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Inflammatory reaction, clinical efficacy, and safety of bacterial cellulose wound dressing containing silk sericin and polyhexamethylene biguanide for wound treatment

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Abstract

Bacterial cellulose wound dressings containing silk sericin and PHMB (BCSP) were developed in our previous studies. It had good physical properties, efficacy, and safety. For further use as a medical material, this dressing was investigated for its efficacy and safety in split-thickness skin graft (STSG) donor-site wound treatment compared to Bactigras® (control). Moreover, the inflammatory responses to both dressings were also deeply investigated. For in vivo study, expressions of anti-inflammatory cytokines were intensely considered in the tissue interfacing area. The result showed that IL-4 and TGF-β from BCSP-treated tissue had advantages over Bactigras®-treated tissue at 14 and 21 days post-implantation. For clinical study, a single-blinded, randomized controlled study was generated. The half of STSG donor site wound was randomly assigned to cover with BCSP or Bactigras®. Twenty-one patients with 32 STSG donor site wounds were enrolled. The results showed that wound-healing time was not significantly different in both dressings. However, wound quality of BCSP was better than Bactigras® at healing time and after 1 month (p < 0.05). The pain scores of BCSP-treated wound were statistically significant lower than Bactigras®-treated wound (p < 0.05). No sign of infection or adverse event was observed after treatment with both dressings. In conclusion, the inflammation responses of the dressing were clearly clarified. The advantages of BCSP were wound-quality improvement, pain reduction, and infection protection without adverse events. It was fit to be used as the alternative treatment of STSG donor site wound.

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Acknowledgements

This research is supported by the 90th Anniversary of Chulalongkorn University, Rachadapisek Sompote Fund to Supamas Napavichayanun.

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Authors and Affiliations

  1. Bioactive Resources for Innovative Clinical Applications Research Unit, Chulalongkorn University, Bangkok, Thailand

    Supamas Napavichayanun & Pornanong Aramwit

  2. Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Chulalongkorn University, PhayaThai Road, Phatumwan, Bangkok, 10330, Thailand

    Supamas Napavichayanun & Pornanong Aramwit

  3. Department of Tropical Pathology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand

    Sumate Ampawong

  4. Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, Chulalongkorn University, PhayaThai Road, Phatumwan, Bangkok, 10330, Thailand

    Tavornchai Harnsilpong & Apichai Angspatt

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  1. Supamas Napavichayanun
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  2. Sumate Ampawong
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Correspondence to Apichai Angspatt or Pornanong Aramwit.

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(Research involving Human Participants and/or Animals) All procedures performed in studies involving animals were in accordance with the ethical standards of the Ethics Committee of the Faculty of Medicine, Chulalongkorn University (CUACUC 13/57). All procedures performed in studies involving human participants were in accordance with the ethical standards of the Ethics Review Committee for Research Involving Human Research Subjects, Institutional Review Board, Faculty of Medicine, Chulalongkorn University (COA No. 843/2015).

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Napavichayanun, S., Ampawong, S., Harnsilpong, T. et al. Inflammatory reaction, clinical efficacy, and safety of bacterial cellulose wound dressing containing silk sericin and polyhexamethylene biguanide for wound treatment. Arch Dermatol Res 310, 795–805 (2018). https://doi.org/10.1007/s00403-018-1871-3

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  • DOI: https://doi.org/10.1007/s00403-018-1871-3

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