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Prudovsky I, Kacer D, Lindner V, Rappold J, Carter DW. Tranexamic acid reduces inflammation, edema and burn wound conversion in a rodent model. Burns 2024; 50:947-956. [PMID: 38336496 DOI: 10.1016/j.burns.2024.01.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 01/15/2024] [Accepted: 01/23/2024] [Indexed: 02/12/2024]
Abstract
Burn wound conversion is the observed process where superficial partial thickness burns convert into deep partial or full thickness burn injuries. This conversion process often involves surgical excision to achieve timely wound healing. Unfortunately, the pathophysiology of this phenomenon is multifactorial and poorly understood. Thus, a therapeutic intervention that may prevent secondary progression and cell death in burn-injured tissue is desirable. Recent work by our group and others has established that tranexamic acid (TXA) has significant anti-inflammatory properties in addition to its well-known anti-fibrinolytic effects. This study investigates TXA as a novel therapeutic treatment to mitigate burn wound conversion and reduce systemic inflammation. Sprague-Dawley rats were subjected to a hot comb burn contact injury. A subset of animals underwent a similar comb burn with an adjacent 30%TBSA contact injury. The interspaces represent the ischemic zones simulating the zone of stasis. The treatment group received injections of TXA (100 mg/kg) immediately after injury and once daily until euthanasia. Animals were harvested for analyses at 6 h and 7 days after injury. Full-thickness biopsies from the ischemic zones and lung tissue were assessed with established histological techniques. Plasma was collected for measurement of damage associated molecular patterns (DAMPs), and liver samples were used to study inflammatory cytokines expression. Treatment with TXA was associated with reduced burn wound conversion and decreased burn-induced systemic inflammatory response syndrome (SIRS). Lung inflammation and capillary leak were also significantly reduced in TXA treated animals. Future research will elucidate the underlying anti-inflammatory properties of TXA responsible for these findings.
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Affiliation(s)
- Igor Prudovsky
- Maine Health Institute for Research, 81 Research Drive, Scarborough, ME 04074, USA
| | - Doreen Kacer
- Maine Health Institute for Research, 81 Research Drive, Scarborough, ME 04074, USA
| | - Volkhard Lindner
- Maine Health Institute for Research, 81 Research Drive, Scarborough, ME 04074, USA
| | - Joseph Rappold
- Maine Health Institute for Research, 81 Research Drive, Scarborough, ME 04074, USA; Maine Medical Center, 22 Bramhall Street, Portland, ME 04105, USA
| | - Damien Wilson Carter
- Maine Health Institute for Research, 81 Research Drive, Scarborough, ME 04074, USA; Maine Medical Center, 22 Bramhall Street, Portland, ME 04105, USA.
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Christy S, Carlsson AH, Larson D, Davenport GJ, Glenn JF, Brumfield R, Avina G, Jockheck-Clark A, Christy RJ, Nuutila K. Topical Noneuphoric Phytocannabinoid Elixir 14 Reduces Inflammation and Mitigates Burn Progression. J Surg Res 2024; 296:447-455. [PMID: 38320364 DOI: 10.1016/j.jss.2024.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 01/02/2024] [Accepted: 01/04/2024] [Indexed: 02/08/2024]
Abstract
INTRODUCTION Thermal injuries are caused by exposure to a wide variety of agents including heat, electricity, radiation, chemicals, and friction. Early intervention can decrease injury severity by preventing excess inflammation and mitigating burn wound progression for improved healing outcomes. Previous studies have demonstrated that cannabinoids can trigger anti-inflammatory responses and promote wound closure. Therefore, the purpose of this study was to investigate whether a topical application of Noneuphoric Phytocannabinoid Elixir 14 (NEPE14) containing a full complement of phytocannabinoids (< 0.3% delta-9-tetrahydrocannabinol or cannabidiol) and other phytochemicals would mitigate burn wound progression in the treatment of deep partial-thickness burn wounds. METHODS Deep partial-thickness burns were created on the dorsum of four anesthetized pigs and treated with NEPE14, Vehicle control, Silverlon, or gauze. The burns were assessed on postburn days 4, 7, and 14. Assessments consisted of digital photographs, Laser-Speckle imagery (blood perfusion), MolecuLight imagery (qualitative bacterial load), and biopsies for histology and immunohistochemistry (interleukin six and tumor necrosis factor-α). RESULTS Topical treatment with NEPE14 significantly (P < 0.001) decreased inflammation (interleukin six and tumor necrosis factor-α) in comparison to control groups. It was also demonstrated that the reduction in inflammation led to mitigation of burn wound progression. In terms of wound healing and presence of bacteria, no statistically significant differences were observed. CONCLUSIONS Topical treatment of deep partial-thickness burns with NEPE14 decreased wound inflammation and mitigated burn wound progression in comparison to control treatments.
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Affiliation(s)
| | - Anders H Carlsson
- Metis Foundation, San Antonio, Texas; United States Army Institute of Surgical Research, Fort Sam Houston, Texas
| | - David Larson
- Metis Foundation, San Antonio, Texas; United States Army Institute of Surgical Research, Fort Sam Houston, Texas
| | | | | | | | | | | | - Robert J Christy
- United States Army Institute of Surgical Research, Fort Sam Houston, Texas
| | - Kristo Nuutila
- United States Army Institute of Surgical Research, Fort Sam Houston, Texas.
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Kim YG, Lee Y, Lee N, Soh M, Kim D, Hyeon T. Ceria-Based Therapeutic Antioxidants for Biomedical Applications. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2024; 36:e2210819. [PMID: 36793245 DOI: 10.1002/adma.202210819] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/20/2023] [Indexed: 06/18/2023]
Abstract
The growing interest in nanomedicine over the last 20 years has carved out a research field called "nanocatalytic therapy," where catalytic reactions mediated by nanomaterials are employed to intervene in disease-critical biomolecular processes. Among many kinds of catalytic/enzyme-mimetic nanomaterials investigated thus far, ceria nanoparticles stand out from others owing to their unique scavenging properties against biologically noxious free radicals, including reactive oxygen species (ROS) and reactive nitrogen species (RNS), by exerting enzyme mimicry and nonenzymatic activities. Much effort has been made to utilize ceria nanoparticles as self-regenerating antioxidative and anti-inflammatory agents for various kinds of diseases, given the detrimental effects of ROS and RNS therein that need alleviation. In this context, this review is intended to provide an overview as to what makes ceria nanoparticles merit attention in disease therapy. The introductory part describes the characteristics of ceria nanoparticles as an oxygen-deficient metal oxide. The pathophysiological roles of ROS and RNS are then presented, as well as their scavenging mechanisms by ceria nanoparticles. Representative examples of recent ceria-nanoparticle-based therapeutics are summarized by categorization into organ and disease types, followed by the discussion on the remaining challenges and future research directions.
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Affiliation(s)
- Young Geon Kim
- Center for Nanoparticle Research, Institute for Basic Science (IBS), Seoul, 08826, Republic of Korea
- School of Chemical and Biological Engineering, and Institute of Chemical Processes, Seoul National University, Seoul, 08826, Republic of Korea
| | - Yunjung Lee
- Center for Nanoparticle Research, Institute for Basic Science (IBS), Seoul, 08826, Republic of Korea
- School of Chemical and Biological Engineering, and Institute of Chemical Processes, Seoul National University, Seoul, 08826, Republic of Korea
| | - Nohyun Lee
- School of Advanced Materials Engineering, Kookmin University, Seoul, 02707, Republic of Korea
| | - Min Soh
- Center for Nanoparticle Research, Institute for Basic Science (IBS), Seoul, 08826, Republic of Korea
- Center for Advanced Pharmaceutical Technology, HyeonTechNBio, Inc., Seoul, 08826, Republic of Korea
| | - Dokyoon Kim
- Department of Bionano Engineering and Bionanotechnology, Hanyang University, Ansan, 15588, Republic of Korea
| | - Taeghwan Hyeon
- Center for Nanoparticle Research, Institute for Basic Science (IBS), Seoul, 08826, Republic of Korea
- School of Chemical and Biological Engineering, and Institute of Chemical Processes, Seoul National University, Seoul, 08826, Republic of Korea
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von Glinski M, Voigt M, Sogorski A, Wallner C, Dadras M, Behr B, Lehnhardt M, Goertz O. Influence of Remote Ischemic Conditioning and Nitrogen Monoxide on Angiogenesis and Microcirculation in a Mouse Ear Burn Model. J Surg Res 2024; 293:347-356. [PMID: 37806221 DOI: 10.1016/j.jss.2023.08.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 07/25/2023] [Accepted: 08/28/2023] [Indexed: 10/10/2023]
Abstract
INTRODUCTION Remote ischemic conditioning (RIC) has been shown to improve tissue resilience against ischemia. The aim of this study was to investigate the influence of RIC and its key factor, nitrogen monoxide (NO), on angiogenesis in a burn wound. MATERIALS AND METHODS A unilateral burn injury on the ear of hairless mice (n = 48) was generated via a hot air jet in a contact-free manner. In four randomized groups, including the control (NoRIC group), RIC alone (RIConly group), RIC plus NO donor (ISDN group), and RIC plus NO synthase inhibitor (L-NAME group), the impact on angiogenesis, vessel diameter, blood flow, edema formation, and leukocyte-endothelial-cell interaction was evaluated over a 12-d period using intravital fluorescence microscopy. RESULTS Tissue perfusion was significantly improved by RIC (Day 3: ISDN group showed 182% and RIConly group showed 200% of baseline [BL], P < 0.001), while angiogenesis was not improved by RIC (nonperfused area on Day 12: mean 52% of BL in all groups, P >0.05). The application of ISDN did not further enhance the positive effect of RIC, whereas the application of L-NAME neutralized the effect of RIC. The most pronounced edema formation was observed in the RIConly group (mean 145% of BL, P ≤0.001), while the NoRIC group showed the least edema formation (Day 12: 117% of BL). CONCLUSIONS RIC led to increased tissue perfusion, which did not result in improved angiogenesis, which may have been due to increased edema formation after RIC performance. The results of the present study do not support the establishment of a causal therapy strategy for burn wounds, including RIC.
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Affiliation(s)
- Maxi von Glinski
- Department of Plastic and Hand Surgery, Burn Center, BG-University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany.
| | - Maria Voigt
- Department of Plastic and Hand Surgery, Burn Center, BG-University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
| | - Alexander Sogorski
- Department of Plastic and Hand Surgery, Burn Center, BG-University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
| | - Christoph Wallner
- Department of Plastic and Hand Surgery, Burn Center, BG-University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
| | - Mehran Dadras
- Department of Plastic and Hand Surgery, Burn Center, BG-University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
| | - Bjoern Behr
- Department of Plastic and Hand Surgery, Burn Center, BG-University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
| | - Marcus Lehnhardt
- Department of Plastic and Hand Surgery, Burn Center, BG-University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
| | - Ole Goertz
- Department of Plastic and Hand Surgery, Burn Center, BG-University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany; Department of Plastic, Reconstructive and Aesthetic Surgery, Hand Surgery, Martin-Luther Hospital, Berlin, Germany
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Evani SJ, Chen P, Karna SR, D'Arpa P, Leung KP. Cerium Nitrate Stiffens In Vitro Skin Models and Reduces Pseudomonas aeruginosa Pathogenicity and Penetration Through Skin Models. Adv Wound Care (New Rochelle) 2023; 12:546-559. [PMID: 36394961 PMCID: PMC10387153 DOI: 10.1089/wound.2022.0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 11/12/2022] [Indexed: 11/18/2022] Open
Abstract
Objective: Cerium nitrate (CeN) plus silver sulfadiazine (SSD) cream has been used for 40-plus years to manage burns. CeN produces a hardened eschar believed to resist bacterial colonization/infection. To evaluate this potential mechanism, we treated in vitro skin models or Pseudomonas aeruginosa with CeN and measured mechanical properties of the models and bacterial virulence, respectively. Approach: We treated three-dimensional-collagen matrix and ex-vivo-burned porcine skin with CeN and evaluated stiffness and P. aeruginosa penetration. In addition, we treated P. aeruginosa with CeN and evaluated the bacteria's motility, skin model penetration, susceptibility to be phagocytized by the human monocytic cell line THP-1, and ability to stimulate this cell line to produce cytokines. Results: CeN treatment of skin models stiffened them and made them resistant to P. aeruginosa penetration. Inversely, CeN treatment of P. aeruginosa reduced their motility, penetration through skin models (ex-vivo-burned porcine skin), and ability to stimulate cytokine production (tumor necrosis factor-α [TNF-α] and interleukin 8 [IL-8]) by THP-1 cells. In addition, CeN-treated Pseudomonas was more readily phagocytized by THP-1 cells. Finally, P. aeruginosa inoculated on CeN-treated ex-vivo-burned porcine skin was more susceptible to killing by a silver dressing. Innovation: In vitro skin models offer a platform for screening drugs that interfere with bacterial penetration into wounded tissue. Conclusion: CeN treatment reduced P. aeruginosa virulence, altered the mechanical properties of ex-vivo-burned porcine skin and collagen matrix, retarded penetration of P. aeruginosa through the skin models, and resulted in increased vulnerability of P. aeruginosa to killing by antimicrobial wound dressings. These data support the use of CeN in burn management.
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Affiliation(s)
- Shankar J. Evani
- Combat Wound Care Group, United States Army Institute of Surgical Research, Fort Sam Houston, Texas, USA
| | - Ping Chen
- Combat Wound Care Group, United States Army Institute of Surgical Research, Fort Sam Houston, Texas, USA
| | - S.L. Rajasekhar Karna
- Combat Wound Care Group, United States Army Institute of Surgical Research, Fort Sam Houston, Texas, USA
| | - Peter D'Arpa
- Combat Wound Care Group, United States Army Institute of Surgical Research, Fort Sam Houston, Texas, USA
| | - Kai P. Leung
- Combat Wound Care Group, United States Army Institute of Surgical Research, Fort Sam Houston, Texas, USA
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The effect of Tarantula cubensis D6 on zone of stasis in a rat burn model. Burns 2023; 49:444-454. [PMID: 35654705 DOI: 10.1016/j.burns.2022.05.002] [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: 11/30/2021] [Revised: 04/04/2022] [Accepted: 05/03/2022] [Indexed: 11/21/2022]
Abstract
AIM Burn injuries are one of the most devastating injuries. Saving the zone of stasis decreases burn size, morbidity, and mortality. Tarantula cubensis (TC) increases epithelization of wounds, and increases wound contraction. In this study, we investigated the effects of TC on the stasis zone. MATERIALS AND METHODS 36 Wistar albino female rats were divided into 3 groups. Using brass comb burn model, at days 0 and 3, physiological serum solution in group 2, TC injection in group 3and no injection in group 1 was applied. Thermal and normal images were taken on day 10 and rats were sacrificed for histopathological examination. RESULTS We found a statistically significant difference between the 1st and 3rd group, 2nd and 3rd group regarding viable wound areas (p < 0.05), temperature difference (body-stasis zone) and mean body temperature (p < 0.05). We found no statistically significant difference between groups regarding neovascularization, inflammatory density, and vital cutaneous appendages. We found a statistically significant difference in epithelial layer thickness between the1st and 3rd groups, 2nd and 3rd groups(p < 0.05). CONCLUSION TC increases stasis zone viability macroscopically, increases epithelial layer thickness histopathologically, thus it promotes wound healing in burn wounds. This increase in stasis zone viability was also established with thermal imaging.
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Deldar R, D'Arpa P, Moffatt L, Leung K, Shupp J. Cerium Nitrate Treatment in the Management of Burns. Adv Wound Care (New Rochelle) 2022; 11:443-454. [PMID: 34015965 DOI: 10.1089/wound.2020.1330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Significance: The standard of care for deep burn wounds is eschar excision and autologous skin grafting within the first postburn days. However, when this is not practical due to medical reasons, unavailable surgical facilities, or lack of donor sites or other coverage, surgeons have used topical cerium nitrate (CN) in a cream with silver sulfadiazine (SSD) for over four decades to convert the eschar into a pliable and protective crust that facilitates the postponement or staging of eschar excision and grafting. CN+SSD treatment is reported to reduce dressing changes, improve patient comfort, and reduce bacterial burden, with unaffected epithelialization and few complications. Recent Advances: CN aqueous solutions applied topically alone or together with solid silver dressings in animal models have mitigated wound injury progression, wound microbial burden, and systemic immune dysfunction. Critical Issues: CN+SSD cream is not approved by U.S. Food and Drug Administration (FDA) and its efficacy in clinical trials has been challenging to demonstrate. One reason is that CN changes the eschar visibly, introducing unavoidable bias. Also, the market and patient population is small and burn wound presentation is highly variable. Future Directions: For use in settings wherein the once- or twice-daily CN+SSD cream dressing changes are least feasible (low-income, military, and mass casualty settings), it may be possible to develop a solid dressing containing cerium and silver that requires infrequent dressing changes. For future clinical studies, the trial design most suited to comparing silver-containing dressings with and without cerium may be paired difference of matched intrapatient wounds.
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Affiliation(s)
- Romina Deldar
- The Burn Center, Medstar Washington Hospital Center, Washington, District of Columbia, USA.,Department of Surgery, Georgetown University School of Medicine, Washington, District of Columbia, USA
| | | | - Lauren Moffatt
- The Burn Center, Medstar Washington Hospital Center, Washington, District of Columbia, USA.,Department of Surgery, Georgetown University School of Medicine, Washington, District of Columbia, USA.,Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, District of Columbia, USA
| | - Kai Leung
- Division of Combat Wound Repair, US Army Institute of Surgical Research, JBSA-Fort Sam Houston, San Antonio, Texas, USA
| | - Jeffrey Shupp
- The Burn Center, Medstar Washington Hospital Center, Washington, District of Columbia, USA.,Department of Surgery, Georgetown University School of Medicine, Washington, District of Columbia, USA.,Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, District of Columbia, USA
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The effect of mesenchymal stem cell lyophilizate on the recovery of the zone of stasis following thermal burns. Burns 2022; 48:1221-1229. [PMID: 34916090 DOI: 10.1016/j.burns.2021.10.008] [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: 06/29/2021] [Revised: 10/01/2021] [Accepted: 10/20/2021] [Indexed: 12/15/2022]
Abstract
INTRODUCTION AND AIM Mesenchymal Stem Cells (MSCs) are known to contribute to wound healing by increasing tissue regeneration. This study examined the effect of MSC-Lyophilizate (MSC-L) on the recovery of the zone of stasis in thermal burns. METHODS A comb was used to induce second-degree thermal burns (1 × 2 cm) on the dorsum of the rats. Within 30 min after the burn, MSC-L derived from the umbilical cord was administered to the experimental group and 1.5 ml of 0.9% isotonic sodium chloride to the sham group. The control group did not receive any intervention. Tissue samples were collected on postoperative day 7. Histopathological assessments were made using a microscope with digital camera attachment. SPSS for IBM 25 was used for data analysis. RESULTS Epithelial loss and subepidermal bullae were observed in the control and sham groups on day 7. In the experimental group, the MSC-L administration was found to increase epithelial tissue formation and neovascularization in the dermis. We found no significant pathological findings in the epidermis and dermis in the experimental group. CONCLUSION Administration of umbilical cord-derived MSC-L is of potential importance in wound healing. In our study, we observed that MSC-L that contained 1.5 million cells contributed significantly to the recovery of the stasis zone of burn.
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Rostami E, Maleki M, Koohestani R, Oghazi MR, Safavi EA, Hayati F. Effect of intermittent fasting on saving zone of stasis in burn wounds in rats. Burns 2022; 49:901-913. [PMID: 35787965 DOI: 10.1016/j.burns.2022.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 05/30/2022] [Accepted: 06/15/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND Intermittent Fasting (IF) has proved to have various positive effects on life span, diseases, and healing of tissues in rodents. We evaluated the protective effect of fasting in maintaining the ischemic zones in burn wounds. METHODS In this study, 20 rats were divided into two groups where the IF rats were deprived of food for three months. Burn wounds were created by burn comb model on the back of all rats. On days 3 and 21 after injury, five rats in each group were euthanized whereby samples were collected for histopathological, immunohistochemical (Bcl2, P53 and VEGF), and biochemical (MDA, TAC, HP) evaluations. RESULTS Histopathological analysis revealed epithelial layer and zone of ischemia remained viable in the intermittent fasting group on day 3. On the 21st day, epithelialization, angiogenesis, inflammation, fibrocyte-fibroblast, and collagen density were different in the ischemic and necrotic zones between the control and intermittent fasting groups (p<0.05). We found no statistical differences in Bcl2, P53, VEGF, MDA, TAC, and HP on day 3 between the intermittent fasting and control groups. CONCLUSIONS Intermittent fasting before burn wounds reduces tissue damage caused by ischemia and enhanced the viability of cells in zone of stasis. It also accelerated wound healing by increasing epithelialization and collagen production in the skin and regulating inflammatory responses. This intervention appears to be related to better collagen arrangement and angiogenesis.
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Lertsakdadet BS, Kennedy GT, Stone R, Kowalczewski C, Kowalczewski AC, Natesan S, Christy RJ, Durkin AJ, Choi B. Assessing multimodal optical imaging of perfusion in burn wounds. Burns 2022; 48:799-807. [PMID: 34696954 DOI: 10.1016/j.burns.2021.08.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 08/04/2021] [Accepted: 08/31/2021] [Indexed: 12/15/2022]
Abstract
A critical need exists for early, accurate diagnosis of burn wound severity to help identify the course of treatment and outcome of the wound. Laser speckle imaging (LSI) is a promising blood perfusion imaging approach, but it does not account for changes in tissue optical properties that can occur with burn wounds, which are highly dynamic environments. Here, we studied optical property dynamics following burn injury and debridement and the associated impact on interpretation of LSI measurements of skin perfusion. We used spatial frequency domain imaging (SFDI) measurements of tissue optical properties to study the impact of burn-induced changes in these properties on LSI measurements. An established preclinical porcine model of burn injury was used (n = 8). SFDI and LSI data were collected from burn wounds of varying severity. SFDI measurements demonstrate that optical properties change in response to burn injury in a porcine model. We then apply theoretical modeling to demonstrate that the measured range of optical property changes can affect the interpretation of LSI measurements of blood flow, but this effect is minimal for most of the measured data. Collectively, our results indicate that, even with a dynamic burn wound environment, blood-flow measurements with LSI can serve as an appropriate strategy for accurate assessment of burn severity.
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Affiliation(s)
- Ben S Lertsakdadet
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, CA 92612, USA; Department of Biomedical Engineering, University of California, Irvine, CA, 92697, USA.
| | - Gordon T Kennedy
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, CA 92612, USA.
| | - Randolph Stone
- United States Army Institute of Surgical Research, 36950 Chambers Pass, Fort Sam Houston, TX 78234, USA.
| | - Christine Kowalczewski
- United States Army Institute of Surgical Research, 36950 Chambers Pass, Fort Sam Houston, TX 78234, USA.
| | - Andrew C Kowalczewski
- United States Army Institute of Surgical Research, 36950 Chambers Pass, Fort Sam Houston, TX 78234, USA.
| | - Shanmugasundaram Natesan
- United States Army Institute of Surgical Research, 36950 Chambers Pass, Fort Sam Houston, TX 78234, USA.
| | - Robert J Christy
- United States Army Institute of Surgical Research, 36950 Chambers Pass, Fort Sam Houston, TX 78234, USA.
| | - Anthony J Durkin
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, CA 92612, USA; Department of Biomedical Engineering, University of California, Irvine, CA, 92697, USA.
| | - Bernard Choi
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, CA 92612, USA; Department of Biomedical Engineering, University of California, Irvine, CA, 92697, USA; Department of Surgery, University of California, Irvine, CA, 92697, USA; Edwards Lifesciences Center for Advanced Cardiovascular Technology, University of California, Irvine, CA, 92697, USA.
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11
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Rescuing the negative effects of aging in burn wounds using tacrolimus applied via microcapillary hydrogel dressing. Burns 2022; 48:1885-1892. [DOI: 10.1016/j.burns.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 01/25/2022] [Accepted: 02/03/2022] [Indexed: 11/19/2022]
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12
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Effects of taurine and apocynin on the zone of stasis. Burns 2022; 48:1850-1862. [DOI: 10.1016/j.burns.2022.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 12/19/2021] [Accepted: 01/05/2022] [Indexed: 11/21/2022]
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Haywood N, Byler MR, Zhang A, Rotar EP, Money D, Gradecki SE, Ta HQ, Salmon M, Kron IL, Laubach VE, Mehaffey JH, Roeser ME. Secondary Burn Progression Mitigated by an Adenosine 2A Receptor Agonist. J Burn Care Res 2021; 43:133-140. [PMID: 33769530 DOI: 10.1093/jbcr/irab053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Current burn therapy is largely supportive with limited therapies to curb secondary burn progression. Adenosine 2A receptor (A2AR) agonists have anti-inflammatory effects with decreased inflammatory cell infiltrate and release of pro-inflammatory mediators. Using a porcine comb burn model, we examined whether A2AR agonists could mitigate burn progression. STUDY DESIGN Eight full-thickness comb burns (4 prongs with 3 spaces per comb) per pig were generated with the following specifications: temperature 115° C, 3 kg force, and 30 second application time. In a randomized fashion, animals (4 per group) were then treated with A2AR agonist (ATL-1223, 3 ng/kg/min, intravenous infusion over 6 hours) or vehicle control. Necrotic interspace development was the primary outcome and additional histologic assessments were conducted. RESULTS Analysis of unburned interspaces (72 per group) revealed that ATL-1223 treatment decreased the rate of necrotic interspace development over the first 4 days following injury (p<0.05). Treatment significantly decreased dermal neutrophil infiltration at 48 hours following burn (14.63±4.30 vs 29.71±10.76 neutrophils/high-power field, p=0.029). Additionally, ATL-1223 treatment was associated with fewer interspaces with evidence of microvascular thrombi through post-burn day 4 (18.8% vs 56.3%, p=0.002). Two weeks following insult, the depth of injury at distinct burn sites (adjacent to interspaces) was significantly reduced by ATL-1223 treatment (2.91±0.47 vs 3.28±0.58 mm, p=0.038). CONCLUSION This work demonstrates the ability of an A2AR agonist to mitigate burn progression through dampening local inflammatory processes. Extended dosing strategies may yield additional benefit and improve cosmetic outcome in those with severe injury.
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Affiliation(s)
- Nathan Haywood
- Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA
| | - Matthew R Byler
- Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA
| | - Aimee Zhang
- Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA
| | - Evan P Rotar
- Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA
| | - Dustin Money
- Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA
| | - Sarah E Gradecki
- Department of Pathology, University of Virginia School of Medicine, Charlottesville, VA
| | - Huy Q Ta
- Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA
| | - Morgan Salmon
- Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA
| | - Irving L Kron
- Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA
| | - Victor E Laubach
- Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA
| | - J Hunter Mehaffey
- Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA
| | - Mark E Roeser
- Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA
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14
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Zhou H, Fang Q, Li N, Yu M, Chen H, Guo S. ASMq protects against early burn wound progression in rats by alleviating oxidative stress and secondary mitochondria‑associated apoptosis via the Erk/p90RSK/Bad pathway. Mol Med Rep 2021; 23:390. [PMID: 33760179 PMCID: PMC8008225 DOI: 10.3892/mmr.2021.12029] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 02/23/2021] [Indexed: 02/07/2023] Open
Abstract
Burn wounds present an evolutionary progression, in which the initial wound tissue deepens and expands following thermal injury. Progressive tissue damage in the zone of stasis may worsen burn injury, which is associated with oxidative stress and secondary apoptosis, and worsen the prognosis of patients with burn wounds. The mitochondrial apoptotic pathway is involved in receiving oxidative signals and regulating tissue apoptosis. Previously, Abnormal Savda Munziq (ASMq), a natural compound of traditional Uyghur Medicine, which includes ten types of herb, has been reported to exhibit a number of effects, including anti-inflammatory, antioxidative and anti-apoptotic activities. The present study demonstrated that ASMq protected against early burn wound progression following thermal injury in rats; this effect may be mediated by its ability to attenuate oxidative stress-induced mitochondria-associated apoptosis. The present study may provide a novel therapeutic method to prevent early burn wound progression following burn injury.
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Affiliation(s)
- Hanlei Zhou
- Department of Vascular Surgery, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China
| | - Quan Fang
- Department of Plastic Surgery, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China
| | - Nan Li
- Department of Plastic Surgery, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China
| | - Meirong Yu
- Clinical Research Center, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China
| | - Hongming Chen
- Department of Plastic Surgery, International Medical Center of The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China
| | - Songxue Guo
- Department of Plastic Surgery, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China
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15
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Guo S, Fang Q, Chen L, Yu M, Chen Y, Li N, Han C, Hu X. Locally activated mitophagy contributes to a "built-in" protection against early burn-wound progression in rats. Life Sci 2021; 276:119095. [PMID: 33493522 DOI: 10.1016/j.lfs.2021.119095] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 01/02/2021] [Accepted: 01/12/2021] [Indexed: 12/23/2022]
Abstract
AIMS Deep burn-wounds undergo a dynamic progression in the initial or periburn area after insults, and the zone of stasis is the crucial region suffering the deterioration, considered as salvageable. Few studies explored the role of mitochondria in this process. This study is to clarify a possible "built-in" protection of mitophagy. MAIN METHODS A classic "comb" scald rat model was established. Histological and blood-flow observation were processed based on hematoxylin-eosin staining and laser analysis. Oxidative and apoptotic status were analyzed by commercial kits. Transmission-electron microscope, immunofluorescence staining, and western blot were applied to detect the mitophagy in the zone of stasis and potential regulators. Adenovirus-based gene-silence contributed to determine the role of HIF-1α as a regulatory mediator. KEY FINDINGS We found that burn-caused typical ischemia and histological deterioration in the zone of stasis, in parallel with increases in oxidative stress and apoptosis. Mitochondrial damage was involved in the aforementioned changes. Furthermore, we detected mitophagy in burn-wounds, which was contradictory to the burn-wound conversion. HIF-1α expression was closely related to the level of mitophagy, while BNIP3 and PARKIN are involved downstream. SIGNIFICANCE We demonstrate that burn-induced mitochondrial impairment contributes to the mobilization of injurious mechanisms in the zone of stasis and that mitophagy provides a beneficial way to protect against burn-wound progression via the elimination of damaged mitochondria. Our findings offer insights into mitochondrial quality control in burn-wound progression and suggest the novel concept that HIF-1α may be a therapeutic target due to its possible regulation on BNIP3- or PARKIN-mediated mitophagy.
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Affiliation(s)
- Songxue Guo
- Department of Plastic Surgery, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang, China
| | - Quan Fang
- Department of Plastic Surgery, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang, China
| | - Leilei Chen
- Department of Hand and Plastic Surgery, First People's Hospital of Yuhang District, Hangzhou 311100, Zhejiang, China
| | - Meirong Yu
- Clinical Research Center, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang, China
| | - Yike Chen
- Department of Neurosurgery, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang, China
| | - Nan Li
- Department of Plastic Surgery, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang, China
| | - Chunmao Han
- Department of Burns, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang, China.
| | - Xueqing Hu
- Department of Plastic Surgery, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang, China.
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16
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Smith RD, Carney BC, Garg G, Monger KW, Prindeze NJ, Shupp JW, Moffatt LT. Modeling Burn Progression Using Comb Burns: The Impact of Thermal Contact Duration on Model Outcomes. J Surg Res 2020; 260:155-162. [PMID: 33340869 DOI: 10.1016/j.jss.2020.11.068] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 10/02/2020] [Accepted: 11/15/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND Burn progression is a phenomenon that remains poorly characterized. The mechanisms of burn conversion are not completely understood, and consequently, both predictive diagnostic tools and interventions are limited. The rat comb burn model is a commonly used approach to study horizontal burn conversion. However, there is significant variability in how the model is performed. Skin contact duration, comb device heating method, comb heating duration, amount of pressure applied, the weight of the comb, and associated depth of burn are all variables that are heterogeneous in studies utilizing the model. MATERIALS AND METHODS Here, contact duration was examined to determine the impact the duration of burn delivery has on the conversion of interspaces in this model. Data from multiple experiments consisting of 10, 15, 20, 30, 40, and 45 s comb burns were compiled and assessed. Burns were made using combs heated in a 100°C dry bath and then monitored for 2 d. Interspace viability was assessed by digital and laser doppler imaging and biopsy procurement. RESULTS Laser Doppler Imaging and viable interspace measurements showed that as burn duration increased, the percentage of the viable interspace and interspace perfusion decreased. Additionally, a contact time of 30 s or greater was required to result in 100% interspace conversion. CONCLUSIONS These results demonstrate a need to better characterize and potentially standardize the rat comb burn model to reduce variation and maintain it as a valuable tool for controlled studies of the pathophysiology of burn wound progression.
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Affiliation(s)
- Robert D Smith
- Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, District of Columbia
| | - Bonnie C Carney
- Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, District of Columbia; Department of Biochemistry and Molecular Biology, Georgetown University, Washington, District of Columbia
| | - Gaurav Garg
- Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, District of Columbia; Department of Surgery, MedStar Washington Hospital Center and MedStar Georgetown University Hospital, Washington, District of Columbia
| | - Kyle W Monger
- Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, District of Columbia
| | - Nicholas J Prindeze
- Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, District of Columbia; Department of Surgery, MedStar Washington Hospital Center and MedStar Georgetown University Hospital, Washington, District of Columbia
| | - Jeffrey W Shupp
- Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, District of Columbia; Department of Biochemistry and Molecular Biology, Georgetown University, Washington, District of Columbia; The Burn Center, Department of Surgery, MedStar Washington Hospital Center, Washington, District of Columbia; Department of Surgery, Georgetown University School of Medicine, Washington, District of Columbia.
| | - Lauren T Moffatt
- Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, District of Columbia; Department of Biochemistry and Molecular Biology, Georgetown University, Washington, District of Columbia; Department of Surgery, Georgetown University School of Medicine, Washington, District of Columbia
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17
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Cancio LC. Topical Antimicrobial Agents for Burn Wound Care: History and Current Status. Surg Infect (Larchmt) 2020; 22:3-11. [PMID: 33124942 DOI: 10.1089/sur.2020.368] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Background: Infection is the leading cause of death after thermal injury. Optimal prevention and treatment of burn wound infection is enabled by an in-depth understanding of burn wound treatment modalities not only from a technical standpoint, but also from the standpoint of the clinical context in which these modalities were originally developed. Methods: A review of the historical literature on the topical antimicrobial care of burn wounds was performed. Results: As our understanding of post-burn infection evolved, and as new products were developed for the prevention of post-burn wound infection, major advances in post-burn survival occurred. Ultimately, improvements in anesthetic, surgical, and critical care management have permitted early excision and grafting of the burn wound, decreasing but not eliminating the importance of topical antimicrobial care, and shifting much of the burden of wound infection prevention to the post-operative period. Conclusions: The development of effective topical antimicrobial agents for wound care was, arguably, the single most important advance in the care of the burn patient. Still, many gaps in our ability to treat complicated burn wounds remain. Fungal infection is an unusual but daunting challenge. Patients with impaired wound healing and those with advanced age or medical comorbidities may not benefit from early excision, and the benefits of early excision may not be available in austere or remote locations. For these reasons, research on optimal topical treatment continues.
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Affiliation(s)
- Leopoldo C Cancio
- U.S. Army Institute of Surgical Research, Fort Sam Houston, Texas, USA
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18
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Gürünlüoğlu K, Demircan M, Taşçı A, Üremiş MM, Türköz Y, Bağ HG, Akıncı A, Bayrakçı E. The Effects of Two Different Burn Dressings on Serum Oxidative Stress Indicators in Children with Partial Burn. J Burn Care Res 2020; 40:444-450. [PMID: 30874292 DOI: 10.1093/jbcr/irz037] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
In this study, we evaluated and compared the effect of treatment with a hydrofiber dressing with silver (HFAg) and a polylactic membrane (PLM) on systemic oxidative stress in systemic inflammatory reaction in thermal burn injuries in children. A prospective randomized and matched pairing study of 20 to 50% of TBSA was performed from children equal to both sexes affected by thermal injuries. The control group was included in normal children of both sexes. Serum malondialdehyde (MDA), total antioxidant capacity (TAC), total oxidant capacity (TOC), and glutathione (GSH) levels were analyzed and the results were analyzed statistically. In this study, it was found that PLM treatment increased TAC and GSH levels in burn patients significantly more than the other group. With the use of PLM, TOC decreased to normal level from day 3. In the HFAg group, TAC and GSH levels began to increase on the seventh day. On the first day of the burn, the TOC level started to increase. This increase continued on days 7 and 14. The TOC level began to fall on the 21st day. The increase in TAC was higher in the PLM group. In the PLM group, TOC fell faster. As a result, we think that different burn dressings can have different systemic effects. We can speculate that PLM has an antioxidant effect in the burn tissue due to high lactate content. Therefore, PLM may have decreased serum oxidative stress indicators more effectively than HFAg.
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Affiliation(s)
- Kubilay Gürünlüoğlu
- Pediatric Intensive Burn Care Unit, Department of Pediatric Surgery, İnönü University Faculty of Medicine, Malatya, Turkey
| | - Mehmet Demircan
- Pediatric Intensive Burn Care Unit, Department of Pediatric Surgery, İnönü University Faculty of Medicine, Malatya, Turkey
| | - Aytaç Taşçı
- Pediatric Intensive Burn Care Unit, Department of Pediatric Surgery, İnönü University Faculty of Medicine, Malatya, Turkey
| | - Muhammed Mehdi Üremiş
- Department of Medical Biochemistry, İnönü University Faculty of Medicine, Malatya, Turkey
| | - Yusuf Türköz
- Department of Medical Biochemistry, İnönü University Faculty of Medicine, Malatya, Turkey
| | - Harika Gözükara Bağ
- Department of Biostatistics and Medical Informatics, İnönü University Faculty of Medicine, Malatya, Turkey
| | - Ayşehan Akıncı
- Department of Pediatric Endocrinology, İnönü University Faculty of Medicine, Malatya, Turkey
| | - Ercan Bayrakçı
- Erzurum Regional Education and Research Hospital, Department of Pediatric Surgery, Erzurum, Turkey
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19
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Wang Y, Ke Z, He Z, Chen X, Zhang Y, Xie P, Li T, Zhou J, Li F, Yang C, Zhang P, Huang C, Kai L. Real-time burn depth assessment using artificial networks: a large-scale, multicentre study. Burns 2020; 46:1829-1838. [PMID: 32826097 DOI: 10.1016/j.burns.2020.07.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 07/15/2020] [Accepted: 07/15/2020] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Early judgment of the depth of burns is very important for the accurate formulation of treatment plans. In medical imaging the application of Artificial Intelligence has the potential for serving as a very experienced assistant to improve early clinical diagnosis. Due to lack of large volume of a particular feature, there has been almost no progress in burn field. METHODS 484 early wound images are collected on patients who discharged home after a burn injury in 48 h, from five different levels of hospitals in Hunan Province China. According to actual healing time, all images are manually annotated by five professional burn surgeons and divided into three sets which are shallow(0-10 days), moderate(11-20 days) and deep(more than 21 days or skin graft healing). These ROIs were further divided into 5637 patches sizes 224 × 224 pixels, of which 1733 shallow, 1804 moderate, and 2100 deep. We used transfer learning suing a Pre-trained ResNet50 model and the ratio of all images is 7:1.5:1.5 for training:validation:test. RESULTS A novel artificial burn depth recognition model based on convolutional neural network was established and the diagnostic accuracy of the three types of burns is about 80%. DISCUSSION The actual healing time can be used to deduce the depth of burn involvement. The artificial burn depth recognition model can accurately infer healing time and burn depth of the patient, which is expected to be used for auxiliary diagnosis improvement.
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Affiliation(s)
- Yuan Wang
- College of Computer Science and Technology, National Defense University of Science and Technology, Changsha, Hunan, China
| | - Zuo Ke
- College of Computer Science and Technology, National Defense University of Science and Technology, Changsha, Hunan, China
| | - Zhiyou He
- Department of Burns and Reconstructive Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China.
| | - Xiang Chen
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Human Engineering Research Center of Skin Health and Disease, Changsha, Hunan, China; Department of Dermatology Xiangya Hospital, Central South University, Changsha, Hunan, China.
| | - Yu Zhang
- Department of Dermatology Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Peizhen Xie
- College of Computer Science and Technology, National Defense University of Science and Technology, Changsha, Hunan, China
| | - Tao Li
- College of Computer Science and Technology, National Defense University of Science and Technology, Changsha, Hunan, China
| | - Jiao Zhou
- College of Computer Science and Technology, National Defense University of Science and Technology, Changsha, Hunan, China
| | - Fangfang Li
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Human Engineering Research Center of Skin Health and Disease, Changsha, Hunan, China; Department of Dermatology Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Canqun Yang
- College of Computer Science and Technology, National Defense University of Science and Technology, Changsha, Hunan, China
| | - Pihong Zhang
- Department of Burns and Reconstructive Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Chun Huang
- College of Computer Science and Technology, National Defense University of Science and Technology, Changsha, Hunan, China
| | - Lu Kai
- College of Computer Science and Technology, National Defense University of Science and Technology, Changsha, Hunan, China
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20
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Orhan E, Sapmaz-Metin M, Tarladaçalışır-Topçu Y, Gündüz Ö, Kaya O. The effect of platelet-rich plasma in inactive form on the burn zone of stasis in rats. J Plast Surg Hand Surg 2019; 53:301-308. [DOI: 10.1080/2000656x.2019.1614454] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Erkan Orhan
- Department of Plastic Surgery, School of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Melike Sapmaz-Metin
- Department of Histology and Embryology, School of Medicine, Trakya University, Edirne, Turkey
| | | | - Özgür Gündüz
- Department of Medical Pharmacology, School of Medicine, Trakya University, Edirne, Turkey
| | - Oktay Kaya
- Department of Physiology, School of Medicine, Trakya University, Edirne, Turkey
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21
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Vitse J, Tchero H, Meaume S, Dompmartin A, Malloizel-Delaunay J, Géri C, Faure C, Herlin C, Teot L. Silver Sulfadiazine and Cerium Nitrate in Ischemic Skin Necrosis of the Leg and Foot: Results of a Prospective Randomized Controlled Study. INT J LOW EXTR WOUND 2019; 17:151-160. [PMID: 30222081 DOI: 10.1177/1534734618795534] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Flammacerium is a topical treatment composed of silver sulfadiazine and cerium nitrate initially used in burns. The objective was to assess the effectiveness of silver sulfadiazine and cerium nitrate on ischemic necrosis wounds of the lower limb as an alternative to amputation for a period of 12 weeks. Patients were prospectively randomized to receive silver sulfadiazine and cerium nitrate or standard care. Patients included adults with an ischemic wound of the lower limb, with necrosis covering over at least 50%. Critical ischemia limb was confirmed by an ankle-brachial index <0.7 or >1.3 with radiological confirmation. Patient demographic data, amputations procedures, wound area, Visual Analogue Scale pain rating, clinical infection, and adverse events were recorded. Fifty patients, 34 males and 16 females, were recruited between January 2010 and April 2014, 25 in each group. The mean age was 75.14 years (±11.64). Nine amputations (36%) occurred in each group. Amputation-free survival was superior in the active treatment group versus the standard group (169 393 days, 95% confidence interval = 134.926-203.861, vs 169 393 days, 95% confidence interval = 134.926-203.861). It was not statistically significant (log-rank, P = .958). Wound area reduction between both groups was not statistically different ( P = .651). Less adverse events of the lower limb occurred in the active treatment group ( P = .001). Our study showed that silver sulfadiazine and cerium nitrate is not inferior to standardized care on ischemic necrotic wounds of the lower extremity. Further studies are still needed to confirm its effectiveness.
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Affiliation(s)
- Julian Vitse
- 1 Montpellier University Hospital, Montpellier, France
| | | | | | | | | | - Chloé Géri
- 1 Montpellier University Hospital, Montpellier, France
| | | | | | - Luc Teot
- 1 Montpellier University Hospital, Montpellier, France
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22
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Uraloğlu M, Ural A, Efe G, Yuluğ E, Livaoğlu M, Karaçal N. The Effect of Platelet-Rich Plasma on the Zone of Stasis and Apoptosis in an Experimental Burn Model. Plast Surg (Oakv) 2018; 27:173-181. [PMID: 31106177 DOI: 10.1177/2292550318800498] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background The zone of stasis that forms in acute burn is initially viable, but coagulation progresses to necrosis in the process that follows. Objective This study investigates the effects of platelet-rich plasma (PRP) on apoptosis in the burn zone of stasis and on the viability of living tissue. Methods Burns were established in the right ears of 20 female New Zealand rabbits using the "comb burn" model. Platelet-rich plasma was obtained from blood collected from rabbits' ears (n = 10) and was injected subcutaneously into the zone of stasis (n = 10). The same amount of saline solution was injected into the zone of stasis of the control group rabbits (n = 10). Histological and immunohistochemical apoptosis analysis was performed to evaluate viable areas. Results Apoptosis levels were higher in the control group than in the experimental group. The area of viable tissue in the zone of stasis was greater than in the control group. Infection-induced neutrophil infiltration was statistically significantly lower in the experimental group. Conclusion In this animal model, apoptosis count and viable tissue area measurement and the anti-inflammatory results in the burn area confirm that PRP therapy has a statistically significant positive impact on the survival of the zone of stasis and in acute burn injury.
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Affiliation(s)
- Muhammet Uraloğlu
- Faculty of Medicine, Department of Plastic and Reconstructive Surgery, Karadeniz Technical University, Trabzon, Turkey
| | - Alper Ural
- Faculty of Medicine, Department of Plastic and Reconstructive Surgery, Sutcuimam University, Kahramanmaraş, Turkey
| | - Gökhan Efe
- Faculty of Medicine, Department of Plastic and Reconstructive Surgery, Karadeniz Technical University, Trabzon, Turkey
| | - Esin Yuluğ
- Faculty of Medicine, Department of Histology and Embryology, Karadeniz Technical University, Trabzon, Turkey
| | - Murat Livaoğlu
- Faculty of Medicine, Department of Plastic and Reconstructive Surgery, Karadeniz Technical University, Trabzon, Turkey
| | - Naci Karaçal
- Faculty of Medicine, Department of Plastic and Reconstructive Surgery, Karadeniz Technical University, Trabzon, Turkey
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23
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Guo F, Zhang H, Qiu G, Zuo H, Chen G, Lou Y, Min D, Guo G. Fabrication of LaCl3-containing nanofiber scaffolds and their application in skin wound healing. J Appl Polym Sci 2018. [DOI: 10.1002/app.46672] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Fei Guo
- First Affiliated Hospital of Nanchang University; YongWaiZheng Load 17 Nanchang Jiangxi China
| | - Huiqing Zhang
- First Affiliated Hospital of Nanchang University; YongWaiZheng Load 17 Nanchang Jiangxi China
| | - Guosheng Qiu
- First Affiliated Hospital of Nanchang University; YongWaiZheng Load 17 Nanchang Jiangxi China
| | - Huijun Zuo
- First Affiliated Hospital of Nanchang University; YongWaiZheng Load 17 Nanchang Jiangxi China
| | - Gangquan Chen
- First Affiliated Hospital of Nanchang University; YongWaiZheng Load 17 Nanchang Jiangxi China
| | - Yuanlei Lou
- First Affiliated Hospital of Nanchang University; YongWaiZheng Load 17 Nanchang Jiangxi China
| | - Dinghong Min
- First Affiliated Hospital of Nanchang University; YongWaiZheng Load 17 Nanchang Jiangxi China
| | - Guanghua Guo
- First Affiliated Hospital of Nanchang University; YongWaiZheng Load 17 Nanchang Jiangxi China
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24
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Hayati F, Ghamsari SM, Dehghan MM, Oryan A. Effects of carbomer 940 hydrogel on burn wounds: an in vitro and in vivo study. J DERMATOL TREAT 2018; 29:593-599. [DOI: 10.1080/09546634.2018.1426823] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Farzad Hayati
- Department of Surgery and Radiology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - Seyed Mehdi Ghamsari
- Department of Surgery and Radiology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - Mohammad Mehdi Dehghan
- Department of Surgery and Radiology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - Ahmad Oryan
- Department of Pathology, School of Veterinary Medicine, Shiraz University, Shiraz, Iran
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25
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Fu GF, Tian SM, Cha XJ, Huang HJ, Lou JH, Wei Y, Xia CD, Li YL, Niu XH. Topically administered rhGM-CSF affects PPARβ expression in the stasis zone. Exp Ther Med 2017; 14:4825-4830. [PMID: 29201186 PMCID: PMC5704314 DOI: 10.3892/etm.2017.5146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 09/11/2017] [Indexed: 11/06/2022] Open
Abstract
Using a rat comb thermal damage model, we investigated the effects of topically administered recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) on peroxisome proliferator-activated receptor PPARβ expression. We created bilateral comb scald models on the backs of fifty Sprague-Dawley rats. The left sides of the backs served as the experimental group and the right sides served as the control group. The experimental group received topically applied rhGM-CSF hydrogel and the control group did not. The survival situations of the stasis zones were compared between the experimental and control groups on the 1st, 3rd, 7th, 14th and 21st post-burn days. Tissues from the surviving stasis zones of both groups were collected at different time-points. Reverse transcriptase-polymerase chain reaction (RT-PCR) and western blotting were used to detect the PPARβ mRNA and protein expression levels. Immunohistochemical methods were applied to detect the localization of PPARβ protein expression. The results showed that, first, the tissue viability numbers for the stasis zones of the experimental group were significantly increased compared with those of the control group. Second, RT-PCR revealed that the PPARβ mRNA expression first increased and then gradually declined in both groups. At all time-points, the expression level in the experimental group was increased compared with that in the control group and the highest expression levels were observed in both groups on the 3rd post-burn day. Third, western blot analysis revealed that the PPARβ protein expression in both groups increased after thermal damage and then gradually decreased. PPARβ protein expression in the experimental group was greater than that in the control group, and the highest expression quantities in both groups were observed on the 3rd post-burn day. In conclusion, rhGM-CSF hydrogel effectively promotes the expression of PPARβ, and the hydrogel had a specific protective effect for the stasis zone.
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Affiliation(s)
- Gen-Feng Fu
- Department of Burn and Plastic Surgery, Taihe Hospital, Changsha, Hunan 410005, P.R. China
| | - She-Min Tian
- Department of Burns, The First People's Hospital of Zhengzhou City, Zhengzhou, Henan 450004, P.R. China
| | - Xin-Jian Cha
- Department of Burns, The First People's Hospital of Zhengzhou City, Zhengzhou, Henan 450004, P.R. China
| | - Hong-Jun Huang
- Department of Burns, The First People's Hospital of Zhengzhou City, Zhengzhou, Henan 450004, P.R. China
| | - Ji-He Lou
- Department of Burns, The First People's Hospital of Zhengzhou City, Zhengzhou, Henan 450004, P.R. China
| | - Ying Wei
- Department of Burns, The First People's Hospital of Zhengzhou City, Zhengzhou, Henan 450004, P.R. China
| | - Cheng-De Xia
- Department of Burns, The First People's Hospital of Zhengzhou City, Zhengzhou, Henan 450004, P.R. China
| | - Yong-Lin Li
- Department of Burns, The First People's Hospital of Zhengzhou City, Zhengzhou, Henan 450004, P.R. China
| | - Xi-Hua Niu
- Department of Burns, The First People's Hospital of Zhengzhou City, Zhengzhou, Henan 450004, P.R. China
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Aykac A, Karanlik B, Sehirli AO. Protective effect of silk fibroin in burn injury in rat model. Gene 2017; 641:287-291. [PMID: 29037999 DOI: 10.1016/j.gene.2017.10.036] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 09/12/2017] [Accepted: 10/11/2017] [Indexed: 11/16/2022]
Abstract
Activation of pro-inflamatuar pathways play major role in formation of major complications as a result of burns. This study was planned to investigate the protective effect of Silk Fibroin in lung injury caused by burn in the experimental rat model. After rinsing the skin of rats under ether anesthesia, the exposed back region, covers 30% of the total body, was kept in the 90°C water bath for 10s. The control rats were kept in the 25°C water bath for 10s. Immediately after burning process, silk fibroin was administered orally at a dose of 600mg/kg. After 24h following burning from all groups the levels of TNF-α, IL-1β in blood samples and the MDA, GSH and the activity of MPO were determined from taken lung tissues. Moreover, the expression of Bcl-2/Bax, Caspase-3 and Caspase-9 were determined. Significant increase in TNF-α, IL-1β, Casp-3 and Casp-9 levels were observed in the Silk Fibroin-treated burn group (p<0.05) whereas for ratio of Bcl-2/Bax, a significant reduction was observed compared to control group (p<0.05). Increased levels of TNF-α, IL-1β, Caspase-3 and Caspase-9 in Silk Fibroin-treated burn groups were found to be reversed. Silk fibroin can be an effective biomaterial in diminishing burn injury in tissue and apoptosis.
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Affiliation(s)
- Asli Aykac
- Near East University, Faculty of Medicine, Department of Biophysics, Nicosia, Cyprus
| | - Buse Karanlik
- Near East University, Vocational School of Health Sciences, Nicosia, Cyprus.
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Fang Q, Guo S, Zhou H, Han R, Wu P, Han C. Astaxanthin protects against early burn-wound progression in rats by attenuating oxidative stress-induced inflammation and mitochondria-related apoptosis. Sci Rep 2017; 7:41440. [PMID: 28128352 PMCID: PMC5269753 DOI: 10.1038/srep41440] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 12/19/2016] [Indexed: 01/09/2023] Open
Abstract
Burn-wound progression can occur in the initial or peri-burn area after a deep burn injury. The stasis zone has a higher risk of deterioration mediated by multiple factors but is also considered salvageable. Astaxanthin (ATX), which is extracted from some marine organisms, is a natural compound with a strong antioxidant effect that has been reported to attenuate organ injuries caused by traumatic injuries. Hence, we investigated the potential effects of ATX on preventing early burn-wound progression. A classic "comb" burn rat model was established in this study for histological and biological assessments, which revealed that ATX, particularly higher doses, alleviated histological deterioration in the stasis zone. Additionally, we observed dose-dependent improvements in oxidative stress and the release of inflammatory mediators after ATX treatment. Furthermore, ATX dose-dependently attenuated burn-induced apoptosis in the wound areas, and this effect was accompanied by increases in Akt and Bad phosphorylation and a downregulation of cytochrome C and caspase expression. In addition, the administration of Ly 294002 further verified the effect of ATX. In summary, we demonstrated that ATX protected against early burn-wound progression in a rat deep-burn model. This protection might be mediated by the attenuation of oxidative stress-induced inflammation and mitochondria-related apoptosis.
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Affiliation(s)
- Quan Fang
- Department of Burns, Second Affiliated Hospital, Zhejiang University, College of Medicine, 88 Jiefang Road, Hangzhou 310009, Zhejiang, China
- Department of Plastic Surgery, Binjiang Branch, Second Affiliated Hospital, Zhejiang University, College of Medicine, 1511 Jianghong Road, Hangzhou 310000, Zhejiang, China
| | - Songxue Guo
- Department of Burns, Second Affiliated Hospital, Zhejiang University, College of Medicine, 88 Jiefang Road, Hangzhou 310009, Zhejiang, China
| | - Hanlei Zhou
- Department of Burns, Second Affiliated Hospital, Zhejiang University, College of Medicine, 88 Jiefang Road, Hangzhou 310009, Zhejiang, China
| | - Rui Han
- Department of Dermatology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 3 East Qingchun Road, Hangzhou 310020, Zhejiang, China
| | - Pan Wu
- Department of Burns, Second Affiliated Hospital, Zhejiang University, College of Medicine, 88 Jiefang Road, Hangzhou 310009, Zhejiang, China
| | - Chunmao Han
- Department of Burns, Second Affiliated Hospital, Zhejiang University, College of Medicine, 88 Jiefang Road, Hangzhou 310009, Zhejiang, China
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Dual therapeutic functions of F-5 fragment in burn wounds: preventing wound progression and promoting wound healing in pigs. MOLECULAR THERAPY-METHODS & CLINICAL DEVELOPMENT 2016; 3:16041. [PMID: 27382602 PMCID: PMC4916949 DOI: 10.1038/mtm.2016.41] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 04/22/2016] [Accepted: 04/25/2016] [Indexed: 12/16/2022]
Abstract
Burn injuries are a leading cause of morbidity including prolonged hospitalization, disfigurement, and disability. Currently there is no Food and Drug Administration-approved burn therapeutics. A clinical distinction of burn injuries from other acute wounds is the event of the so-called secondary burn wound progression within the first week of the injury, in which a burn expands horizontally and vertically from its initial boundary to a larger area. Therefore, an effective therapeutics for burns should show dual abilities to prevent the burn wound progression and thereafter promote burn wound healing. Herein we report that topically applied F-5 fragment of heat shock protein-90α is a dual functional agent to promote burn wound healing in pigs. First, F-5 prevents burn wound progression by protecting the surrounding cells from undergoing heat-induced caspase 3 activation and apoptosis with increased Akt activation. Accordingly, F-5-treated burn and excision wounds show a marked decline in inflammation. Thereafter, F-5 accelerates burn wound healing by stimulating the keratinocyte migration-led reepithelialization, leading to wound closure. This study addresses a topical agent that is capable of preventing burn wound progression and accelerating burn wound healing.
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Deutsch G, Bokehi LC, Silva AEGPR, Guimarães Junior LM, Rodrigues R, Esper LMR, Gonzalez AGM, Paula GRD, Castilho SRD, Teixeira LA. Balneotherapy is a potential risk factor for Pseudomonas aeruginosa colonization. BRAZ J PHARM SCI 2016. [DOI: 10.1590/s1984-82502016000100014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT The practice of immersion in burn patient has been abandoned in many parts of the world but in Brazil it is still common. The aim of this study was to ascertain if balneotherapy is a risk factor for Pseudomonas aeruginosa colonization in thermally injured patients. Eighteen patients from a Burn Center were studied for 14 weeks for Pseudomonas aeruginosa. Samples were collected by swabbing the exudate of wounds, before and after giving bath to the patients and from balneotherapy table. Pulsed-field gel electrophoresis was used to determine bacterial genetic relatedness. Thirty-seven P. aeruginosa isolates were detected from 292 swabs collected from patients' burn surface area and from the balneotherapy table. Profile analysis of P. aeruginosa DNA fragmentation showed 10 clones among the 37 strains analyzed. Type A is the most prevalent clone, with 23 strains distributed into eight subtypes. These were present in the swabs collected, before and after the patients' bath, from the surface of the bath table, suggesting that there was cross-contamination between the patients in different ways. This work demonstrates that balneotherapy is a risk factor in the Burn Center studied, because the same clone was found among P. aeruginosa isolates collected at various points and times.
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Salibian AA, Rosario ATD, Severo LDAM, Nguyen L, Banyard DA, Toranto JD, Evans GRD, Widgerow AD. Current concepts on burn wound conversion-A review of recent advances in understanding the secondary progressions of burns. Burns 2016; 42:1025-1035. [PMID: 26787127 DOI: 10.1016/j.burns.2015.11.007] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Revised: 09/16/2015] [Accepted: 11/24/2015] [Indexed: 01/27/2023]
Abstract
Burn wound conversion describes the process by which superficial partial thickness burns convert into deeper burns necessitating surgical intervention. Fully understanding and thus controlling this phenomenon continues to defy burn surgeons. However, potentially guiding burn wound progression so as to obviate the need for surgery while still bringing about healing with limited scarring is the major unmet challenge. Comprehending the pathophysiologic background contributing to deeper progression of these burns is an essential prerequisite to planning any intervention. In this study, a review of articles examining burn wound progression over the last five years was conducted to analyze trends in recent burn progression research, determine changes in understanding of the pathogenesis of burn conversion, and subsequently examine the direction for future research in developing therapies. The majority of recent research focuses on applying therapies from other disease processes to common underlying pathogenic mechanisms in burn conversion. While ischemia, inflammation, and free oxygen radicals continue to demonstrate a critical role in secondary necrosis, novel mechanisms such as autophagy have also been shown to contribute affect significantly burn progression significantly. Further research will have to determine whether multiple mechanisms should be targeted when developing clinical therapies.
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Affiliation(s)
- Ara A Salibian
- Center for Tissue Engineering, Department of Plastic Surgery, University of California, Irvine, 200 S. Manchester Avenue, Orange, CA, 92868-3298, United States
| | - Angelica Tan Del Rosario
- Center for Tissue Engineering, Department of Plastic Surgery, University of California, Irvine, 200 S. Manchester Avenue, Orange, CA, 92868-3298, United States
| | - Lucio De Almeida Moura Severo
- Center for Tissue Engineering, Department of Plastic Surgery, University of California, Irvine, 200 S. Manchester Avenue, Orange, CA, 92868-3298, United States
| | - Long Nguyen
- Center for Tissue Engineering, Department of Plastic Surgery, University of California, Irvine, 200 S. Manchester Avenue, Orange, CA, 92868-3298, United States
| | - Derek A Banyard
- Center for Tissue Engineering, Department of Plastic Surgery, University of California, Irvine, 200 S. Manchester Avenue, Orange, CA, 92868-3298, United States
| | - Jason D Toranto
- Center for Tissue Engineering, Department of Plastic Surgery, University of California, Irvine, 200 S. Manchester Avenue, Orange, CA, 92868-3298, United States
| | - Gregory R D Evans
- Center for Tissue Engineering, Department of Plastic Surgery, University of California, Irvine, 200 S. Manchester Avenue, Orange, CA, 92868-3298, United States
| | - Alan D Widgerow
- Center for Tissue Engineering, Department of Plastic Surgery, University of California, Irvine, 200 S. Manchester Avenue, Orange, CA, 92868-3298, United States.
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Zang T, Broszczak DA, Broadbent JA, Cuttle L, Lu H, Parker TJ. The biochemistry of blister fluid from pediatric burn injuries: proteomics and metabolomics aspects. Expert Rev Proteomics 2015; 13:35-53. [PMID: 26581649 DOI: 10.1586/14789450.2016.1122528] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Burn injury is a prevalent and traumatic event for pediatric patients. At present, the diagnosis of burn injury severity is subjective and lacks a clinically relevant quantitative measure. This is due in part to a lack of knowledge surrounding the biochemistry of burn injuries and that of blister fluid. A more complete understanding of the blister fluid biochemistry may open new avenues for diagnostic and prognostic development. Burn insult induces a highly complex network of signaling processes and numerous changes within various biochemical systems, which can ultimately be examined using proteome and metabolome measurements. This review reports on the current understanding of burn wound biochemistry and outlines a technical approach for 'omics' profiling of blister fluid from burn wounds of differing severity.
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Affiliation(s)
- Tuo Zang
- a Tissue Repair and Regeneration Program , Institute of Health and Biomedical Innovation , Kelvin Grove , Australia.,b School of Biomedical Sciences , Queensland University of Technology , Brisbane , Australia.,c Wound Management Innovation Co-operative Research Centre , West End , Australia
| | - Daniel A Broszczak
- a Tissue Repair and Regeneration Program , Institute of Health and Biomedical Innovation , Kelvin Grove , Australia.,b School of Biomedical Sciences , Queensland University of Technology , Brisbane , Australia.,c Wound Management Innovation Co-operative Research Centre , West End , Australia
| | - James A Broadbent
- a Tissue Repair and Regeneration Program , Institute of Health and Biomedical Innovation , Kelvin Grove , Australia.,b School of Biomedical Sciences , Queensland University of Technology , Brisbane , Australia.,c Wound Management Innovation Co-operative Research Centre , West End , Australia
| | - Leila Cuttle
- a Tissue Repair and Regeneration Program , Institute of Health and Biomedical Innovation , Kelvin Grove , Australia.,b School of Biomedical Sciences , Queensland University of Technology , Brisbane , Australia.,d Centre for Children's Burns and Trauma Research , Queensland University of Technology, Institute of Health and Biomedical Innovation at the Centre for Children's Health Research , South Brisbane , Australia
| | - Haitao Lu
- a Tissue Repair and Regeneration Program , Institute of Health and Biomedical Innovation , Kelvin Grove , Australia.,b School of Biomedical Sciences , Queensland University of Technology , Brisbane , Australia
| | - Tony J Parker
- a Tissue Repair and Regeneration Program , Institute of Health and Biomedical Innovation , Kelvin Grove , Australia.,b School of Biomedical Sciences , Queensland University of Technology , Brisbane , Australia
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Burmeister DM, Ponticorvo A, Yang B, Becerra SC, Choi B, Durkin AJ, Christy RJ. Utility of spatial frequency domain imaging (SFDI) and laser speckle imaging (LSI) to non-invasively diagnose burn depth in a porcine model. Burns 2015; 41:1242-52. [PMID: 26138371 DOI: 10.1016/j.burns.2015.03.001] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Revised: 02/26/2015] [Accepted: 03/02/2015] [Indexed: 01/26/2023]
Abstract
Surgical intervention of second degree burns is often delayed because of the difficulty in visual diagnosis, which increases the risk of scarring and infection. Non-invasive metrics have shown promise in accurately assessing burn depth. Here, we examine the use of spatial frequency domain imaging (SFDI) and laser speckle imaging (LSI) for predicting burn depth. Contact burn wounds of increasing severity were created on the dorsum of a Yorkshire pig, and wounds were imaged with SFDI/LSI starting immediately after-burn and then daily for the next 4 days. In addition, on each day the burn wounds were biopsied for histological analysis of burn depth, defined by collagen coagulation, apoptosis, and adnexal/vascular necrosis. Histological results show that collagen coagulation progressed from day 0 to day 1, and then stabilized. Results of burn wound imaging using non-invasive techniques were able to produce metrics that correlate to different predictors of burn depth. Collagen coagulation and apoptosis correlated with SFDI scattering coefficient parameter [Formula: see text] and adnexal/vascular necrosis on the day of burn correlated with blood flow determined by LSI. Therefore, incorporation of SFDI scattering coefficient and blood flow determined by LSI may provide an algorithm for accurate assessment of the severity of burn wounds in real time.
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Affiliation(s)
- David M Burmeister
- United States Army Institute of Surgical Research, 3698 Chambers Pass, JBSA Fort Sam Houston, TX 78234, USA
| | - Adrien Ponticorvo
- Beckman Laser Institute and Medical Clinic, University of California Irvine, 1002 Health Sciences Road East, Irvine, CA 92617, USA
| | - Bruce Yang
- Beckman Laser Institute and Medical Clinic, University of California Irvine, 1002 Health Sciences Road East, Irvine, CA 92617, USA
| | - Sandra C Becerra
- United States Army Institute of Surgical Research, 3698 Chambers Pass, JBSA Fort Sam Houston, TX 78234, USA
| | - Bernard Choi
- Beckman Laser Institute and Medical Clinic, University of California Irvine, 1002 Health Sciences Road East, Irvine, CA 92617, USA; Biomedical Engineering Department, University of California Irvine, 3120 Natural Sciences II, Irvine, CA 92697, USA
| | - Anthony J Durkin
- Biomedical Engineering Department, University of California Irvine, 3120 Natural Sciences II, Irvine, CA 92697, USA
| | - Robert J Christy
- United States Army Institute of Surgical Research, 3698 Chambers Pass, JBSA Fort Sam Houston, TX 78234, USA.
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Guo SX, Jin YY, Fang Q, You CG, Wang XG, Hu XL, Han CM. Beneficial effects of hydrogen-rich saline on early burn-wound progression in rats. PLoS One 2015; 10:e0124897. [PMID: 25874619 PMCID: PMC4395383 DOI: 10.1371/journal.pone.0124897] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Accepted: 03/06/2015] [Indexed: 12/19/2022] Open
Abstract
Introduction Deep burn wounds undergo a dynamic process known as wound progression that results in a deepening and extension of the initial burn area. The zone of stasis is more likely to develop more severe during wound progression in the presence of hypoperfusion. Hydrogen has been reported to alleviate injury triggered by ischaemia/reperfusion and burns in various organs by selectively quenching oxygen free radicals. The aim of this study was to investigate the possible protective effects of hydrogen against early burn-wound progression. Methods Deep-burn models were established through contact with a boiled, rectangular, brass comb for 20 s. Fifty-six Sprague-Dawley rats were randomly divided into sham, burn plus saline, and burn plus hydrogen-rich saline (HS) groups with sacrifice and analysis at various time windows (6 h, 24 h, 48 h) post burn. Indexes of oxidative stress, apoptosis and autophagy were measured in each group. The zone of stasis was evaluated using immunofluorescence staining, ELISA, and Western blot to explore the underlying effects and mechanisms post burn. Results The burn-induced increase in malondialdehyde was markedly reduced with HS, while the activities of endogenous antioxidant enzymes were significantly increased. Moreover, HS treatment attenuated increases in apoptosis and autophagy postburn in wounds, according to the TUNEL staining results and the expression analysis of Bax, Bcl-2, caspase-3, Beclin-1 and Atg-5 proteins. Additionally, HS lowered the level of myeloperoxidase and expression of TNF-α, IL-1β, and IL-6 in the zone of stasis while augmenting IL-10. The elevated levels of Akt phosphorylation and NF-κB p65 expression post burn were also downregulated by HS management. Conclusion Hydrogen can attenuate early wound progression following deep burn injury. The beneficial effect of hydrogen was mediated by attenuating oxidative stress, which inhibited apoptosis and inflammation, and the Akt/NF-κB signalling pathway may be involved in regulating the release of inflammatory cytokines.
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Affiliation(s)
- Song Xue Guo
- Department of Burns, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yun Yun Jin
- Department of Burns, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Quan Fang
- Department of Plastic Surgery, Binjiang Branch, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Chuan Gang You
- Department of Burns, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Xin Gang Wang
- Department of Burns, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Xin Lei Hu
- Department of Orthopaedics, Binjiang Branch, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Chun-Mao Han
- Department of Burns, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- * E-mail:
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Silva-Dias A, Miranda IM, Branco J, Cobrado L, Monteiro-Soares M, Pina-Vaz C, Rodrigues AG. In vitro antifungal activity and in vivo antibiofilm activity of cerium nitrate against Candida species. J Antimicrob Chemother 2015; 70:1083-93. [PMID: 25558078 DOI: 10.1093/jac/dku511] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVES The objective of this study was to clarify the antifungal properties of cerium, a lanthanide member, against Candida species. A comprehensive study with planktonic and sessile cells was performed. The ability of cerium nitrate (CN) to impair in vitro and in vivo biofilm formation was evaluated and its potential use in biofilm treatment was also evaluated. METHODS Forty-eight clinical isolates of different Candida species and the type strain ATCC 90028 were tested according to the protocol M27-A3. The MICs and minimum lethal concentrations were determined. A time-kill assay was performed and a cytometric kinetic study was performed using live/dead markers. Biofilm inhibition and biofilm susceptibility in the presence of cerium was evaluated by quantification of the biofilm metabolic activity and total biomass with XTT and crystal violet assays, respectively. CN in vivo efficacy as a coating for medical indwelling devices was evaluated for the first time for Candida parapsilosis, using a mouse subcutaneous foreign body model using polyurethane catheter segments. Scanning electron microscopy was used to assess biofilm architecture after CN treatment. RESULTS The MICs for planktonic cells correlated with severe cellular metabolic activity impairment and membrane damage after 3 h of incubation. Moreover, CN efficiently prevented biofilm formation both in vitro and in vivo in segments of polyurethane catheters. At higher concentrations, it was also able to disorganize and almost eradicate preformed biofilms. CONCLUSIONS Our results strongly suggest that CN application in the clinical setting might be effective in preventing the formation of biofilm-associated infections, namely through catheter coating and ultimately as an antimicrobial lock therapy.
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Affiliation(s)
- Ana Silva-Dias
- Department of Microbiology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal Cardiovascular Research & Development Unit, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal CINTESIS, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
| | - Isabel M Miranda
- Department of Microbiology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal Cardiovascular Research & Development Unit, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal CINTESIS, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
| | - Joana Branco
- Department of Microbiology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
| | - Luís Cobrado
- Department of Microbiology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal Cardiovascular Research & Development Unit, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal CINTESIS, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal Burn Unit and Department of Plastic and Reconstructive Surgery, Centro Hospitalar S. João, 4200-319 Porto, Portugal
| | - Matilde Monteiro-Soares
- CIDES, Department of Information and Decision Sciences in Health, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
| | - Cidália Pina-Vaz
- Department of Microbiology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal Cardiovascular Research & Development Unit, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal CINTESIS, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal Department of Microbiology, Centro Hospitalar S. João, 4200-319 Porto, Portugal
| | - Acácio G Rodrigues
- Department of Microbiology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal Cardiovascular Research & Development Unit, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal CINTESIS, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal Burn Unit and Department of Plastic and Reconstructive Surgery, Centro Hospitalar S. João, 4200-319 Porto, Portugal
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Treatment of Secondary Burn Wound Progression in Contact Burns—A Systematic Review of Experimental Approaches. J Burn Care Res 2015; 36:e176-89. [DOI: 10.1097/bcr.0000000000000131] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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36
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Ponticorvo A, Burmeister DM, Yang B, Choi B, Christy RJ, Durkin AJ. Quantitative assessment of graded burn wounds in a porcine model using spatial frequency domain imaging (SFDI) and laser speckle imaging (LSI). BIOMEDICAL OPTICS EXPRESS 2014; 5:3467-81. [PMID: 25360365 PMCID: PMC4206317 DOI: 10.1364/boe.5.003467] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Accepted: 08/28/2014] [Indexed: 05/02/2023]
Abstract
Accurate and timely assessment of burn wound severity is a critical component of wound management and has implications related to course of treatment. While most superficial burns and full thickness burns are easily diagnosed through visual inspection, burns that fall between these extremes are challenging to classify based on clinical appearance. Because of this, appropriate burn management may be delayed, increasing the risk of scarring and infection. Here we present an investigation that employs spatial frequency domain imaging (SFDI) and laser speckle imaging (LSI) as non-invasive technologies to characterize in-vivo burn severity. We used SFDI and LSI to investigate controlled burn wounds of graded severity in a Yorkshire pig model. Burn wounds were imaged starting at one hour after the initial injury and daily at approximately 24, 48 and 72 hours post burn. Biopsies were taken on each day in order to correlate the imaging data to the extent of burn damage as indicated via histological analysis. Changes in reduced scattering coefficient and blood flow could be used to categorize burn severity as soon as one hour after the burn injury. The results of this study suggest that SFDI and LSI information have the potential to provide useful metrics for quantifying the extent and severity of burn injuries.
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Affiliation(s)
- Adrien Ponticorvo
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, 1002 Health Sciences Road East, Irvine, CA 92617, USA
- co-first authors
| | - David M. Burmeister
- United States Army Institute of Surgical Research, 3698 Chambers Pass, Fort Sam Houston, TX, 78234, USA
- co-first authors
| | - Bruce Yang
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, 1002 Health Sciences Road East, Irvine, CA 92617, USA
| | - Bernard Choi
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, 1002 Health Sciences Road East, Irvine, CA 92617, USA
- Department of Biomedical Engineering, University of California, Irvine, 3120 Natural Sciences II, Irvine, CA 92697, USA
| | - Robert J. Christy
- United States Army Institute of Surgical Research, 3698 Chambers Pass, Fort Sam Houston, TX, 78234, USA
| | - Anthony J. Durkin
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, 1002 Health Sciences Road East, Irvine, CA 92617, USA
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37
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Yüksel EB, Yıldırım AM, Bal A, Kuloglu T. The effect of different topical agents (silver sulfadiazine, povidone-iodine, and sodium chloride 0.9%) on burn injuries in rats. PLASTIC SURGERY INTERNATIONAL 2014; 2014:907082. [PMID: 25328700 PMCID: PMC4195403 DOI: 10.1155/2014/907082] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Accepted: 09/03/2014] [Indexed: 11/17/2022]
Abstract
It was aimed to comparatively evaluate the effects of dressing methods with silver sulfadiazine, povidone-iodine, and saline which have a common use in routine practices for burn injuries. Twenty-eight Sprague Dawley adult female rats were used in this study. All the rats were divided into 4 groups: the control group, the povidone-iodine group, the saline group, and the silver sulfadiazine group. On each rat, a second degree burn which covered less than 10% of the body surface area was created under general anesthesia by a metal comb including four probes with 2 × 1 cm area. The control group did not have any treatment during the experiment. Povidone-iodine, saline, and silver sulfadiazine administrations were performed under ether anesthesia every day. On 0, 7th, 14th, and 21st days of the study, tissue samples were taken for histological analyses. The sections taken from the paraffin blocks were stained and avidin-biotin-peroxidase method was used for collagen immune-reactivity. In the light microscope analyses, number of inflammatory cells, vascularization, fibroblast proliferation, collagen formation and epithelialization were evaluated histologically in all groups and analysed statistically. The agents that we used for injury healing in the treatment groups did not show any significant better results in comparison with the control group. In conclusion, further studies with the use of sodium chloride, silver sulfadiazine, and povidone-iodine by creating deeper and/or larger burn injury models are needed in order to accept these agents in routine treatment.
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Affiliation(s)
- Emir Burak Yüksel
- Department of Plastic, Reconstructive & Esthetic Surgery, Elbistan State Hospital, Kahramanmaras, Turkey
| | - Alpagan Mustafa Yıldırım
- Department of Plastic, Reconstructive & Esthetic Surgery, Afyon Kocatepe University, Afyon, Turkey
| | - Ali Bal
- Department of Plastic, Reconstructive & Esthetic Surgery, Malatya State Hospital, Malatya, Turkey
| | - Tuncay Kuloglu
- Department of Histology & Embryology, Firat University, Elazıg, Turkey
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38
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Moloney MP, Causse J, Loubat C, Grandjean A. Sodium “Activation” of Silano-Phosphonate Modified Mesoporous TiO2Leading to Improved Rare-Earth Element Extraction. Eur J Inorg Chem 2014. [DOI: 10.1002/ejic.201400027] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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39
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Abstract
Approximately 2457 research articles were published with burns in the title, abstract, and/or keyword in 2012. This number continues to rise through the years; this article reviews those selected by the Editor of one of the major journals in the field (Burns) and his colleague that are most likely to have the greatest likelihood of affecting burn care treatment and understanding. As done previously, articles were found and divided into these topic areas: epidemiology of injury and burn prevention, wound and scar characterization, acute care and critical care, inhalation injury, infection, psychological considerations, pain and itching management, rehabilitation, long-term outcomes, and burn reconstruction. Each selected article is mentioned briefly with comment from the authors; readers are referred to the full papers for further details.
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Affiliation(s)
- Steven E Wolf
- Division of Burn, Trauma, and Critical Care, Department of Surgery, University of Texas - Southwestern Medical Center, Dallas, TX 75390-9158, United States.
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40
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Tan JQ, Zhang HH, Lei ZJ, Ren P, Deng C, Li XY, Chen SZ. The roles of autophagy and apoptosis in burn wound progression in rats. Burns 2013; 39:1551-6. [PMID: 23751274 DOI: 10.1016/j.burns.2013.04.018] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Revised: 04/16/2013] [Accepted: 04/16/2013] [Indexed: 12/19/2022]
Abstract
Understanding the role of cell death in burn wound progression is crucial for giving appropriate diagnoses and designing therapy regimens for burn patients. A well-described and reliable "comb burns model" was employed to evaluate the roles of autophagy and apoptosis in burn wound progression at 2 h, 6 h, 12 h, 24 h, and 48 h post-burn in a rat model. Immunohistochemistry (IHC) results showed that autophagy was detectable in hair follicle epithelium at 2 h post-burn, peaked at 12 h post-burn, then declined. Conversely, apoptosis was mainly located in the stratum epidermis and took place at low levels until 6 h post-burn, at which point it slowly increased. Bcl-2 and Bax, which are regulators of both processes, showed protein expression level patterns that were consistent with the IHC results. This study of autophagy in burn wound tissue progression represents a conceptual expansion of cell death in burn wounds. Based on these results, we suggest that different treatments should be performed on a specific post-burn time course depending on the most prevalent type of cell death occurring at that time.
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Affiliation(s)
- Jia-Qi Tan
- Department of Plastic and Burn Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, China
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