Can Pure Silk Compete with the Established Mepilex Ag® in the Treatment of Superficial Partial Thickness Burn Wounds? A Prospective Intraindividual Study

Abstract

Introduction: Superficial partial thickness burns generally do not require surgical intervention and are managed with specialized wound dressings. Mepilex Ag^® is commonly used and often represents the standard of care. This study evaluated the clinical performance of pure silk compared to Mepilex Ag^®.

Methods: A prospective, single-center intraindividual study was conducted on adult patients with superficial partial thickness burns. Each burn wound was divided, treating one half with pure silk and the other with Mepilex Ag^®. Clinical parameters including wound closure time, pain levels, and scar quality at 3-month follow-up were analyzed.

Results: Twenty-four patients were included (mean TBSA: 5.8%). Mepilex Ag^® showed a trend towards a shorter wound closure time (10.5 vs. 11.5 days; p = 0.223). Pain scores remained below 4/10 for both dressings throughout treatment. However, Mepilex Ag^® demonstrated significantly lower pain on day one (3.5 vs. 2.77; p = 0.039) and day two (2.91 vs. 2.27; p = 0.041). Scar quality after 3 months was similar.

Conclusion: Both dressings proved to be effective treatment options. Pure silk required fewer resources, showed high clinical practicality, and demonstrated a similar performance to Mepilex Ag^® in key clinical parameters, making it an interesting option for other clinics and our standard of care.

Keywords: Mepilex Ag®; burns; pure silk; superficial partial thickness; wound dressings.

Figure 1

Relative distribution of burn mechanisms in the patient cohort (n = 24). The diagram depicts the relative number of patients injured by the different burn mechanisms as a percentage: hot liquid (58%), open flame (29%), and explosion (13%).

Figure 2

Wound healing of a patient who sustained a partial superficial burn to the left hand. Half of the burn wound at the palm was treated with Dressilk^® and the other half of the wound was treated with Mepilex Ag^®. Photos show the wound at different time points of the therapy: (a) initial presentation on the day of the trauma, (b) post-debridement, (c) after application of Dressilk^® on the ulnar side and Mepilex Ag^® on the radial side of the wound (the Mepilex Ag^® is partially detached at the edges), (d) clinical appearance after four days, (e) clinical appearance after eight days, (f) clinical appearance after four weeks, (g) clinical appearance after three months.

Figure 3

Dot plot diagram of pain levels as reported by the patients (n = 22) using the Numeric Rating Scale (NRS). Comparison of the wound area treated with Mepilex Ag^® (represented in black) and Dressilk^® (represented in white) at different time points (days 1, 2, 4, 8, 16, 24). Reported pain levels in areas treated with Mepilex Ag^® were significantly lower on day 1 (p = 0.039) and day 2 (p = 0.041). Statistical significance was set at p < 0.05.

Figure 4

Dot plot diagram of the level of exudation in the patient group (n = 18) as evaluated by the attending burn surgeon using the visual rating scale (VRS). Comparison of the wound area treated with Mepilex Ag^® (represented in black) and Dressilk^® (represented in white) at different time points (days 1, 2, 4, 8, 16, 24). There was no significant difference between the two wound dressings. Statistical significance was set at p < 0.05.