Study Demonstrates Effectiveness of Chitosan Dressings in Improving Healing for Deep Second-Degree Burns

Researchers at the Department of Burn and Wound Repair, Yueqing City People's Hospital: Wenzhou Medical College Affiliated Yueqing Hospital, Yueqing County, Wenzhou, China, recently completed a single-blind, positive control clinical trial that showed improved healing outcomes when adding chitosan wound dressings to silver ion wet antibacterial biological dressing in the treatment of deep second-degree burns. Trial subjects in the study group displayed faster healing times, fewer infections, lower pain scores, and lower rates of scar hyperplasia compared with those in the control group where the wet dressing alone was used. Notably, the addition of chitosan dressings did not result in higher treatment costs, and no adverse effects were observed.

Deep burn wounds come with high risks of infection and can even be life-threatening, which means that effective treatments should be administered as quickly as possible after a burn occurs. Researchers in this study examined the effects of a chitosan dressing used in conjunction with a silver ion wet antibacterial biological dressing. Chitosan is a polysaccharide well suited to wound-healing purposes thanks to its natural bacteriostatic and hemostatic properties. It is also biocompatible and biodegradable, making it a good choice for treatment in surgical wounds and burns. The primary objective of this study was “To evaluate the efficacy and safety of wet dressing combined with chitosan wound dressing for deep II degree burn wounds and provide the basis for clinical application.”

The study included patients admitted to the hospital’s Burn Plastic Department between October 2019 and October 2021 who were between 18 and 60 years of age, had suffered a flame or hydrothermal burn within the previous 24 hours, and had not received any treatment prior to admission. Subjects included presented with second-degree burns with total body surface area (TBSA) between 5% and 10% and had no history of allergies, immune disease, or metabolic disease. A total of 80 patients were included in the study, with the subjects divided randomly into control or study groups of 40 patients each. There were no significant differences in demographics, vital signs, and baseline data between the groups, and the study was single-blind for patients.

Both the study and control groups received initial debridement, cleansing, and disinfection of their burn wounds. The control group had their wounds treated with a silver ion wet antibacterial biological dressing and sterile gauze, whereas the study group additionally received a chitosan wound dressing, which was added at each dressing change.

Patients in the study group observed wound healing time of 9.53 ± 2.74 days compared with 24.78 ± 4.86 days for the control group. Percentages of wound healing were also higher in the study group at days 14, 21, and 28 after initial treatment. Scar scores 3 months after treatment were 6.00 ± 0.98 for the study group and 8.77 ± 1.19 for the control group, demonstrating lower instances of scar hyperplasia in the study group after 3 months. The study group also presented lower rates of infection, with bacterial culture rates significantly lower than those in the control group at 7 and 14 days after treatment began. The cost of treatment between the two groups showed no statistically significant difference, and no adverse events were observed in either group.

“Early and correct treatment is the key factor of burn wound healing,” according to the study’s authors. Despite some limitations due to the small study size and difficulty of achieving double-blind observation, researchers felt the study showed promising results for the treatment of deep second-degree burn wounds using chitosan dressings in addition to a conventional wet dressing. “The results showed that chitosan dressing had a good effect on burn and scald wounds. It can significantly shorten the time of wound healing, reduce wound pain and wound infection, and effectively improve scar hyperplasia. It meets the requirements of safe and effective clinical use, and is worthy of clinical application.”

—Kirra Fedyszyn, Associate Digital Editor

Reference: Hu, J, Lin, Y, Cui, C, et al. Clinical efficacy of wet dressing combined with chitosan wound dressing in the treatment of deep second-degree burn wounds: A prospective, randomised, single-blind, positive control clinical trial. Int Wound J. 2022; 1- 7. doi:10.1111/iwj.13911