Could Bacterial Cellulose Be the Future of Varicose Ulcer Treatment?
"A randomized controlled trial explores the effectiveness of bacterial cellulose membranes in treating chronic venous ulcers, offering new hope for a common and debilitating condition."
Chronic venous disease (CVD) in the lower limbs is a widespread issue, stemming from malfunctioning vein valves and impacting blood flow. Affecting a significant portion of the population, particularly women, CVD can lead to serious complications, diminish quality of life, and trigger psychological distress. Open ulcers, classified as CEAP 6, represent the most severe manifestation of this condition.
Traditional treatments for chronic venous ulcers (CVU) often involve expensive materials that are not readily accessible. This is especially true within healthcare systems with budget constraints. However, bacterial cellulose (BC) membranes, derived from sugarcane molasses, offer a promising alternative. Developed at the Experimental Station of Sugar Cane in Carpina (EECC), Federal University of Pernambuco, Brazil, BC has demonstrated non-toxic and biocompatible properties suitable for tissue remodeling.
A recent study delved into the efficacy of BC membrane dressings in treating chronic varicose ulcers of the lower limbs. This article will explore the study's findings, highlighting the potential of BC as a cost-effective and efficient treatment option.
From Traditional Dressings to Bacterial Cellulose
Wound care has a long history of using polysaccharide materials, from oil-soaked linen strips and cotton gauze to advanced wound-care products. Bacterial cellulose has been proposed as a promising wound-dressing material, including for venous and varicose ulcers. A 2021 study set out to evaluate bacterial cellulose, gel, and a multi-perforated film for lower-limb chronic venous ulcers, against a backdrop in which some suggested dressings were expensive and generally unavailable in public health services. A later study proposed a film made from bacterial cellulose obtained from sugar-cane molasses as an alternative to microporous tape in lower-limb varicose vein surgery.
Bacterial Cellulose Membranes: A New Hope for Healing?
The study was a prospective, randomized, controlled intervention, researchers evaluated 25 patients with CVD ulcers (CEAP 6) in their lower limbs. Participants were treated at the Angiology and Vascular Surgery Service of the Clinics Hospital of the Federal University of Pernambuco (HC/UFPE) and the Salgado Polyclinic.
- Reduced Wound Area: Both groups experienced a reduction in wound area over the 120-day study period.
- No Adverse Reactions: Neither group reported infections or adverse reactions to the treatments.
- Pain Reduction: Patients in the BC group reported decreased pain and discontinued analgesic use earlier than the control group.
Clinical Findings and Ongoing Research
A review reports that a bacterial cellulose dressing applied to venous leg ulcers for 120 days was not associated with adverse effects and was accompanied by a decrease in overall ulcer depth. Another review describes findings in male patients in which bacterial cellulose reduced lower-limb ulcer depth, supported tissue remodeling, and initiated tissue granulation without toxicity compared with limbs without a dressing. A 2025 randomized clinical trial on bacterial cellulose film in varicose vein surgery reports that patients experienced less pain during dressing removal and could keep the dressing in place for up to 7 days, while conventional dressings required changes every 2 days. A 2026 article describes venous leg ulcers as a chronic condition that can cause disability, with frequency rising with age and substantial healthcare costs.
The Search for an Ideal Dressing
There is no consensus on the ideal dressing for covering wounds after varicose vein surgery. The source says that expected features include low cost, hypoallergenicity, and good adherence. It reports that bacterial cellulose film was evaluated in patients undergoing varicose vein surgery because it was considered to meet those features. The available source material does not provide results that establish whether the film failed or how it compared with alternatives.
Dressings in Wound Care
Dressings are used to protect wounds, prevent infection, and assist healing. Gauze is described as the most common dressing on the market, while other dressing materials may accelerate wound healing. Bacterial cellulose dressings have been the subject of multiple studies and applications, and research also considers natural or artificial compounds that may benefit tissue repair. The supplied source material does not provide comparative outcome figures for bacterial cellulose versus gauze or those other compounds.
The Future of Wound Care?
The study highlights the potential of bacterial cellulose membranes as a practical and effective alternative for treating chronic venous ulcers. This is especially significant considering the limitations and high costs associated with traditional treatments.
Promising Results in Varicose Vein Surgery
The randomized controlled trial highlighted in the source describes bacterial cellulose film as a safe and effective dressing for varicose vein surgery. It reports that operative wounds closed in approximately 3 days. The trial also reports less pain during application and removal than with microporous tape. These findings are specific to operative wounds in varicose vein surgery.
A Dressing Studied for Chronic Venous Ulcers
A 2021 report describes Silva and colleagues’ randomized controlled clinical intervention study of lower-limb venous ulcers using bacterial cellulose in membrane, gel, and other forms. A separate source identifies a February 2017 randomized controlled trial of bacterial cellulose membrane for lower-limb chronic varicose ulcers. That trial’s conclusion was that bacterial cellulose membrane can be used as a dressing for lower-limb varicose ulcers. The supplied excerpts do not give further patient-reported outcomes or detailed trial results.
Further research can explore structural modifications to BC membranes to optimize their properties, such as increasing water absorption and antimicrobial activity. Combining BC with controlled-release systems for antibiotics or other active ingredients could also enhance its therapeutic effects.
The bacterial cellulose membrane presents ideal properties for wound dressings. It maintains humidity, absorbs excess fluids, limits infection, and protects against mechanical trauma. This innovative material offers a promising alternative for treating chronic varicose ulcers of the lower limbs, potentially improving patient outcomes and reducing healthcare costs.