Treatment of burn wounds using chitosan wound dressings
Abstract
Today, burn injuries
are an urgent problem because of the high level of global industrialization, as
well as the peculiarities of social and household factors which follow it.
Despite the long-term practice of treating burns, this topic is of interest in
the development of new innovative methods of treatment.
According to the
results of a randomized study with 43 patients included, the use of innovative
hydrogel-based dressings (“Chitocol”) facilitates the process of therapy in the
burn unit patients who do not need a large operation. When observed for 30–120
days using the author’s evaluation scale by O.V. Vladimirova, it was noted that
the patients of the study group did not complain of significant pain syndrome
in wounds both during dressings and during the entire period of application of
“Chitocol”. This coating creates natural conditions for the regeneration of the
superficial and deep layers of the skin and thereby facilitates the work of
doctors, reducing the number of dressings compared to standard methods of
treatment. The use of “Chitocol” reduces the healing time of wound defects,
thereby improving the quality of life of patients undergoing long-term
rehabilitation, both in hospital and outpatient.
Keywords:burns; chitosan; treatment of burns; hydrogel wound coating; Chitocol
Funding. The study had no sponsor support.
Conflict of
interest. The authors declare no conflict of interest.
For citation: Vladimirova O.V., Lavreshin P.M., Minaev S.V., Korablina S.S.,
Baychorov H.M., Terekhin A.V., Vergasov M.M., Rybalko A.E. Treatment of burn
wounds using chitosan wound dressings. Clinical and Experimental Surgery.
Petrovsky Journal. 2023; 11 (3): 99–104. DOI: https://doi.org/10.33029/2308-1198-2023-11-3-99-104
(in Russian)
References
1. Greenhalgh D.G. Management of burns. N Engl J Med. 2019; 380 (24): 2349–59. DOI: https://doi.org/10.1056/NEJMra1807442 PMID: 31189038.
2. Porter C., Hardee J.P., Herndon D.N., Suman O.E. The role of exercise in the rehabilitation of patients with severe burns. Exerc Sport Sci Rev. 2015; 43 (1): 34–40. DOI: https://doi.org/10.1249/JES.0000000000000029 PMID: 25390300; PMCID: PMC4272612.
3. Daigeler A., Kapalschinski N., Lehnhardt M. Therapie von Brandverletzungen [Therapy of burns]. Chirurg. 2015; 86 (4): 389–401. DOI: https://doi.org/10.1007/s00104-014-2919-3 PMID: 25894015. (in German)
4. Tolles J. Emergency department management of patients with thermal burns. Emerg Med Pract. 2018; 20 (2): 1–4. Epub 2018 Feb 1. PMID: 29369586.
5. Pittinger T., Curran D., Hermans M. Treatment of burns in adult patients with a concentrated surfactant gel: a real-life retrospective evaluation. Wounds. 2020; 32 (12): 339–44. PMID: 33472159.
6. Fronchek E.V., Grigor’yan A.Yu., Blatun L.A. Innovative biologically active wound healing and hemostatic agents based on chitosan and collagen: stages of development and medical and technical characteristics. Rany i ranevye infektsii. Zhurnal imeni professora N.M. Kostyuchenko [Wounds and Wound Infections. Journal named after Professor B.M. Kostyuchenko]. 2018; 5 (4): 14–21. URL: https://cyberleninka.ru/article/n/innovatsionnye-biologicheski-aktivnye-ranozazhivlyayuschie-i-krovoostanavlivayuschie-sredstva-na-osnove-hitozana-i-kollagena-etapy (date of access April 08, 2023). (in Russian)
7. Global burn registry. URL: www.who.int (date of access March 17, 2023).
8. Medvedev G.V., Rodomanova L.A., Timirbaeva O.Yu., Zhogina M.A., Mel’nikova O.A., Mustafaev A.Sh., et al. Epidemiology of thermal hand injury in adults. Sibirskoe meditsinskoe obozrenie [Siberian Medical Review]. 2022; (4): 89–97. DOI: https://doi.org/10.20333/25000136-2022-4-89-97 (in Russian)
9. Surgical treatment of burn victims. Clinical guidelines. In: A.A. Alekseev, A.E. Bobrovnikov, S.B. Bogdanov, et al. Moscow, 2015: 12 p. (in Russian)
10. Kozka A.A., Olifarova O.S. Burn injury. A textbook. Blagoveshchensk, 2021: 85 p. (in Russian)
11. Burns. World Health Organization. URL: https://www.who.int/news-room/fact-sheets/detail/burns (date of access October 14, 2021).
12. Liu H.F., Zhang F., Lineaweaver W.C. History and advancement of burn treatments. Ann Plast Surg. 2017; 78 (2 suppl 1): S2–8. DOI: https://doi.org/10.1097/SAP.0000000000000896 PMID: 28079548.
13. Agadzhanova K.V. International standards for the treatment of burns. E-Scio. 2019; 12 (39). URL: https://cyberleninka.ru/article/n/mezhdunarodnye-standarty-dlya-lecheniya-ozhogov (date of access March 24, 2023). (in Russian)
14. Petrov S.V. General surgery. A textbook for universities. 2nd ed., revised and additional. Saint Petersburg: Piter, 2004: 768 p. SBN 5-318-00564-0. (in Russian)
15. Alekseev A.A., Krutikov M.G., Yakovlev V.P. Burn infection: etiology, pathogenesis, diagnosis, prevention and treatment. Moscow: Vuzovskaya kniga, 2010: 416 p. ISBN 978-5-9502-0419-7. (in Russian)
16. Bezhin A.I., Lipatov V.A., Fronchek E.V., Grigor’yan A.Yu., Naimzada M.D.Z. The use of chitosan-collagen complex with silver nanoparticles and chymotrypsin in the treatment of purulent-necrotic wounds. Vestnik novykh meditsinskikh tekhnologiy [Bulletin of New Medical Technologies]. 2019; 26 (3): 23–8. URL: https://cyberleninka.ru/article/n/primenenie-hitozan-kollagenovogo-kompleksa-s-nano-chastitsami-serebra-i-himotripsinom-v-lechenii-gnoyno-nekroticheskih-ran (date of access April 04, 2023). (in Russian)
17. Zudina I.V., Vedyaeva A.P., Bulkina N.V., et al. Study of the effect of chitosan on the process of bone defect healing in experiments in vivo and in vitro. Izvestiya Saratovskogo university. Novaya seriya. Seriya: Khimiya. Biologiya. Ekologiya [Proceedings of the Saratov University. New Series. Series: Chemistry. Biology. Ecology]. 2016; 16 (2): 171–9. (in Russian)
18. Vladimirova O.V., Lavreshin P.M., Minaev S.V., Korablina S.S., Grigorova A.N., Zybinsky I.A. The experience of applying the coating «Khitokol» in the treatment of infected wounds of various etiologies. Glavvrach Yuga Rossii [Chief Physician of the South of Russia]. 2021: 5 (80). URL: https://cyberleninka.ru/article/n/opyt-primeneniya-pokrytiya-hitokol-v-lechenii-infitsirovannyh-ran-razlichnoy-etiologii (дата обращения: 21.03.2023). (in Russian)
19. Rabea E.I., Badawy M.E.-T., Stevens C.V., et al. Chitosan as antimicrobial agent: applications and mode of action. Biomacromolecules. 2003; 6 (4): 1457–65.
20. Ueno H., Mori T., Fujinaga T. Topical formulations and wound healing applications of chitosan. Adv Drug Deliv Rev. 2001; 52 (2): 105–15. DOI: https://doi.org/10.1016/S0169-409X(01)00189-2
21. Bogdanov S.B., Zinov’ev E.V., Osmanov K.F., Karakulev A.V., Polyakov A.V., Popov A.A., et al. Improvement of physical factors in the local treatment of burn wounds. Innovatsionnaya meditsina Kubani [Innovative Medicine of the Kuban’]. 2019; (1): 44–52. URL: https://inovmed.elpub.ru/jour/article/view/154/153 (in Russian)
22. Griban’ P.A., Afanasov I.M., Usov V.V., Moguryan O.E., Sotnichenko S.A., Filatov Yu.N., et al. The effectiveness of the use of bioplastic materials based on chitosan in the local treatment of borderline burns. Saratovskiy nauchno-meditsinskiy zhurnal [Saratov Journal of Medical Scientific Research]. 2021; 17 (4): 709–14. URL: https://cyberleninka.ru/article/n/effektivnost-primeneniya-bioplasticheskih-materialov-na-osnove-hitozana-v-mestnom-lechenii-pogranichnyh-ozhogov (date of access April 13, 2023). (in Russian)