Use of xenograft compared to synthetic dermal substitute made of nanocellulose in patients with deep second-degree thermal burns, January 2022–July 2023
DOI:
https://doi.org/10.24265/horizmed.2025.v25n1.09Keywords:
Transplants, Biological Dressings , Tissue Donors , Burn UnitsAbstract
Objective: To compare scar formation between regenerated nanocellulose dermal substitutes and xenografts in patients with deep second-degree thermal burns. Materials and methods: A comparative, interventional, analytical, prospective and longitudinal study was conducted. We present the report of 60 cases evaluated in a private clinic in Lima, Peru, between January 2022 and July 2023. Patients aged 1 to 60 years without comorbidities were evaluated for scar formation from deep second-degree thermal burns within the first 24 hours of the accident. Both dermal substitutes were used in all patients. The study was authorized with informed consent. Results: An evaluation was conducted at 90 days, showing better scar formation with the synthetic dermal substitute made of nanocellulose compared to the xenograft. The results were evaluated using the Vancouver Scar Scale (VSS) (vascularization, pigmentation, pliability and height) and showed that the synthetic dermal substitute made of nanocelullose had less redness and greater elasticity, which were the most favorable indicators. The importance of the study lies in evaluating the quality of scar formation with the use of two treatments for deep second-degree burns. Conclusions: It was evident that the synthetic dermal substitute made of nanocellulose is an important alternative that favors the quality of scar formation in burned areas. It has proved to be more efficient than xenograft when evaluated and compared across its four parameters using the VSS, an international tool for wound healing evaluation. This efficient alternative for the treatment of second-degree burns promotes a better scar formation process, providing an adequate environment for healing under improved conditions.
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References
Quezada MB, Ayala R, Yáñez V. Uso de sustituto dérmico en niños con secuelas de quemaduras: tres casos clínicos. Rev Chil Pediatr [Internet]. 2009;80(2):150-6.
Koudoukpo C, Atadokpèdé F, Adégbidi H, Assogba F, Akpadjan F, Dégboé B, et al. Évaluation clinique du délai de cicatrisation des lésions d’ulcère de Buruli de diamètre inférieur ou égal à 10 centimètres à Pobè (Bénin). Ann Dermatol Venereol [Internet]. 2015;142(12):612.
Vásquez González D, Fierro Arias L, Arellano Mendoza I, Tirado Sánchez A, Peniche Castellanos A. Estudio comparativo entre el uso de apósito hidrocoloide vs uso de tie-over para valorar el porcentaje de integración de los injertos cutáneos de espesor total. Dermatol Rev Mex [Internet]. 2011;55(4):175-9.
Toniollo CL, Da Matta ES. Abordagem multidisciplinar na cicatrização de úlcera venosa crônica. Braz J Surg Clin Res [Internet]. 2015;11(3):12-16.
Rapado Raneque M, Rodríguez Rodríguez A, Peniche Covas C. Hydrogel wound dressing preparation at laboratory scale by using electron beam and gamma radiation. Nucleus [Internet]. 2013;53:24-31.
Enoch S, Leaper DJ. Basic science of wound healing. Surgery (Oxford) [Internet]. 2008;26(2):31-7
Paredes Esteban L, Castillo Fernández O, Gómez Beltrán V, Vargas Cruz CH, Lasso Betancor R, Granero Cendón JI, et al. Nuestra experiencia en el manejo de quemaduras con apósito antimicrobiano de plata, carbón activo y tecnología Safetac®. Acta Pediatr Esp [Internet]. 2009;67(7):165-71.
Plaza Heresi O. Tratamiento del paciente quemado hospitalario durante las primeras 48 horas: análisis de 36 casos en el Hospital Nacional Arzobispo Loayza. Horiz Med [Internet]. 2005;5(2):38-47.
Ferreiro González I, Gabilondo Zubizarreta J, Prousskaia E. Aplicaciones de la dermis artificial para la prevención y tratamiento de cicatrices hipertróficas y contracturas. Cir Plast Iberolatinoam [Internet]. 2012;38(1):61-7.
Mora-González R, Hernández-López AE, Polo-Soto SM. Estudio comparativo experimental entre xenoinjerto de dermis acelular humana desnaturalizada y xenoinjerto de esclera porcina desnaturalizada para evaluar la integración del injerto en defectos esclerales de espesor parcial. Rev Sanid Milit [Internet]. 2004;58(2):59-64.
QRskin. Epicitehydro [Internet]. Würzburg: QRskin; 2017. Disponible en https://www.qrskin.com/products/epicite-hydro/properties.html
López-Delis A, De S Rodrigues FRS, De Souza PEN, Carneiro MBL, Rosa MFF, Macedo YCL, et al. Characterization of the cicatrization process in diabetic foot ulcers based on the production of reactive oxygen species. J Diabetes Res [Internet].2018;2018:4641364.
Paredes EL, Castillo Fernández O, Gómez Beltrán G, Vargas Cruz CH, Lasso Betancor L, Granero Cendón R, et al. Nuestra experiencia en el manejo de quemaduras con apósito antimicrobiano de plata, carbón activo y tecnología. Acta Pediatr Esp [Internet]. 2013;71(8):165-71.
1library. V.A.C. Freedom® El sistema portátil para la curación eficaz de heridas [Internet]. 1library; 2021. Disponible en: https://1library. co/document/z15prx3y-v-c-freedom-sistema-portatil-curacion-eficazheridas.html
Salem C, Pérez JA, Henning L, Uherek F, Schultz C, Butte B, et al. Heridas. Conceptos generales. Cuad Cir [Internet]. 2000;14(3):90-9.
Sosa-Serrano F, Álvarez-Díaz C, Cuenca-Pardo J, Juárez-Aguilar E, KuriHarcuch W. Tratamiento de quemaduras de espesor total mediante autoinjertos mallados cubiertos con aloinjertos criopreservados de epidermis humana cultivada in vitro. Reporte de un caso. Cir Plast [Internet]. 1999;9(3):126-9.
Lee RC, Astumian RD. The physicochemical basics for thermal and non-thermal “burn” injuries. Burns [Internet]. 1996;22(7):509-19.
Friedstat JS, Klein MB. Acute management of facial burns. Clin Plastic Surg [Internet]. 2009;36(4):653-60.
Schiefer JL, Aretz FG, Fuchs PC, Lefering R, Yary P, Opländer C, et al. Comparison of long-term skin quality and scar formation in partialthickness burn wounds treated with Suprathel® and epicitehydro® wound dressings. Medicina (Kaunas) [Internet]. 2022;58(11):1550.
Schiefer JL, Aretz GF, Fuchs PC, Bagheri M, Funk M, Schulz A, et al. Comparison of wound healing and patient comfort in partial-thickness burn wounds treated with SUPRATHEL and epictehydro wound dressings. Int Wound J [Internet]. 2021;19(4):782-90.
Urbina G, Rider J. Manejo de heridas complejas con sustitutos dérmicos. Rev Chil Cir [Internet]. 2016;68(3):245-9.
Pham C, Greenwood J, Cleland H, Woodruff P, Maddern G. Bioengineered skin substitutes for the management of burns. Burns [Internet]. 2007;33(8):946-57.
Marx J, Hockberger RS, Walls R. Emergency medicine. 6a ed. Philadelphia: Elsevier – Health; 2006.
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