Evaluation of Bacterial Cellulose Dressing versus Vaseline Gauze in Partial Thickness Burn Wounds and Skin Graft Donor Sites: A Two-Center Randomized Controlled Clinical Study

Abstract

Objective: Bacterial cellulose (BC) dressing, which can maintain a moist environment and prevent the invasion of pathogens, has become a competitive dressing material for burn wound treatment. This study was conducted to evaluate the treatment efficacy of a novel China-made BC dressing for the treatment of second-degree burn wounds and skin graft donor sites.

Methods: 212 patients with second-degree burn wounds or skin graft donor sites were enrolled from two research centers. They were randomly assigned to the BC dressing group (study group) or the Vaseline gauze (VG) dressing group (control group). Wound conditions were assessed before and after treatment. Dressings were changed according to the condition of the wound bed. Healing rate and healing time were recorded as primary endpoints to evaluate the efficacy of BC dressing against VG dressing. Erythema, swelling, exudation, bleeding, subeschar purulence, and pain were assessed as secondary endpoints.

Results: 207 participants completed the trial and their wounds all healed within 28 days. The average healing times for superficial and deep secondary burn wounds and skin graft donor sites in the BC group were 8.12, 15.77, and 10.55 days, respectively. In the VG group, the average healing times for superficial and deep secondary burn wounds and skin graft donor sites were 9.30, 15.27, and 11.19 days, respectively. The healing time of superficial burn wounds in the BC group was statistically shorter than that in the VG group. There was no difference in the frequency of dressing changing between two groups. The BC dressing showed equal efficacy with the VG dressing at all secondary endpoints.

Conclusion: The novel BC dressing could be used for the management of second-degree burn wounds and skin graft donor sites. With a shorter healing time in superficial secondary burn wound than that of the VG dressing, the BC dressing showed noninferiority in the treatment of superficial and deep secondary burn wounds and skin graft donor sites versus the VG dressing. This study is registered with the Chinese Clinical Trial Registry (registry number: ChiCTR1800014377 (http://www.chictr.org.cn)).

Figure 1

The flowchart of the randomized controlled clinical trial on wound dressing.

Figure 2

The application of BC dressing and VG dressing in second-degree burn wounds. Bacterial cellulose (BC) dressing and Vaseline gauze (VG) dressing were used in second-degree burn wounds in the two-center randomized controlled clinical study. Their treatment efficacies were compared as well. (a) Deep second-degree burn wound on left forearm. (b) BC dressing was applied. BC dressing was translucent, which allowed the wound to be checked easily. (c) Without changing BC dressing, wound healed on day 12; BC dressing dried up and fell off. (d) Deep second-degree burn wound on right forearm. (e) VG dressing was less translucent than BC dressing, making checking less convenient. 12 days later, VG was stuck to the wound bed and was not able to be changed. Hemorrhage was observed when changing outer cover of VG. (f) Wound healed on day 21, but there were difficulties when removing VG.