Department of Plastic, Reconstructive and Burn Surgery, Arzobispo Loayza National Hospital, Lima, Peru.
Academic Department of Surgery, Hipolito Unanue School of Medicine, Federico Villarreal National University, Lima, Peru.
Facial Plast Surg. 2023 Apr;39(2):130-141. doi: 10.1055/a-1860-8504. Epub 2022 May 24.
Previous studies have evaluated the effectiveness of bacterial nanocellulose (BNC) for the treatment of thermal injuries, but the synergic effect of platelet-rich plasma (PRP) with BNC-based dressing for burns still requires further investigation. Herein, we evaluated the effectiveness of BNC dressings in the management of facial burns using PRP. Patients with second-degree facial burns were treated with BNC-based wound dressings after debridement. The burn's depth and epithelialization were evaluated by clinical assessment. Besides using the dressings, we injected PRP subcutaneously into the left-hemifacial burns. The right hemiface was only treated with the dressings. Scar quality was assessed using the Patient and Observer Scar Assessment Scale (POSAS). Eight patients were included with superficial second-degree burns in 75% of the cases and deep second-degree burns in 25%. Overall, dressings were placed 3.25 days after the initial insult. None of the patients presented with complications after dressing placement. Dressing changes were not required, and no further surgical management was necessary. The mean time for epithelialization was 11.4 days. During subgroup analysis, we did not find a significant difference in the epithelialization time when comparing BNC-based dressings (11.8 days) to BNC-based dressings + PRP (11 days, = 0.429). The mean POSAS scores from a patient (17 vs. 12.3, = 0.242) and surgeon (13.5 vs. 11.3, = 0.26) standpoint were not significantly different using BNC-based dressings versus BNC-based dressings + PRP. Nanocellulose-based dressings are effective to treat second-degree facial burns. It enhances reepithelialization with optimal esthetic outcomes with or without PRP.
先前的研究已经评估了细菌纳米纤维素（BNC）在治疗热损伤方面的有效性，但富含血小板的血浆（PRP）与基于 BNC 的敷料联合用于烧伤的协同作用仍需要进一步研究。在这里，我们评估了 PRP 用于治疗面部烧伤的 BNC 敷料的效果。在清创后，用 BNC 基伤口敷料治疗二度面部烧伤患者。通过临床评估评估烧伤深度和上皮化。除了使用敷料外，我们还将 PRP 皮下注射到左半面烧伤。右侧仅用敷料治疗。使用患者和观察者疤痕评估量表（POSAS）评估疤痕质量。8 名患者包括 75%的浅二度烧伤和 25%的深二度烧伤。总体而言，敷料在初始损伤后 3.25 天放置。敷料放置后，没有患者出现并发症。不需要更换敷料，也不需要进一步的手术治疗。上皮化的平均时间为 11.4 天。在亚组分析中，我们在比较基于 BNC 的敷料（11.8 天）与基于 BNC 的敷料+PRP（11 天， = 0.429）时，上皮化时间没有发现显著差异。从患者（17 对 12.3， = 0.242）和外科医生（13.5 对 11.3， = 0.26）的立场来看，使用基于 BNC 的敷料与基于 BNC 的敷料+PRP 时，POSAS 评分的平均值没有显著差异。基于纳米纤维素的敷料可有效治疗二度面部烧伤。它通过最佳美容效果增强再上皮化，无论是否使用 PRP。
