Civil Engineering Reference
In-Depth Information
5. display an optional shape and surface area; and
6. allow for easy and painless release from the wound.
E f orts have been made during the last few years towards the development of new
artii cial wound covering which will meet the necessary requirements for the treatment
of surgical and nonsurgical wounds. h ere are many biocompatible wound dressing
materials reported by researchers. Among those materials, microbial cellulose provide
a promising future for wound care dressing applications. In 1990, Fontana
et al.
[45]
i rst reported the application of microbial cellulose pellicles, named Bioi lls, of varying
thickness, as temporary skin substitutes. It has been used for several skin injury treat-
ments such as basal cell carcinoma/skin grat , severe body burns, facial peeling, sutures,
dermabrasions, skin lesions, chronic ulcers [45].
h e treatment of chronic wounds such as venous leg ulcers, bedsores, and diabetic
ulcers remains a signii cant clinical challenge both to the patients and to the health care
professionals. According to recent reports on applications of microbial cellulose dress-
ings in the treatment of chronic wounds, they display superior properties compared to
other existing wound-healing materials. Mayall
et al.
[46] used a Bioi ll skin substitute
in the treatment of trophic ulcerations of the limbs and [47] applied a microbial cel-
lulose i lm on the lesion region with a loss of epithelial tissue acts as a new skin. h e
study showed that this material was very ef ective by shortening the cicatrization time,
reducing contamination, eliminating pain symptoms, enhancing absorption of wound
exudates and reducing the cost of treatment. Fontana
et al.
[45] listed out the advan-
tages of using Bioi lls as a biological wound dressing which have been coni rmed in
more than 300 treatments. h e advantages of the use of Bioi lls include immediate pain
relief, good and close adhesion to the wound bed, good barrier against infection, easi-
ness of wound inspection, faster healing, improved exudates retention or reduced time
of treatment, as well as reduced costs. In 1998, Wouk
et al.
[48] made a comparison of
dif erent skin promoters on animal models and reported that Bioi lls dressing to be the
most ef ective compared to the other four tested. Slezak
et al.
analyzed the osmotic-
dif usive properties of microbial cellulose wound dressing by measuring the coei cient
values of hydraulic permeability, rel ection, and dif usive permeability [49]. h e analy-
sis showed that the cellulose membrane is characterized by a low selectivity and is easily
permeable by water and other solutions (aqueous solution of glucose, sucrose, ethanol,
NaCl, KCl), and they suggested that the material might be used in the therapy of scalds
and ulceration. Kucharzewski
et al.
[50] studied the advantages of microbial cellulose
wound dressing (Bioprocesss), for the treatment of nonhealing venous leg ulcers over
Unna's boot hydrocolloid dressing, which is widely used in the therapy of these types of
wounds. h ey found that microbial cellulose wound dressing was more ef ective than
Unna's boot [50]. Recently, Alvarez
et al.
[37] reported the use of microbial cellulose
in the form of a hydrated membrane (Xcells, Xylos Co.) in the treatment of chronic
venous ulcers and reported that microbial cellulose was more ef ective than a standard
protocol (nonadherent cellulose acetate gauze) in the process of autolytic debridement.
h ey claimed that microbial cellulose created a protective, moist environment, very
similar to a natural undisturbed wound protected by blister. h e recent studies showed
that dressing was easy to apply and kept on the wound for a week without changes [51].
Also the use of Xcells may facilitate an easier dressing change and reduce the amount
