Effectiveness of Chitosan versus Collagen Membrane for Wound Healing in Maxillofacial Soft Tissue Defects: A Comparative Clinical Study

Abstract

Wound healing is a specific biological process related to the general phenomenon of growth and tissue regeneration [1]. The variety of wound types has resulted in a wide range of wound dressing materials with new products frequently introduced to target different aspects of the wound healing process. Wound dressings and devices form an important segment of the medical and pharmaceutical market. The ideal dressing should achieve rapid healing at reasonable cost with minimal inconvenience to the patient. In the past, traditional dressings such as natural or synthetic bandages, cotton wool, lint and gauzes all with varying degrees of absorbency were used for the management of wounds. Modern dressings are based on the concept of creating an optimum environment to allow epithelial cells to move unimpeded, for the treatment of wounds. Such optimum conditions include a moist environment around the wound, effective oxygen circulation to aid regenerating cells and tissues and a low bacterial load [2]. It is important therefore, that different dressings be evaluated and Received 6 August 2019 Accepted 30 September 2019 Published online 31 March 2020 Chitosan has been shown to act as an effective hemostat and antimicrobial agent with additional aid in wound healing. The purpose of this study was to compare the wound healing properties of Chitosan versus a more established material like Collagen in a clinical controlled trial. A study conducted at our institution, encompassed all the patients with facial soft tissue abrasions, from July 2016 to July 2017. They were randomly divided into two groups, half treated with Chitosan membrane and the other half treated with Collagen. Comparisons were made according to the pain, time taken for granulation tissue formation and scarring. Sixty patients were included in the study. It was observed that pain reduction over a week was significantly higher in the Collagen group than in the Chitosan group. Significant results in favor of Chitosan were found with regard to average time taken for granulation tissue formation and pigmentation of the resultant scars. The results indicate that Chitosan enhances soft tissue healing, improves color matching and minimizes scarring, as compared to Collagen. Chitosan in its non-resorbable form, however required multiple dressing changes. Chitosan membrane can be an alternative to Collagen membrane as a facial wound dressing material.