Temple University School of Podiatric Medicine Journal Review Club

Editor's note: This post is part of the Temple University School of Podiatric Medicine (TUSPM) journal review club blog series. In each blog post, a TUSPM student will review a journal article relevant to wound management and related topics and provide their evaluation of the clinical research therein.

Article title: Assessment of Chicken-Egg Membrane as a Dressing for Wound Healing
Authors: Fernando Guarderas, MD; Yaowaree Leavell, MD; Trisha Sengupta, BBA; Mariya Zhukova, BS; and Timothy L. Megraw, PhD.
Journal name and issue: Advances in Skin & Wound Care. March 2016. Vol. 29(3) (pages 131-134).
Reviewed by: Randi Heming, Class of 2017, Temple University School of Podiatric Medicine.

Although unconventional, anecdotal evidence exists citing the use of chicken egg membrane as a home remedy for lacerations and wound management. Within western medicine, the only established use of egg membrane has been noted in the field of ophthalmology. Egg membrane is composed of type I, IV, and V collagen which is a major component of bodily tissues that is utilized during wound healing. Not only is egg membrane 90% protein by weight, but it also has been found to act as a temporary barrier to bacterial invasion. This alternative material also has adhesive properties and contracts while hardening, thus aiding in the process of wound closure. An assessment of the efficacy of its use in wound healing was evaluated using a rat model and wound treatment protocol.

Methods

Two trials using 6 and 8 male rats were completed with the animals under inhalation anesthesia. Two full-thickness circular wounds were made with a skin punch, one between the scapula at the midline and the other 1.5cm posterior to the original. One wound received the chicken egg membrane dressing and the other received no treatment as a control. The egg membranes were peeled and dipped into a penicillin/streptomycin solution to prevent infection prior to being placed. After 5 days, the dressed wounds were debrided, photographed, and new egg membrane placed at the wound site. Subsequent repetition of the stated procedure was performed again on day 8 and 10 respectively. Imaging of the site was continued till day 20 of the experiment and used to determine a pixel count of the open lesion. Percentage of healing was calculated by dividing the current area of the open wound by the initial area.

Results

During the early stages of wound healing between day 0 and day 5, the results indicated there was a statistically significant faster rate of healing in wounds dressed with the chicken egg membrane treatment. The control group healed 21% slower during the early days of healing compared to the experimental group. However, the overall wounds healed at indistinguishable rates from day 8 to day 21. The control wounds healed at rates similar to other wound healing studies within the literature.

Conclusion

Day 0 to day 5 delineates the lag phase of wound healing during which disorganized fibroblast migration occurs in order to act as a scaffold to support the recovering wound. The chicken egg membrane treatment could have contributed to the framework for this cell migration and thus enhanced the lag phase. Other possible processes that could have accelerated wound healing include the added nutrients from egg membrane proteins (particularly albumin) and increased wound contracture. The authors' data proposes the addition of egg membrane to a wound is a safe form of dressing and might provide benefits over that of an uncovered wound. One should exercise caution though in the presence of patients with allergies to eggs and note the risk of infection from Salmonella. Egg membranes may significantly improve the early stages of cutaneous wound healing and could be incorporated into both bandages and skin grafts. Further study is required with more frequent time points along the day 0 to day 5 data collection. Additional investigation also needs to look at the effects of the egg membrane being dipped into the antibiotic solution and how that extra exposure may contribute to wound healing. The control wounds did not receive this added antibiotic contact and thus could represent a confounding variable of the study.

About the Authors:
Randi Heming is a third-year student at Temple University School of Podiatric Medicine (TUSPM). She graduated from the University of Cincinnati in Cincinnati, Ohio in 2014 with a Bachelor of Science in Health Sciences. Her curiosity about the podiatric profession first piqued due to her grandfather’s own diabetic foot care needs.

Dr. James McGuire is the director of the Leonard S. Abrams Center for Advanced Wound Healing and an associate professor of the Department of Podiatric Medicine and Orthopedics at the Temple University School of Podiatric Medicine in Philadelphia.