21.5.5 Nanocellulose in the Treatment of Chronic Wounds and Burns
Burns are very complex injuries, causing extensive damage to skin tissues. Burns are classified according to depth and identified by three degrees (Latarjet 1995): first-degree burn – usually superficial, affects only the outer layer of skin (epidermis); second-degree burn – either superficial, with damage to the epidermis layer of the skin (second-degree A), or deep when penetrating into the dermis (second-degree B); third-degree burn – a total destruction of all the epidermis and dermis, extending into subcutaneous tissue (skin grafting is recommended). The healing process involves the regeneration of the epidermis and the repair of the dermis, both of which result in the formation of scar tissue (Balasubramani et al. 2001). The major goal during treatment of burn patients is to quickly accomplish effective wound closure to increase the rate of healing and significantly reduce pain (Demling and DeSanti 1999; Jones et al. 2002; Prasanna et al. 2004). In addition, proper wound management must prohibit the wound from becoming infected and dehydrated (Gallin and Hepperle 1998). Despite the fact that many different biological and synthetic wound dressings have already been developed, the search for an ideal wound dressing is still in progress. According to the modern approaches in the field of wound healing, an ideal wound dressing system must be structurally and functionally similar to autograft skin (Quinn et al. 1985).