Clinical Study of Nanofibrillar Cellulose Hydrogel Dressing for Skin Graft Donor Site Treatment

Abstract

Co-last responsibility. Objective: Skin graft donor site management is a concern particularly for elderly patients and patients with poor wound healing competence, and also because donor sites are a source of pain and discomfort. Although different types of dressings exist, there is no consensus regarding optimal dressing type on donor site care to promote healing, reduce pain, and improve patients' comfort. Approach: This prospective, single-center clinical trial evaluated the performance of nanofibrillar cellulose (NFC) wound dressing (FibDex Ò by UPM-Kymmene Corporation) for treatment of donor sites compared with a polylactide-based copolymer dressing. The study enrolled 24 patients requiring skin grafting with mean age of 49-18. The primary outcome measure was wound healing time. Secondary outcomes, the epithelialization, subjective pain, the scar appearance assessed using the Patient and Observer Scar Assessment Scale (POSAS), and skin elasticity and transepidermal water loss (TEWL), were evaluated at 1 and 6 months postoperatively. Results: No statistically significant differences were observed between NFC and copolymer dressings regarding wound healing time, epithelialization, experience of pain, or TEWL. Significant differences were observed in the POSAS results for thickness and vascularity in the Observer score, in the favor of NFC over copolymer dressing. Moreover, skin elasticity was significantly improved with NFC dressing in terms of viscoelasticity and elastic modulus at 1 month postoperatively. Innovation: NFC dressing is a new, green sustainable product for wound treatment without animal or human-origin components. Conclusion: NFC dressing provides efficient wound healing at skin graft donor sites and is comparable or even preferable compared with the copolymer dressing.

Nanofibrillar cellulose wound dressing supports the growth and characteristics of human mesenchymal stem/stromal cells without cell adhesion coatings

“…We have previously shown in a clinical study that NFC wound dressing performs comparably with a commercial wound dressing for the treatment of skin graft donor sites [31]. In the current project, we studied the potential use of NFC dressing as a cell-culturing platform for multipotent hASCs in order to develop cell transplantation method free from animal-derived components for wound care.…”

“…Three different NFC wound dressings, type 1 and 3 NFC dressings and type 4 NFC dressing (FibDex®), were kindly supplied by UPM-Kymmene Corporation (UPM), Finland. All dressings were manufactured from unmodified wood-based NFC as described previously by Hakkarainen et al [29] and Koivuniemi et al [31].…”

“…We have previously shown in a clinical study that NFC-based wound dressing supports the healing of skin graft donor sites [29,31]. In the present study, we evaluated the potential of NFC dressing as the cell scaffold material for hASCs to be used as a cell transplantation method in the future.…”

Bio-Based Electrospun Fibers for Wound Healing

“…In recent years, considerable advances have been achieved in designing modern dressings to protect the wound from dehydration and infection, and facilitate the healing process instead of just covering the wound [3,11,12]. Wound dressings in the form of hydrogels [13][14][15], hydrocolloids [16][17][18], sponges [19][20][21][22], alginates [23][24][25], and transparent films [11] have been developed and some of them are commercially available. These materials are different in their inherent features, such as hydrophobicity, permeability, and adsorption capacity.…”

Effects of nanofibrillated cellulose hydrogels on adipose tissue extract and hepatocellular carcinoma cell spheroids in freeze-drying

“…Native NFC can be further processed into anionic nanofibrillated cellulose (ANFC) for example trough TEMPO [(2,2,6,6-tetramethylpiperidin-1-yl)oxyl] oxidation [45,46]. The suitability of nanofibrillated cellulose in regenerative medicine and in controlled drug delivery has been shown [31][32][33]42]. In addition, ANFC can be freeze-dried and rehydrated without the loss of rheological properties [42].…”