Clinical application of chitosan-based biopolymer wound dressing in the treatment of a patient with lymphoma and extensive chronic wounds

   The aim of the study is to analyze the existing scientific data on the use of chitosan-based wound dressings and their effectiveness, as well as to present our own experience with the use of chitosan-based polymer coatings in the treatment of chronic wounds in a lymphoma patient in the purulent surgery department.

   Material and methods. A clinical case of a 69-year-old patient with recurrent B-cell lymphoma, initially treated in the hematology department, and subsequently transferred to the purulent surgery department due to the development of necrotizing fasciitis, is presented. Chitosan-based polymer dressings were used for the healing of a large chronic skin defect that developed after necrosectomy. Dressings were applied for 20 days in the hospital and for 30 days in the outpatient setting.

   Results. The application of chitosan-based polymer dressings showed significant positive dynamics: the wound began to epithelialize, which was accompanied by an improvement in the patient’s overall condition and compensation of comorbidities during the treatment. As a result, significant progress was made in restoring the patient’s functional activity, and they were
discharged with the ability to move independently. At the 6-month follow-up, complete wound healing was noted.

   Conclusions. The analysis of the existing literature and our own experience with chitosan-based biopolymer dressings demonstrated their effectiveness in the treatment of chronic wounds in patients with severe comorbidities. This method represents a promising trend in the surgical treatment of such patients.

1. Sorg H., Tilkorn D.J., Hager S., Hauser J., Mirastschijski U. Skin wound healing: an update on the current knowledge and concepts. Eur. Surg. Res. 2017;58(1-2):81–94. doi: 10.1159/000454919

2. Wang P.H., Huang B.S., Horng H.C., Yeh C.C., Chen Y.J. Wound healing. J. Chin. Med. Assoc. 2018;81(2):94–101. doi: 10.1016/j.jcma.2017.11.002

3. Hamm R.L. Wounds. Diagnosis and treatment: atlas-reference book. Moscow: GEOTAR-media, 2023, 536 p. [In Russian].

4. Pleshkov V.G., Privolnev V.V., Golub A.V. Treatment of chronic wounds. Vestnik Smolenskoy gosudarstvennoy meditsinskoy akademii = Vestnik of the Smolensk State Medical Academy. 2015;14(2):58–65. [In Russian].

5. Gardikiotis I., Cojocaru F.D., Mihai C.T., Balan V., Dodi G. Borrowing the features of biopolymers for emerging wound healing dressings : a review. Int. J. Mol. Sci. 2022;23(15):8778. doi: 10.3390/ijms23158778

6. Halder T., Barot H., Kumar B., Kaushik V., Patel H., Bhut H., Saha B., Poddar S., Acharya N. An insight into biodegradable polymers and their biomedical applications for wound healing. Curr. Pharm. Des. 2024;30(31):2425–2444. doi: 10.2174/0113816128295935240425101509

7. Sahana T.G., Rekha P.D. Biopolymers: Applications in wound healing and skin tissue engineering. Mol. Biol. Rep. 2018;45(6):2857–2867. doi: 10.1007/s11033-018-4296-3

8. Singh R., Shitiz K., Singh A. Chitin and chitosan: biopolymers for wound management. Int. Wound. J. 2017;14(6):1276–1289. doi: 10.1111/iwj.12797

9. Loo H.L., Goh B.H., Lee L.H., Chuah L.H. Application of chitosan-based nanoparticles in skin wound healing. Asian J. Pharm. Sci. 2022;17(3):299–332. doi: 10.1016/j.ajps.2022.04.001

10. Francesko A., Tzanov T. Chitin, chitosan and derivatives for wound healing and tissue engineering. Adv. Biochem. Eng. Biotechnol. 2011;125:1–27. doi: 10.1007/10_2010_93

11. Piekarska K., Sikora M., Owczarek M., Jóźwik-Pruska J., Wiśniewska-Wrona M. Chitin and chitosan as polymers of the future-obtaining, modification, life cycle assessment and main directions of application. Polymers (Basel). 2023;15(4):793. doi: 10.3390/polym15040793

12. Petrova V.V., Smirnov G.A., Arzhelas M.N., Afanasov I.M. A successful closure of an extensive wound defect on the plantar surface in a patient with diabetes mellitus type 1 with combined application of bioplastic materials. Rany i ranevyye infektsii. Zhurnal imeni professora B.M. Kostyuchonka = Wounds and Wound Infections. The Journal Named after Professor B.M. Kostyuchenok. 2022;9(1):40–45. [In Russian]. doi: 10.25199/2408-9613-2022-9-1-40-45