The use of silk dressings in the treatment of skin injuries: A systematic review

Background: Skin injuries like superficial burns and skin graft donor sites are currently managed using various dressings. Frequent challenges include discomfort and trauma during dressing changes, suboptimal healing and significant scarring. Silk dressings show promise by reducing the need for frequent changes, allowing wound evaluation due to its transparency, exerting antibacterial properties, and minimizing scarring. However, silk is not yet widely adopted in clinical settings. Methods: A systematic review was conducted. A search through 3 databases (PubMed, Embase, Cochrane Library) according to the PRISMA guidelines was performed. Only RCTs, cohort studies, case-control studies and case series were included. Appropriate quality tests were performed. Results: 1373 search results were identified. After deduplication, 979 were screened by title and abstract, of which 20 full-text articles remained and ultimately, 9 articles were included. Parameters examined were: healing duration, pain, subjective and objective skin measurements, adverse events, infection rates, transparency and price. Conclusion: Silk dressings demonstrate comparable efficacy to existing dressings concerning transparency, healing time, pain, erythema, pigmentation, water loss normalization, firmness, visco-elasticity recovery, microcirculation, adverse events and infection rates. They are an economically interesting alternative for managing superficial partial-thickness skin burns and skin graft donor sites. Nonetheless, larger high-quality studies are needed to confirm these findings.