the course of early surgical treatment in patients with local border burns, the use of the wound coating «HitoPran» allows to achieve spontaneous epithelialization of wounds in dry environment after dermabrasion or escharotomy within the surface layers of dermis due to chitosan adhesion to the wound bottom, to reduce the number of dressings in the postoperative period. Covering skin grafts with perforation index 1:4 and 1:6 with wound «ChitoPran» coating in case of autodermoplasty in deep burn wounds provides satisfactory cellular epithelialization, reduces risk of regression of grafts, reduces consumption of wound coating and dressing material.Conclusion Application of Russian modern biodegradable coatings based on «HitoPran» chitosan in complex treatment in patients with local and common burns with different depth allows to optimize local treatment of burn injuries, as well as to reduce the cost of used dressing material in comparison with foreign alternatives.

Comparative Morphological Characteristics of the Results of Implantation of Decellularized and Recellularized Porcine Skin Scaffolds

“…By day 12, DDM became dry and dense and freely detached from the wound surface, which required excision of the scar tissue formed under DDM and autodermoplasty on day 20 to close the wound defect. Similar changes, according to clinical observations, occur in burn patients when using temporary wound dressings [2].…”

Principles for the use of modern wound dressings for local treatment of limited borderline burns

“…Следовательно, необходимо применение раневых покрытий с совершенно иными свойствами -прежде всего обеспечивающими щелочную среду в ране и определенный микроклимат. Все больший интерес вызывает сульфатированный хитозан -главным образом из-за структурного сходства с гепарином [40,41], а также благодаря его совместимости с биологически активными веществами [42].…”

Comparative evaluation of lethal outcome prediction methods in severely burned patients

“…Some methods used in practice include the physical parameters of patients being treated in the intensive care unit, excluding the pathogenesis and state of burn injury, previous surgical treatment (VAC therapy, wound dressings, cellular technologies) that improve the outcome of treatment [8,9]. Despite the ease of use and the maximum prevalence of existing models, the assessment of the outcome in each of them is questionable, since the emphasis in different indices is on different indicators, avoiding the overall clinical picture of the disease [10][11][12].…”