1
|
Vasella M, Cirebea J, Gousopoulos E, Wang A, Schweizer R, Waldner M, Grieb G, Buehler P, Plock JA, Kim BS. Outcome of Facial Burn Injuries Treated by a Nanofibrous Temporary Epidermal Layer. J Clin Med 2023; 12:5273. [PMID: 37629315 PMCID: PMC10455532 DOI: 10.3390/jcm12165273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 08/04/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND The face is commonly affected in thermal injuries, with a demand for proper recognition and the correct choice of treatment to guarantee optimal aesthetic and functional outcomes. It is highly vascularized and often heals conservatively, highlighting the particular relevance of conservative treatment modalities, many of which require daily re-applications or dressing changes, which can be painful and tedious for both the patient and the healthcare providers. Motivated by encouraging results of a novel temporary nanofibrous epidermal layer, we herein present a case series of this technology in a case series of patients suffering from facial burns and treated in our Burn Center. PATIENTS AND METHODS Patients with superficial partial-thickness facial burns and mixed pattern burns, which were treated with SpinCare™, an electrospun nanofibrous temporary epidermal layer, between 2019 and 2021, at our institution were analyzed retrospectively. The Manchester scar scale (MSS) and numeric rating scale (NRS) were used for scar, pain, and outcome evaluation at different time points by five independent board-certified plastic surgeons with profound experience in burn surgery. RESULTS Ten patients (m = 9; f = 1) were treated and evaluated retrospectively. The mean age was 38.8 ± years (SD ± 17.85). The mean healing time was 6.4 days (SD ± 1.56). The mean follow-up was 16.4 months (SD ± 11.33). The mean MSS score was 5.06 (SD ± 1.31), and the mean NRS Score for pain was significantly reduced from initially 7 to 0.875 upon application (mean (pre-application) 7 ± 0.7 and (application) 0.875 ± 1.26; p ≤ 0.0001). Patients reported a NRS score of 10 in terms of functional and cosmetic outcomes at their final follow-up appointment. No adverse effects were observed. CONCLUSIONS The application of a nanofibrous temporary epidermal layer such as SpinCare™ represents a relatively easy-to-use, well-tolerated, and effective alternative for the treatment of partial-thickness facial burns.
Collapse
Affiliation(s)
- Mauro Vasella
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, 8091 Zurich, Switzerland; (M.V.); (E.G.); (A.W.); (R.S.); (M.W.); (J.A.P.)
| | - Jan Cirebea
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, 8091 Zurich, Switzerland; (M.V.); (E.G.); (A.W.); (R.S.); (M.W.); (J.A.P.)
| | - Epameinondas Gousopoulos
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, 8091 Zurich, Switzerland; (M.V.); (E.G.); (A.W.); (R.S.); (M.W.); (J.A.P.)
| | - Anna Wang
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, 8091 Zurich, Switzerland; (M.V.); (E.G.); (A.W.); (R.S.); (M.W.); (J.A.P.)
- Department of Plastic Surgery and Hand Surgery, Cantonal Hospital Aarau, 5001 Aarau, Switzerland
| | - Riccardo Schweizer
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, 8091 Zurich, Switzerland; (M.V.); (E.G.); (A.W.); (R.S.); (M.W.); (J.A.P.)
- Department of Plastic, Reconstructive and Aesthetic Surgery, Regional Hospital Lugano, 6900 Lugano, Switzerland
| | - Matthias Waldner
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, 8091 Zurich, Switzerland; (M.V.); (E.G.); (A.W.); (R.S.); (M.W.); (J.A.P.)
| | - Gerrit Grieb
- Department of Plastic Surgery and Hand Surgery, Gemeinschaftskrankenhaus Havelhoehe, 14089 Berlin, Germany;
- Department of Plastic Surgery & Hand Surgery, Burn Center, Medical Faculty, Hospital of the RWTH Aachen University, 52074 Aachen, Germany
| | - Philipp Buehler
- Center of Intensive Care Medicine, Cantonal Hospital Winterthur, 8400 Winterthur, Switzerland;
| | - Jan Alexander Plock
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, 8091 Zurich, Switzerland; (M.V.); (E.G.); (A.W.); (R.S.); (M.W.); (J.A.P.)
- Department of Plastic Surgery and Hand Surgery, Cantonal Hospital Aarau, 5001 Aarau, Switzerland
| | - Bong-Sung Kim
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, 8091 Zurich, Switzerland; (M.V.); (E.G.); (A.W.); (R.S.); (M.W.); (J.A.P.)
| |
Collapse
|
2
|
Egro F, Repko A, Narayanaswamy V, Ejaz A, Kim D, Schusterman MA, Loughran A, Ayyash A, Towsend SM, Baker S, Ziembicki J, Marra K, Rubin P. Soluble chitosan derivative treats wound infections and promotes wound healing in a novel MRSA-infected porcine partial-thickness burn wound model. PLoS One 2022; 17:e0274455. [PMID: 36240206 PMCID: PMC9565743 DOI: 10.1371/journal.pone.0274455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 08/28/2022] [Indexed: 11/19/2022] Open
Abstract
Burns are physically debilitating and potentially fatal injuries. The most common etiology of burn wound infections in the US is methicillin-resistant Staphylococcus aureus (MRSA), which is particularly recalcitrant when biofilms form. The current standard of care, silver sulfadiazine (SSD) is effective in reducing bacterial load, but less effective in improving burn wound healing. New treatments that can manage infection while simultaneously improving healing would provide a benefit in the treatment of burns. Porcine models are frequently used as a model for human wound healing but can be expensive due to the need to separate wounds to avoid cross contamination. The porcine model developed in this study offers the capability to study multiple partial thickness burn wound (PTBW) sites on a single animal with minimal crosstalk to study wound healing, infection, and inflammation. The current study evaluates a wound rinse and a wound gel formulated with a non-toxic, polycationic chitosan derivative that is hypothesized to manage infection while also promoting healing, providing a potential alternate to SSD. Studies in vitro and in this PTBW porcine model compare treatment with the chitosan derivative formulations to SSD. The wound rinse and wound gel are observed to disrupt mature MRSA biofilms in vitro and reduce the MRSA load in vivo when compared to that of the standard of care. In vivo data further show increased re-epithelialization and faster healing in burns treated with wound rinse/gel as compared to SSD. Taken together, the data demonstrate the potential of the wound rinse/gel to significantly enhance healing, promote re-epithelialization, and reduce bacterial burden in infected PTBW using an economical porcine model.
Collapse
Affiliation(s)
- Francesco Egro
- Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Alex Repko
- Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, PA, United States of America
| | | | - Asim Ejaz
- Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Deokyeol Kim
- Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - M. Asher Schusterman
- Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, PA, United States of America
| | | | - Ali Ayyash
- Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, PA, United States of America
| | | | - Shenda Baker
- Synedgen Inc., Claremont, CA, United States of America
| | - Jenny Ziembicki
- Department of Surgery, University of Pittsburgh Medical Center Mercy, Pittsburgh, PA, United States of America
| | - Kacey Marra
- Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, PA, United States of America
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States of America
- McGowan Institute of Regenerative Medicine, Pittsburgh, PA, United States of America
| | - Peter Rubin
- Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, PA, United States of America
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States of America
- McGowan Institute of Regenerative Medicine, Pittsburgh, PA, United States of America
- * E-mail:
| |
Collapse
|
3
|
Two-piece facial orthosis. BURNS OPEN 2021. [DOI: 10.1016/j.burnso.2021.08.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
|
4
|
Nathan JM, Ettinger KS. Management of Nasal Trauma. Oral Maxillofac Surg Clin North Am 2021; 33:329-341. [PMID: 34088554 DOI: 10.1016/j.coms.2021.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Facial trauma can have long-lasting physical and mental consequences. Trauma to the nose is commonly seen in the emergency department. Nasal lacerations account for 7% of all facial lacerations. Thorough examination and documentation including photographs is important for documentation and creating a reconstruction plan. Underlying damage to cartilage or bone must be reconstructed initially or in a delayed fashion to recreate the pretrauma anatomy and function. There are several options for soft tissue nasal reconstruction, including local flaps, skin grafts, pedicle flaps, and free flaps. At present there is no standard of care for postoperative facial trauma wound care.
Collapse
Affiliation(s)
- John M Nathan
- Division of Oral & Maxillofacial Surgery, Department of Surgery, Mayo Clinic, Mail Code: ro_ma_12_03E-OS, 200 First Street Southwest, Rochester, MN 55905, USA
| | - Kyle S Ettinger
- Section of Head & Neck Oncologic and Reconstructive Surgery, Division of Oral & Maxillofacial Surgery, Department of Surgery, Mayo Clinic, Mail Code: ro_ma_12_03E-OS, 200 First Street Southwest, Rochester, MN 55905, USA.
| |
Collapse
|
5
|
Zakaria R, J Musa R, Faraj J, H Mahmoud Abudayeh Z, A Mohammed H. Evaluation of the Wheat Germ Oil Topical Formulations for Wound Healing Activity in Rats. Pak J Biol Sci 2021; 24:706-715. [PMID: 34486347 DOI: 10.3923/pjbs.2021.706.715] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Wheat Germ Oil (WGO), the flour-milling by-product of wheat has essential constituents for skin health care as vitamin E, B-complex, squalene and unsaturated fatty acids. Incorporate WGO into polymers of the cream and ointment bases and evaluate the wound healing potential of these WGO formulations in the rat-animal model. <b>Materials and Methods:</b> WGO creams and ointments were prepared in two concentrations, 10 and 20% and evaluated for storage stability, homogeneity and compatibility using Fourier Transform Infrared (FT-IR) spectrometry. An amount of 0.5 g of the WGO formulations was applied daily to the injured area of the rats back. Wounds were observed for any clinical changes and healing compared to the control animal group. <b>Results:</b> The WGO was compatible with the cream and ointment bases and physically stables over 60 days of storage. The formulations of WGO have induced dose-dependent wound healing properties however the ointment formulations were demonstrating wound healing activity significantly better than the creams at all the intervals of the treatment. Within three weeks, 20% WGO ointment has induced a 90%reduction in the wound size diameter. Also, wounds recovered by 50% in 10 and 14 days of treatment with 20% WGO ointment and cream, respectively. <b>Conclusion:</b> The results revealed that WGO is a potential wound-healing agent from the scope that WGO is a common cosmetic ingredient and available at affordable prices.
Collapse
|
6
|
Guo HF, Mohd Ali R, Abd Hamid R, Chang SK, Rahman MH, Zainal Z, Khaza'ai H. Epidermal Growth Factor and Tocotrienol-Rich Fraction Cream Formulation Accelerates Burn Healing Process Based on Its Gene Expression Pattern in Deep Partial-Thickness Burn Wound Model. INT J LOW EXTR WOUND 2020; 21:544-554. [PMID: 33241700 DOI: 10.1177/1534734620971066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Our previous study has demonstrated that epidermal growth factor (EGF) with tocotrienol-rich fraction (TRF) cream formulation accelerating postburn wound healing with deep partial-thickness burn in rats. Current study was conducted to determine the gene expression levels related to burn wound healing process. A total of 180 Sprague-Dawley rats were randomly divided into 6 groups: untreated control, treated with Silverdin cream, base cream, base cream with 0.00075% EGF, base cream with 3% TRF or base cream with 0.00075% EGF, and 3% TRF, respectively. Burn wounds were created and the above-mentioned creams were applied once daily. Six animals from each group were sacrificed on days 3, 7, 11, 14, and 21 postburn. RNA was extracted from wound tissues and quantitative real-time polymerase chain reaction was performed to analyze the 9 wound healing-related genes against time postburn. Results demonstrated that topically applied EGF + TRF formulation downregulated the expression levels of IL-6 (interluekin-6), TNF-α (tumor necrosis factor-α) and iNOS (inducible nitric oxide synthase) throughout the whole healing process. TGF-β1 (transforming growth factor-β) and VEGF-A (vascular endothelial growth factor-A) were reduced on day 14 postburn. On the contrary, increased expression of Collagen-1 in the early stage of wound healing was observed with no effects on epidemal growth factor receptor (EGFR). The results showed beneficial application of EGF + TRF cream in the treatment of burn wound since it accelerated wound healing by relieving oxidative stress, decreasing inflammation, and promoting proper tissue modelling in the burn wound.
Collapse
Affiliation(s)
- Hui-Fang Guo
- Chengde Medical University, Chengde Hebei, China.,Universiti Putra Malaysia, Serdang, Malaysia
| | | | | | - Sui Kiat Chang
- South China Botanical Garden, Chinese Academy of Sciences, Guangzhou, Guangdong, China
| | | | - Zaida Zainal
- Malaysian Palm Oil Board, Bandar Baru Bangi, Kajang, Selangor, Malaysia
| | | |
Collapse
|
7
|
Kwon SH, Barrera JA, Noishiki C, Chen K, Henn D, Sheckter CC, Gurtner GC. Current and Emerging Topical Scar Mitigation Therapies for Craniofacial Burn Wound Healing. Front Physiol 2020; 11:916. [PMID: 32848859 PMCID: PMC7403506 DOI: 10.3389/fphys.2020.00916] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 07/09/2020] [Indexed: 01/22/2023] Open
Abstract
Burn injury in the craniofacial region causes significant health and psychosocial consequences and presents unique reconstructive challenges. Healing of severely burned skin and underlying soft tissue is a dynamic process involving many pathophysiological factors, often leading to devastating outcomes such as the formation of hypertrophic scars and debilitating contractures. There are limited treatment options currently used for post-burn scar mitigation but recent advances in our knowledge of the cellular and molecular wound and scar pathophysiology have allowed for development of new treatment concepts. Clinical effectiveness of these experimental therapies is currently being evaluated. In this review, we discuss current topical therapies for craniofacial burn injuries and emerging new therapeutic concepts that are highly translational.
Collapse
Affiliation(s)
- Sun Hyung Kwon
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, United States
| | - Janos A Barrera
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, United States
| | - Chikage Noishiki
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, United States
| | - Kellen Chen
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, United States
| | - Dominic Henn
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, United States
| | - Clifford C Sheckter
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, United States
| | - Geoffrey C Gurtner
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, United States
| |
Collapse
|
8
|
Hoogewerf CJ, Hop MJ, Nieuwenhuis MK, Oen IM, Middelkoop E, Van Baar ME. Topical treatment for facial burns. Cochrane Database Syst Rev 2020; 7:CD008058. [PMID: 32725896 PMCID: PMC7390507 DOI: 10.1002/14651858.cd008058.pub3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Burn injuries are an important health problem. They occur frequently in the head and neck region. The face is the area central to a person's identity that provides our most expressive means of communication. Topical interventions are currently the cornerstone of treatment of burns to the face. OBJECTIVES To assess the effects of topical interventions on wound healing in people with facial burns of any depth. SEARCH METHODS In December 2019 we searched the Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE (including In-Process & Other Non-Indexed Citations); Ovid Embase and EBSCO CINAHL Plus. We also searched clinical trials registries for ongoing and unpublished studies, and scanned reference lists of relevant included studies as well as reviews, meta-analyses and health technology reports to identify additional studies. There were no restrictions with respect to language, date of publication or study setting. SELECTION CRITERIA Randomised controlled trials (RCTs) that evaluated the effects of topical treatment for facial burns were eligible for inclusion in this review. DATA COLLECTION AND ANALYSIS Two review authors independently performed study selection, data extraction, risk of bias assessment and GRADE assessment of the certainty of the evidence. MAIN RESULTS In this first update, we included 12 RCTs, comprising 507 participants. Most trials included adults admitted to specialised burn centres after recent burn injuries. Topical agents included antimicrobial agents (silver sulphadiazine (SSD), Aquacel-Ag, cerium-sulphadiazine, gentamicin cream, mafenide acetate cream, bacitracin), non-antimicrobial agents (Moist Exposed Burn Ointment (MEBO), saline-soaked dressings, skin substitutes (including bioengineered skin substitute (TransCyte), allograft, and xenograft (porcine Xenoderm), and miscellaneous treatments (growth hormone therapy, recombinant human granulocyte-macrophage colony-stimulating factor hydrogel (rhGMCS)), enzymatic debridement, and cream with Helix Aspersa extract). Almost all the evidence included in this review was assessed as low or very low-certainty, often because of high risk of bias due to unclear randomisation procedures (i.e. sequence generation and allocation concealment); lack of blinding of participants, providers and sometimes outcome assessors; and imprecision resulting from few participants, low event rates or both, often in single studies. Topical antimicrobial agents versus topical non-antimicrobial agents There is moderate-certainty evidence that there is probably little or no difference between antimicrobial agents and non-antimicrobial agents (SSD and MEBO) in time to complete wound healing (hazard ratio (HR) 0.84 (95% confidence interval (CI) 0.78 to 1.85, 1 study, 39 participants). Topical antimicrobial agents may make little or no difference to the proportion of wounds completely healed compared with topical non-antimicrobial agents (comparison SSD and MEBO, risk ratio (RR) 0.94, 95% CI 0.68 to 1.29; 1 study, 39 participants; low-certainty evidence). We are uncertain whether there is a difference in wound infection (comparison topical antimicrobial agent (Aquacel-Ag) and MEBO; RR 0.38, 95% CI 0.12 to 1.21; 1 study, 40 participants; very low-certainty evidence). No trials reported change in wound surface area over time or partial wound healing. There is low-certainty evidence for the secondary outcomes scar quality and patient satisfaction. Two studies assessed pain but it was incompletely reported. Topical antimicrobial agents versus other topical antimicrobial agents It is uncertain whether topical antimicrobial agents make any difference in effects as the evidence is low to very low-certainty. For primary outcomes, there is low-certainty evidence for time to partial (i.e. greater than 90%) wound healing (comparison SSD versus cerium SSD: mean difference (MD) -7.10 days, 95% CI -16.43 to 2.23; 1 study, 142 participants). There is very low-certainty evidence regarding whether topical antimicrobial agents make a difference to wound infection (RR 0.73, 95% CI 0.46 to 1.17; 1 study, 15 participants). There is low to very low-certainty evidence for the proportion of facial burns requiring surgery, pain, scar quality, adverse effects and length of hospital stay. Skin substitutes versus topical antimicrobial agents There is low-certainty evidence that a skin substitute may slightly reduce time to partial (i.e. greater than 90%) wound healing, compared with a non-specified antibacterial agent (MD -6.00 days, 95% CI -8.69 to -3.31; 1 study, 34 participants). We are uncertain whether skin substitutes in general make any other difference in effects as the evidence is very low certainty. Outcomes included wound infection, pain, scar quality, adverse effects of treatment and length of hospital stay. Single studies showed contrasting low-certainty evidence. A bioengineered skin substitute may slightly reduce procedural pain (MD -4.00, 95% CI -5.05 to -2.95; 34 participants) and background pain (MD -2.00, 95% CI -3.05 to -0.95; 34 participants) compared with an unspecified antimicrobial agent. In contrast, a biological dressing (porcine Xenoderm) might slightly increase pain in superficial burns (MD 1.20, 95% CI 0.65 to 1.75; 15 participants (30 wounds)) as well as deep partial thickness burns (MD 3.00, 95% CI 2.34 to 3.66; 10 participants (20 wounds)), compared with antimicrobial agents (Physiotulle Ag (Coloplast)). Miscellaneous treatments versus miscellaneous treatments Single studies show low to very low-certainty effects of interventions. Low-certainty evidence shows that MEBO may slightly reduce time to complete wound healing compared with saline soaked dressing (MD -1.7 days, 95% CI -3.32 to -0.08; 40 participants). In addition, a cream containing Helix Aspersa may slightly increase the proportion of wounds completely healed at 14 days compared with MEBO (RR 4.77, 95% CI 1.87 to 12.15; 43 participants). We are uncertain whether any miscellaneous treatment in the included studies makes a difference in effects for the outcomes wound infection, scar quality, pain and patient satisfaction as the evidence is low to very low-certainty. AUTHORS' CONCLUSIONS There is mainly low to very low-certainty evidence on the effects of any topical intervention on wound healing in people with facial burns. The number of RCTs in burn care is growing, but the body of evidence is still hampered due to an insufficient number of studies that follow appropriate evidence-based standards of conducting and reporting RCTs.
Collapse
Affiliation(s)
| | - M Jenda Hop
- Burn Centre, Maasstad Hospital, Association of Dutch Burn Centres, Rotterdam, Netherlands
| | - Marianne K Nieuwenhuis
- Burn Centre, Martini Hospital, Association of Dutch Burn Centres, Groningen, Netherlands
| | - Irma Mmh Oen
- Burn Centre, Maasstad Hospital, Association of Dutch Burn Centres, Rotterdam, Netherlands
| | - Esther Middelkoop
- Plastic Reconstructive and Hand Surgery, Amsterdam Movement Sciences and Association of Dutch Burn Centers, Red Cross Hospital, Amsterdam, Netherlands
| | - Margriet E Van Baar
- Burn Centre, Maasstad Hospital, Association of Dutch Burn Centres, Rotterdam, Netherlands
| |
Collapse
|
9
|
Kawano Y, Jordan O, Hanawa T, Borchard G, Patrulea V. Are Antimicrobial Peptide Dendrimers an Escape from ESKAPE? Adv Wound Care (New Rochelle) 2020; 9:378-395. [PMID: 32320368 PMCID: PMC7307686 DOI: 10.1089/wound.2019.1113] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 03/18/2020] [Indexed: 12/16/2022] Open
Abstract
Significance: The crisis of antimicrobial resistance (AMR) increases dramatically despite all efforts to use available antibiotics or last resort antimicrobial agents. The spread of the AMR, declared as one of the most important health-related issues, warrants the development of new antimicrobial strategies. Recent Advances: Antimicrobial peptides (AMPs) and AMP dendrimers (AMPDs), as well as polymer dendrimers are relatively new and promising strategies with the potential to overcome drug resistance issues arising in ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species) colonizing chronic wounds. Critical Issues: AMPs-AMPDs suffer from limited efficacy, short-lasting bioactivity, and concerns of toxicity. To circumvent these drawbacks, their covalent coupling to biopolymers and/or encapsulation into different drug carrier systems is investigated, with a special focus on topical applications. Future Directions: Scientists and the pharmaceutical industry should focus on this challenging subject to either improve the activity of existing antimicrobial agents or find new drug candidates. The focus should be put on the discovery of new drugs or the combination of existing drugs for a better synergy, taking into account all kinds of wounds and existing pathogens, and more specifically on the development of next-generation antimicrobial peptides, encompassing the delivery carrier toward improved pharmacokinetics and efficacy.
Collapse
Affiliation(s)
- Yayoi Kawano
- Laboratory of Preformulation Study, Faculty of Pharmaceutical Sciences, Tokyo University of Science, Chiba, Japan
| | - Olivier Jordan
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Geneva, Switzerland
| | - Takehisa Hanawa
- Laboratory of Preformulation Study, Faculty of Pharmaceutical Sciences, Tokyo University of Science, Chiba, Japan
| | - Gerrit Borchard
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Geneva, Switzerland
| | - Viorica Patrulea
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Geneva, Switzerland
| |
Collapse
|
10
|
Aguilar HA, Mayer HF. A New Method for Securing Dermal Substitutes and Skin Grafts to Difficult Portions of the Face Using a Custom 3D-Printed Facemask. J Burn Care Res 2019; 40:1015-1018. [PMID: 31290964 DOI: 10.1093/jbcr/irz128] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Management of third-degree facial burns remains one of the most difficult challenges in burn care. Patients with deep facial burns usually require gradual escharectomy, tangential excision of the wound, and resurfacing with full-thickness skin grafts or dermal substitutes associated with split-thickness skin grafts to provide better and superior cosmetic results. Immobilization of skin grafts and dermal substitutes by reducing shearing forces and hematoma formation underneath is paramount to improve success rates. Due to the irregular shape of the face, the proper immobilization of grafts with traditional methods is often difficult, especially over concave portions of the face. Herein, we report the original use of a custom three-dimensional printing facemask for securing dermal substitutes and skin grafts to difficult sites on the face.
Collapse
Affiliation(s)
- Hernán A Aguilar
- Plastic Surgery Department, Hospital Italiano de Buenos Aires, University of Buenos Aires (UBA) School of Medicine, Buenos Aires, Argentina
| | - Horacio F Mayer
- Plastic Surgery Department, Hospital Italiano de Buenos Aires, University of Buenos Aires (UBA) School of Medicine, Buenos Aires, Argentina
| |
Collapse
|
11
|
Colla C, Kant SB, Van den Kerckhove E, Van der Hulst RRWJ, Piatkowski de Grzymala AA. Manual fabrication of a specialized transparent facial pressure mask: A technical note. Prosthet Orthot Int 2019; 43:356-360. [PMID: 30632878 PMCID: PMC6557004 DOI: 10.1177/0309364618820141] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND AND AIM The objective of this study was to describe the manual fabrication of a transparent facial pressure mask for treating facial deformities. The mask combines the use of a silicone inner liner and mechanical pressure in the facial region. TECHNIQUE A negative mold is formed by covering the face with plaster. Manipulation of soft tissue is a crucial part in this process. After hardening and removal of the negative mold, the positive mold is formed and dried. Next a rolled silicone sheet is placed over the positive mold in a vacuum environment. Subsequently, the silicones are vulcanized. Then the rigid outside of the mask is created. The silicone inner liner and outside shell are then affixed. DISCUSSION This described technique results in accurate facemasks with precise fitting. During therapy, the mask is adjusted multiple times to keep excellent fit, as remodeling of scars and deformities takes place. CLINICAL RELEVANCE Facemasks are a reputable therapeutic modality to reduce excessive facial scarring. They require excellent fitting to give pleasing results. To provide a better understanding of facemask therapy, this study describes the manual fabrication technique.
Collapse
Affiliation(s)
- Carlo Colla
- Department of Plastic, Reconstructive and Hand Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Sander B Kant
- Department of Plastic, Reconstructive and Hand Surgery, Maastricht University Medical Center, Maastricht, The Netherlands,Sander B Kant, Department of Plastic, Reconstructive and Hand Surgery, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands.
| | - Eric Van den Kerckhove
- Department of Plastic, Reconstructive and Hand Surgery, Maastricht University Medical Center, Maastricht, The Netherlands,KU Leuven, Department of Rehabilitation Sciences, Faber, Universitaire Ziekenhuizen Leuven, Leuven, Belgium,Department of Physical Medicine and Rehabilitation and Burns Center, Universitaire Ziekenhuizen Leuven, Leuven, Belgium
| | - René RWJ Van der Hulst
- Department of Plastic, Reconstructive and Hand Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | | |
Collapse
|
12
|
|
13
|
Wei Y, Wang Y, Zhang M, Yan G, Wu S, Liu W, Ji G, Li-Tsang CW. The application of 3D-printed transparent facemask for facial scar management and its biomechanical rationale. Burns 2018; 44:453-461. [DOI: 10.1016/j.burns.2017.08.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 07/17/2017] [Accepted: 08/09/2017] [Indexed: 11/30/2022]
|
14
|
Saaiq M. Caveats do not constitute contraindications for early excision and grafting of deep burns in a well equipped burn centre. Burns 2017; 44:231-232. [PMID: 29174726 DOI: 10.1016/j.burns.2017.09.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 09/15/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Muhammad Saaiq
- National Institute of Rehabilitation Medicine (NIRM), Pakistan Institute of Medical Sciences (PIMS), Shaheed Zulfiqar Ali Bhutto Medical University (SZABMU), Islamabad, Pakistan.
| |
Collapse
|
15
|
A new treatment for reliable functional and esthetic outcome after local facial flap reconstruction: a transparent polycarbonate facial mask with silicone sheeting. EUROPEAN JOURNAL OF PLASTIC SURGERY 2017; 40:407-416. [PMID: 28989235 PMCID: PMC5610215 DOI: 10.1007/s00238-017-1306-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 03/29/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND Facial flap surgery predominantly leads to good functional results. However, in some cases, it can cause unsatisfactory esthetic results. They include persistent erythema, pincushioning, and development of hypertrophic scars. Conservative, reliable treatment for facial flaps is lacking. Pressure and silicone therapy have proven to result in significant improvement in scar erythema, pliability, and thickness in postburn hypertrophic scars. By combining these therapies in a facial mask, the esthetic outcome of facial flaps could be improved. In this retrospective study, the efficacy of a unique transparent face mask containing silicone sheets on the esthetic outcome of postsurgical facial flaps is assessed. METHODS Twenty-one patients were assigned to facial pressure mask therapy after they underwent facial flap surgery between July 2012 and September 2015. Patients were treated for a mean duration of 46 weeks. The effects of pressure mask therapy were examined by means of the Patient and Observer Scar Assessment Scale (POSAS). RESULTS All POSAS components showed a reduction between start and end of therapy, while itchiness, pigmentation, pliability, thickness, and relief of the flap improved significantly (P < 0.05). Mean total and patient score showed significant reduction between start and end of therapy. CONCLUSIONS This study shows that a facial pressure mask layered with silicone results in noticeable flap improvement with a long-lasting result. Level of Evidence: Level III, therapeutic study.
Collapse
|
16
|
Abstract
Management of head and neck burns involves acute and intermediate phases. Acutely, the goals are establish a secure airway and treat life-threatening injuries. Then, optimize nutrition, assess extent of the burn, perform local wound care, and provide eye protection. Management depends on the degree of the head and neck burn. Postinjury splinting and rehabilitation are vital to healing. After the acute inflammation has resolved and the scars have matured, reconstruction begins with the goals of restoring both function and aesthetics. Reconstruction ranges from simple scar release, to skin grafting, and possibly free flap reconstruction.
Collapse
Affiliation(s)
- Shannon Wong
- Department of Plastic Surgery, University of Nebraska Medical Center, 983335 Nebraska Medical Center, Omaha, NE 68198, USA.
| | - Alyson Melin
- Department of Plastic Surgery, University of Nebraska Medical Center, 983335 Nebraska Medical Center, Omaha, NE 68198, USA
| | - Debra Reilly
- Department of Plastic Surgery, University of Nebraska Medical Center, 983335 Nebraska Medical Center, Omaha, NE 68198, USA
| |
Collapse
|
17
|
Han Y, Zhao J, Tao R, Guo L, Yang H, Zeng W, Song B, Xia W. Repair of Craniomaxillofacial Traumatic Soft Tissue Defects With Tissue Expansion in the Early Stage. J Craniofac Surg 2017; 28:1477-1480. [DOI: 10.1097/scs.0000000000003852] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
18
|
Wei Y, Li-Tsang CW, Liu J, Xie L, Yue S. 3D-printed transparent facemasks in the treatment of facial hypertrophic scars of young children with burns. Burns 2017; 43:e19-e26. [DOI: 10.1016/j.burns.2016.08.034] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 08/24/2016] [Accepted: 08/31/2016] [Indexed: 11/27/2022]
|
19
|
[Reconstruction of the ear in the burns patient]. CIR CIR 2017; 85:454-458. [PMID: 28279397 DOI: 10.1016/j.circir.2017.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 02/02/2017] [Indexed: 11/20/2022]
Abstract
Face burns are a singular pathology with great functional and psychological impact in the patients suffering them. The ears play a fundamental role in personal interactions and damage to this organ results in physical and emotional distress. The reconstructive treatment of the burned ear is a challenge. Multiple procedures have been described to achieve success in the reconstruction of the burned ear; immediate reconstruction with autologous rib cartilage, secondary reconstruction, alloplastic material reconstruction, tissue expansion, skin grafts and also microvascular flaps are some of the most common procedures used in this patients. All these techniques focus on giving a natural appearance to the patient. Burns to the ears affect 30% of the patients with facial burns, they require an excellent treatment given by a multidisciplinary team.
Collapse
|
20
|
|
21
|
A Pilot Study of the Efficacy of Active Leptospermum Honey for the Treatment of Partial-Thickness Facial Burns. Adv Skin Wound Care 2016; 29:349-55. [DOI: 10.1097/01.asw.0000484666.83140.b0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
22
|
Affiliation(s)
- XingGuo Cheng
- Microencapsulation & Nanomaterials Department, Southwest Research Institute, 6220 Culebra Road, San Antonio, TX 78238, USA
| | - James J Yoo
- Wake Forest Institute for Regenerative Medicine, Medical Center Boulevard Winston-Salem, NC 27157, USA
| | - Robert G Hale
- Colonel, Dental Corps Commander, US Army Dental & Trauma Research Detachment, US Army Institute of Surgical Research, 3698 Chambers Pass Suite B, Fort Sam Houston, TX 78234, USA
| |
Collapse
|
23
|
Hermans MHE. Porcine xenografts vs. (cryopreserved) allografts in the management of partial thickness burns: is there a clinical difference? Burns 2013; 40:408-15. [PMID: 24018214 DOI: 10.1016/j.burns.2013.08.020] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Revised: 08/15/2013] [Accepted: 08/17/2013] [Indexed: 10/26/2022]
Abstract
Porcine xenografts and cryopreserved allografts are used for the management of partial thickness burns and both biological materials have strong advocates with regard to clinical performance, the possibility of disease transfer from donor to recipient and other clinical aspects. A literature analysis was performed in an attempt to investigate whether true (statistically significant) differences exist on clinical performance and on other determinants for use. Comparing the results of this study with a similar, previously published study performed on possible differences amongst different types of allograft in the management of partial thickness burns, both allografts and porcine xenograft seem to perform equally well clinically with regard to healing related outcomes. In addition, the risk of disease transfer, in real life, was shown to be minimal. Consequently, clinical aspects being equal, other aspects such as price and availability should be used to decide which material to use for the management of partial thickness burns.
Collapse
|
24
|
Mittermayr R, Branski L, Moritz M, Jeschke MG, Herndon DN, Traber D, Schense J, Gampfer J, Goppelt A, Redl H. Fibrin biomatrix-conjugated platelet-derived growth factor AB accelerates wound healing in severe thermal injury. J Tissue Eng Regen Med 2013; 10:E275-85. [DOI: 10.1002/term.1749] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2011] [Revised: 02/16/2013] [Accepted: 03/19/2013] [Indexed: 01/01/2023]
Affiliation(s)
- Rainer Mittermayr
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology; Austrian Cluster for Tissue Regeneration; Vienna Austria
| | - Ludwik Branski
- Shriner's Hospital for Children; University of Texas Medical Branch; Galveston TX USA
| | - Martina Moritz
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology; Austrian Cluster for Tissue Regeneration; Vienna Austria
| | - Marc G. Jeschke
- Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, Department of Surgery, Division of Plastic Surgery; University of Toronto; Canada
| | - David N. Herndon
- Shriner's Hospital for Children; University of Texas Medical Branch; Galveston TX USA
| | - Daniel Traber
- Shriner's Hospital for Children; University of Texas Medical Branch; Galveston TX USA
| | | | - Jörg Gampfer
- Baxter Innovations GmbH, Division of Biosurgery; Vienna Austria
| | - Andreas Goppelt
- Baxter Innovations GmbH, Division of Biosurgery; Vienna Austria
| | - Heinz Redl
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology; Austrian Cluster for Tissue Regeneration; Vienna Austria
| |
Collapse
|
25
|
|
26
|
Hoogewerf CJ, Van Baar ME, Hop MJ, Nieuwenhuis MK, Oen IMMH, Middelkoop E. Topical treatment for facial burns. Cochrane Database Syst Rev 2013:CD008058. [PMID: 23440823 DOI: 10.1002/14651858.cd008058.pub2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Burn injuries are an important health problem. They occur frequently in the head and neck region - the area central to a person's identity, that provides our most expressive means of communication. Topical interventions are currently the cornerstone of treatment of partial-thickness burns to the face. OBJECTIVES To assess the effects of topical interventions on wound healing in people with facial burns of any depth. SEARCH METHODS We searched the Cochrane Wounds Group Specialised Register (searched 12 November 2012); the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 10); Ovid MEDLINE (1950 to November Week 1 2012); Ovid MEDLINE - In-process & Other Non-Indexed Citations (searched November 12, 2012); Ovid EMBASE (1980 to 2012 Week 45); and EBSCO CINAHL (1982 to 9 November 2012) for relevant trials. We did not apply date or language restrictions. SELECTION CRITERIA Randomised controlled trials (RCTs) that evaluated the effects of topical treatment for facial burns were eligible for inclusion in this review. DATA COLLECTION AND ANALYSIS Two review authors independently assessed and included the references identified by the search strategy. Included trials were assessed using a risk of bias form, and data were extracted using a standardised data extraction sheet. For dichotomous and continuous outcomes, we calculated risk ratios and mean differences, respectively, both with 95% confidence intervals (CI). MAIN RESULTS We included five RCTs, comprising a total of 119 participants. Two studies compared two different antimicrobial agents and three compared a biological or bioengineered skin substitute with an antimicrobial agent. All studies had small sample sizes and were at high risk of bias. Heterogeneity of interventions and outcomes prevented pooling of data. In three studies time to complete wound healing was significantly shorter for those using a skin substitute than for those using an antibacterial agent, but the quality of the evidence was low. Pain was significantly reduced with the use of skin substitutes in both studies that reported this outcome in all groups, range mean differences -2.00 (95% CI -3.82 to -0.18) to -4.00 (95% CI -5.05 to -2.95) on a 10-point scale. AUTHORS' CONCLUSIONS There is insufficient high quality research and evidence to enable conclusions to be drawn about the effects of topical interventions on wound healing in people with facial burns.
Collapse
Affiliation(s)
- Cornelis J Hoogewerf
- Burn Centre, Maasstad Hospital, Association of Dutch Burn Centres, Rotterdam, Netherlands
| | | | | | | | | | | |
Collapse
|
27
|
Duteille F, Perrot P. Management of 2nd-degree facial burns using the Versajet® hydrosurgery system and xenograft: A prospective evaluation of 20 cases. Burns 2012; 38:724-9. [DOI: 10.1016/j.burns.2011.12.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2011] [Revised: 11/28/2011] [Accepted: 12/09/2011] [Indexed: 11/26/2022]
|
28
|
Abstract
Some patients who have heterotrophic ossification (HO) in a postburn scar are occasionally seen in the clinic. The occurrence of HO following hip and abdominal surgery is common in males, whereas females are frequently affected following burns. The HO of skin grafts in burn scars of the superior body parts is uncommon, especially on the face. We report a recent case of a male patient in whom HO arose on skin grafts on his chin. The patient presented with a history of a painless chin mass for 48 years. Computed tomography scan suggested that the mass was located within subcutaneous tissue away from the lower jaw. The density of the mass was almost the same as the cortical bone of the lower jaw. The mass was completely resected under general anesthesia. It was a rectangular mass of 3× 0.5× 0.3 cm. Histological examination gave the diagnosis of HO, which was also confirmed by immunohistochemical stainings for vimentin. Recurrence was not found in this case by clinical and radiologic follow-up at 1 year after surgery.
Collapse
|
29
|
Clinical application of full-face, whole, full-thickness skin grafting: a case report. J Plast Reconstr Aesthet Surg 2012; 65:1576-9. [PMID: 22613691 DOI: 10.1016/j.bjps.2012.04.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Revised: 01/12/2012] [Accepted: 04/02/2012] [Indexed: 11/21/2022]
Abstract
A considerable portion of burn patients suffers severe full-face burns. Even after they were treated, some severe abnormalities still stay with them such as upper- and lower-eyelid ectropions, upper- and lower-lip ectropions, microstomia and extensive facial scar hyperplasia accompanied with pruritus. Patients suffer a great deal physically, emotionally and socially. Here we conclude our treatment experience of full-face burns with the full-face, whole, full-thickness skin grafting, which has not yet reported in the literature. We transplanted a whole, full-thickness skin graft to cover the wound in the primary operation and then remedied eyelid ectropions and microstomia in the operation that followed. The results of a 4-year-follow-up suggest that the patient has recovered part of facial expression and sensation without any geographic scars. Full-face, whole, full-thickness skin grafting appears to be an effective and relatively simple method for full-face burns that do not respond well to facial composite tissue allotransplantation (CTA).
Collapse
|
30
|
Improved hair restoration method for burns. Burns 2011; 37:427-33. [DOI: 10.1016/j.burns.2010.09.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2010] [Revised: 09/14/2010] [Accepted: 09/17/2010] [Indexed: 11/21/2022]
|
31
|
Hashemi B, Bayat A, Kazemei T, Azarpira N. Comparison between topical honey and mafenide acetate in treatment of auricular burn. Am J Otolaryngol 2011; 32:28-31. [PMID: 20015812 DOI: 10.1016/j.amjoto.2009.07.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2009] [Accepted: 07/06/2009] [Indexed: 01/22/2023]
Abstract
The auricle is a frequently injured part of the head and neck during thermal injury leading to ear deformity. The burned ear represents one of the most difficult problems for reconstructive surgeons. Mafenide acetate is a topical agent used routinely for these patients, but it has some disadvantages including painful application and allergic rash. Some authors have reported the healing effect and antibacterial activity of honey. The study reported here was undertaken to compare the effect of honey and mafenide acetate on auricular burn in rabbit. In our study, although the pathologic score of the honey group was better than that of the mafenide group both on 14 and 21 days after burning, it was not statistically significant. In the mafenide acetate group, deep complication of burn (chondritis) was significantly lower than that of the honey group. In conclusion, in contrast to healing and antibiotic activity reported for honey, it may have failure in preventing deep bacterial complications of wound (like chondritis). So in deep wounds, the use of honey as dressing is not recommended.
Collapse
Affiliation(s)
- Basir Hashemi
- Department of Otolaryngology, Khalili Hospital, Shiraz, Iran
| | | | | | | |
Collapse
|
32
|
Álvaro Cuadra C, José Luis Piñeros B, Ricardo Roa G. Quemaduras faciales: “manejo inicial y tratamiento”. REVISTA MÉDICA CLÍNICA LAS CONDES 2010. [DOI: 10.1016/s0716-8640(10)70504-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
|
33
|
Abstract
Because burns destroy the barrier against invading bacteria, topical antimicrobial agents have been developed to minimize the proliferation of bacteria and other microorganisms. The topical treatment depends on the depth of burns. The goal for superficial burns is to optimize re-epithelialization. For deep burns, topical antimicrobial agents should be used to minimize microbial growth until the wound is grafted. This article introduces a strategy for the rational use of these agents.
Collapse
Affiliation(s)
- David G Greenhalgh
- Shriners Hospitals for Children Northern California, Department of Surgery, University of California, Davis, Sacramento, 95817, USA.
| |
Collapse
|