Bacterial cellulose an effective material in the treatment of chronic venous ulcers of the lower limbs

Abstract

Chronic venous ulcers (CVU) of the lower limbs (LL) are common and cause psychological changes and significant social impact, as they make the patient susceptible to pain, absence from work and social bonds. Some materials are suggested as dressings for the treatment of CVU, but they are expensive and are generally not available for use in public health services. To evaluate the efficacy of the treatment for lower limbs (LL) chronic venous ulcer (CVU) using bacterial cellulose (BC), gel and multi-perforated film associated. A randomized controlled clinical-intervention study was performed among participants with LL CVU, divided into two groups: experimental (EG), treated with BC wound dressing and control (CG), treated with a cellulose acetate mesh impregnated with essential fatty acids (Rayon®). The participants were followed for 180 days, evaluated according to the MEASURE methodology. Thirty-nine patients were treated, 20 from the EG and 19 from the CG. In both groups, the wound area decreased significantly (p < 0.001), the healing rate was similar to the CG. The mean number of dressing changes in the SG was 18.33 ± 11.78, while in the CG it was 55.24 ± 25.81, p < 0.001. The healing dressing of bacterial cellulose, gel and associated film, when stimulating the epithelization of the lesions, showed a significant reduction in the initial area, with a percentage of cure similar to the Rayon® coverage. In addition to requiring less direct manipulation of ulcers.

Antibacterial and Antibiofilm Potential of Bacterial Cellulose Hydrogel Containing Vancomycin against Multidrug-Resistant Staphylococcus aureus and Staphylococcus epidermidis

“…has undergone comprehensive evaluation in toxicity tests, as described by Pinto et al [34], and safety studies conducted by Silva et al [24]. Clinical research led by Silva et al [26] confirmed not only the safety of the product but also its high capacity to promote wound healing in chronic venous ulcers in the lower extremities, showing significant reductions in wound area, improved healing rates, and positive patient outcomes when compared to standard dressings.…”

“…The structure of hydrogel is similar to the extract of an extracellular matrix and soft tissues, which presents a distinct three-dimensional conformation of nanofibrils and microfibrils that enables the adhesion of compounds due to the hydroxyl groups that make up its surface [19][20][21][22]. A hydrogel produced from sugar cane molasses has been tested in different medical and biomedical areas, showing promising results, including stability due to sugar polymerization, low toxicity, biocompatibility, and efficiency for tissue remodeling [23][24][25][26].…”

Bacterial Cellulose-Based Materials as Dressings for Wound Healing

“…In the study by Silva et al [ 134 ], a randomized controlled clinical intervention study of venous ulcers of the lower limbs using bacterial cellulose in the form of a membrane, gel, and multiperforated film was performed. The experimental group (EG), with 20 patients, was treated with BC-based dressings, and the control group (CG), with 19 patients, was treated with dressings made of a cellulose acetate mesh impregnated with essential fatty acids (RAYON ® ).…”

Bacterial Cellulose Properties Fulfilling Requirements for a Biomaterial of Choice in Reconstructive Surgery and Wound Healing

“…Rayon dressings are often used to treat chronic leg ulcers. When compared to rayon dressings for wound care, BC dressings have been shown (Silva et al, 2021) to be superior due to lower dressing change frequency, minimized direct contact with wounds, less risk of contamination and infection, greater patient autonomy and less dressing adhesion to bed (Silva et al, 2021).…”