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First Report on Medical Treatment and Outcome of Burnt Cattle. Vet Sci 2023; 10:vetsci10030187. [PMID: 36977226 PMCID: PMC10058702 DOI: 10.3390/vetsci10030187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/17/2023] [Accepted: 02/23/2023] [Indexed: 03/05/2023] Open
Abstract
The management of livestock affected by fire often comes down to two options: euthanasia or slaughtering. However, the therapeutic approach can be attempted for high-value cattle. The aim of a primary assessment is to identify signs of smoke inhalation injuries, cardiovascular impairment and shock and to determine the severity and extent of burn injuries. Full-thickness burns covering 40% or more of the body are highly unfavorable prognostic factors and are usually fatal. Moreover, it can take several days for the burns to appear in their full extent, leaving the prognosis uncertain. In this case report, the clinical findings, treatment and outcome of two burnt Holstein heifers are described. Daily wound care required cleaning, the removal of eschars and the application of topical antibacterial agents for seven months in order to discharge one heifer. The topical use of honey with a solution of povidone–iodine proved to be affordable and successful, with no residue risks. The other heifer was more severely wounded, and despite the administration of fluid therapy, pain management, anti-oxidants and anti-microbials, after initial stabilization, the animal’s condition worsened, leading to euthanasia. This confirms that the treatment of burnt cattle is possible but challenging due to the late onset of multi-organ failure.
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Duan YR, Wang XB, Zhang BL. Letter to Editor Regarding "Methylene Blue Staining and Ultrasonic Debridement: A Superior Therapeutic Strategy for Pressure Ulcer Debridement". INT J LOW EXTR WOUND 2023:15347346231156010. [PMID: 36775932 DOI: 10.1177/15347346231156010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
The treatment of pressure ulcer is of an extreme clinical and social concern. Effective and thorough debridement lays the foundation for favorable wound healing. Recently, a case report confirmed the efficacy of a combined application of methylene blue staining and ultrasonic debridement for pressure ulcer debridement. A 91-year-old male who suffered from severe pressure ulcers for over 6 years eventually obtained a favorable restoration after receiving surgical debridement optimized with methylene blue staining and ultrasonic debridement. We write to learn more about the details of the case. In this letter, we raised some questions involving the identification capability of methylene blue staining among different tissues, the application of methylene blue staining for various wounds, the arrangement of the debridement liquid, and the management strategy after wound closure. We thank the authors for creating a successful paradigm and hope the discussion can make sense for guiding subsequent clinical practice.
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Affiliation(s)
- Yu-Ren Duan
- Department of Plastic and Reconstructive Surgery, 105862First Hospital of Shanxi Medical University, Taiyuan, People's Republic of China
| | - Xiao-Bing Wang
- Department of Plastic and Reconstructive Surgery, 105862First Hospital of Shanxi Medical University, Taiyuan, People's Republic of China
| | - Bao-Lin Zhang
- Department of Plastic and Reconstructive Surgery, 105862First Hospital of Shanxi Medical University, Taiyuan, People's Republic of China
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Mazurek Ł, Szudzik M, Rybka M, Konop M. Silk Fibroin Biomaterials and Their Beneficial Role in Skin Wound Healing. Biomolecules 2022; 12:biom12121852. [PMID: 36551280 PMCID: PMC9775069 DOI: 10.3390/biom12121852] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/06/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022] Open
Abstract
The skin, acting as the outer protection of the human body, is most vulnerable to injury. Wound healing can often be impaired, leading to chronic, hard-to-heal wounds. For this reason, searching for the most effective dressings that can significantly enhance the wound healing process is necessary. In this regard, silk fibroin, a protein derived from silk fibres that has excellent properties, is noteworthy. Silk fibroin is highly biocompatible and biodegradable. It can easily make various dressings, which can be loaded with additional substances to improve healing. Dressings based on silk fibroin have anti-inflammatory, pro-angiogenic properties and significantly accelerate skin wound healing, even compared to commercially available wound dressings. Animal studies confirm the beneficial influence of silk fibroin in wound healing. Clinical research focusing on fibroin dressings is also promising. These properties make silk fibroin a remarkable natural material for creating innovative, simple, and effective dressings for skin wound healing. In this review, we summarise the application of silk fibroin biomaterials as wound dressings in full-thickness, burn, and diabetic wounds in preclinical and clinical settings.
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4
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De Bellis F, Di Mattia D. Approach to emergency dermatology cases in dogs and cats. IN PRACTICE 2022. [DOI: 10.1002/inpr.247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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5
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Cowled BD, Bannister-Tyrrell M, Doyle M, Clutterbuck H, Cave J, Hillman A, Plain K, Pfeiffer C, Laurence M, Ward MP. The Australian 2019/2020 Black Summer Bushfires: Analysis of the Pathology, Treatment Strategies and Decision Making About Burnt Livestock. Front Vet Sci 2022; 9:790556. [PMID: 35242835 PMCID: PMC8886614 DOI: 10.3389/fvets.2022.790556] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 01/17/2022] [Indexed: 12/03/2022] Open
Abstract
In 2019/2020, Australia experienced a severe bushfire event, with many tens of thousands of livestock killed or euthanized. Little systematic research has occurred to understand livestock bushfire injuries, risk factors for injury, or how to make decisions about management of bushfire-injured livestock. Addressing this research gap is important as there is an increasing bushfire incidence globally. This paper presents qualitative research findings about bushfire-injured and killed livestock in the south-east of Australia after the 2019/2020 Australian bushfires. We describe observed pathology, treatments used, and risk factors for injury, then use thematic analysis to understand decision making about managing fire-injured livestock. Livestock injured by the fires showed pathology predominantly associated with the common integument (feet, hooves and skin) and signs of acute respiratory damage. It could take several days for the full extent of burns to become apparent, leaving prognostic doubt. Treatment strategies included immediate euthanasia, salvage slaughter, retention for later culling, treatment and recovery on farm, hospitalization and intensive treatment, or no intervention. Risk factors reported for livestock injury included lack of warnings about an impending fire, the type and amount of vegetation around livestock and the weather conditions on the day the fire reached livestock. Moving stock to an area with little vegetation before fire arrived was seen as protective. Decision making regarding injured livestock appeared influenced by three main themes: (1) observations on the severity of pathology, clinical signs and level of prognostic doubt, (2) pre-existing beliefs about animal welfare (responsibility to minimize unnecessary suffering) and (3) assumptions about the future. The management of livestock was largely appropriate due to the rapid provision of veterinary expertise. However, it is likely that some injured livestock were euthanized due to conservative veterinary advice driven by a lack of opportunity to re-assess stock, with impacts on farmers. In future, resourcing regular revisits of injured livestock to manage risks of gradual progression of burn pathology may facilitate more accurate prognostic assessment, provided injured animals can receive appropriate pain relief. In addition, a more comprehensive burns classification system linked to prognosis that can be rapidly applied in the field may assist assessments.
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Affiliation(s)
- Brendan D. Cowled
- Ausvet Pty Ltd., Bruce, ACT, Australia
- Faculty of Science, Sydney School of Veterinary Science, University of Sydney, Camden, NSW, Australia
- *Correspondence: Brendan D. Cowled
| | | | - Mark Doyle
- South East Local Land Services, Goulburn, NSW, Australia
| | | | - Jeff Cave
- Biosecurity and Agriculture Services, Agriculture Victoria, Wodonga, VIC, Australia
| | | | - Karren Plain
- Faculty of Science, Sydney School of Veterinary Science, University of Sydney, Camden, NSW, Australia
| | - Caitlin Pfeiffer
- Faculty of Veterinary and Agricultural Science, Melbourne Veterinary School, University of Melbourne, Parkville, VIC, Australia
| | | | - Michael P. Ward
- Faculty of Science, Sydney School of Veterinary Science, University of Sydney, Camden, NSW, Australia
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Dawson KA, Mickelson MA, Blong AE, L Walton RA. Management of severe burn injuries with novel treatment techniques including maggot debridement and applications of acellular fish skin grafts and autologous skin cell suspension in a dog. J Am Vet Med Assoc 2022; 260:428-435. [PMID: 34843435 DOI: 10.2460/javma.20.10.0579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
CASE DESCRIPTION A 3-year-old 27-kg female spayed American Bulldog with severe burn injuries caused by a gasoline can explosion was evaluated. CLINICAL FINDINGS The dog had extensive partial- and full-thickness burns with 50% of total body surface area affected. The burns involved the dorsum extending from the tail to approximately the 10th thoracic vertebra, left pelvic limb (involving 360° burns from the hip region to the tarsus), inguinal area bilaterally, right medial aspect of the thigh, and entire perineal region. Additional burns affected the margins of the pinnae and periocular regions, with severe corneal involvement bilaterally. TREATMENT AND OUTCOME The dog was hospitalized in the hospital's intensive care unit for 78 days. Case management involved provision of aggressive multimodal analgesia, systemic support, and a combination of novel debridement and reconstructive techniques. Debridement was facilitated by traditional surgical techniques in combination with maggot treatment. Reconstructive surgeries involved 6 staged procedures along with the use of novel treatments including applications of widespread acellular fish (cod) skin graft and autologous skin cell suspension. CLINICAL RELEVANCE The outcome for the dog of the present report highlighted the successful use of maggot treatment and applications of acellular cod skin and autologous skin cell suspension along with aggressive systemic management and long-term multimodal analgesia with debridement and wound reconstruction for management of severe burn injuries encompassing 50% of an animal's total body surface area.
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7
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Sun T, Ying W, Wang S, Chen C, Sun P, Tan J. Clinical Application of Vacuum Sealing Drainage for the Treatment of Deep Burn Wounds. Am Surg 2021:31348211054527. [PMID: 34797180 DOI: 10.1177/00031348211054527] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND This study aimed to determine the effect of the clinical application of vacuum sealing drainage (VSD) on the treatment of deep burn wounds. METHODS This single-blind, randomized, controlled study included patients who were admitted to our hospital with deep burns from January 2018 to December 2020; the patients were randomly divided into the VSD and control (CON) groups. The number of days from treatment to skin grafting; survival rate of the first skin graft; rate of positive bacterial culture; visual analog scale (VAS) pain score; and durations of wound healing, antibiotic drug use, and hospitalization were analyzed and compared between the groups. RESULTS The application of VSD significantly shortened the number of days from treatment to skin grafting (P < .05); improved the survival rate of the first skin graft in patients with severe burns (P < .05); reduced the rate of positive bacterial culture (P < .05); reduced the VAS pain score (P < .05); and shortened the durations of wound healing (P < .05), antibiotic drug use (P < .05), and hospitalization (P < .05). CONCLUSION Vacuum sealing drainage had a good clinical effect on the recovery of deep burn wounds.
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Affiliation(s)
- Tao Sun
- Department of Burns and Plastic Surgery, The First People's Hospital of Wenling, Wenling, China
| | - Wenjie Ying
- Department of Burns and Plastic Surgery, The First People's Hospital of Wenling, Wenling, China
| | - Shuangshuang Wang
- Department of Burns and Plastic Surgery, The First People's Hospital of Wenling, Wenling, China
| | - Caiqiang Chen
- Department of Burns and Plastic Surgery, The First People's Hospital of Wenling, Wenling, China
| | - Pengyu Sun
- Department of Burns and Plastic Surgery, The First People's Hospital of Wenling, Wenling, China
| | - Jinglei Tan
- Department of Burns and Plastic Surgery, The First People's Hospital of Wenling, Wenling, China
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Mohd Zaid MH, Hanafi MF, Haris MS. review of black seed extract as an agent in the wound healing process. JOURNAL OF PHARMACY 2021. [DOI: 10.31436/jop.v1i2.67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Introduction: Nigella Sativa or Black Cumin is an annual flowering plant that can be used for wound treatment. In the treatment for wound healing, this plant contains many beneficial components that can help with the treatment but this plant utilisation in the medical field is still limited. This review will provide an overview of the advantages when this plant is used in the wound healing treatment.
Method: The review was based on the ROSES protocol, and the databases used were ScienceDirect, PubMed, and Google Scholar. After the search, only 11 papers had been chosen to be included in the results and they were divided into four main themes that were used for the analysis of the results.
Results: The themes were gross analysis, microscopic analysis, biochemical analysis and antimicrobial analysis.
Conclusion: In conclusion, the black seed extract contains several valuable properties, such as antimicrobial and antioxidant properties, which help improve the wound healing process. Further study needs to be done to discover more potential of Nigella Sativa in treating the wound.
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Solati K, Karimi M, Rafieian-Kopaei M, Abbasi N, Abbaszadeh S, Bahmani M. Phytotherapy for Wound Healing: The Most Important Herbal Plants in Wound Healing Based on Iranian Ethnobotanical Documents. Mini Rev Med Chem 2021; 21:500-519. [PMID: 33213344 DOI: 10.2174/1389557520666201119122608] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 06/13/2020] [Accepted: 06/23/2020] [Indexed: 11/22/2022]
Abstract
Wound healing is a process that starts with the inflammatory response after the occurrence of any damage. This process initiates by restoring the wound surface coating tissue, migrating fibroblasts to form the required collagen, forming a healing tissue and finally, leading to contortion and extraction of the wound. Today, various drugs are used to heal wounds. However, the drugs used to repair wounds have some defects and side effects. In spite of all attempts to accelerate wound healing definitely, no safe drug has been introduced for this purpose. Therefore, the necessity to identify herbal plants in ethnopharmacology and ethnobotany documents with healing effects is essential. In this article, we tried to review and present effective Iranian medicinal plants and herbal compounds used for wound healing. Searching was performed on databases, including ISI Web of Science, PubMed, PubMed Central, Scopus, ISC, SID, Magiran and some other databases. The keywords used included wound healing, skin treatment, medicinal plants, ethnobotany, and phytotherapy. In this regard, 139 medicinal plants effective on wound healing were identified based on ethnopharmacology and ethnobotanical sources of Iran. Plants such as Salvia officinalis, Echium amoenum, Verbascum spp., G1ycyrrhiza glabra, Medicago sativa, Mentha pulegium, Datura stramonium L., Alhagi spp., Aloe vera, Hypericum perforatum, Pistacia atlantica and Prosopis cineraria are the most important and useful medicinal plants used for wound healing in Iran. These native Iranian medicinal plants are rich in antioxidants and biological compounds and might be used for wound healing and preparation of new drugs.
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Affiliation(s)
- Kamal Solati
- Department of Psychiatry, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Mehrdad Karimi
- Department of Surgery, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Mahmoud Rafieian-Kopaei
- Medical Plants Research Center, Basic Health Sciences Institute, Shahrekord University of Medical Sciences, Shahrekord Shahrekord, Iran
| | - Naser Abbasi
- Biotechnology and Medicinal Plants Research Center, Ilam University of Medical Sciences, Ilam, Iran
| | - Saber Abbaszadeh
- Department of Clinical Biochemistry, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Mahmoud Bahmani
- Biotechnology and Medicinal Plants Research Center, Ilam University of Medical Sciences, Ilam, Iran
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Lipový B, Raška F, Kocmanová I, Hanslianová M, Hladík M, Holoubek J, Bezdíček M, Macháček C. Trichoderma longibrachiatum and Aspergillus fischeri Infection as a Cause of Skin Graft Failure in a Patient with Critical Burns after Liver Transplantation. J Fungi (Basel) 2021; 7:jof7060487. [PMID: 34207136 PMCID: PMC8234584 DOI: 10.3390/jof7060487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 06/03/2021] [Accepted: 06/14/2021] [Indexed: 11/16/2022] Open
Abstract
Infectious complications are responsible for the majority of mortalities and morbidities of patients with critical burns. Although bacteria are the predominant etiological agents in such patients, yeasts and fungi have become relatively common causes of infections over the last decade. Here, we report a case of a young man with critical burns on 88% TBSA (total body surface area) arising as a part of polytrauma. The patient's history of orthotopic liver transplantation associated with the patient's need to use combined immunosuppressant therapy was an additional complication. Due to deep burns in the forearm region, we have (after a suitable wound bed preparation) applied a new bi-layered dermal substitute. The patient, however, developed a combined fungal infection in the region of this dermal substitute caused by Trichoderma longibrachiatum and Aspergillus fischeri (the first case ever reported). The infection caused the loss of the split-thickness skin grafts (STSGs); we had to perform repeated hydrosurgical and mechanical debridement and a systemic antifungal treatment prior to re-application of the STSGs. The subsequent skin transplant was successful.
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Affiliation(s)
- Břetislav Lipový
- Department of Burns and Plastic Surgery, Institution Shared with University Hospital Brno, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic; (B.L.); (F.R.); (J.H.)
- CEITEC—Central European Institute of Technology, Brno University of Technology, 612 00 Brno, Czech Republic
| | - Filip Raška
- Department of Burns and Plastic Surgery, Institution Shared with University Hospital Brno, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic; (B.L.); (F.R.); (J.H.)
| | - Iva Kocmanová
- Department of Clinical Microbiology, University Hospital Brno, 625 00 Brno, Czech Republic;
| | - Markéta Hanslianová
- Department of Clinical Microbiology, Vyškov Hospital, 628 01 Vyškov, Czech Republic;
| | - Martin Hladík
- Department of Burns and Plastic Surgery, Institution Shared with University Hospital Brno, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic; (B.L.); (F.R.); (J.H.)
- Correspondence: ; Tel.: +420-532-232-206
| | - Jakub Holoubek
- Department of Burns and Plastic Surgery, Institution Shared with University Hospital Brno, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic; (B.L.); (F.R.); (J.H.)
| | - Matěj Bezdíček
- Centre of Molecular Biology and Gene Therapy, Department of Internal Medicine—Hematology and Oncology, Institution Shared with University Hospital Brno, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic;
| | - Ctirad Macháček
- Department of Pathology, Institution Shared with University Hospital Brno, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic;
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11
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Yao Y, Zhang A, Yuan C, Chen X, Liu Y. Recent trends on burn wound care: hydrogel dressings and scaffolds. Biomater Sci 2021; 9:4523-4540. [PMID: 34047308 DOI: 10.1039/d1bm00411e] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Acute and chronic wounds can cause severe physical trauma to patients and also result in an immense socio-economic burden. Thus, wound management has attracted increasing attention in recent years. However, burn wound management is still a major challenge in wound management. Autografts are often considered the gold-standard for burn care, but their application is limited by many factors. Hence, ideal burn dressings and skin substitute dressings are desirable. With the development of biomaterials and progress of tissue engineering technology, some innovative dressings and tissue engineering scaffolds, such as nanofibers, films, foams and hydrogels, have been widely used in the field of biomedicine, especially in wound management. Among them, hydrogels have attracted tremendous attention with their unique advantages. In this review, we discuss the challenges in burn wound management, several crucial design considerations with respect to hydrogels for burn wound healing, and available polymers for hydrogels in burn wound care. In addition, the potential application and plausible prospect of hydrogels are also highlighted.
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Affiliation(s)
- Yingxia Yao
- College of Marine Life Science, Ocean University of China, Qingdao, 266003, P.R. China.
| | - Andi Zhang
- College of Marine Life Science, Ocean University of China, Qingdao, 266003, P.R. China.
| | - Congshan Yuan
- College of Marine Life Science, Ocean University of China, Qingdao, 266003, P.R. China.
| | - Xiguang Chen
- College of Marine Life Science, Ocean University of China, Qingdao, 266003, P.R. China. and Qingdao National Laboratory for Marine Science and Technology, Qingdao, 266000, P.R. China
| | - Ya Liu
- College of Marine Life Science, Ocean University of China, Qingdao, 266003, P.R. China.
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12
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Karakaya E, Akdur A, Aydoğan C, Türk E, Sayin CB, Ayvazoğlu Soy E, Yücebaş SC, Alshalabi O, Haberal M. A model for acute kidney injury in severe burn patients. Burns 2021; 48:69-77. [PMID: 33879373 DOI: 10.1016/j.burns.2021.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 11/11/2020] [Accepted: 04/06/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION In patients with severe burns, morbidity and mortality are high. One factor related to poor prognosis is acute kidney injury. According to the AKIN criteria, acute kidney injury has 3 stages based on urine output, serum creatinine level, and renal replacement therapy. In this study, we aimed to create a decision tree for estimating risk of acute kidney injury in patients with severe burn injuries. METHODS We retrospectively evaluated 437 adult patients with ≥20% total burn surface area injury who were treated at the Baskent University Ankara and Konya Burn Centers from January 2000 to March 2020. Patients who had high-voltage burn and previous history of kidney disease were excluded. Patient demographics, medical history, mechanism of injury, presence of inhalation injury, depth of burn, laboratory values, presence of oliguria, need for renal replacement therapy, central venous pressure, and prognosis were evaluated. These data were used in a "decision tree method" to create the Baskent University model to estimate risk of acute kidney injury in severe burn patients. RESULTS Our model provided an accuracy of 71.09% for risk estimation. Of 172 patients, 78 (45%) had different degrees of acute kidney injury, with 26 of these (15.1%) receiving renal replacement therapy. Our model showed that total burn surface area was the most important factor for estimation of acute kidney injury occurrence. Other important factors included serum creatinine value, burn injury severity score, hemoglobin value, neutrophil-to-lymphocyte ratio, and platelet count. CONCLUSION The Baskent University model for acute kidney injury may be helpful to determine risk of acute kidney injury in burn patients. This determination would allow appropriate treatment to be given to high-risk patients in the early period, reducing the incidence of acute kidney injury.
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Affiliation(s)
- Emre Karakaya
- Baskent University, Departmant of General Surgery, Yukarı Bahçelievler, Mareşal Fevzi Çakmak St. No:45, 06490 Çankaya, Ankara, Turkey.
| | - Aydıncan Akdur
- Baskent University, Departmant of General Surgery, Yukarı Bahçelievler, Mareşal Fevzi Çakmak St. No:45, 06490 Çankaya, Ankara, Turkey.
| | - Cem Aydoğan
- Baskent University, Departmant of General Surgery, Yukarı Bahçelievler, Mareşal Fevzi Çakmak St. No:45, 06490 Çankaya, Ankara, Turkey.
| | - Emin Türk
- Baskent University Konya Research Center, Department of General Surgery, Hocacihan Saray St., No:1, 42080 Selçuklu, Konya, Turkey.
| | - Cihat Burak Sayin
- Baskent University, Departmant of Nephrology, Yukarı Bahçelievler, Mareşal Fevzi Çakmak St. No:45, 06490 Çankaya, Ankara, Turkey.
| | - Ebru Ayvazoğlu Soy
- Baskent University, Departmant of General Surgery, Yukarı Bahçelievler, Mareşal Fevzi Çakmak St. No:45, 06490 Çankaya, Ankara, Turkey.
| | - Sait Can Yücebaş
- Canakkale Onsekiz Mart Univesity, Faculty of Engineering, Computer Engineering Department, arbaros, 17100 Kepez, Çanakkale, Turkey.
| | - Omar Alshalabi
- Baskent University, Departmant of General Surgery, Yukarı Bahçelievler, Mareşal Fevzi Çakmak St. No:45, 06490 Çankaya, Ankara, Turkey.
| | - Mehmet Haberal
- Baskent University, Departmant of General Surgery, Yukarı Bahçelievler, Mareşal Fevzi Çakmak St. No:45, 06490 Çankaya, Ankara, Turkey.
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13
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Liliac IM, Popescu EL, Văduva IA, Pirici D, Mogoşanu GD, Streba CT, Busuioc CJ, Bejenaru LE, Bejenaru C, Crăciunoiu N, Dumitru I, Elayan H, Mogoantă L. Nanoparticle-functionalized dressings for the treatment of third-degree skin burns - histopathological and immunohistochemical study. ROMANIAN JOURNAL OF MORPHOLOGY AND EMBRYOLOGY = REVUE ROUMAINE DE MORPHOLOGIE ET EMBRYOLOGIE 2021; 62:159-168. [PMID: 34609418 PMCID: PMC8597381 DOI: 10.47162/rjme.62.1.15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Skin burns are one of the most common injuries associated with increased morbidity and mortality, especially in the children and the elderlies. Severe burns, especially, result in a systemic immune and inflammatory response, which may reflect in multiple organ insufficiency, and a fast and effective local restorative process is essential for functionality recovering, as well as for interrupting the generalized systemic response. We have aimed here to assess the effect of different wound dressings in what it regards the morphology and clinical restoration after a skin burn. On a rat animal model, we have evaluated the macroscopic and histopathological features of controlled third degree skin burns in control animals versus treatments with local dressings of silver sulfadiazine (SDA) cream, simple gel (G), gel + silver nanoparticles (AgNPs) (G+NPS), gel + exosomes (G+EXO) and gel + AgNPs + exosomes (Gel+NPS+EXO), at 14 days and, respectively, 21 days after the lesion. Tissue fragments were harvested and processed for histopathology and immunohistochemistry. Immunofluorescence was utilized to evaluate the maturity of underlaying granulation tissue based on double stainings for smooth muscle actin (SMA) and cluster of differentiation 31 (CD31). Our study showed variability in what it regards the vessel density and immunoexpression of SMA between the treatments, and image analysis revealed that most SMA reduction and blood vessel density reduction in the maturing granulation tissue occurred for the G+NPS and G+NPS+EXO treatments. A complete re-epithelization was also observed for the G+NPS+EXO treatment. Overall, our results show that improved topic treatments promote faster re-epithelization and reparation of the dermis after skin burn lesions, providing thus an avenue for new treatments that aim both local recuperation and systemic infection prevention.
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14
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Yi H, Wang Y, Yang Z, Xie Z. Efficacy assessment of mesenchymal stem cell transplantation for burn wounds in animals: a systematic review. Stem Cell Res Ther 2020; 11:372. [PMID: 32859266 PMCID: PMC7456061 DOI: 10.1186/s13287-020-01879-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 06/23/2020] [Accepted: 08/06/2020] [Indexed: 01/09/2023] Open
Abstract
Background Clinically, severe burns remain one of the most challenging issues, but an ideal treatment is yet absent. Our purpose is to compare the efficacy of stem cell therapy in a preclinical model of burn wound healing. Methods Research reports on mesenchymal stem cells (MSCs) for burn wound healing were retrieved from 5 databases: PubMed, Embase, MEDLINE, Web of Science, and the Cochrane Library. The primary outcomes reported in this article include the un-healing rate of the wound area, the closure rate, and the wound area. Secondary outcomes included CD-31, vascular density, interleukin (IL)-10, thickness of eschar tissue, vascular endothelial growth factor (VEGF), and white blood cell count. Finally, a subgroup analysis was conducted to explore heterogeneity that potentially impacted the primary outcomes. A fixed-effects model with a 95% confidence interval (CI) was performed when no significant heterogeneity existed. Otherwise, a random-effects model was used. All data analysis was conducted by using Engauge Digitizer 10.8 and R software. Results Twenty eligible articles were finally included in the analysis. Stem cell therapy greatly improved the closure rate (2.00, 95% CI 0.52 to 3.48, p = 0.008) and compromised the wound area (− 2.36; 95% CI − 4.90 to 0.18; p = 0.069) rather than the un-healing rate of the wound area (− 11.10, 95% CI − 32.97 to 10.78, p = 0.320). Though p was 0.069, there was a trend toward shrinkage of the burn wound area after stem cell therapy. Vascular density (4.69; 95% CI 0.06 to 9.31; p = 0.047) and thickness of eschar tissue (6.56, 95% CI 1.15 to 11.98, p = 0.017) were also discovered to be significantly improved in the burn site of stem cell-treated animals. Moreover, we observed that animals in the stem cell group had an increased white blood cell count (0.84, 95% CI 0.01 to 1.66, p = 0.047) 5 days post treatment. Other indicators, such as VEGF (p = 0.381), CD-31 (p = 0.335) and IL-10 (p = 0.567), were not significantly impacted. Conclusions Despite limited data from preclinical trials, this meta-analysis suggests that stem cell therapy is curative in decreasing the burn wound area and provides some insights into future clinical studies of stem cell therapy for burns.
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Affiliation(s)
- Hanxiao Yi
- The First Affiliated Hospital of Nanchang University, No. 17, Yongwai Zhengjie, Nanchang, JiangXi Province, China
| | - Yang Wang
- Spine Surgery, Third Affiliated Hospital of Sun-Yat Sen University, No. 600, Tianhe Road, Tianhe District, Guangzhou, Guangdong Province, China
| | - Zhen Yang
- The First Affiliated Hospital of Nanchang University, No. 17, Yongwai Zhengjie, Nanchang, JiangXi Province, China.
| | - Zhiqin Xie
- The First Affiliated Hospital of Nanchang University, No. 17, Yongwai Zhengjie, Nanchang, JiangXi Province, China
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Sallehuddin N, Nordin A, Bt Hj Idrus R, Fauzi MB. Nigella sativa and Its Active Compound, Thymoquinone, Accelerate Wound Healing in an In Vivo Animal Model: A Comprehensive Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4160. [PMID: 32545210 PMCID: PMC7312523 DOI: 10.3390/ijerph17114160] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 04/15/2020] [Accepted: 04/18/2020] [Indexed: 02/07/2023]
Abstract
Nigella sativa (NS) has been reported to have a therapeutic effect towards skin wound healing via its anti-inflammatory, tissue growth stimulation, and antioxidative properties. This review examines all the available studies on the association of Nigella sativa (NS) and skin wound healing. The search was performed in Medline via EBSCOhost and Scopus databases to retrieve the related papers released between 1970 and March 2020. The principal inclusion criteria were original article issued in English that stated wound healing criteria of in vivo skin model with topically applied NS. The search discovered 10 related articles that fulfilled the required inclusion criteria. Studies included comprise different types of wounds, namely excisional, burn, and diabetic wounds. Seven studies unravelled positive results associated with NS on skin wound healing. Thymoquinone has anti-inflammatory, antioxidant, and antibacterial properties, which mainly contributed to wound healing process.
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Affiliation(s)
- Nusaibah Sallehuddin
- Tissue Engineering Centre, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur 56000, Malaysia; (N.S.); (R.B.H.I.)
| | - Abid Nordin
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur 56000, Malaysia;
| | - Ruszymah Bt Hj Idrus
- Tissue Engineering Centre, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur 56000, Malaysia; (N.S.); (R.B.H.I.)
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur 56000, Malaysia;
| | - Mh Busra Fauzi
- Tissue Engineering Centre, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur 56000, Malaysia; (N.S.); (R.B.H.I.)
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16
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Salyer CE, Bomholt C, Beckmann N, Bergmann CB, Plattner CA, Caldwell CC. Novel Therapeutics for the Treatment of Burn Infection. Surg Infect (Larchmt) 2020; 22:113-120. [PMID: 32429749 DOI: 10.1089/sur.2020.104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background: Burn injury continues to be a significant cause of morbidity and death, with infectious complications being the primary cause of death. Patients are susceptible to overwhelming infection secondary to both the physical breakdown of the skin and mucosal barrier and the immune dysfunction that accompanies the inflammatory response to a major burn. With resistance to traditional antibiosis looming as a serious threat to patient outcome, advancement in the treatment of burn infections is imperative. Methods: Between February 15 and March 15, 2020, a search of Pubmed and clinicaltrials.gov was performed using search terms such as "burn immunotherapy," "therapeutic microorganisms in burn," "burn infection clinical trials," and applicable variations. Results: Topical antimicrobial drugs continue to be standard of care for burn wound injuries, but personalized and molecular treatments that rely on immune manipulation of the host show great promise. We discuss novel therapeutics for the treatment of burn infection: Probiotics and therapeutic microorganisms, immune modulators, tailored monoclonal antibodies, and extracellular vesicles and proteins. Conclusions: The treatment strategies discussed employ manipulation of structure and function in host immune cells and pathogen virulence for improved outcomes in burn infection.
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Affiliation(s)
- Christen E Salyer
- Division of Research and Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Christina Bomholt
- Division of Research and Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Nadine Beckmann
- Division of Research and Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Christian B Bergmann
- Division of Research and Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Courtney A Plattner
- Urology Division, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Charles C Caldwell
- Division of Research and Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.,Division of Research, Shriners Hospital for Children, Cincinnati, Ohio, USA
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17
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Paggiaro AO, Bastianelli R, Carvalho VF, Isaac C, Gemperli R. Is allograft skin, the gold-standard for burn skin substitute? A systematic literature review and meta-analysis. J Plast Reconstr Aesthet Surg 2019; 72:1245-1253. [PMID: 31176542 DOI: 10.1016/j.bjps.2019.04.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 01/26/2019] [Accepted: 04/06/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Allograft skin (AS) transplantation has been considered to be the gold standard for replacing tissue damage, following burns. However, increasingly new biosynthetic skin substitutes are being developed as alternatives. The objective of this systematic review is to compare AS with other skin substitutes, which have been used in the treatment of burns. METHODS Randomized clinical trial (RCT) and nonrandomized clinical trial (NRCT) studies comparing AS to any other skin substitute in the treatment of burns were extracted from PubMed/Medline, Scopus, EMBASE, and Web of Science. For the risk of bias analysis, the Cochrane bias risk handbook was used for RCT studies and ROBINS-1 was used for NRCT studies. Outcomes such as healing, self-grafting, scar appearance, and mortality were evaluated. RESULTS Twelve RCT and six NRCT were selected, with most of the methodologies presenting a high risk of bias. Based on the outcomes of the studies, it was not possible to detect any advantages for using AS, as opposed to other skin substitutes. In the meta-analysis, only two outcomes could be evaluated: healing and graft take percentage; however, no significant differences were observed between the groups. CONCLUSION Because of the poor quality of the primary studies, it was not possible to identify differences in the results that compared the use of AS with other substitutes in the treatment of patients with burns. These results support the fact that surgeons primarily base the choice of skin substitute on clinical experience and cost, at least when treating burns.
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Affiliation(s)
- André O Paggiaro
- Nursing Post Graduation, Universidade Guarulhos, 229, Praça Tereza Cristina, Guarulhos, São Paulo 07023-070, Brazil.
| | - Renata Bastianelli
- Nursing Post Graduation, Universidade Guarulhos, 229, Praça Tereza Cristina, Guarulhos, São Paulo 07023-070, Brazil
| | - Viviane F Carvalho
- Nursing Post Graduation, Universidade Guarulhos, 229, Praça Tereza Cristina, Guarulhos, São Paulo 07023-070, Brazil
| | - Cesar Isaac
- Plastic Surgery Division, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, 255, Rua Eneas de Carvalho Aguiar, São Paulo 05403-000, Brazil
| | - Rolf Gemperli
- Plastic Surgery Division, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, 255, Rua Eneas de Carvalho Aguiar, São Paulo 05403-000, Brazil
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18
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Wei C, Ding X, Liu C, Pei Y, Zhong Y, Sun W. Mechanism of taurine in alleviating myocardial oxidative stress in rats after burn through p38 MAPK signaling pathway. Minerva Med 2019; 110:472-475. [PMID: 30784253 DOI: 10.23736/s0026-4806.19.05982-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Cui'e Wei
- Department of Burns and Plastic Surgery, Lianyungang First People's Hospital, Lianyungang, China
| | - Xiangsheng Ding
- Department of Burns and Plastic Surgery, Lianyungang First People's Hospital, Lianyungang, China
| | - Changhai Liu
- Department of Burns and Plastic Surgery, Lianyungang First People's Hospital, Lianyungang, China
| | - Yongdong Pei
- Department of Burns and Plastic Surgery, Lianyungang First People's Hospital, Lianyungang, China
| | - Yuren Zhong
- Department of Burns and Plastic Surgery, Lianyungang First People's Hospital, Lianyungang, China
| | - Wentao Sun
- Department of Plastic Surgery, First Affiliated Hospital of Kunming Medical University, Kunming, China -
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19
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Foubert P, Liu M, Anderson S, Rajoria R, Gutierrez D, Zafra D, Tenenhaus M, Fraser JK. Preclinical assessment of safety and efficacy of intravenous delivery of autologous adipose-derived regenerative cells (ADRCs) in the treatment of severe thermal burns using a porcine model. Burns 2018; 44:1531-1542. [PMID: 29958745 DOI: 10.1016/j.burns.2018.05.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 04/10/2018] [Accepted: 05/16/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVE A number of studies have reported that application of autologous adipose-derived cell populations leads to improved outcome in different preclinical models of thermal burn injury. However, these studies were limited to assessment of relatively small injuries amounting to only ∼2% of total body surface area (TBSA) in which the complications associated with large burns (e.g.: systemic inflammation and the need for fluid resuscitation) are absent. In anticipation of translating this approach to a clinical trial in which these complications would be present we applied a preclinical model that more closely resembles a patient with large thermal burn injury requiring skin grafting. Thus, the present study used a porcine model to investigate safety and efficacy of intravenous delivery of ADRCs in the treatment of a complex burn injury comprising ∼20% TBSA and including both moderately deep (44%) partial and full thickness burns, and the injury associated with skin graft harvest. METHODS Two pairs of full thickness and partial thickness burns involving in total ∼20% TBSA were created on the back of Yorkshire pigs (n=15). Three days post-burn, full thickness wounds were excised and grafted with a 3:1 meshed autologous split thickness skin graft (STSG). Partial thickness wounds were not treated other than with dressings. Animals were then randomized to receive intravenous delivery of ADRCs (n=8) or vehicle control (n=7). Safety was assessed by monitoring systemic parameters (blood gases, hematology, and clinical chemistry) throughout the course of the study. Wound healing for both types of burn wound and for the skin graft donor sites was followed for 18days using wound imaging, histology, and trans-epidermal water loss (TEWL; skin barrier function assessment). RESULTS No serious adverse events related to ADRC infusion were noted in any of the animals. Delivery of ADRCs appeared to be safe with none of the systemic safety parameters worsened compared to the control group. TEWL and histological analyses revealed that ADRC treatment was associated with significantly accelerated healing of skin graft (27.1% vs. 1.1% on Day 5 post-grafting), donor site (52.8% vs. 33.1% on Day 5 post-excision) and partial thickness burn (81.8% vs. 59.8% on Day 18 post-treatment). Data also suggested that ADRC treatment improved parameters associated with skin graft elasticity. CONCLUSIONS This study demonstrated that intravenous delivery of autologous ADRCs appears to be a safe and feasible approach to the treatment of large burns and supports the use of ADRCs as an adjunct therapy to skin grafting in patients with severe burns.
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Affiliation(s)
| | - Mike Liu
- Cytori Therapeutics Inc, San Diego, CA, USA
| | | | | | | | | | - Mayer Tenenhaus
- UCSD Medical Center, University of California, San Diego, CA, USA
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