A novel human ex-vivo burn model and the local cooling effect of a bacterial nanocellulose-based wound dressing

Abstract Background Burn wound progression is a major problem since initially superficial burns can convert into full thickness burns over time. Cooling is an efficient method to reduce burn wound conversion. However, if the cooling agent is ice-cold water or similar cold products, depending on the wound size the patient is at risk of hypothermia. Additionally, the tissue perfusion is reduced leading to an aggravation of burn wound progression. We investigated if wound dressings based on non-pre-cooled bacterial nanocellulose (BNC) with a high water content could be used to cool a burn just by evaporation and reduce the intradermal damages in the skin. Material and methods In a human ex-vivo model, skin explants were inflicted contact burns using a 100 °C hot steel block. The burned areas were divided into two groups of which one was cooled with a BNC-based wound dressing. Intradermal temperature probes measured temperature in cooled and uncooled burn sites over 24 h. For histological assessments of the burned areas biopsies were taken at different time points. High mobility group box-1 (HMBG1) staining served as marker for cell vitality and necrosis in the different skin layers. Results Intradermal temperature measurement showed that application of the BNC-based wound dressing reduced temperature significantly in burned skin. This cooling effect resulted in a maximum temperature difference of 6.4 ± 1.9 °C and a significant mean reduction of the area under the curve in the first hour post-burn of 62% (p  Conclusion Based on our results, BNC-based wound dressings can be used in order to cool a burn. Intradermal temperature as well as thermal damage of the tissue was reduced. The tested BNC-based wound dressing can be used without pre-cooling to cool a burn as well as to reduce the burn BNC-based wound progression through its evaporation cooling effect.