Haemostasis, inflammation, proliferation, and remodelling are the steps that comprise the complex biological process of wound healing. Chronic wounds often remain static in the inflammatory stage of wound healing beyond the expected duration and resist healing. Biosilk or biomodified silk dressing is believed to aid in accelerating the wound healing process. The combination bio functionalised silk matrix with silver oxide and Centella asiatica, a medicinal plant with wound healing properties, has been found to be effective in managing chronic non-healing wounds.

Wounds healing is a complex biological process which comprises of haemostasis, inflammation, proliferation, and remodelling. Cells that are involved in this process include neutrophils, macrophages, lymphocytes, keratinocytes, fibroblasts, and endothelial cells.[1] A chronic wound is one that does not heal in the expected sequence and in a predictable length of time, or one that does not heal within three months.[2] Chronic wounds often remain static in the inflammatory stage of wound healing beyond the expected duration. The predominant issue that patients with chronic ulcers face is persistent pain. In the recent years, biological dressings have gained popularity and have been found to benefit patients with chronic wounds. One such dressing substance being explored is biosilk containing silver oxide and Centella asiatica, a medicinal plant. Its use is thought to enhance the wound healing process.

An 82 years old gentleman, with no comorbidities, presented with complaints of thermal burns of 35% BSA by cylinder blast. On examination of the left upper limb: 2nd degree superficial to deep burns on the forearm on the dorsal aspect with multiple blisters. 

Wound at admission (Figure 1) 

                                                                                       Figure 1: Wound at presentation with BJWAT score- 36

and on Day 3 of admission when Biosilk was applied (Figure 2). 

                                                                           Figure 2: Wound on Day 3 of admission on the left upper arm.

Wound on 10th day of admission on the left upper arm (Figure 3 and 4).

                                                 Figure 3 and 4:  Wound with BJWAT 24 score on 10th day of admission on the left upper arm.

At the end biosilk dressing, there was accelerated wound healing noted of the raw area of right thigh with healthy granulation tissue.

Wound healing to be adequate requires rapid haemostasis, appropriate inflammation. mesenchymal cell differentiation, proliferation, and migration to the wound site, angiogenesis, prompt re-epithelialization and proper synthesis, cross-linking, and alignment of collagen to provide strength to the healing tissue.[4] Growth factors such as transforming growth factor (TGF)- platelet-derived growth factor (GF), fibroblast growth factor (FGF), and epidermal growth factor (EGF) play a crucial role in facilitating the above-mentioned steps of wound healing

The aim of this study was to explore the effects of use of biosilk in wound healing. The combination used here included silk, Centella asiatica extract, and silver oxide, each of which carry important properties that affect wound healing. Due to the unique properties of silk, such as, great mechanical strength, outstanding biocompatibility, and the capacity to modify the structural and morphological aspects of silk proteins, they represent a now class of sophisticated biomaterials. It has proven to be a beneficial material in biomedical engineering applications such as skin, bone, and vascular grafts. [5-9] Schneider et al conducted a study regarding use of silk mats incorporated with epidermal growth factor (EGF), for the promotion of wound healing processes and was concluded that there was an increase in wound closure by the epidermal tongue by 90%.[10]

Centella asiatica facilitate the wound healing process in both incision and burn wounds. Amongst a variety of extracts obtained for this plant, ascitic acid in the ethyl acetate extract seemed to be the most active component for healing the wound.[11] It has been reported that 1

In this study, we have understood to role of biosilk or biomodified silk in enhancement of wound healing and the properties of various properties of biosilk that facilitate the same. To confirm the effectivity of biosilk in healing of wound, it is required to conduct larger randomised control trials.