Biobrane versus topical agents in the treatment of adult scald burns

Research progress and application of chitosan dressings in hemostasis: A review

Hemorrhage affects human health, and severe bleeding remains a leading contributor to trauma-related mortality. The speed and effectiveness of the application of hemostatic materials are critical. Conventional hemostatic dressings such as bandages and gauze are gradually being replaced by new types of hemostatic dressings due to their poor hemostatic and antibacterial properties. Chitosan, a biopolymer, is biodegradable and nontoxic and possesses hemostatic and antibacterial properties. Chitosan induces hemostasis through direct contact with red corpuscles and platelets, independent of the coagulation pathways of the host, rendering it an optimal hemostatic dressing. It is widely used in wound care, particularly to stop bleeding, promote wound healing, and provide antimicrobial properties. This article reviews the recent research and development of chitosan-based hemostatic dressings, focusing on trauma hemostasis, burn hemostasis, diabetic skin ulcer hemostasis and other aspects. It also emphasizes the significance of chitosan dressings in wound hemostasis and healing, identifies their research opportunities in hemostasis and wound healing, and explores new research directions.

miR-27b promotes angiogenesis and skin repair in scalded rats through regulating VEGF-C expression

In this study, the effects of miR-27b on angiogenesis in skin repair procedure in rats with deep II degree scald were explored. The rat model of deep II scald was established. miR-27b mimics and inhibitor were injected daily at the wound site for 3 weeks. The healing of scald was observed at 0, 3, 7, 14, and 21 days after the model was established, and the pathological changes of skin were observed by HE and Masson's trichrome stains. Skin tissues were taken 14 days after the operation; CD31 and Ki-67 immunohistochemistry was exerted to evaluate neovascularization and proliferation. Human microvascular endothelial cells (HMEC-1) cells were cultured in vitro. miR-27b mimics or inhibitor was transfected to construct over-expression or inhibition cell lines. MTT assay, scratch test, and angiogenesis test were used to evaluate cell proliferation, migration, and vascular regeneration. Finally, RT-PCR and Western blot were exerted to determine the expression of vascular endothelial growth factor C (VEGF-C), epidermal growth factor (EGF) mRNAs, and protein, respectively. Control, inhibitor, mi-NC, VEGF-C, inhibitor + si-NC, and inhibitor + VEGF-C siRNA groups were used to further analyze the mechanism of miR-27b on VEGF-C; the above experiments were repeated. In contrast to model group, miR-27b inhibitor could significantly promote the healing of scalded skin, alleviate the pathological status of scalded, and promote the angiogenesis and proliferation (p < 0.05). In vitro, miR-27b inhibitor evidently promoted cell proliferation, migration, and angiogenesis and increased the expression of VEGF-C, EGF genes, and protein, while miR-27b mimics significantly reversed the above trends. Further studies shown that downregulation of miR-27b expression can promote the proliferation, migration, and angiogenesis of HMEC-1 cells by promoting the expression of VEGF-C. miR-27b promotes angiogenesis and skin repair in scalded rats through regulating VEGF-C expression.

The optimal timing of outpatient Biobrane™ application for superficial and mid dermal partial thickness burns: Evidence for the '12-hour rule'

BACKGROUND

Biobrane™ is a skin substitute used for the definitive management of partial thickness burns. No studies have examined the optimal timing of Biobrane™ application in this setting. The purpose of this study was to determine whether there was a clinically significant difference in applying Biobrane to a superficial and mid dermal partial thickness burn within 12h after burn.

METHODS

From August 2016-February 2017, 29 consecutive superficial and mid dermal partial thickness burn injuries were prospectively treated with Biobrane™ within 12h of the injury. This 'early Biobrane™' cohort was compared to a historical cohort of 148 patients who were treated with Biobrane™ for superficial and mid dermal burns after 12h after injury during 2015 to 2016. Multivariate regression analysis was used to determine the difference in time to re-epithelialisation and number of outpatient visits between the two cohorts.

RESULTS

In the 'early Biobrane™' group, the mean TBSA was 3.5±2.7%. and the mean time to Biobrane™ application was 7.1±2.7h after burn injury. The mean time to re-epithelialisation in this group was 9.1±3.0 days, and no patients underwent skin grafting. In the 'delayed Biobrane™' group, the mean TBSA was 2.6±2.8% and the mean time to Biobrane™ application was 35.1±21.4h. The mean time to re-epithelialisation was 14.8±8.7 days, with 3 patients undergoing skin grafting. Regression analysis demonstrated a statistically significant 63% reduction in time to re-epithelialisation (95% CI=0.23-0.60; P<0.0001) with early Biobrane™ application.

CONCLUSION

Patients treated with application of Biobrane™ within 12h of superficial and mid dermal partial thickness burns have a statistically significant reduction in healing time when compared to patients treated with standard Biobrane™ practice.