1
|
Elsheikh R, Makram AM. Multidrug-Resistant Organisms: The Silent Plight of Burn Patients. J Burn Care Res 2024; 45:877-886. [PMID: 38695094 PMCID: PMC11303128 DOI: 10.1093/jbcr/irae075] [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: 02/27/2024] [Indexed: 07/20/2024]
Abstract
The global increasing spread of multidrug-resistant organisms (MDROs) is threatening the control of various infections in vulnerable populations and patient groups. One of the most affected groups is patients with burns, who are prone to hyperinfection as they suffer from a hypermetabolic state and weaken immune barriers. Those patients also share the infection risk of patients hospitalized for a long time, including ventilator-associated pneumonia and urinary tract infections. While some preventative and therapeutic management styles are still controversial, we discuss consensuses here. In this review, we aim to present the current knowledge on multidrug resistance with a special focus on patients with burns, discuss various causative organisms and their treatment options, and highlight the importance of antibiotic stewardship and teamwork in responding to an outbreak of MDROs.
Collapse
Affiliation(s)
- Randa Elsheikh
- Deanery of Biomedical Sciences at Edinburgh Medical School, University of Edinburgh, Edinburgh EH8 9YL, UK
| | | |
Collapse
|
2
|
Pérez-Torres D, Martín-Luengo AI, Cuenca-Rubio C, Berezo-García JÁ, Díaz-Rodríguez C, Canas-Pérez I, Fernández-Rodríguez ML, Colmenero-Calleja C, Sánchez-Ballesteros J, Blanco-Schweizer P, Ticona-Espinoza TG, Piqueras-Pérez JM. Selective decontamination of the digestive tract in a burns unit reduces the incidence of hospital-acquired infections: A retrospective before-and-after cohort study. Med Intensiva 2024:S2173-5727(24)00139-5. [PMID: 38897897 DOI: 10.1016/j.medine.2024.06.001] [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: 03/28/2024] [Accepted: 05/17/2024] [Indexed: 06/21/2024]
Abstract
OBJECTIVE To evaluate the effect of selective decontamination of the digestive tract (SDD) on hospital-acquired infections (HAIs) in patients with acute burn injury requiring admission to a Burns Unit (BU). DESIGN Retrospective before-and-after cohort study, between January 2017 and June 2023. SDD was implemented in March 2019, dividing patients into two groups. SETTING Four-bed BU, in a referral University Hospital in Spain. PATIENTS All the patients admitted during the study period were eligible for analysis. Patients who died or were discharged within 48hours of admission, and patients with an estimated survival less than 10% not considered for full escalation of therapy were excluded. INTERVENTION SDD comprised the administration of a 4-day course of an intravenous antibiotic, and an oral suspension and oral topical paste of non-absorbable antibiotics during the stay in the BU. MAIN VARIABLE OF INTEREST Incidence of HAIs during the stay in the BU. SECONDARY OUTCOMES incidence of specific types of infections by site (bacteremia, pneumonia, skin and soft tissue infection) and microorganism (Gram-positive, Gram-negative, fungi), and safety endpoints. RESULTS We analyzed 72 patients: 27 did not receive SDD, and 45 received SDD. The number of patients who developed HAIs were 21 (77.8%) and 21 (46.7%) in the non-SDD and the SDD groups, respectively (p=0.009). The number of hospital-acquired infectious episodes were 2.52 (1.21-3.82) and 1.13 (0.54-1.73), respectively (p=0.029). CONCLUSIONS SDD was associated with a reduced incidence of bacterial HAIs and a decrease in the number of infectious episodes per patient.
Collapse
Affiliation(s)
- David Pérez-Torres
- Servicio de Medicina Intensiva, Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y León (SACYL), Calle Dulzaina, 2, 47012, Valladolid, Spain; Unidad de Quemados, Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y León (SACYL), Calle Dulzaina, 2, 47012, Valladolid, Spain; Programa de Optimización del Uso de Antimicrobianos (PROA), Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y León (SACYL), Calle Dulzaina, 2, 47012, Valladolid, Spain.
| | - Ana Isabel Martín-Luengo
- Servicio de Medicina Intensiva, Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y León (SACYL), Calle Dulzaina, 2, 47012, Valladolid, Spain; Unidad de Quemados, Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y León (SACYL), Calle Dulzaina, 2, 47012, Valladolid, Spain
| | - Cristina Cuenca-Rubio
- Servicio de Medicina Intensiva, Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y León (SACYL), Calle Dulzaina, 2, 47012, Valladolid, Spain
| | - José Ángel Berezo-García
- Servicio de Medicina Intensiva, Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y León (SACYL), Calle Dulzaina, 2, 47012, Valladolid, Spain; Unidad de Quemados, Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y León (SACYL), Calle Dulzaina, 2, 47012, Valladolid, Spain
| | - Cristina Díaz-Rodríguez
- Servicio de Medicina Intensiva, Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y León (SACYL), Calle Dulzaina, 2, 47012, Valladolid, Spain; Unidad de Quemados, Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y León (SACYL), Calle Dulzaina, 2, 47012, Valladolid, Spain
| | - Isabel Canas-Pérez
- Servicio de Medicina Intensiva, Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y León (SACYL), Calle Dulzaina, 2, 47012, Valladolid, Spain
| | - María Lorena Fernández-Rodríguez
- Servicio de Medicina Intensiva, Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y León (SACYL), Calle Dulzaina, 2, 47012, Valladolid, Spain; Unidad de Quemados, Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y León (SACYL), Calle Dulzaina, 2, 47012, Valladolid, Spain
| | - Cristina Colmenero-Calleja
- Servicio de Medicina Intensiva, Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y León (SACYL), Calle Dulzaina, 2, 47012, Valladolid, Spain
| | - Jesús Sánchez-Ballesteros
- Servicio de Medicina Intensiva, Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y León (SACYL), Calle Dulzaina, 2, 47012, Valladolid, Spain; Unidad de Quemados, Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y León (SACYL), Calle Dulzaina, 2, 47012, Valladolid, Spain
| | - Pablo Blanco-Schweizer
- Servicio de Medicina Intensiva, Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y León (SACYL), Calle Dulzaina, 2, 47012, Valladolid, Spain; Unidad de Quemados, Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y León (SACYL), Calle Dulzaina, 2, 47012, Valladolid, Spain
| | - Thalia Gloria Ticona-Espinoza
- Servicio de Medicina Intensiva, Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y León (SACYL), Calle Dulzaina, 2, 47012, Valladolid, Spain
| | - José María Piqueras-Pérez
- Unidad de Quemados, Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y León (SACYL), Calle Dulzaina, 2, 47012, Valladolid, Spain; Servicio de Cirugía Plástica, Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y León (SACYL), Calle Dulzaina, 2, 47012, Valladolid, Spain
| |
Collapse
|
3
|
Hagiga A, Dheansa B. Multi-resistant organisms in burn patients: an end or a new beginning. Burns 2024; 50:1045-1052. [PMID: 38472000 DOI: 10.1016/j.burns.2024.02.024] [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: 08/25/2023] [Revised: 01/16/2024] [Accepted: 02/26/2024] [Indexed: 03/14/2024]
Abstract
Infections are a major cause of morbidity and mortality in burn patients, and the rise of multidrug-resistant organisms (MDROs) has made it more challenging to manage and prevent infections. This review examines the available treatment options for MDROs in burn patients and anticipates the future challenges posed by their increasing prevalence. The review covers new antibiotics, such as Eravacycline and Plazomicin, as well as non-antibiotic therapies, such as bacteriophages and nanoparticles. Future research should focus on examining the long-term efficacy, cost-effectiveness, and in vivo efficacy of different treatment modalities. The potential of alternative therapies, such as probiotics and low-frequency magnetic fields, should also be explored. Accurate and rapid diagnostic and monitoring tools for detecting MDROs in burn patients should be developed. The emergence of MDROs in burn care is a challenge and a new beginning in infection innovation and novel treatments.
Collapse
Affiliation(s)
- Ahmed Hagiga
- Queen Victoria Hospital NHS Foundation Trust, East Grinstead, United Kingdom.
| | - Baljit Dheansa
- Queen Victoria Hospital NHS Foundation Trust, East Grinstead, United Kingdom
| |
Collapse
|
4
|
Surya KG, Shanmugam R, Behera A, Dharmalingam Jothinathan MK. Assessment of Antibacterial Properties and Cytotoxic Effect of Ethanolic Extracts of Clitoria ternatea and Camellia sinensis Herbal Formulation Against Clinical Pathogens. Cureus 2024; 16:e58287. [PMID: 38752090 PMCID: PMC11094523 DOI: 10.7759/cureus.58287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 04/14/2024] [Indexed: 05/18/2024] Open
Abstract
Aim The study aims to evaluate the antibacterial properties of ethanolic extracts from Clitoria ternatea and Camellia sinensis against pathogens causing UTI, wound pathogens, and other clinical bacterial infections and their cytotoxic effects using the brine shrimp lethality assay (BSLA). Methods Ethanolic extracts of C. ternatea and C. sinensis were prepared, and their antibacterial activity was tested against Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Enterococcus faecalis using the well diffusion method. The cytotoxicity was assessed through the BSLA, determining the LC50 values for each extract. Results The formulation of both plant extracts exhibited significant antibacterial activity against UTI pathogens, and wound pathogen bacteria showed higher efficacy compared to other studies. The BSLA revealed a dose-dependent increase in toxicity, with C. ternatea extracts demonstrating higher cytotoxicity than C. sinensis. Conclusion The ethanolic extracts of C. ternatea and C. sinensis possess antibacterial properties against UTI-causing bacteria and show cytotoxic effects in a brine shrimp model. These findings suggest the potential of these plants for developing alternative treatments for UTI. However, further research is necessary to fully understand their safety and efficacy in human subjects.
Collapse
Affiliation(s)
- Krithick G Surya
- Nanobiomedicine Lab, Centre for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
| | - Rajeshkumar Shanmugam
- Nanobiomedicine Lab, Centre for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
| | - Archana Behera
- Centre for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
| | | |
Collapse
|
5
|
Orbay H, Ziembicki JA, Yassin M, Egro FM. Prevention and Management of Wound Infections in Burn Patients. Clin Plast Surg 2024; 51:255-265. [PMID: 38429048 DOI: 10.1016/j.cps.2023.11.003] [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] [Indexed: 03/03/2024]
Abstract
The leading cause of morbidity in burn patients is infection with pneumonia, urinary tract infection, cellulitis, and wound infection being the most common cause. High mortality is due to the immunocompromised status of patients and abundance of multidrug-resistant organisms in burn units. Despite the criteria set forth by American Association of Burn, the diagnosis and treatment of burn infections are not always straightforward. Topical antimicrobials, isolation, hygiene, and personal protective equipment are common preventive measures. Additionally medical and nutritional optimization of the patients is crucial to reverse the immunocompromised status triggered by burn injury.
Collapse
Affiliation(s)
- Hakan Orbay
- Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Jenny A Ziembicki
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Mohamed Yassin
- Division of Infectious Diseases, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Francesco M Egro
- Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA; Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA.
| |
Collapse
|
6
|
Thamizhchelvan AM, Masoud AR, Su S, Lu Y, Peng H, Kobayashi Y, Wang Y, Archer NK, Hong S. Bactericidal Efficacy of the Combination of Maresin-like Proresolving Mediators and Carbenicillin Action on Biofilm-Forming Burn Trauma Infection-Related Bacteria. Int J Mol Sci 2024; 25:2792. [PMID: 38474038 PMCID: PMC10932429 DOI: 10.3390/ijms25052792] [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: 01/26/2024] [Revised: 02/16/2024] [Accepted: 02/26/2024] [Indexed: 03/14/2024] Open
Abstract
Biofilm-associated bacterial infections are the major reason for treatment failure in many diseases including burn trauma infections. Uncontrolled inflammation induced by bacteria leads to materiality, tissue damage, and chronic diseases. Specialized proresolving mediators (SPMs), including maresin-like lipid mediators (MarLs), are enzymatically biosynthesized from omega-3 essential long-chain polyunsaturated fatty acids, especially docosahexaenoic acid (DHA), by macrophages and other leukocytes. SPMs exhibit strong inflammation-resolving activities, especially inflammation provoked by bacterial infection. In this study, we explored the potential direct inhibitory activities of three MarLs on Gram-positive (Staphylococcus aureus) and Gram-negative (Pseudomonas aeruginosa and Escherichia coli) bacteria in their biofilms that are leading bacteria in burn trauma-related infections. We also examined the effects of MarLs on the bactericidal activities of a typical broad-spectrum antibiotic, carbenicillin (carb), on these bacteria in their preformed biofilms. The results revealed that MarLs combined with carbenicillin can inhibit the survival of Gram-positive and Gram-negative bacteria in their biofilms although MarLs alone did not exhibit bactericidal activity. Thus, our findings suggest that the combination of MarLs and carbenicillin can lower the antibiotic requirements to kill the bacteria in preformed biofilms.
Collapse
Affiliation(s)
- Anbu Mozhi Thamizhchelvan
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health New Orleans, 2020 Gravier St., New Orleans, LA 70112, USA
| | - Abdul-Razak Masoud
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health New Orleans, 2020 Gravier St., New Orleans, LA 70112, USA
| | - Shanchun Su
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health New Orleans, 2020 Gravier St., New Orleans, LA 70112, USA
| | - Yan Lu
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health New Orleans, 2020 Gravier St., New Orleans, LA 70112, USA
| | - Hongying Peng
- Biostatistics, Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH 45221, USA
| | - Yuichi Kobayashi
- Department of Bioengineering, Tokyo Institute of Technology, Box B-52, Nagatsuta-cho 4259, Midori-ku, Yokohama 226-8501, Kanagawa, Japan
- Organization for the Strategic Coordination of Research and Intellectual Properties, Meiji University, 1-1-1 Higashimita, Tama-ku, Kawasaki 214-8571, Kanagawa, Japan
| | - Yu Wang
- Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, MD 21231, USA; (Y.W.); (N.K.A.)
| | - Nathan K. Archer
- Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, MD 21231, USA; (Y.W.); (N.K.A.)
| | - Song Hong
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health New Orleans, 2020 Gravier St., New Orleans, LA 70112, USA
- Department of Ophthalmology, School of Medicine, Louisiana State University Health New Orleans, 2020 Gravier St., New Orleans, LA 70112, USA
| |
Collapse
|
7
|
Gómez-Salgado MDRH, Beltrán-Gómez JÁ, Díaz-Nuñez JL, Rivera-Chávez JA, García-Contreras R, Estrada-Velasco ÁY, Quezada H, Serrano Bello CA, Castillo-Juárez I. Efficacy of a Mexican folk remedy containing cuachalalate (Amphipterygium adstringens (Schltdl.) Schiede ex Standl) for the treatment of burn wounds infected with Pseudomonas aeruginosa. JOURNAL OF ETHNOPHARMACOLOGY 2024; 319:117305. [PMID: 37848078 DOI: 10.1016/j.jep.2023.117305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 10/02/2023] [Accepted: 10/08/2023] [Indexed: 10/19/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Cuachalalate (Amphipterygium adstringens) stem bark has been used to heal wounds and counteract microbial infections since pre-Hispanic times. However, its effect in treating infected burns remains unclear. STUDY OBJECTIVES To determine the antipathogenic capacity of a folk remedy (FR) containing cuachalalate stem bark to treat lesions caused by thermal damage and bacterial infection. MATERIALS AND METHODS The antipathogenic capacity of the hexanic extract (HE) and FR was evaluated in a burned mouse model infected with Pseudomonas aeruginosa. Second to third-degree burns were induced with 95 °C water in CD1 mice in similar ratios of males to females. The mice were randomly grouped into non-inoculated (Group 1) and P. aeruginosa inoculated. The latter were divided into untreated infection (Group 2) and infection topically treated with HE (Group 3), silver sulfadiazine (Group 4), and tween 80 (Group 5). In the case of FR, the lesions were washed with an aqueous extract (AE) and applied powdered stem bark (Group 6). Animal survival, establishment of the bacteria in the lesions, and systemic dispersion were determined. In addition, histopathological analysis was performed. The chemical composition of the AE was analyzed through molecular networking analysis, and the antivirulence capacity was determined through the inhibition of pyocyanin production and caseinolytic activity. RESULTS Only the FR showed antipathogenic activity and increased animal survival by 50% by reducing the systemic dispersion of P. aeruginosa. In addition, it stimulated the formation of granulation tissue and the generation of new blood vessels. The AE did not show bactericidal activity but reduced bacterial virulence, and glycosylated flavonoids and catechins were identified as its main constituents. CONCLUSIONS The results of this study contribute to validating the effectiveness of a popular remedy containing cuachalalate stem bark for treating burns infected with P. aeruginosa.
Collapse
Affiliation(s)
| | - José Ángel Beltrán-Gómez
- Laboratorio de Investigación y Aplicación de Fitoquímicos Bioactivos, Posgrado en Botánica, Colegio de Postgraduados, Texcoco, 56230, Mexico.
| | - José Luis Díaz-Nuñez
- Laboratorio de Investigación y Aplicación de Fitoquímicos Bioactivos, Posgrado en Botánica, Colegio de Postgraduados, Texcoco, 56230, Mexico.
| | - José Alberto Rivera-Chávez
- Departamento de Productos Naturales, Instituto de Química, Universidad Nacional Autónoma de México, CDMX, Mexico.
| | - Rodolfo García-Contreras
- Departamento de Microbiología y Parasitología, Universidad Nacional Autónoma de México, Ciudad Universitaria, CDMX, 04510, Mexico.
| | - Ángel Yahir Estrada-Velasco
- Departamento de Microbiología y Parasitología, Universidad Nacional Autónoma de México, Ciudad Universitaria, CDMX, 04510, Mexico.
| | - Héctor Quezada
- Laboratorio de Investigación en Inmunología y Proteómica, Hospital Infantil de México Federico Gómez, CDMX, 06720, Mexico.
| | - Carlos Alberto Serrano Bello
- Departamento de Patología Clínica y Experimental, Hospital Infantil de México Federico Gómez, CDMX, 06720, Mexico.
| | - Israel Castillo-Juárez
- Laboratorio de Investigación y Aplicación de Fitoquímicos Bioactivos, Posgrado en Botánica, Colegio de Postgraduados, Texcoco, 56230, Mexico.
| |
Collapse
|
8
|
Rissetto NG, de Oliveira JW, Nisihara R. Main Pathogens Causing Infections and Antibiotic Resistance Profile in Major Burns in Brazil Comparing Two Periods: 2015/2016 and 2019/2020. J Burn Care Res 2024; 45:145-150. [PMID: 37596810 DOI: 10.1093/jbcr/irad123] [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: 05/09/2023] [Indexed: 08/20/2023]
Abstract
Sepsis is the main cause of death in major burns. In this retrospective study conducted in a reference hospital in Brazil, the main agents causing infection and the resistance profile to antibiotics were identified. In addition, the epidemiological profile, length of hospital stay, type of burn, and total body surface area (TBSA) in major burns were collected from medical records, comparing the years 2015/2016 and 2019/2020. In both time periods, there was a predominance of males with a mean age of 43 years. Burns with less than 30% of TBSA predominated. There was a significant increase in positive cultures (P = .00026), from 58.7% to 80%, and an increase in skin punch culture collection from 25.6% to 43.9% in the years 2019/2020. The predominant etiological agent was Pseudomonas aeruginosa, followed by Acinetobacter baumannii resistant to carbapenems, and Staphylococcus aureus in both evaluated periods. The percentage of deaths was higher in 2019/2020 (26.2% vs. 14.6%; P = .026). The length of hospital stay was shorter in the latter period (P = .0081). Sepsis was the cause of death in 81.2% of cases in 2015/2020 and 78.3% in 2019/2020. Among the deaths, P. aeruginosa was the main agent identified. There was no change in the main pathogens and bacterial antibiotic resistance between the 2 time periods.
Collapse
Affiliation(s)
- Nicoli Gueno Rissetto
- Department of Medicine, Mackenzie Evangelical School of Medicine, Curitiba, Paraná, Brazil
| | | | - Renato Nisihara
- Department of Medicine, Mackenzie Evangelical School of Medicine, Curitiba, Paraná, Brazil
| |
Collapse
|
9
|
Greenhalgh DG, Hill DM, Burmeister DM, Gus EI, Cleland H, Padiglione A, Holden D, Huss F, Chew MS, Kubasiak JC, Burrell A, Manzanares W, Gómez MC, Yoshimura Y, Sjöberg F, Xie WG, Egipto P, Lavrentieva A, Jain A, Miranda-Altamirano A, Raby E, Aramendi I, Sen S, Chung KK, Alvarez RJQ, Han C, Matsushima A, Elmasry M, Liu Y, Donoso CS, Bolgiani A, Johnson LS, Vana LPM, de Romero RVD, Allorto N, Abesamis G, Luna VN, Gragnani A, González CB, Basilico H, Wood F, Jeng J, Li A, Singer M, Luo G, Palmieri T, Kahn S, Joe V, Cartotto R. Surviving Sepsis After Burn Campaign. Burns 2023; 49:1487-1524. [PMID: 37839919 DOI: 10.1016/j.burns.2023.05.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 05/02/2023] [Indexed: 10/17/2023]
Abstract
INTRODUCTION The Surviving Sepsis Campaign was developed to improve outcomes for all patients with sepsis. Despite sepsis being the primary cause of death after thermal injury, burns have always been excluded from the Surviving Sepsis efforts. To improve sepsis outcomes in burn patients, an international group of burn experts developed the Surviving Sepsis After Burn Campaign (SSABC) as a testable guideline to improve burn sepsis outcomes. METHODS The International Society for Burn Injuries (ISBI) reached out to regional or national burn organizations to recommend members to participate in the program. Two members of the ISBI developed specific "patient/population, intervention, comparison and outcome" (PICO) questions that paralleled the 2021 Surviving Sepsis Campaign [1]. SSABC participants were asked to search the current literature and rate its quality for each topic. At the Congress of the ISBI, in Guadalajara, Mexico, August 28, 2022, a majority of the participants met to create "statements" based on the literature. The "summary statements" were then sent to all members for comment with the hope of developing an 80% consensus. After four reviews, a consensus statement for each topic was created or "no consensus" was reported. RESULTS The committee developed sixty statements within fourteen topics that provide guidance for the early treatment of sepsis in burn patients. These statements should be used to improve the care of sepsis in burn patients. The statements should not be considered as "static" comments but should rather be used as guidelines for future testing of the best treatments for sepsis in burn patients. They should be updated on a regular basis. CONCLUSION Members of the burn community from the around the world have developed the Surviving Sepsis After Burn Campaign guidelines with the goal of improving the outcome of sepsis in burn patients.
Collapse
Affiliation(s)
- David G Greenhalgh
- Department of Burns, Shriners Children's Northern California and Department of Surgery, University of California, Davis, Sacramento, CA, USA.
| | - David M Hill
- Department of Clinical Pharmacy & Translational Scre have been several studies that have evaluatedience, College of Pharmacy, University of Tennessee, Health Science Center; Memphis, TN, USA
| | - David M Burmeister
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Eduardo I Gus
- Division of Plastic & Reconstructive Surgery, The Hospital for Sick Children; Department of Surgery, University of Toronto, Toronto, Canada
| | - Heather Cleland
- Department of Surgery, Monash University and Alfred Hospital, Melbourne, Australia
| | - Alex Padiglione
- Department of Surgery, Monash University and Alfred Hospital, Melbourne, Australia
| | - Dane Holden
- Department of Surgery, Monash University and Alfred Hospital, Melbourne, Australia
| | - Fredrik Huss
- Department of Surgical Sciences, Plastic Surgery, Uppsala University/Burn Center, Department of Plastic and Maxillofacial Surgery, Uppsala University Hospital, Uppsala, Sweden
| | - Michelle S Chew
- Department of Anaesthesia and Intensive Care, Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - John C Kubasiak
- Department of Surgery, Loyola University Medical Center, Maywood, IL, USA
| | - Aidan Burrell
- Department of Epidemiology and Preventative Medicine, Monash University and Alfred Hospital, Intensive Care Research Center (ANZIC-RC), Melbourne, Australia
| | - William Manzanares
- Department of Critical Care Medicine, Universidad de la República (UdelaR), Montevideo, Uruguay
| | - María Chacón Gómez
- Division of Intensive Care and Critical Medicine, Centro Nacional de Investigacion y Atencion de Quemados (CENIAQ), National Rehabilitation Institute, LGII, Mexico
| | - Yuya Yoshimura
- Department of Emergency and Critical Care Medicine, Hachinohe City Hospital, Hachinohe, Japan
| | - Folke Sjöberg
- Department of Anaesthesia and Intensive Care, Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Wei-Guo Xie
- Institute of Burns, Tongren Hospital of Wuhan University (Wuhan Third Hospital), Wuhan, China
| | - Paula Egipto
- Centro Hospitalar e Universitário São João - Burn Unit, Porto, Portugal
| | | | | | | | - Ed Raby
- Infectious Diseases Department, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | | | - Soman Sen
- Department of Burns, Shriners Children's Northern California and Department of Surgery, University of California, Davis, Sacramento, CA, USA
| | - Kevin K Chung
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | | | - Chunmao Han
- Department of Burn and Wound Repair, Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, China
| | - Asako Matsushima
- Department of Emergency and Critical Care, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Moustafa Elmasry
- Department of Hand, Plastic Surgery and Burns, Linköping University, Linköping, Sweden
| | - Yan Liu
- Department of Burn, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Carlos Segovia Donoso
- Intensive Care Unit for Major Burns, Mutual Security Clinical Hospital, Santiago, Chile
| | - Alberto Bolgiani
- Department of Surgery, Deutsches Hospital, Buenos Aires, Argentina
| | - Laura S Johnson
- Department of Surgery, Emory University School of Medicine and Grady Health System, Georgia
| | - Luiz Philipe Molina Vana
- Disciplina de Cirurgia Plastica da Escola Paulista de Medicina da Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | | | - Nikki Allorto
- Grey's Hospital Pietermaritzburg Metropolitan Burn Service, University of KwaZulu Natal, Pietermaritzburg, South Africa
| | - Gerald Abesamis
- Alfredo T. Ramirez Burn Center, Division of Burns, Department of Surgery, University of Philippines Manila - Philippine General Hospital, Manila, Philippines
| | - Virginia Nuñez Luna
- Unidad Michou y Mau Xochimilco for Burnt Children, Secretaria Salud Ciudad de México, Mexico
| | - Alfredo Gragnani
- Disciplina de Cirurgia Plastica da Escola Paulista de Medicina da Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Carolina Bonilla González
- Department of Pediatrics and Intensive Care, Pediatric Burn Unit, Clinical Studies and Clinical Epidemiology Division, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Hugo Basilico
- Intensive Care Area - Burn Unit - Pediatric Hospital "Prof. Dr. Juan P. Garrahan", Buenos Aires, Argentina
| | - Fiona Wood
- Department of Surgery, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | - James Jeng
- Department of Surgery, University of California, Irvine, CA, USA
| | - Andrew Li
- Department of Surgery, Monash University and Alfred Hospital, Melbourne, Australia
| | - Mervyn Singer
- Department of Intensive Care Medicine, University College London, London, United Kingdom
| | - Gaoxing Luo
- Institute of Burn Research, Southwest Hospital, Army (Third Military) Medical University, Chongqing, China
| | - Tina Palmieri
- Department of Burns, Shriners Children's Northern California and Department of Surgery, University of California, Davis, Sacramento, CA, USA
| | - Steven Kahn
- The South Carolina Burn Center, Department of Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Victor Joe
- Department of Surgery, University of California, Irvine, CA, USA
| | - Robert Cartotto
- Department of Surgery, Sunnybrook Medical Center, Toronto, Ontario, Canada
| |
Collapse
|
10
|
Hemmati J, Azizi M, Asghari B, Arabestani MR. Multidrug-Resistant Pathogens in Burn Wound, Prevention, Diagnosis, and Therapeutic Approaches (Conventional Antimicrobials and Nanoparticles). THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2023; 2023:8854311. [PMID: 37521436 PMCID: PMC10386904 DOI: 10.1155/2023/8854311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 06/26/2023] [Accepted: 07/13/2023] [Indexed: 08/01/2023]
Abstract
Multidrug-resistant pathogens are one of the common causes of death in burn patients and have a high risk of nosocomial infections, especially pneumonia, urinary tract infections, and cellulitis. The role of prolonged hospitalization and empirical antibiotics administration in developing multidrug-resistant pathogens is undeniable. In the early days of admitting burn patients, Gram-positive bacteria were the dominant isolates with a more sensitive antibiotic pattern. However, the emergence of Gram-negative bacteria that are more resistant later occurs. Trustworthy guideline administration in burn wards is one of the strategies to prevent multidrug-resistant pathogens. Also, a multidisciplinary therapeutic approach is an effective way to avoid antibiotic resistance that involves infectious disease specialists, pharmacists, and burn surgeons. However, the emerging resistance to conventional antimicrobial approaches (such as systemic antibiotic exposure, traditional wound dressing, and topical antibiotic ointments) among burn patients has challenged the treatment of multidrug-resistant infections, and using nanoparticles is a suitable alternative. In this review article, we will discuss different aspects of multidrug-resistant pathogens in burn wounds, emphasizing the full role of these pathogens in burn wounds and discussing the application of nanotechnology in dealing with them. Also, some advances in various types of nanomaterials, including metallic nanoparticles, liposomes, hydrogels, carbon quantum dots, and solid lipid nanoparticles in burn wound healing, will be explained.
Collapse
Affiliation(s)
- Jaber Hemmati
- Department of Microbiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
- Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mehdi Azizi
- Department of Tissue Engineering and Biomaterials, School of Advanced Medical Sciences and Technologies, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Babak Asghari
- Department of Microbiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohammad Reza Arabestani
- Department of Microbiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
- Infectious Disease Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| |
Collapse
|
11
|
Sulastri E, Lesmana R, Zubair MS, Abdelwahab Mohammed AF, Elamin KM, Wathoni N. Ulvan/Silver nanoparticle hydrogel films for burn wound dressing. Heliyon 2023; 9:e18044. [PMID: 37483826 PMCID: PMC10362238 DOI: 10.1016/j.heliyon.2023.e18044] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 07/03/2023] [Accepted: 07/05/2023] [Indexed: 07/25/2023] Open
Abstract
Ulvan is a polysaccharide from green algae that shows good hydrogel film dressing characteristics. Silver nanoparticles (AgNP) can be incorporated into the hydrogel film to improve antibacterial properties and provide a potential burn treatment. In this study, we developed a novel hydrogel film wound dressing composed of ulvan and silver nanoparticles. Two concentrations (0.5 mM and 1 mM) of silver nitrate were used to produce ulvan-silver nanoparticles hydrogel film (UHF-AgNP0.5 and UHF-AgNP1), respectively. The physicochemical characteristics of the hydrogel films were evaluated, including particle size, zeta potential, Fourier transform infrared (FTIR), X-ray diffractometry (XRD), scanning electron microscope and energy-dispersive X-ray (SEM-EDX). Furthermore, the in vitro antimicrobial activity, and second-degree burn wound healing test were evaluated. The UHF-AgNP0.5 showed the highest antimicrobial activity compared to UHF-AgNP1 and UHF film. Meanwhile, an in vivo study using Wistar rats induced second-degree burns showed that UHF-AgNP0.5 significantly accelerated the healing process by regulating the inflammatory process, increasing re-epithelialization, and improving the vascularization process. Ulvan-silver nanoparticle hydrogel films have the ability to accelerate the healing of second-degree burns and are potential candidates for wound dressings.
Collapse
Affiliation(s)
- Evi Sulastri
- Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, 45363, Indonesia
- Department of Pharmacy, Faculty of Mathematics and Natural Sciences, Universitas Tadulako, Palu, 94119, Indonesia
| | - Ronny Lesmana
- Department of Anatomy, Physiology and Biology Cell, Faculty of Medicine, Universitas Padjadjaran, Sumedang, 45363, Indonesia
| | - Muhammad Sulaiman Zubair
- Department of Pharmacy, Faculty of Mathematics and Natural Sciences, Universitas Tadulako, Palu, 94119, Indonesia
| | | | - Khaled M. Elamin
- Graduate School of Pharmaceutical Sciences, Kumamoto University, 5-1 Oe-honmachi, Chuo-ku, Kumamoto, 862-0973, Japan
| | - Nasrul Wathoni
- Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, 45363, Indonesia
| |
Collapse
|
12
|
Choy K, Dyamenahalli KU, Khair S, Colborn KL, Wiktor AJ, Idrovo JP, McMahan RH, Burnham EL, Kovacs EJ. Aberrant inflammatory responses in intoxicated burn-injured patients parallel impaired cognitive function. Alcohol 2023; 109:35-41. [PMID: 36690221 PMCID: PMC10175175 DOI: 10.1016/j.alcohol.2023.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 01/10/2023] [Accepted: 01/12/2023] [Indexed: 01/22/2023]
Abstract
Burn-injured patients with alcohol use disorder (AUD) have increased morbidity and mortality compared to alcohol-abstaining individuals with similar injuries. It is hypothesized that this is due, in part, to alcohol-induced dysregulation of the systemic inflammatory response, leading to worsened clinical outcomes, including increased susceptibility to infection, and heightened cognitive impairment. To examine the effects of alcohol on inflammatory markers after burn injury, we used multiplex assays to measure a panel of 48 cytokines, chemokines, and growth factors in the plasma of burn patents within 24 h of admission to the University of Colorado Burn Center. Thirty patients were enrolled between July 2018 to February 2020 and were stratified based on presence of AUD and total body surface area (TBSA) burn of ≥20% into four groups: [AUD-, TBSA <20%, N = 12], [AUD+, TBSA <20%, N = 3], [AUD-, TBSA ≥20%, N = 8], [AUD+, TBSA ≥20%, N = 7]. In addition, Confusion Assessment Method (CAM) scores were collected to evaluate patient delirium during the course of hospitalization. Multivariate statistical analysis demonstrated a number of cytokines and other factors that were significantly different between the groups. For example, the anti-inflammatory cytokine interleukin 1 receptor antagonist (IL-1ra) was dampened in the AUD+, TBSA ≥20% cohort with a 75.2% decrease compared to AUD-, TBSA ≥20%, and an 83.9% decrease compared to AUD-, TBSA <20% (p = 0.008). Additionally, plasma levels of the pro-inflammatory mediator CXCL12 (C-X-C motif chemokine ligand 12, also known as stromal cell-derived factor 1, SDF-1) was higher in the AUD + groups (p = 0.03) and similarly, IL-18 levels were greater in AUD+, TBSA ≥20% (p = 0.009). Eotaxin (also known as cytokine CC motif ligand 11, CCL11) was markedly elevated in the AUD+, TBSA ≥20% cohort with a 2.4-fold increase over the AUD-, TBSA ≥20%, and a 1.7-fold rise compared to the AUD-, TBSA <20% cohorts (p = 0.04). Interestingly, there was also a marked rise in CAM + delirium scores (85.7%) among the AUD + patients with TBSA ≥20% (p = 0.02). Not surprisingly, we found that hospital stays increased with AUD+ and larger burns (p = 0.0009). Our findings reveal that burn patients who misuse alcohol have aberrant inflammatory responses that may lead to greater immune dysregulation and worse clinical outcomes.
Collapse
Affiliation(s)
- Kevin Choy
- Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Kiran U Dyamenahalli
- Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Shanawaj Khair
- Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, United States; Graduate Program in Molecular Biology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Kathryn L Colborn
- Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Arek J Wiktor
- Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Juan-Pablo Idrovo
- Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Rachel H McMahan
- Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, United States; Rocky Mountain Regional Veterans Administration Medical Center, Veterans Administration Eastern Colorado Health Care System Research Service, Aurora, CO, United States
| | - Ellen L Burnham
- Department of Medicine, Pulmonary Sciences and Critical Care Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Elizabeth J Kovacs
- Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, United States; Graduate Program in Molecular Biology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States; Rocky Mountain Regional Veterans Administration Medical Center, Veterans Administration Eastern Colorado Health Care System Research Service, Aurora, CO, United States; Department of Immunology and Microbiology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States.
| |
Collapse
|
13
|
Muacevic A, Adler JR. Pediatric First-Degree Burn Management With Honey and 1% Silver Sulfadiazine (Ag-SD): Comparison and Contrast. Cureus 2022; 14:e32842. [PMID: 36570107 PMCID: PMC9779910 DOI: 10.7759/cureus.32842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2022] [Indexed: 12/24/2022] Open
Abstract
Background The cardinal area of managing fire wounds is guided by adequately evaluating the burn-induced lesion's profundity and size. Superficial second-degree burns are often treated through daily reinstating with fresh sterile bandaging with appropriate topical antimicrobials to allow rapid spontaneous epithelialization. Around the world, a wide variety of substances are used to treat these wounds, from honey to synthetic biological dressings. Objective This study intended to determine honey's therapeutic potential compared with 1% silver sulfadiazine (Ag-SD) in arsenal-caused contusion medicament fulfillment. Methods A total of 70 cases were evaluated in this research work after fulfilling the required selection criteria during the study period of January 2014 to December 2014 and January 2017 to December 2017. Purposive selection criteria were adopted in the study to select research patients. The patients in Group-1 (n = 35) relied on honey as medication, while patients in Group-2 (n = 35) relied on 1% Ag-SD. Results In Group-1, exudation (68.4%) and sloughing (82.9%) were substantially reduced by Days 3 and 5 of therapeutic intervention, respectively. However, in Group-2, a reduction of exudation (17.1%) and sloughing (22.9%) occurred after Days 3 and 5 of treatment, respectively. Completion of the epithelialization process was observed among Group-1 and Group-2 cases. It was detected after Days 7 and 10 of treatment at 36.3% and 77% (Group-1) and 27% and 67% (Group-2), respectively. Around 3 ml of 1% honey was required per body surface area per dressing in Group-1. On the other hand, in Group-2, 2 gm Ag-SD was needed per body surface area per dressing. Conclusion Patients treated with honey found better clinical outcomes in managing superficial partial-thickness burns.
Collapse
|
14
|
Lv Y, Han Y, Yu Z, Chen J, Li C, Wang C, Hu P, Liu Y. Core-shell alum-borneol fiber for high bioavailability. Prog Biomater 2022; 11:253-261. [PMID: 35731421 DOI: 10.1007/s40204-022-00192-9] [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: 03/26/2022] [Accepted: 05/29/2022] [Indexed: 11/29/2022] Open
Abstract
Currently, the treatment of burns poses a significant challenge to clinical surgical. The use of nanofibers combined with drugs provides an entirely new option for treating burns. Alum-borneol combination has been shown as a promising alternative in clinical burn treatment. However, the utilization of the alum-borneol combination is not optimistic due to the low solubility of borneol. In this study, alum-borneol incorporated polyvinyl pyrrolidone fibers with a core-shell structure were fabricated through coaxial electrospinning. In vitro Borneol release behavior of fibers with different ratios of alum to borneol was explored. Scanning electron microscopy, transmission electron microscope, Fourier transform infrared spectroscopy, X-ray diffraction, differential scanning calorimeter, in vitro drug release, and in vitro release mechanism were evaluated. The results showed that the fiber membranes maintained an integrated morphology. In vitro dissolution data showed an improved solubility of borneol, which reached more than 82% at 240 min in alum-borneol fibers. It was 4.8 times higher than borneol powder, and the ratio of alum to borneol was 2:1 for the best results. Therefore, alum-borneol incorporated polyvinyl pyrrolidone fibers can significantly improve the dissolution rate of borneol, which opens up a new way for the combined application of the alum and borneol.
Collapse
Affiliation(s)
- Yarong Lv
- Beijing Key Laboratory of Advanced Functional Polymer Composites, College of Material Science and Engineering, Beijing University of Chemical Technology, Beijing, 100029, China
| | - Yufen Han
- Beijing Key Laboratory of Advanced Functional Polymer Composites, College of Material Science and Engineering, Beijing University of Chemical Technology, Beijing, 100029, China
| | - Zhongxun Yu
- Beijing Key Laboratory of Advanced Functional Polymer Composites, College of Material Science and Engineering, Beijing University of Chemical Technology, Beijing, 100029, China
| | - Jia Chen
- Beijing Key Laboratory of Advanced Functional Polymer Composites, College of Material Science and Engineering, Beijing University of Chemical Technology, Beijing, 100029, China
| | - Chenxi Li
- Beijing Key Laboratory of Advanced Functional Polymer Composites, College of Material Science and Engineering, Beijing University of Chemical Technology, Beijing, 100029, China
| | - Ce Wang
- Alan G. MacDiarmid Institute, Jilin University, Changchun, 130012, Jilin, China
| | - Ping Hu
- Department of Chemical Engineering, Tsinghua University, Beijing, 100084, China
| | - Yong Liu
- Beijing Key Laboratory of Advanced Functional Polymer Composites, College of Material Science and Engineering, Beijing University of Chemical Technology, Beijing, 100029, China.
| |
Collapse
|
15
|
Zeng Z. Impact of Status quo and Resistance to Innovation on the Failure of Detection and Prevention Strategies of Drugs Control Committee in Malaysia. Front Psychol 2022; 13:922785. [PMID: 35800947 PMCID: PMC9255556 DOI: 10.3389/fpsyg.2022.922785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 05/17/2022] [Indexed: 11/26/2022] Open
Abstract
The detection and prevention strategies for drug control have gained significant attention from the drug control committees globally and need the researchers’ attention to improve these strategies worldwide. Hence, this research investigates the impact of the status quo (SQ) and resistance to the innovative nature of the drug control committee on the failure of detection and prevention strategies (FDPS) in Malaysia. This article also analyzes the mediating role of poor team performance (PTP) among the SQ and resistance to the innovative nature of the drug control committee and the FDPS in Malaysia. This study has employed the primary data collection ways such as questionnaires to gather the data from selected respondents. The researchers also applied the SPSS-AMOS to check the association among variables and testing of hypotheses. The results revealed that the SQ and resistance to the innovative nature of the drug control committee have a positive association with the FDPS in Malaysia. The findings have also exposed that PTP significantly mediates between the SQ and resistance to the innovative nature of the drug control committee and the FDPS in Malaysia. This study guides the policymakers that they should develop the policies that eliminate the SQ nature and motivate the committee to adopt innovations that enhance the team performance and success of detection and prevention strategies in Malaysia.
Collapse
|
16
|
Elkenawy NM, Karam HM, Aboul-Magd DS. Development of gamma irradiated SSD-embedded hydrogel dyed with prodigiosin as a smart wound dressing: Evaluation in a MDR infected burn rat model. Int J Biol Macromol 2022; 211:170-182. [DOI: 10.1016/j.ijbiomac.2022.05.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 05/04/2022] [Accepted: 05/08/2022] [Indexed: 11/25/2022]
|
17
|
Xu C, Xia Y, Jia Z, Wang S, Zhao T, Wu L. The curative effect of Shenfu-injection in the treatment of burn sepsis and its effect on the patient's immune function, HMGB, and vWF. Am J Transl Res 2022; 14:2428-2435. [PMID: 35559405 PMCID: PMC9091091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 02/23/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To investigate and analyze the immune regulatory effect of Shenfu-Injection (SFI) on patients with burn-injured sepsis by monitoring the serum level of high mobility group box 1 (HMGB1) and von Willebrand factor (vWF). METHODS In this retrospective study, the Acute Physiology and Chronic Health Evaluation (APACHE II) score, Marshall score, peripheral blood T lymphocyte count, and NK cell concentration, levels of cytokines such as HMGB-1, and vWF in peripheral blood before and after treatment in patients from the control group (convention treatments, n=51) and the observation group (convention treatments plus SFI treatment, n=57) were analyzed. The prognosis of the two groups of patients at 28 days was analyzed and compared. RESULTS After treatment, APACHE II score, Marshall score, IL-6, CPR, HMGB-1, and vWF in patients from the two groups decreased greatly when compared with those before the treatment (P<0.05). The APACHE II score, Marshall score, IL-6, CPR, HMGB-1, and vWF in the group for observation were significantly lower (P<0.05) than those in the control group. Concentrations of CD3+, CD4+, and NK cells in these two groups after 7 days of treatment were greatly higher than those before the treatment (P<0.05). Concentrations of CD3+, CD4+, and NK cells in the observation group were higher than those in the control group after treatment (P<0.05). There was no significant difference in terms of mortality between these two groups after 28 days (P<0.05). The average survival time of the non-survivors in the observation group was significantly longer than that in the control group (P<0.05). CONCLUSION SFI can effectively improve the immunity of patients with burn-injured sepsis, reduce the expression of cytokines such as HMGB and vWF, and is of great help for the improvement of clinical prognosis.
Collapse
Affiliation(s)
- Chuanzhen Xu
- Department of Burn and Plastic Surgery, Binzhou Medical University HospitalBinzhou 256603, Shandong, China
| | - Yongfu Xia
- Department of Respiratory and Critical Care Medicine, Binzhou Medical University HospitalBinzhou 256603, Shandong, China
| | - Zhuting Jia
- Department of Emergency Medicine, Binzhou Medical University HospitalBinzhou 256603, Shandong, China
| | - Shasha Wang
- Department of Respiratory and Critical Care Medicine, Binzhou Medical University HospitalBinzhou 256603, Shandong, China
| | - Tongzhen Zhao
- Department of Oncology, Binzhou Municipal Hospital of Traditional Chinese MedicineBinzhou 256603, Shandong, China
| | - Liqiang Wu
- Department of Emergency Medicine, Binzhou Medical University HospitalBinzhou 256603, Shandong, China
| |
Collapse
|
18
|
Pourhajibagher M, Pourakbari B, Bahador A. Contribution of antimicrobial photo-sonodynamic therapy in wound healing: an in vivo effect of curcumin-nisin-based poly (L-lactic acid) nanoparticle on Acinetobacter baumannii biofilms. BMC Microbiol 2022; 22:28. [PMID: 35039005 PMCID: PMC8762960 DOI: 10.1186/s12866-022-02438-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 01/07/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The biofilm-forming ability of Acinetobacter baumannii in the burn wound is clinically problematic due to the development of antibiotic-resistant characteristics, leading to new approaches for treatment being needed. In this study, antimicrobial photo-sonodynamic therapy (aPSDT) was used to assess the anti-biofilm efficacy and wound healing activity in mice with established A. baumannii infections. METHODS Following synthesis and confirmation of Curcumin-Nisin-based poly (L-lactic acid) nanoparticle (CurNisNp), its cytotoxic and release times were evaluated. After determination of the sub-significant reduction (SSR) doses of CurNisNp, irradiation time of light, and ultrasound intensity against A. baumannii, anti-biofilm activity and the intracellular reactive oxygen species (ROS) generation were evaluated. The antibacterial and anti-virulence effects, as well as, histopathological examination of the burn wound sites of treated mice by CurNisNp-mediated aPSDTSSR were assessed and compared with silver sulfadiazine (SSD) as the standard treatment group. RESULTS The results showed that non-cytotoxic CurNisNp has a homogeneous surface and a sphere-shaped vesicle with continuous release until the 14th day. The dose-dependent reduction in cell viability of A. baumannii was achieved by increasing the concentrations of CurNisNp, irradiation time of light, and ultrasound intensity. There was a time-dependent reduction in biofilm growth, changes in gene expression, and promotion in wound healing by the acceleration of skin re-epithelialization in mice. Not only there was no significant difference between aPSDTSSR and SSD groups in antibacterial and anti-virulence activities, but also wound healing and re-epithelialization occurred more efficiently in aPSDTSSR than in the SSD group. CONCLUSIONS In conclusion, CurNisNp-mediated aPSDT might be a promising complementary approach to treat burn wound infections.
Collapse
Affiliation(s)
- Maryam Pourhajibagher
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Babak Pourakbari
- Pediatric Infectious Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Bahador
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
- Fellowship in Clinical Laboratory Sciences, BioHealth Lab, Tehran, Iran.
| |
Collapse
|
19
|
Wang P, Zhang Z, Yin B, Li J, Xialin C, Lian W, Su Y, Jia C. Identifying changes in immune cells and constructing prognostic models using immune-related genes in post-burn immunosuppression. PeerJ 2022; 10:e12680. [PMID: 35070500 PMCID: PMC8761370 DOI: 10.7717/peerj.12680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 12/02/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Burn patients are prone to infection as well as immunosuppression, which is a significant cause of death. Currently, there is a lack of prognostic biomarkers for immunosuppression in burn patients. This study was conducted to identify immune-related genes that are prognosis biomarkers in post-burn immunosuppression and potential targets for immunotherapy. METHODS We downloaded the gene expression profiles and clinical data of 213 burn patients and 79 healthy samples from the Gene Expression Omnibus (GEO) database. Immune infiltration analysis was used to identify the proportion of circulating immune cells. Functional enrichment analyses were carried out to identify immune-related genes that were used to build miRNA-mRNA networks to screen key genes. Next, we carried out correlation analysis between immune cells and key genes that were then used to construct logistic regression models in GSE77791 and were validated in GSE19743. Finally, we determined the expression of key genes in burn patients using quantitative reverse transcription polymerase chain reaction (qRT-PCR). RESULTS A total of 745 differently expressed genes were screened out: 299 were up-regulated and 446 were down-regulated. The number of Th-cells (CD4+) decreased while neutrophils increased in burn patients. The enrichment analysis showed that down-regulated genes were enriched in the T-cell activation pathway, while up-regulated genes were enriched in neutrophil activation response in burn patients. We screened out key genes (NFATC2, RORA, and CAMK4) that could be regulated by miRNA. The expression of key genes was related to the proportion of Th-cells (CD4+) and survival, and was an excellent predictor of prognosis in burns with an area under the curve (AUC) value of 0.945. Finally, we determined that NFATC2, RORA, and CAMK4 were down-regulated in burn patients. CONCLUSION We found that NFATC2, RORA, and CAMK4 were likely prognostic biomarkers in post-burn immunosuppression and potential immunotherapeutic targets to convert Th-cell dysfunction.
Collapse
Affiliation(s)
- Peng Wang
- Department of Burns and Plastic & Wound Repair Surgery, Xiang’an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Zexin Zhang
- Department of Burns and Plastic & Wound Repair Surgery, Xiang’an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Bin Yin
- Department of Burns and Plastic & Wound Repair Surgery, Xiang’an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Jiayuan Li
- Department of Anesthesia Operation, Xiang’an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Cheng Xialin
- Department of Burns and Plastic & Wound Repair Surgery, Xiang’an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Wenqin Lian
- Department of Burns and Plastic & Wound Repair Surgery, Xiang’an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Yingjun Su
- Department of Burns and Plastic Surgery, Plastic Surgery Hospital, Xi’an International Medical Center, Xi’an, Shaanxi, China
| | - Chiyu Jia
- Department of Burns and Plastic & Wound Repair Surgery, Xiang’an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| |
Collapse
|
20
|
Dyamenahalli K, Choy K, Frank DN, Najarro K, Boe D, Colborn KL, Idrovo JP, Wagner AL, Wiktor AJ, Afshar M, Burnham EL, McMahan RH, Kovacs EJ. Age and Injury Size Influence the Magnitude of Fecal Dysbiosis in Adult Burn Patients. J Burn Care Res 2022; 43:1145-1153. [PMID: 35020913 PMCID: PMC9435505 DOI: 10.1093/jbcr/irac001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Clinical studies have demonstrated that age 50 years or older is an independent risk factor associated with poor prognosis after burn injury, the second leading cause of traumatic injuries in the aged population. While mechanisms driving age-dependent postburn mortality are perplexing, changes in the intestinal microbiome, may contribute to the heightened, dysregulated systemic response seen in aging burn patients. The fecal microbiome from 22 patients admitted to a verified burn center from July 2018 to February 2019 was stratified based on the age of 50 years and total burn surface area (TBSA) size of ≥10%. Significant differences (P = .014) in overall microbiota community composition (ie, beta diversity) were measured across the four patient groups: young <10% TBSA, young ≥10% TBSA, older <10% TBSA, and older ≥10% TBSA. Differences in beta diversity were driven by %TBSA (P = .013) and trended with age (P = .087). Alpha diversity components, richness, evenness, and Shannon diversity were measured. We observed significant differences in bacterial species evenness (P = .0023) and Shannon diversity (P = .0033) between the groups. There were significant correlations between individual bacterial species and levels of short-chain fatty acids. Specifically, levels of fecal butyrate correlated with the presence of Enterobacteriaceae, an opportunistic gut pathogen, when elevated in burn patients lead to worsen outcomes. Overall, our findings reveal that age-specific changes in the fecal microbiome following burn injuries may contribute to immune system dysregulation in patients with varying TBSA burns and potentially lead to worsened clinical outcomes with heightened morbidity and mortality.
Collapse
Affiliation(s)
| | | | - Daniel N Frank
- Department of Medicine, Division of Infectious Diseases, University of Colorado Anschutz Medical Campus, Aurora, USA,Gastrointestinal and Liver and Innate Immunity Program, University of Colorado Anschutz Medical Campus, Aurora, USA
| | - Kevin Najarro
- Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, USA,Rocky Mountain Regional VA Medical Center, VA Eastern Colorado Health Care System Research Service, Aurora, USA
| | - Devin Boe
- Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, USA
| | - Kathryn L Colborn
- Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, USA
| | - Juan-Pablo Idrovo
- Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, USA
| | - Anne L Wagner
- Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, USA
| | - Arek J Wiktor
- Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, USA
| | - Majid Afshar
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, USA
| | - Ellen L Burnham
- Department of Medicine, Pulmonary Sciences and Critical Care Medicine, University of Colorado Anschutz Medical Campus, Aurora, USA
| | - Rachel H McMahan
- Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, USA,Rocky Mountain Regional VA Medical Center, VA Eastern Colorado Health Care System Research Service, Aurora, USA
| | - Elizabeth J Kovacs
- Address correspondence to Elizabeth J. Kovacs, PhD, Department of Surgery, GITES, University of Colorado Anschutz Medical Campus, 12700 East 19th Ave, RC2, Mail Stop #8620, Aurora, CO 80045, USA.
| |
Collapse
|
21
|
Li N, Li X, Li J, Yang M, Ren L, Li C. Preparation of Silver Ion Antimicrobial Dressings and Prevention and Treatment of Central Venous Catheter-Related Infection on Burn Wounds of Critically Burned Patients. J BIOMATER TISS ENG 2022. [DOI: 10.1166/jbt.2022.2861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
To further understand the characteristics of Ag+ antimicrobial dressings and its application value in the prevention and treatment of infections in burn patients, in the study, the Ag+ gel dressings were prepared and their physical and chemical characteristics
were analyzed, and relationship between the gel dressing and central venous catheter (CVC)-related infections was further explored. The results showed that silver nitrate was made into nano silver particles, and its structure was clearly visible under microscope, and nano silver was further
applied to preparation of Ag+ antibacterial dressings. Fibrocytes were clearly visible in Ag+ gel dressing and arranged uniformly, which indicated that Ag+ gel dressing had good compatibility with biological materials and had no obvious toxicity. Further clinical
trials showed that Ag+ gel dressing can effectively reduce CVC-related infections. From 1 to 4 weeks of the experiment, the bacterial infection rate in burn wounds and blood of the treatment group (TG), which applied Ag+ gel dressing, was lower than the control group
(P < 0.05). During the treatment, the burn healing rate of the TG was also greatly higher than the control group (P < 0.05). In addition, the burn wound exudate in the TG was greatly less than the control group (P < 0.05). In summary, the Ag+ gel dressing
prepared has good biological and physical and chemical properties, which have bright prospects in the prevention and treatment of burn wounds and CVC-related infections. This study provides an experimental basis for clinical application of Ag+ gel dressing.
Collapse
Affiliation(s)
- Na Li
- Department of Burns and Plastic Surgery, The First Hospital of Hebei Medical University, Shijiazhaung City, 050031, China
| | - Xi Li
- Department of Burns and Plastic Surgery, The First Hospital of Hebei Medical University, Shijiazhaung City, 050031, China
| | - Juan Li
- Department of Burns and Plastic Surgery, The First Hospital of Hebei Medical University, Shijiazhaung City, 050031, China
| | - Meng Yang
- Department of Burns and Plastic Surgery, The First Hospital of Hebei Medical University, Shijiazhaung City, 050031, China
| | - Liqing Ren
- Department of Burns and Plastic Surgery, The First Hospital of Hebei Medical University, Shijiazhaung City, 050031, China
| | - Cuikun Li
- Department of Burns and Plastic Surgery, The First Hospital of Hebei Medical University, Shijiazhaung City, 050031, China
| |
Collapse
|
22
|
Musick KL, Jones SL, Norris AM, Hochstetler LJ, Williams FN, McKinzie BP. Evaluation of Voriconazole and Posaconazole Dosing in Patients with Thermal Burn Injuries. J Burn Care Res 2021; 43:802-807. [PMID: 34672325 DOI: 10.1093/jbcr/irab200] [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] [Indexed: 11/14/2022]
Abstract
Fungal infections are a recognized cause of increased morbidity and mortality in thermal burn patients. Adequate treatment regimens remain a challenge due to unpredictable pharmacokinetic/pharmacodynamic changes caused by a hypermetabolic state and individual patient factors. A retrospective evaluation of adult thermal burn patients from April 2014 to April 2020 was conducted to assess voriconazole and posaconazole antifungal dosing regimens. The primary outcome was the incidence of attaining a therapeutic steady-state trough level on the patient's initial voriconazole or posaconazole regimen. Of the 35 patients analyzed, 28 (80.0%) patients achieved a therapeutic level during azole therapy. However, only 13 (46.4%) patients achieved a therapeutic level on their first azole regimen. The median time to therapeutic level was 8.0 + 21.1 days from the start of azole therapy. Optimal dosing strategies for azole therapy in patients with thermal burns remains undefined. Further assessment is needed to delineate patient-specific factors that can contribute to subtherapeutic azole levels in thermal burn patients and the overall clinical impact of population-specific dosing regimens.
Collapse
Affiliation(s)
- Kaitlin L Musick
- Department of Pharmacy, University of North Carolina Medical Center, Chapel Hill, USA
| | - Savannah L Jones
- Department of Pharmacy, University of North Carolina Medical Center, Chapel Hill, USA
| | - Ashlyn M Norris
- Department of Pharmacy, University of North Carolina Medical Center, Chapel Hill, USA
| | - Lauren J Hochstetler
- Department of Pharmacy, University of North Carolina Medical Center, Chapel Hill, USA
| | - Felicia N Williams
- Jaycee Burn Center, University of North Carolina Medical Center, Chapel Hill, USA
| | - Brian P McKinzie
- Department of Pharmacy, University of North Carolina Medical Center, Chapel Hill, USA
| |
Collapse
|
23
|
Multidrug-resistant Bacterial Profile and Patterns for Wound Infections in Nongovernmental Hospitals of Jordan. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2021. [DOI: 10.22207/jpam.15.3.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Globally, multidrug-resistant bacteria affects wound infections, both hospital-acquired infections and community-acquired infections. The main isolates cultured from 607 subjects with wound infections were methicillin-resistant Staphylococcus aureus (MRSA), Escherichia coli, Pseudomonas aeruginosa, and Acinetobacter spp. [multidrug resistant (MDR)]. Gram-negative bacteria caused most of the infections (67%) compared with gram-positive bacteria. Diabetic patients tend to have wound infections with mixed causative agents compared with non-diabetic patients.
Collapse
|
24
|
Molecular detection of extended spectrum β-lactamases, metallo β-lactamases, and Amp-Cβ-lactamase genes expressed by multiple drug resistant Pseudomonas aeruginosa isolates collected from patients with burn/wound infections. BURNS OPEN 2020. [DOI: 10.1016/j.burnso.2020.07.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
|
25
|
Melnikova N, Vorobyova O, Balakireva A, Malygina D, Solovyeva A, Belyaeva K, Orekhov D, Knyazev A. The New Pharmaceutical Compositions of Zinc Oxide Nanoparticles and Triterpenoids for the Burn Treatment. Pharmaceuticals (Basel) 2020; 13:E207. [PMID: 32842689 PMCID: PMC7558657 DOI: 10.3390/ph13090207] [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: 08/10/2020] [Revised: 08/18/2020] [Accepted: 08/19/2020] [Indexed: 02/06/2023] Open
Abstract
We studied oleogels containing zinc oxide nanoparticles (ZnO NPs) and lupane triterpenoids in sunflower oil for the treatment of burns. The modification of ZnO was carried out by treatment with alcohol solutions of betulin, betulonic acid, betulin diacetate and betulin diphosphate. The properties of modified ZnO NPs were studied by powder XRD (average sizes of 10-20 nm), FTIR (νZnO 450 cm-1), UV-vis (345-360 nm), and blue-violet emission (380-420 nm). The identification and assay of modified ZnO NPs and triterpenoids were estimated. The treatment by oleogels of deep II-degree burns was studied on rats using histological studies, Doppler flowmetry and evaluation of enzymes activity and malonic dialdehyde (MDA) level. After the action of oleogels, burn wound area, and the necrosis decreased twice on the 10th day in comparison with the 1st day after burn. The microcirculation index in the near-wound zone by 20-30% improved compared with the group without treatment. Evaluation of the enzyme activity and the MDA level after treatment by oleogels during the course of 10 days showed them returning to normal. The improvement of antioxidant biochemical indexes, as well as wounds' healing, was mainly determined by the influence of zinc oxide nanoparticles.
Collapse
Affiliation(s)
- Nina Melnikova
- Department of Pharmaceutical Chemistry, Privolzhsky Research Medical University, 10/1 Minin sq., 603950 Nizhny Novgorod, Russia; (O.V.); (A.B.); (D.M.); (A.S.); (K.B.)
| | - Olga Vorobyova
- Department of Pharmaceutical Chemistry, Privolzhsky Research Medical University, 10/1 Minin sq., 603950 Nizhny Novgorod, Russia; (O.V.); (A.B.); (D.M.); (A.S.); (K.B.)
| | - Alyona Balakireva
- Department of Pharmaceutical Chemistry, Privolzhsky Research Medical University, 10/1 Minin sq., 603950 Nizhny Novgorod, Russia; (O.V.); (A.B.); (D.M.); (A.S.); (K.B.)
| | - Darina Malygina
- Department of Pharmaceutical Chemistry, Privolzhsky Research Medical University, 10/1 Minin sq., 603950 Nizhny Novgorod, Russia; (O.V.); (A.B.); (D.M.); (A.S.); (K.B.)
| | - Anna Solovyeva
- Department of Pharmaceutical Chemistry, Privolzhsky Research Medical University, 10/1 Minin sq., 603950 Nizhny Novgorod, Russia; (O.V.); (A.B.); (D.M.); (A.S.); (K.B.)
| | - Kseniya Belyaeva
- Department of Pharmaceutical Chemistry, Privolzhsky Research Medical University, 10/1 Minin sq., 603950 Nizhny Novgorod, Russia; (O.V.); (A.B.); (D.M.); (A.S.); (K.B.)
| | - Dmitry Orekhov
- Department of Engineering Physics and Chemistry, Nizhny Novgorod State Technical University n.a. R.E. Alekseev, 24 Minin st., 603950 Nizhny Novgorod, Russia;
| | - Alexander Knyazev
- Faculty of Chemistry, Lobachevsky University, 23/5 Gagarin Av., 603950 Nizhny Novgorod, Russia;
| |
Collapse
|