Chronic ulcers of the lower limbs are common and recurrent, especially in the elderly population, they are disabling injuries that generate a great socioeconomic burden. This scenario encourages the development of new, low-cost therapeutic alternatives. The present study aims to describe the use of bacterial cellulose in the treatment of lower limb ulcers. This is an integrative literature review, carried out in the PubMed and Science Direct databases by associating the descriptors, with the inclusion criteria being clinical studies in the last 5 years, available in full in English, Portuguese and Spanish. Five clinical trials were analyzed and the main therapeutic effects obtained in the experimental groups that used bacterial cellulose dressings were a reduction in the area of the wounds, one of the studies showed a reduction of 44.18cm² in the area of the wound, the initial lesions measured on average 89.46cm² and at the end of the follow-up, they had an average of 45.28cm², since the reduction in pain and the decrease in the number of exchanges were advantages described in all groups that used the BS. It is concluded that BC dressings are an alternative for the treatment of lower limb ulcers, their use also reduces operational costs related to the treatment of ulcers.

Key words: Urinary Incontinence; Urethra; ethyl-2-hydroxyethylcellulose [Supplementary Concept]; Polysaccharides, Bacterial; Biocompatible Materials

The poor healing of diabetic wounds is characterized by prolonged inflammation and decreased collagen deposition. Diabetic patients exhibit changes in the plasma concentrations of pro-inflammatory cytokines, and the role of specific dressings may have an impact on healing. This study aims to evaluate the effects of a combined treatment comprising a bacterial cellulose dressing and melatonin application on the regulation and expression of inflammatory cytokines, VEGF, PCNA, and collagen in the healing of cutaneous wounds of diabetic rats. Pro-inflammatory cytokines, including IL-6, TNF-α, and VEGF, along with PCNA and type I and III collagen, were evaluated after 14 days. Immunohistochemistry showed decreased levels of IL-6, TNF-α, and VEGF, along with an increased expression of PCNA and type I collagen, in the groups treated exclusively with melatonin and bacterial cellulose associated with melatonin compared to the control and the commercial healing agent. It was concluded that treating the skin lesions of diabetic animals supplemented with melatonin using a bacterial cellulose-based dressing has positive effects in regulating the expression of inflammatory cytokines, vascular endothelial growth factor, and collagen, showing that this association could be a viable therapy approach in wound healing.

Objetivou-se monitorar a evolução do processo cicatricial das lesões por pressão (LP) em pacientes hospitalizados emUnidades de Terapia Intensiva (UTI), a partir da aplicação da cobertura de celulose bacteriana (CB). Trata-se de uma sériede casos, amostra constituída por 10 pacientes internados na UTI. Foram excluídos crianças, adolescentes, e pacientes comoutros tipos de lesões de pele. Foram aplicadas as escalas preditivas de Braden e a de MEASURE. Realizado monitoramento fotográfico pelo programa MOWA®. A pesquisa foi desenvolvida no setor de terapia intensiva de um hospital universitário em Recife, Pernambuco. A maioria dos pacientes era do sexo feminino (60%), com média de idade de 60±12anos.Quanto as comorbidades, 3 pacientes apresentavam diabetes mellitus (DM), 2 hipertensão arterial sistêmica (HAS), 3 DMe HAS e 2 negaram doença crônica. Sete pacientes foram acompanhados por 30 dias, em média. O risco avaliado pelaescala de Braden foi de 9,66. As LP localizavam-se na região sacral, com área média de 84,48cm2 à avaliação inicial. Após30 dias de acompanhamento observou-se redução da área média das LP (-14,7cm²). A CB funcionou como barreira físicae indutor do remodelamento tecidual.Palavras -chave: Cicatrização; Lesão por pressão; Celulose; Cana-de-açúcar. ABSTRACTThe objective of this study was to monitor the evolution of the cicatricial process of pressure lesions (LP) in patientshospitalized in Intensive Care Units (ICU), from the application of bacterial cellulose (CB) coverage. This is a series of cases, a sample consisting of 10 patients hospitalized in the ICU. Children, adolescents, and patients with other types of skinlesions were excluded. Predictive scales of Braden and MEASURE were applied. Photographic monitoring carried out bythe MOWA® program. The research was developed in the intensive care sector of a university hospital in Recife, Pernambuco. The majority of the patients were female (60%), with a mean age of 60 ± 12 years. As for comorbidities, 3 patientshad diabetes mellitus (DM), 2 systemic arterial hypertension (SAH), 3 DM and SAH and 2 denied chronic disease. Sevenpatients were followed for 30 days, on average. The risk assessed by the Braden scale was 9.66. LPs were located in thesacral region, with a mean area of 84.48 cm2 at the initial evaluation. After 30 days of follow-up, we observed a reductionin the mean area of LP (-14.7 cm²). CB worked as a physical barrier and inducer of tissue remodeling.Keywords: Wound healing; Pressure injury; Cellulose; Sugar cane.

The aim of this study is to evaluate if a gel of bacterial cellulose gel can revert the loss of anal resting pressure after anorectum sphincter injury in rat model, elected as a model to simulate fecal incontinence. Thirty-nine animals were equally divided into three groups: Control (CG), Sphincter injury plus Saline injection (SG) and Sphincter injury plus Bacterial Cellulose Gel injection (BCG). Anal pressure at rest was assessed for all animal in the three groups using anorectum manometry. Saline and Gel groups were subject to anorectum sphincter injury to reduce the anal pressure at rest. Fifteen days later Saline or Gel was injected into the anorectum, according to their groups. Sixty days later first manometry, the anorectum of all animals were removed and processed histologically. The CG group showed maintenance of their mean anorectal resting pressure levels; SG presented a fall in their mean anorectal resting pressure. The BCG presented a significant elevation of the mean anorectal resting pressure levels, surpassing the pressure of CG. The gel of bacterial cellulose remained at the injection site and was neovascularized, colonized by fibroblasts and dense conjunctive tissue. Those data suggest that BC can be used as a future filling agent treatment for fecal incontinence in clinical trial protocols.