Clinical Potential of a Silk Sericin-Releasing Bioactive Wound Dressing for the Treatment of Split-Thickness Skin Graft Donor Sites (original) (raw)
Related papers
Evidence-Based Complementary and Alternative Medicine, 2015
We developed the novel silk fibroin-based bilayered wound dressing for the treatment of partial thickness wounds. And it showed relevant characteristics and accelerated the healing of full-thickness wounds in a rat model. This study is the clinical evaluation of the bilayered wound dressing to confirm its safety and efficacy for the treatment of split-thickness skin donor sites. The safety test was performed using a patch model and no evidence of marked and severe cutaneous reactions was found. The efficacy test of the bilayered wound dressing was conducted on 23 patients with 30 split-thickness skin graft donor sites to evaluate healing time, pain score, skin barrier function, and systemic reaction in comparison to Bactigras. We found that the healing time of donor site wounds treated with the bilayered wound dressing (11 ± 6 days) was significantly faster than those treated with Bactigras (14 ± 6 days) (p=10-6). The wound sites treated with the bilayered wound dressing showed sign...
Journal of Personalized Medicine
Background: Split-thickness skin grafting (STSG) is a frequently used reconstructive technique, and its donor site represents a standardized clinical model to evaluate wound dressings. We compared hydroactive nanocellulose-based, silver-impregnated and ibuprofen-containing foam wound dressings. Methods: A total of 46 patients scheduled for elective surgery were evaluated on the STSG donor site for wound healing (time-to-healing, Hollander Wound Evaluation Scale), pain level (Visual Analogue Scale), and handling (ease of use), as well as scar quality (Patient Scar Assessment Scale, Vancouver Scar Scale) after 3, 6 and 12 months. Results: Almost all dressings compared equally well. We observed statistically relevant differences for pain level favoring the ibuprofen-containing dressing (p = 0.002, ΔAIC = 8.1), and user friendliness in favor of nanocellulose (dressing removal: p = 0.037, ΔAIC = 2.59; application on patient: p = 0.042, ΔAIC = 2.33; wound adhesion: p = 0.017, ΔAIC = 4.16;...
International Wound Journal, 2014
This study was intended to investigate the healing effect of five different products on split-thickness skin graft (STSG) donor sites and full-thickness cutaneous wounds (FTCWs) using an occlusive dressing model. Six groups were planned, 1 control and 5 experimental groups, with a total of 24 rats, using an occlusive dressing model. STSG donor and FTCWs were established in two separate areas, to the right and left on the animals' backs. Wound sites were dressed with one of the following materials: fine mesh gauze, microporous polysaccharide hemosphere (MPH), clinoptilolite, alginate, hydrogel or biosynthetic wound dressing (Biobran ®. These materials were compared in terms of healing rate, healing quality and histopathological findings. Occlusive dressings were applied for each wound on days 0, 3, 5, 7, 10 and 14. Area measurements were performed with photographs for each dressing. The alginate and clinoptilolite groups gave the best healing rate results for both STSG donor (P = 0•003) and FTCWs (P = 0•003). MPH came third in each group. The alginate group produced better results in terms of healing quality criteria, followed by hydrogel, MPH, clinoptilolite and Biobran ® , in that order. Statistically, significantly successful results were obtained in all groups compared to the control group (P < 0•0007). Rapid and good healing quality for both the STSG donor sites and FTCWs were obtained with alginate. Healing with clinoptilolite and MPH was rapid, but poor quality, while slower but good healing quality was obtained with hydrogel. Slower and worse quality healing was obtained with Biobran ® .
Plast Reconstr Surg, 2011
BACKGROUND: The almost single disadvantage of conventional polyurethane film dressings, uncontrolled leakage, is probably as often described as its numerous advantages for split-thickness skin graft donor sites. This shortcoming can be overcome by perforating the polyurethane dressing, which permits controlled leakage into a secondary absorbent dressing. The study was conducted to compare the polyurethane dressing system and Aquacel, a hydrofiber wound dressing, which also seems to fulfill all criteria of an ideal donor-site dressing. METHODS: This prospective, randomized, double-blind clinical trial included 50 adult patients. Skin graft donor sites were divided equally for the application of Aquacel and polyurethane dressing. The dressings were kept unchanged for 10 days. After removal of the dressing at day 10, the epithelialization rate of both sites was evaluated. Pain scores were assessed according to a 0 to 5 numeric pain scale every postoperative day and during dressing removal. RESULTS: On postoperative day 10, 86.4 percent of the polyurethane dressing donor sites showed complete reepithelialization compared with 54.5 percent of the Aquacel-treated donor sites (p<0.001). Polyurethane dressing was significantly less painful until and during removal of the dressing (p<0.001). There was no significant difference with respect to scar formation. CONCLUSIONS: Overall, polyurethane dressing was superior to Aquacel. Further attributes of the polyurethane dressing such as ease of application, low labor input, high patient comfort, and protection against secondary wound infection qualify this dressing system as an ideal wound covering for donor sites. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.
Burns, 2010
Split-thickness skin grafting (STSG) is a frequently used reconstructive technique but is associated with a large variation regarding the management of the donor site. The aim of this study is to compare five different dressings for management of the STSG donor site in a prospective trial.100 consecutive patients, in whom reconstruction with STSG was performed, were included into the study. The grafts are harvested in a standard manner and the donor sites were dressed with one of the following materials: Aquacel® Ag, Bactigras® with Melolin®, Comfeel® Plus Transparent, Opsite® Flexigrid and Adaptic®. The materials are compared regarding to the time required for complete epithelialization, pain sensed by the patients, incidence of infection, scar formation, ease of application and the cost.The earliest complete epithelialization was observed for Aquacel® Ag and the latest for Bactigras® with Melolin®·Comfeel® Plus Transparent was the most painless dressing and Bactigras® with Melolin® was the most painful. The incidence of infection was highest for Bactigras® with Melolin®·Opsite® Flexigrid was the most economical dressing and Aquacel® Ag was the most expensive one.The aim is to provide the earliest complete epithelialization with minimal patient discomfort and lower cost in management of the STSG donor sites. None of the tested materials were ideal regarding these criteria, but Comfeel® Plus Transparent, as the least painful and one of the most economical materials, may be offered as the dressing of choice among the tested materials.
Hydrogel dressings for donor sites of split-thickness skin grafts
Cochrane Database of Systematic Reviews, 2020
This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the e ects of hydrogel dressings of donor site wounds following split-thickness skin gra s (STSGs) for improving healing.
Journal of Tissue Viability, 2009
The aim of this study was to compare the effectiveness of a hemicellulose dressing with that of rayon dressing in the healing of split-thickness skin graft donor sites. Twenty-eight patients were selected from five different hospitals and randomized into two groups: hemicellulose dressing group and rayon dressing group. All patients underwent split-thickness skin grafting for various reasons, and the skin graft donor site wounds were covered with hemicellulose dressing (n ¼ 14) or rayon dressing (n ¼ 14). The donor site was assessed on postoperative days 1, 7, 14, 21, and 28 for hyperemia, pruritus, pain, exudate level, and adherence of the wound dressing. At the 60-day follow-up visit, the donor site was assessed again for pruritus and pain. Touch-pressure, thermal, and pain sensibility tests were performed preoperatively and on postoperative day 60 together with the assessment of color and texture of the re-epithelialized area. In all patients, re-epithelialization was completed between 14 and 21 days after surgery. There were no significant differences between the two groups with regard to pain, hyperemia, pruritus, exudate, and final appearance (color and texture) of the skin graft donor site. The rayon dressing provided significantly better adherence than the * Corresponding author. Tel.: þ55 11 5576 4118; fax: þ55 11 5571 6579. hemicellulose dressing, and both dressings showed similar results with regard to the parameters evaluated when used in the treatment of split-thickness skin graft donor sites.
International Journal of Pharmaceutics, 2012
Silk sericin has been recently reported for its advantageous biological properties to promote wound healing. In this study, we established that the ethyl alcohol (EtOH) could be used to precipitate sericin and form the stable sericin/polyvinyl alcohol (PVA) scaffolds without the crosslinking. The sericin/PVA scaffolds were fabricated via freeze-drying and subsequently precipitating in various concentrations of EtOH. The EtOH-precipitated sericin/PVA scaffolds showed denser structure, higher compressive modulus, but lower water swelling ability than the non-precipitated scaffolds. Sericin could be released from the EtOHprecipitated sericin/PVA scaffolds in a sustained manner. After cultured with L929 mouse fibroblasts, the 70 vol% EtOH-precipitated sericin/PVA scaffolds showed the highest potential to promote cell proliferation. After applied to the full-thickness wounds of rats, the 70 vol% EtOH-precipitated sericin/PVA scaffolds showed significantly higher percentage of wound size reduction and higher extent of type III collagen formation and epithelialization, compared with the control scaffolds without sericin. The accelerated wound healing by the 70 vol% EtOH-precipitated sericin/PVA scaffolds was possibly due to (1) the bioactivity of sericin itself to promote wound healing, (2) the sustained release of precipitated sericin from the scaffolds, and (3) the activation and recruitment of wound healing-macrophages by sericin to the wounds. This finding suggested that the EtOH-precipitated sericin/PVA scaffolds were more effective for the wound healing, comparing with the EtOH-precipitated PVA scaffolds without sericin.
2014
The gold standard with regards to skin transplantation is the use of the patient’s own skin obtained from a healthy donor site. Such grafts can be either full thickness skin or more commonly nowadays, split thickness skin. Various materials, having either natural and or synthetic origins, have been used in the engineering of skin substitutes to-date and these grafts are then confronted against autologous skin grafts. If proven to be successful, such matrices could be utilised in clinical applications such as in the treatment of burn wounds and in cases of skin ulcers amongst others. In this study the primary cells used, keratinocytes and fibroblast, were obtained from donor skin and cultured. Scaffolds of xenogenic (raw silk) as well as of allogenic (acellular dermal matrices) origins were obtained via low-cost methods and seeded using the fibroblasts and keratinocytes so as to determine which gave the closest mimic to skin grafts. Out of the matrices assessed, the raw silk matrix a...