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7th Brazilian Conference on Stomal Therapy

October 21-25, 2007 – Curitiba – Paraná

USE OF CELLULOSIC MEMBRANE IN GRAFT DONOR SITES
Silveira, Jocilene de Mesquita1
Castro, Maria Euridéa de2
Pinheiro, Alessandra Rocha Mororó3
Filho, Marcus Vinicius Ponte de Souza4

INTRODUCTION
A graft donor site is an elective lesion, flat and with little exudate, and its possible intercurrences like critical
colonization and infection represent a challenge to the interdisciplinary team during the tissue regeneration process.
There are transparent and permeable membranes or films available in the marketplace that is indicated to occlude this
kind of lesion. The transparency of such membranes makes it easy to visualize the lesion and its characteristics 1, and
permits early identification of complications during the treatment. The cellulosic membrane synthesized by
Acetobacter xylinum2, a gram negative bacillus, has a physical chemical structure that promotes functions similar to
those of the corneal layer of the epidermis, providing protection to lesion tissues, and is indicated as a temporary skin
substitute3, bringing benefits to the patient and optimizing tissue regeneration.

OBJECTIVES

To describe the effects of the cellulosic membrane synthesized by Acetobacter xylinum used as a temporary
skin substitute at the graft donor site;
To report the interdisciplinary team experience in treating such lesion.

METHODS
This is a clinical case study carried out at the surgery department and monitored at the Specialties Clinic of a Public
Hospital in the city of Fortaleza, state of Ceará, from April to June 2007. Male patient, age 68, diabetic, cardiac, with
fasciitis on the left leg, for which the plastic surgeon indicated a graft. Skin selected to be graft donor: size: 18 cm x
15 cm, taken from the front and side of the left thigh.
The dressing selected for the donor site was composed of a cellulosic membrane synthesized by the gram negative
baccilus Acetobacter xylinum (Photo1) for tissue regeneration. The dressing effectiveness and the lesion evolution
were monitored by free observation and photographic records. Before the study began, we explained orally to the
patient its objectives and methods, and asked him to authorize it in writing, according to the National Health Council
Resolution 196/96 on ethics applied to research using human subjects.

1

Graduate Degree in Stomal Therapy – Assisting Nurse and specialist in infection control at a Private Hospital. (Address): Rua
Deoclécio de Araújo, 245, Lagoa Redodnda district; Phone: 55 85 3278-2032 – 55 85 9902-0190; (city): Fortaleza, (state): Ceará;
email: jocilenems@oi.com.br
2
Graduate Degree in Stomal Therapy and PhD – Professor
3
Nurse - Coordinator of the Interdisciplinary Commission for Lesion Prevention and Treatment – working towards a graduate
degree in Stomal Therapy – Public Hospital
4
Masters Degree in Surgery. Member of the Interdisciplinary Commission for Lesion Prevention and Treatment – Public Hospital

We did not observe any adverse reactions to the product. and exudate dehydration. and dressing changes were carried out by the surgeon and/or nurse. Photo 2: Localized change RESULTS AND DISCUSSIONS With the use of the cellulosic membrane. and 20% in the last 10 days with the use of Essential Fatty Acid (EFA) to regulate epidermal proliferation. with the formation of a scab that protected the epithelium until it was regenerated. 4 (Photo 3). nor trauma in the epithelization when the dressing was changed. a gradual epithelization occurred in 50% of the area in 20 days. The membrane promoted haemostasis. the size of the donor site (18 x 15 cm) and the presence of localized colonization (slow dehydration of the localized exudate inhibiting scab formation) contributed to the total period of 40 days for the total regeneration of the tissue and localized EFA replacement. analgesia.Photo 1 – Cellulosic membrane PROCEDURES The first donor site dressing was performed during the surgery by the plastic surgeon. During the 40-day period in which the treatment was conducted at the hospital (both stay and outpatient clinic). . Primary dressing consisted of the cellulosic membrane and the secondary was made of simple cotton gauze and crepe bandage. in 30% of the area during the following 10 days. We noted that the patient’s risk factors (co-morbities). the cellulosic membrane was totally replaced once and two localized changes on the lesion were performed (interaction of the cellulosic membrane and/or colonization) (Photo 2).

. albeit comparative studies will have to be carried out with other patients monitored by specialized interdisciplinary teams.Photo 3 – Gradual epithelization of the donor site CONCLUSIONS We have concluded that the use of this cellulosic membrane in a graft donor site may be an effective alternative as a new temporary skin substitute.

P.R. GARCIA-CRUZ.5. H.E. S.4. Produção fermentativa de polissacarídeos extracelulares por bactérias (Extracellular polyssaccharides fermentative production by bacteria) Semina: Ciências Agrárias.R.A.M. DE. C. p.25. D. (Biofill: use and clinical assessment of a cellulosic film for cutaneous lesions). Londrina. Efeitos do triglicerídeos de cadeia media na acelação do processo de cicatrização de feridas. D. Rev..N. p. DANTAS. bras. S. . V. Oct.. S. Biofill: uso e avaliação clínica de uma película celulósica em lesões cutâneas.81-99 2 SOUZA. DANTAS.E Abordagem multiprofissional do tratamento de feridas (Multiprofessional approach in wound treatment). R. _ Curativos e Coberturas para o Tratamento de Feridas (Dressings and Coverings for Wound Treatment) in: JORGE.P. n. v.M. (Effects of medium chain triglycerides in the acceleration of the wound healing process). S.4-8. Nutrição Enteral e Esportiva.. p. JORGE. 1994. 4 DECLAIR. São Paulo: Atheneu. 2003. SANTOS.-Dec 2004. 78(2): 141-5..A. Rev. Chapter 8. n. cir.1 BAJAY. Mar-Apr 1988. dos.H.331-340 3 PEIXOTO.L.