Feasibility of Pure Silk for the Treatment of Large Superficial Burn Wounds Covering Over 10% of the Total Body Surface

Abstract

Large, superficial burn wounds require many painful dressing changes and, thus, dressings that can stay on the wound and peel off during re-epithelization such as Biobrane® and Suprathel® are preferred, but they are costly. Natural silk has shown good outcomes with respect to wound healing, scarring, and patient satisfaction. This study aimed to evaluate the efficacy of natural silk compared with that of initially used dressings for the treatment of superficial burn wounds greater than 10% of the TBSA. Patients with superficial burns covering >10% of the TBSA were treated with pure silk for the first time (treatment group). Complications during wound healing with respect to the need for further surgery and scarring were compared with those of patients with similar burns of more than 10% TBSA and treated with nylon mesh and collagen instead of silk (treatment group). The treatment and control group comprised 25 and 13 patients, respectively. In total, 88% of patients in the treatment group did not require further treatment, while two patients with chemical burns needed further surgeries. Moreover, patients reported high satisfaction with respect to scarring and aesthetic outcome. Meanwhile, 85% of patients in the control group healed without further surgery and showed higher median hypopigmentation and hyperpigmentation after 12 months. Silk is an effective wound dressing for the treatment of large superficial burn wounds. It avoids painful dressing changes and yields satisfactory aesthetic outcomes. However, especially in large burns, careful initial wound depth assessment is crucial to prevent infection and reoperations.

Impact of silk hydrogel secondary structure on hydrogel formation, silk leaching and in vitro response

“…A small ongoing clinical trial (NCT04085822) sponsored by Silk Medical Aesthetics Inc (Medford, MA, USA) is examining the use of this technology to improve aesthetic and the results are eagerly awaited. Small-scale clinical trials using fibroin formulated as silk films 15 , sponges 16 and knitted scaffolds 17 , 18 have also shown favourable outcomes for both wound repair and aesthetics. This work is now being complemented by preclinical studies.…”

Comparison of wound healing and patient comfort in partial‐thickness burn wounds treated with SUPRATHEL and epictehydro wound dressings

“…[8][9][10][11] Nowadays, cost-effectiveness also plays a central role in the selection of suitable wound treatment products. 5,6 Among the wide variety of available dressings, the synthetic dressing SUPRATHEL (PolyMedics Innovations GmbH, Denkendorf, Germany) has shown good usability and effectiveness in the treatment of partial-thickness burn injuries 6,[11][12][13][14] and has been compared with a number of different wound dressings in the past. Schwarze et al compared SUPRATHEL with Omniderm (Omikron Scientific Ltd., Rehovot, Israel), a transparent, hydrophilic, polyurethane membrane, and found no significant difference in healing time but observed a significant reduction in pain scores and increased patient comfort in burn wounds treated with SUPRATHEL.…”

“…2 , 3 , 4 The optimal wound dressing protects the wound against infection, has good biocompatibility, maintains a moist wound environment, and accelerates wound healing. 5 , 6 , 7 , 8 Furthermore, pain reduction during wound healing and decreased scar formation are important criteria for selecting an ideal wound dressing. 8 , 9 , 10 , 11 Nowadays, cost‐effectiveness also plays a central role in the selection of suitable wound treatment products.…”

“… 8 , 9 , 10 , 11 Nowadays, cost‐effectiveness also plays a central role in the selection of suitable wound treatment products. 5 , 6 …”

Made in Germany: A Quality Indicator Not Only in the Automobile Industry But Also When It Comes to Skin Replacement: How an Automobile Textile Research Institute Developed a New Skin Substitute

“…In the European consensus update, it was declared as appropriate, and in the Spanish consensus [107][108][109], it was declared as a most appropriate dressing material after E.D. in different publications [107][108][109][110][111][112]. Due to the increased effusion after E.D., a prolonged after soaking period of 5-8 h is indicated [112].…”