Silk Fibroin Biomaterial Shows Safe and Effective Wound Healing in Animal Models and a Randomized Controlled Clinical Trial.
Due to its excellent biological and mechanical properties, silk fibroin has been intensively explored for tissue engineering and regenerative medicine applications. However, lack of translational evidence has hampered its clinical application for tissue repair. Here a silk fibroin film is developed and its translational potential is investigated for skin repair by performing comprehensive preclinical and clinical studies to fully evaluate its safety and effectiveness. The silk fibroin film fabricated using all green chemistry approaches demonstrates remarkable characteristics, including transmittance, fluid handling capacity, moisture vapor permeability, waterproofness, bacterial barrier properties, and biocompatibility. In vivo rabbit full-thickness skin defect study shows that the silk fibroin film effectively reduces the average wound healing time with better skin regeneration compared with the commercial wound dressings. Subsequent assessment in porcine model confirms its long-term safety and effectiveness for full-thickness skin defects. Finally, a randomized single-blind parallel controlled clinical trial with 71 patients shows that the silk fibroin film significantly reduces the time to wound healing and incidence of adverse events compared to commercial dressing. Therefore, the study provides systematic preclinical and clinical evidence that the silk fibroin film promotes wound healing thereby establishing a foundation towards its application for skin repair and regeneration in the clinic.
Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine, School of Medicine, Zhejiang University, Hangzhou, 310058, China.
Wei
W
Zhang
Zhejiang Provincial Key Research Institute of Medical Materials and Tissue Engineering, Hangzhou, 310000, China.
Longkun
L
Chen
Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine, School of Medicine, Zhejiang University, Hangzhou, 310058, China.
Jialin
J
Chen
Zhejiang Provincial Key Research Institute of Medical Materials and Tissue Engineering, Hangzhou, 310000, China.
Lingshuang
L
Wang
Zhejiang Provincial Key Research Institute of Medical Materials and Tissue Engineering, Hangzhou, 310000, China.
Xuexian
X
Gui
Department of Orthopaedics, The Second Affiliated Hospital, Zhejiang University, Hangzhou, 310052, China.
Jisheng
J
Ran
Zhejiang Provincial Key Research Institute of Medical Materials and Tissue Engineering, Hangzhou, 310000, China.
Guowei
G
Xu
Zhejiang Provincial Key Research Institute of Medical Materials and Tissue Engineering, Hangzhou, 310000, China.
Hongshi
H
Zhao
Zhejiang Provincial Key Research Institute of Medical Materials and Tissue Engineering, Hangzhou, 310000, China.
Mengfeng
M
Zeng
Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine, School of Medicine, Zhejiang University, Hangzhou, 310058, China.
Junfeng
J
Ji
Department of Burn and Plastic Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, China.
Li
L
Qian
Department of Burn and Plastic Surgery, The Third Xiangya Hospital, Central South University, Changsha, 410083, China.
Jianda
J
Zhou
Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine, School of Medicine, Zhejiang University, Hangzhou, 310058, China.
Hongwei
H
Ouyang
Clinical Research Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, China.
Xiaohui
X
Zou
D000818:Animals; D001672:Biocompatible Materials / Q000009:adverse effects* / Q000737:chemistry* / Q000627:therapeutic use; D005349:Fibroins / Q000737:chemistry*; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D047011:Silk / Q000737:chemistry*; D014945:Wound Healing / Q000187:drug effects
D001672:Biocompatible Materials; D047011:Silk; D005349:Fibroins
bench to bedside; controlled clinical trial; silk fibroin biomaterial; skin repair and regeneration; wound healing