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

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.

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

“…Therefore, we do not know, if both dressings had an analgesic effect. Nevertheless, epicite hydro showed similar pain scores compared with SUPRATHEL, which is in accordance with results found in previous studies 7,8,32 …”

“…They treated 18 patients with superficial burn injuries with a mean TBSA of 8.2%. The median healing time was 28 days (13‐80 days), which is appreciably higher than the time for final closure in the epicite hydro treated wounds in the current study (16.1 days) 7 . Karlsson et al also reported patients who described that the cellulose got “stiff” over their joints 7 .…”

“…One such alternative dressing is epicite hydro (QRSKIN GmbH, Würzburg, Germany), which consists of biotechnologically generated bacterial nanocellulose (BNC) synthesised by Komagataeibacter xylinus and 95% water 15,16 . The high amount of water incorporated in the cellulose reduces the intradermal temperature, wound progression, and pain through an evaporative cooling effect 17 and is loadable with antiseptic substances 7,16,18‐21 …”

2 - Treatment of 2a-b degree burns of the face with a alloplastic nanocellulose-based epidermal substitute ( epicite hydro)

“…• Frequent dressing changes leading to increased length of stay/ outpatient visits • Increased cost • In some cases increased pain and stress to the patient. [2] To address these issues a literature review of EPIPROTECT was undertaken and there were common phenomenon's found; reduction in pain , reduced dressing changes and a decreased length in hospital stays [1,2,]. EPIPROTECT is also not associated with any ethical or cultural issues due to its biosynthetic nature [ 1,2 ] and has been proven to be cost effective.…”

“…[2] To address these issues a literature review of EPIPROTECT was undertaken and there were common phenomenon's found; reduction in pain , reduced dressing changes and a decreased length in hospital stays [1,2,]. EPIPROTECT is also not associated with any ethical or cultural issues due to its biosynthetic nature [ 1,2 ] and has been proven to be cost effective. [3] For this case series we decided to target patients who had sustained superficial partial thickness burns with a focus on facial and hand injuries.…”