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Jiang Z, Wu J, Qiu Y, Shen G. Perfusion Analysis Using High-Definition Indocyanine Green Angiography in Burn Comb Model. J Burn Care Res 2024; 45:373-383. [PMID: 37830308 DOI: 10.1093/jbcr/irad156] [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: 07/04/2023] [Indexed: 10/14/2023]
Abstract
Indocyanine green angiography (ICGA) has been widely employed for quantitative evaluation of the rat comb burn model, but the imaging equipment, imaging protocol, and fluorescence data interpretation of ICGA remain unsatisfactory. This study aims to provide better solutions for the application of ICGA in perfusion analysis. The rat comb burn model was established under a series of different comb contact durations, including 10, 20, 25, 30, 35, and 40 s. Indocyanine green angiography was used to analyze wound perfusion. In total, 16 rats were divided into ibuprofen and control groups for the burn model, and their perfusion was compared. A total of 16 identical models were divided into standard- and high-dose indocyanine green (ICG) groups, and ICGA was conducted to investigate the dynamic change in wound fluorescence. Escharectomy was performed under real-time fluorescence mapping and navigation. The results showed that a comb contact duration of 30 s was optimum for the burn model. Indocyanine green angiography could accurately evaluate the histologically determined depth of thermal injury and wound perfusion in the rat comb model. Digital subtraction of residual fluorescence was necessary for multiple comparisons of perfusion. Dynamic changes in fluorescence and necrotic tissues were observed more clearly by high-dose (0.5 mg/kg) ICG in angiography. In conclusion, perfusion analysis by ICGA can be used to assess the histologically determined depth of thermal injury and the impact of a specific treatment on wound perfusion. Indocyanine green angiography can help to identify necrotic tissue. The above findings and related imaging protocols lay the foundation for future research.
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Affiliation(s)
- Zhaolong Jiang
- Department of Burn and Plastic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China
- Department of Burn and Plastic Surgery, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Junqiang Wu
- Department of Breast Surgery, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Yunjie Qiu
- Department of Medical Statistics, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Guoliang Shen
- Department of Burn and Plastic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China
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Weiss F, Agua K, Weinzierl A, Schuldt A, Egana JT, Schlitter AM, Steiger K, Machens HG, Harder Y, Schmauss D. A modified burn comb model with a new dorsal frame that allows for local treatment in partial-thickness burns in rats. J Burn Care Res 2022; 43:1329-1336. [PMID: 35259276 DOI: 10.1093/jbcr/irac032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Burn wound progression (BWP) leads to vertical and horizontal injury extension. The "burn comb model" is commonly used, in which a full-thickness burn with intercalated unburned interspaces is induced. We aimed to establish an injury progressing to the intermediate dermis, allowing repeated wound evaluation. Furthermore, we present a new dorsal frame that enables topical drug application. 8 burn field and 6 interspaces were induced on each of 17 rats' dorsa with a 10-second burn comb application. A developed 8-panel aluminum frame was sutured onto 12 animals and combined with an Elizabethan collar. Over 14 days, macroscopic & histologic wound assessment and Laser-Speckle-Contrast-Imaging (LSCI) were performed besides evaluation of frame durability. The 10-second group was compared to 9 animals injured with a full-thickness 60-second model. Frame durability was sufficient up to day 4 with 8 of 12 frames (67%) still mounted. The 60-second burn led to an increased extent of interspace necrosis (p=0.002). The extent of necrosis increased between days 1 and 2 (p=0.001), following the 10-second burn (24%±SEM 8% to 40%±SEM 6%) and the 60-second burn (57%±SEM 6% to 76%±SEM 4%). Interspace LSCI perfusion was higher than burn field perfusion. It earlier reached baseline levels in the 10-second group (on day 1: 142%±SEM 9% vs. 60%±SEM 5%; p<0.001). Within day 1, the 10-second burn showed histological progression to the intermediate dermis, both in interspaces and burn fields. This burn comb model with its newly developed fixed dorsal frame allows investigation of topical agents to treat BWP in partial-thickness burns.
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Affiliation(s)
- Fabian Weiss
- Department of Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Kariem Agua
- Department of Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Andrea Weinzierl
- Department of Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany.,Department of Plastic, Reconstructive and Aesthetic Surgery, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland
| | - Anna Schuldt
- Department of Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Jose Tomas Egana
- Department of Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany.,Institute for Biological and Medical Engineering, Schools of Engineering, Medicine and Biological Sciences, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Anna Melissa Schlitter
- Institute of Pathology, School of Medicine, Technische Universität München, Munich, Germany
| | - Katja Steiger
- Institute of Pathology, School of Medicine, Technische Universität München, Munich, Germany
| | - Hans-Günther Machens
- Department of Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Yves Harder
- Department of Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany.,Department of Plastic, Reconstructive and Aesthetic Surgery, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland.,Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland
| | - Daniel Schmauss
- Department of Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany.,Department of Plastic, Reconstructive and Aesthetic Surgery, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland.,Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland
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Effect of Combining Immersion Therapy with Shengji Ointment on Wound Healing Rate and Adverse Reaction Rate in Patients with Second-Degree Burn. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:1339683. [PMID: 34868510 PMCID: PMC8635873 DOI: 10.1155/2021/1339683] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 11/05/2021] [Indexed: 01/10/2023]
Abstract
Objective To explore the effect of combining immersion therapy with Shengji ointment on wound healing rate and adverse reaction rate (ARR) in patients with second-degree burn. Methods The data of 80 patients with second-degree burn treated in our hospital from February 2019 to February 2020 were retrospectively analyzed by the means of retrospective study, and the patients were equally divided into the treatment group and the control group according to their admission order, with 40 cases each. Immersion therapy was performed to all patients (7 d); after that, patients in the control group received routine medication (7 d), and those in the treatment group were treated with Shengji ointment until the wounds were healed, so as to compare their wound healing condition, ARRs, levels of inflammatory factors, and infection incidence. Results Compared with the control group after treatment, the treatment group presented significantly shorter wound healing time (12.14 ± 1.26 vs. 15.98 ± 1.20, P < 0.001), better wound healing rate and quality (P < 0.05), and lower levels of inflammatory factors (P < 0.001); no significant between-group difference in ARRs was shown (P > 0.05); 34 patients in the treatment group (85.0%) and 26 patients in the control group (65.0%) had no infections, so the incidence rate of infections was significantly lower in the treatment group than in the control group (P < 0.05). Conclusion Combining immersion therapy with Shengji ointment can reduce the levels of inflammatory factors in patients with second-degree burn, lower the incidence rate of infections, provide the conditions for wound healing, and increase the wound healing rate, which shall be promoted and applied in practice.
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El Ayadi A, Salsbury JR, Enkhbaatar P, Herndon DN, Ansari NH. Metal chelation attenuates oxidative stress, inflammation, and vertical burn progression in a porcine brass comb burn model. Redox Biol 2021; 45:102034. [PMID: 34139550 PMCID: PMC8218731 DOI: 10.1016/j.redox.2021.102034] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 05/18/2021] [Accepted: 06/03/2021] [Indexed: 12/29/2022] Open
Abstract
Oxidative stress and inflammation may mediate cellular damage and tissue destruction as the burn wound continues to progress after the abatement of the initial insult. Since iron and calcium ions play key roles in oxidative stress, this study tested whether topical application of a metal chelator proprietary lotion (Livionex Formulation (LF) lotion), that contains disodium EDTA as a metal chelator and methyl sulfonyl methane (MSM) as a permeability enhancer, would prevent progression or reduce burn wound severity in a porcine model. We have reported earlier that in a rat burn model, LF lotion reduces thermal injury progression. Here, we used the porcine brass comb burn model that closely mimics the human condition for contact burns and applied LF lotion every 8 h starting 15 min after the injury. We found that LF lotion reduces the depth of cell death as assessed by TUNEL staining and blood vessel blockage in the treated burn sites and interspaces. The protein expression of pro-inflammatory markers IL-6, TNF-a, and TNFα Converting Enzyme (TACE), and lipid aldehyde production (protein-HNE) was reduced with LF treatment. LF lotion reversed the burn-induced decrease in the aldehyde dehydrogenase (ALDH-1) expression in the burn sites and interspaces. These data show that a topically applied EDTA-containing lotion protects both vertical and horizontal burn progression when applied after thermal injury. Curbing burn wound conversion and halting the progression of second partial burn to third-degree full-thickness burn remains challenging when it comes to burn treatment strategies during the acute phase. Burn wound conversion can be reduced with targeted treatments to attenuate the oxidative and inflammatory response in the immediate aftermath of the injury. Our studies suggest that LF lotion could be such a targeted treatment.
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Affiliation(s)
- Amina El Ayadi
- Department of Surgery, University of Texas Medical Branch, Galveston, TX, 77555-0647, USA.
| | - John R Salsbury
- Department of Anesthesiology, University of Texas Medical Branch, Galveston, TX, 77555-0647, USA
| | - Perenlei Enkhbaatar
- Department of Anesthesiology, University of Texas Medical Branch, Galveston, TX, 77555-0647, USA
| | - David N Herndon
- Department of Surgery, University of Texas Medical Branch, Galveston, TX, 77555-0647, USA
| | - Naseem H Ansari
- Department of Biochemistry & Molecular Biology, University of Texas Medical Branch, Galveston, TX, 77555-0647, USA
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