Polylactide-based biodegradable wound dressings for skin injury treatment and their applicability to the maxillofacial region: a systematic review
https://doi.org/10.33925/1683-3759-2025-1160
Abstract
Relevance. The identification of biocompatible wound dressings for the management of various skin injuries represents a relevant interdisciplinary challenge. Advances in wound-care materials are driven by the need to meet the following criteria: protection of the wound surface from mechanical damage, prevention of infection, sufficient permeability to prevent exudate accumulation, maintenance of a moist wound environment, flexibility, atraumatic removal, and reduced pain during healing. Since the introduction of biopolymeric polylactide-based dressings— most notably Suprathel (PolyMedics Innovations, Germany)—numerous studies have evaluated their clinical performance and compared them with established wound-care materials.
Objective. To conduct a systematic review of studies evaluating the treatment of skin injuries using polylactide-based wound dressings and to assess their applicability in the management of skin injuries in the maxillofacial region.
Materials and methods. The systematic review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A literature search was conducted in international and national databases using search terms in both English and Russian, including wound dressing, biodegradable polymer materials, polylactide, burns, biopolymer wound dressings, burn treatment, donor site wounds, and skin regeneration. Methodological quality was assessed using the RoB 2 tool (Revised Cochrane risk-of-bias tool for randomized trials) for randomized controlled trials and the Newcastle–Ottawa Scale (NOS) for cohort and case–control studies. Eligible studies were subsequently included in the analysis.
Results. A total of 14 randomized controlled trials, 5 cohort studies, and 1 case–control study were included. The studies were categorized into two groups: those addressing the treatment of acute wounds (burns and donor site wounds) and those focused on chronic wounds (diabetic foot ulcers). The wound dressings used in each group were analyzed.
Conclusion. The review demonstrated that polylactide-based wound dressings offer several clinically relevant advantages, including the absence of a need for dressing changes until complete healing, reduced pain intensity, and a marked acceleration of epithelialization in chronic wounds. No evidence was identified to suggest reduced effectiveness of these materials when applied to wounds in the maxillofacial region. However, well-designed randomized controlled trials focusing exclusively on patients with skin injuries in this anatomical area are required to provide more robust evidence.
Keywords
About the Authors
A. V. LysenkoRussian Federation
Anna V. Lysenko - DDS, PhD, Docent, Head of the Department of Oral and Outpatient Maxillofacial Surgery, Research Institute of Dentistry and Maxillofacial Surgery.
6 Lev Tolstoy Str., Saint Petersburg, 197022
A. I. Yaremenko
Russian Federation
Andrey I. Yaremenko - DDS, PhD, DSc, Professor, Vice-rector, Head of the Department of Oral and Maxillofacial Surgery.
Saint Petersburg
A. S. Mursalova
Russian Federation
Anna S. Mursalova - 5th year student, Dental School.
Saint Petersburg
References
1. Rahmanian-Schwarz A, Beiderwieden A, Willkomm LM, Amr A, Schaller HE, Lotter O. A clinical evaluation of Biobrane(®) and Suprathel(®) in acute burns and reconstructive surgery. Burns. 2011;37(8): 1343–1348. https://doi.org/10.1016/j.burns.2011.07.010
2. Cussons D, Sullivan J, Frew Q, Barnes D. Suprathel Versus Hypafix in the Management of Split-Thickness Donor Site Wounds in the Elderly: A Randomised Controlled Trial. European burn journal. 2024;5(4):335-345. https://doi.org/10.3390/ebj5040031
3. Koivuniemi R, Hakkarainen T, Kiiskinen J, Kosonen M, Vuola J, Valtonen J, et al. Clinical Study of Nanofibrillar Cellulose Hydrogel Dressing for Skin Graft Donor Site Treatment. Advances in wound care. 2020;9(4):199-210. https://doi.org/10.1089/wound.2019.0982
4. Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097. https://doi.org/10.1371/journal.pmed.1000097
5. Higgins JPT, Savović J, Page MJ, Sterne JAC. Revised Cochrane risk-of-bias tool for randomized trials (RoB 2). Short version (CRIBSHEET). Available from: https://drive.google.com/file/d/1Q4Fk3HCuBRwIDWTGZa5oH11OdR4Gbhdo/view
6. Rebrova O.Y., Fedyaeva V.K. The questionnaire to assess the risk of systematic bias in non-randomized comparative studies: the Russian-language version of the Newcastle-Ottawa scale. Medical technologies. Assessment and choice. 2014;(3):77-84(InRuss.). Available from: https://www.elibrary.ru/item.asp?id=26710963
7. Hundeshagen G, Collins VN, Wurzer P, Sherman W, Voigt CD, Cambiaso-Daniel J, et al.A Prospective, Randomized, Controlled Trial Comparing the Outpatient Treatment of Pediatric and Adult Partial-Thickness Burns with Suprathel or MepilexAg. Journal of burn care & research. 2018;39(2):261-267. https://doi.org/10.1097/BCR.0000000000000584
8. Schwarze H, Küntscher M, Uhlig C, Hierlemann H, Prantl L, Ottomann C, et al. Suprathel, a new skin substitute, in the management of partial-thickness burn wounds: results of a clinical study. Annals of plastic surgery. 2008;60(2):181–185. https://doi.org/10.1097/SAP.0b013e318056bbf6.
9. Schwarze H, Küntscher M, Uhlig C, Hierlemann H, Prantl L, Noack N, Hartmann B. Suprathel, a new skin substitute, in the management of donor sites of splitthickness skin grafts: results of a clinical study. Burns: journal of the International Society for Burn Injuries. 2007;33(7):850–854. https://doi.org/10.1016/j.burns.2006.10.393
10. Heitzmann W, Mossing M, Fuchs PC, Akkan J, Seyhan H, Grieb G, et al. Comparative Clinical Study of Suprathel® and Jelonet® Wound Dressings in Burn Wound Healing after Enzymatic Debridement. Biedicines. 2023;11(10):2593. https://doi.org/10.3390/biomedicines11102593
11. Schiefer JL, Andreae J, Bagheri M, Fuchs PC, Lefering R, Heitzmann W, Schulz A. A clinical comparison of pure knitted silk and a complex synthetic skin substitute for the treatment of partial thickness burns. International Wound Journal. 2022;19(1):178-187. https://doi.org/10.1111/iwj.13613
12. Schiefer JL, Aretz GF, Fuchs PC, Bagheri M, Funk M, Schulz A, Daniels M. Comparison of wound healing and patient comfort in partial-thickness burn wounds treated with SUPRATHEL and epictehydrowound dressings. International Wound Journal. 2022;19(4):782-790. https://doi.org/10.1111/iwj.13674
13. Keck M, Selig HF, Lumenta DB, Kamolz LP, Mittlböck M, Frey M. The use of Suprathel(®) in deep dermal burns: first results of a prospective study. Burns. 2012;38(3):388-395. https://doi.org/10.1016/j.burns.2011.09.026
14. Uhlig C, Rapp M, Hartmann B, Hierlemann H, Planck H, Dittel KK. Suprathel-an innovative, resorbable skin substitute for the treatment of burn victims. Burns. 2007; 33(2):221-229. https://doi.org/10.1016/j.burns.2006.04.024
15. Koroleva T.A., Budkevich L.I., Shurova L.V., Dolotova D.D. Estimated effectiveness of usage of modern skin equivalents in treatment of children with deep burns. Russian journal of pediatric surgery, anesthesia and intensive care. 2014;4(3):77-84 (In Russ.). Available from: https://www.rps-journal.ru/jour/article/viewFile/63/64
16. Liden BA, Ramirez-GarciaLuna JL.Efficacy of a polylactic acid matrix for the closure of Wagner grade 1 and 2 diabetic foot ulcers: a single-center, prospective randomized trial. Wounds. 2023;35(8):E257-E260. https://doi.org/10.25270/wnds/23094
17. Wang G, Li X, Ju S, Li Y, Li W, He H, at al. Effect of electrospun poly (L-lactide-co-caprolactone) and formulated porcine fibrinogen for diabetic foot ulcers. European journal of pharmaceutical sciences. 2024;198:106800. https://doi.org/10.1016/j.ejps.2024.106800
18. Highton L, Wallace C, Shah M. Use of Suprathel® for partial thickness burns in children. Burns. 2013;39(1):136-141. https://doi.org/10.1016/j.burns.2012.05.005
19. Rashaan ZM, Krijnen P, Allema JH, Vloemans AF, Schipper IB, Breederveld RS.Usability and effectiveness of Suprathel® in partial thickness burns in children. European journal of trauma and emergency surgery. 2017;43(4):549-556. https://doi.org/10.1007/s00068-016-0708-z
20. van de Warenburg MS, El Yadari S, Hummelink S, Ulrich DJ, Vehmeijer-Heeman M. Suprathel's usability and effectiveness for the treatment of paediatric partial thickness burns: a 10-year retrospective cohort study. Burns. 2025;51(4):107451. https://doi.org/10.1016/j.burns.2025.107451
21. Blome-Eberwein SA, Amani H, Lozano DD, Gogal C, Boorse D, Pagella P. A bio-degradable synthetic membrane to treat superficial and deep second degree burn wounds in adults and children 4 year experience. Burns. 2021;47(4):838-846. https://doi.org/10.1016/j.burns.2020.08.008
22. Larson BM, Elkady D, Sharma S, Beaucock B, Lou RB, Khandelwal A.Comparative results of autologous skin cell suspension combined with a contact layer dressing versus autologous skin cell suspension and a poly-lactic acid dressing in larger total body surface burns. Burns. 2024;50(7):1832-1839. https://doi.org/10.1016/j.burns.2024.04.008
23. Karlsson M, Steinvall I, Elmasry M. Suprathel® or Mepilex® Ag for treatment of partial thickness burns in children: A case control study. Burns. 2023;49(7):1585-1591. https://doi.org/10.1016/j.burns.2023.03.003
Review
For citations:
Lysenko AV, Yaremenko AI, Mursalova AS. Polylactide-based biodegradable wound dressings for skin injury treatment and their applicability to the maxillofacial region: a systematic review. Parodontologiya. 2025;30(4):373-384. (In Russ.) https://doi.org/10.33925/1683-3759-2025-1160
JATS XML


























