Clinical efficacy of biocellulose, carboxymethyl cellulose and normal saline dressing in epidermolysis bullosa

Abstract

Objective: To evaluate the efficacy of a biocellulose, a carboxymethyl cellulose and a normal saline wound dressing in the wound care management of epidermolysis bullosa (EB) skin wounds. Methods: This was a single-blind, randomised controlled trial involving wounds from patients with EB. Wounds were divided into three groups: group I with biocellulose wound dressing, group II with carboxymethyl cellulose wound dressing and group III with normal saline wound dressing as a control. All dressing changes and wound parameters were recorded. Observations were conducted every three days until complete wound closure or up to one month. Results: The outcomes of treatment of 36 wounds from four patients were evaluated in this study. Mean healing time in group I was seven days, eight days in group II and 14 days in group III. There were significant differences in healing times between group I and group III (p=0.0001) and between group II and III (p=0.001). The results showed a significant reduction in the percentage of wounds area on day three for each group: 51.7% in group I, 51.9% in group II, and 26% for group III. All wounds in groups I and II had healed at day 12 (100%) and at day 24 (100%) in group III. There were significant differences in the reduction of percentage wound area between group I and group III at day three (p=0.044) and day six (p=0.000), and between group II and III at day six (p=0.003). Conclusion: The study demonstrates that both the biocellulose and the carboxymethyl cellulose wound dressings significantly reduced percentage wound areas and complete healing times compared with the normal saline wound dressing in EB skin wounds, demonstrating they are both equally good for wound care management in EB patients.

Management of Skin Lesions in Patients with Epidermolysis Bullosa by Topical Treatment: Systematic Review and Meta-Analysis

“…In five clinical trials involving 458 wounds, with 228 in the intervention group and 230 in the control group, the efficacy of utilizing topical treatments, as opposed to the use of a placebo, in wounds in individuals with EB was assessed. Two studies exhibited a low risk of bias, while the remaining three showed a moderate level of risk [ 38 , 39 , 44 , 47 , 50 ].…”

“…Finally, we found studies on cotton acetate dressings coated with dialkylcarbamoyl chloride. Dialkylcarbamoyl chloride has a microorganism trapping action to kill bacteria and fungi due to its hydrophobic capacity [ 37 , 38 , 39 , 40 ].…”

“… Bias assessment by a one-to-one summary plot [ 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 ]. …”

A pilot and open trial to evaluate topical Bacterial Cellulose bio-curatives in the treatment of cutaneous leishmaniasis caused by L. braziliensis

“…BC is considered an optimal dressing as it maintains high humidity at the wound site, removes excess exudates, is non-toxic and nonallergenic, allows oxygen exchange, prevents microbial invasion, is easily managed by the patient and is cost-effective (Dart et al, 2019;Felgueiras et al, 2020;Jannesari et al, 2011;Rezvani Ghomi et al, 2019). Indeed, application of BC bio-curatives decreased healing time in patients with epidermolysis bullosa (Dwiyana et al, 2019), a condition characterized by chronic multiple wounds, and in skin graft donor patients (Alves et al, 2009;Brown and Holloway, 2018). BC when used as an implant, stimulated fibroblasts and collagen production (Helenius et al, 2006) and bacterial cellulose film supports the growth, spreading and migration of human keratinocytes (Sanchavanakit et al, 2006).…”