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Šuca H, Čoma M, Tomšů J, Sabová J, Zajíček R, Brož A, Doubková M, Novotný T, Bačáková L, Jenčová V, Kuželová Košťáková E, Lukačín Š, Rejman D, Gál P. Current Approaches to Wound Repair in Burns: How far Have we Come From Cover to Close? A Narrative Review. J Surg Res 2024; 296:383-403. [PMID: 38309220 DOI: 10.1016/j.jss.2023.12.043] [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: 08/10/2023] [Revised: 12/06/2023] [Accepted: 12/29/2023] [Indexed: 02/05/2024]
Abstract
Burn injuries are a significant global health concern, with more than 11 million people requiring medical intervention each year and approximately 180,000 deaths annually. Despite progress in health and social care, burn injuries continue to result in socioeconomic burdens for victims and their families. The management of severe burn injuries involves preventing and treating burn shock and promoting skin repair through a two-step procedure of covering and closing the wound. Currently, split-thickness/full-thickness skin autografts are the gold standard for permanent skin substitution. However, deep burns treated with split-thickness skin autografts may contract, leading to functional and appearance issues. Conversely, defects treated with full-thickness skin autografts often result in more satisfactory function and appearance. The development of tissue-engineered dermal templates has further expanded the scope of wound repair, providing scar reductive and regenerative properties that have extended their use to reconstructive surgical interventions. Although their interactions with the wound microenvironment are not fully understood, these templates have shown potential in local infection control. This narrative review discusses the current state of wound repair in burn injuries, focusing on the progress made from wound cover to wound closure and local infection control. Advancements in technology and therapies hold promise for improving the outcomes for burn injury patients. Understanding the underlying mechanisms of wound repair and tissue regeneration may provide new insights for developing more effective treatments in the future.
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Affiliation(s)
- Hubert Šuca
- Prague Burn Center, Third Faculty of Medicine, Charles University and Královské Vinohrady University Hospital, Prague, Czech Republic
| | - Matúš Čoma
- Department of Pharmacology, Faculty of Medicine, Pavol Jozef Šafárik University, Košice, Slovak Republic; Department of Biomedical Research, East-Slovak Institute of Cardiovascular Diseases, Inc, Košice, Slovak Republic
| | - Júlia Tomšů
- Laboratory of Biomaterials and Tissue Engineering, Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic
| | - Jana Sabová
- Department of Pharmacology, Faculty of Medicine, Pavol Jozef Šafárik University, Košice, Slovak Republic
| | - Robert Zajíček
- Prague Burn Center, Third Faculty of Medicine, Charles University and Královské Vinohrady University Hospital, Prague, Czech Republic
| | - Antonín Brož
- Laboratory of Biomaterials and Tissue Engineering, Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic
| | - Martina Doubková
- Laboratory of Biomaterials and Tissue Engineering, Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic
| | - Tomáš Novotný
- Department of Orthopaedics, University J.E. Purkině and Masaryk Hospital, Ústí nad Labem, Czech Republic; Department of Histology and Embryology, Second Faculty of Medicine, Charles University, Prague, Czech Republic; Department of Orthopaedic Surgery, Faculty of Medicine in Hradec Králové, Charles University, Hradec Králové, Czech Republic
| | - Lucie Bačáková
- Laboratory of Biomaterials and Tissue Engineering, Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic
| | - Věra Jenčová
- Department of Chemistry, Faculty of Science, Humanities and Education, Technical University of Liberec, Liberec, Czech Republic
| | - Eva Kuželová Košťáková
- Department of Chemistry, Faculty of Science, Humanities and Education, Technical University of Liberec, Liberec, Czech Republic
| | - Štefan Lukačín
- Department of Heart Surgery, East-Slovak Institute of Cardiovascular Diseases, Inc, Košice, Slovak Republic
| | - Dominik Rejman
- Institute of Organic Chemistry and Biochemistry, Czech Academy of Sciences, Prague, Czech Republic
| | - Peter Gál
- Prague Burn Center, Third Faculty of Medicine, Charles University and Královské Vinohrady University Hospital, Prague, Czech Republic; Department of Pharmacology, Faculty of Medicine, Pavol Jozef Šafárik University, Košice, Slovak Republic; Department of Biomedical Research, East-Slovak Institute of Cardiovascular Diseases, Inc, Košice, Slovak Republic; Department of Pharmacognosy and Botany, Faculty of Pharmacy, Comenius University, Bratislava, Slovak Republic; Biomedical Research Center of the Slovak Academy of Sciences, Košice, Slovak Republic.
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Chen J, Zhao X, Qiao L, Huang Y, Yang Y, Chu D, Guo B. Multifunctional On-Demand Removability Hydrogel Dressing Based on in Situ Formed AgNPs, Silk Microfibers and Hydrazide Hyaluronic Acid for Burn Wound Healing. Adv Healthc Mater 2024; 13:e2303157. [PMID: 38247348 DOI: 10.1002/adhm.202303157] [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: 09/19/2023] [Revised: 12/14/2023] [Indexed: 01/23/2024]
Abstract
Elevated temperatures can deactivate tissues in the burn wound area, allowing pathogenic bacteria to multiply on the wound surface, ultimately leading to local or systemic infection. An ideal burn dressing should provide antibacterial properties and facilitate painless dressing changes. Silk microfibers coated with poly (2, 3, 4-trihydroxybenzaldehyde) (referred to as mSF@PTHB) to in situ reduce AgNO3 to silver nanoparticles (AgNPs) in a hydrazide hyaluronic acid-based hydrogel are utilized. The findings indicate a more homogeneous distribution of the silver elements compared to directly doped AgNPs, which also conferred antioxidant and antibacterial properties to the hydrogel. Moreover, hydrogels containing pH-responsive dynamic acylhydrazone bonds can undergo a gel-sol transition in a weak acid environment, leading to the painless removal of adhesive hydrogel dressings. Notably, the on-demand replaceable self-healing antioxidant hydrogel dressing exhibits antibacterial effects and cytocompatibility in vitro, and the wound-healing performance of the hydrogel is validated by treating a burn mouse model with full-thickness skin defects. It is demonstrated that hydrogel dressings offer a viable therapeutic approach to prevent infection and facilitate the healing of burn wounds.
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Affiliation(s)
- Jueying Chen
- State Key Laboratory for Mechanical Behavior of Materials, Frontier Institute of Science and Technology, and Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, 710049, P. R. China
| | - Xin Zhao
- State Key Laboratory for Mechanical Behavior of Materials, Frontier Institute of Science and Technology, and Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, 710049, P. R. China
| | - Lipeng Qiao
- State Key Laboratory for Mechanical Behavior of Materials, Frontier Institute of Science and Technology, and Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, 710049, P. R. China
| | - Ying Huang
- State Key Laboratory for Mechanical Behavior of Materials, Frontier Institute of Science and Technology, and Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, 710049, P. R. China
| | - Yutong Yang
- State Key Laboratory for Mechanical Behavior of Materials, Frontier Institute of Science and Technology, and Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, 710049, P. R. China
| | - Dake Chu
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, P. R. China
| | - Baolin Guo
- State Key Laboratory for Mechanical Behavior of Materials, Frontier Institute of Science and Technology, and Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, 710049, P. R. China
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Ramos C, Lorenz K, Putrinš M, Hind CK, Meos A, Laidmäe I, Tenson T, Sutton JM, Mason AJ, Kogermann K. Fibrous matrices facilitate pleurocidin killing of wound associated bacterial pathogens. Eur J Pharm Sci 2024; 192:106648. [PMID: 37992909 DOI: 10.1016/j.ejps.2023.106648] [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: 05/29/2023] [Revised: 10/20/2023] [Accepted: 11/16/2023] [Indexed: 11/24/2023]
Abstract
Conventional wound infection treatments neither actively promote wound healing nor address the growing problem of antibacterial resistance. Antimicrobial peptides (AMPs) are natural defense molecules, released from host cells, which may be rapidly bactericidal, modulate host-immune responses, and/or act as endogenous mediators for wound healing. However, their routine clinical use has hitherto been hindered due to their instability in the wound environment. Here we describe an electrospun carrier system for topical application of pleurocidin, demonstrating sufficient AMP release from matrices to kill wound-associated pathogens including Acinetobacter baumannii and Pseudomonas aeruginosa. Pleurocidin can be incorporated into polyvinyl alcohol (PVA) fiber matrices, using coaxial electrospinning, without major drug loss with a peptide content of 0.7% w/w predicted sufficient to kill most wound associated species. Pleurocidin retains its activity on release from the electrospun fiber matrix and completely inhibits growth of two strains of A. baumannii (AYE; ATCC 17978) and other ESKAPE pathogens. Inhibition of P. aeruginosa strains (PAO1; NCTC 13437) is, however, matrix weight per volume dependent, with only larger/thicker matrices maintaining complete inhibition. The resulting estimation of pleurocidin release from the matrix reveals high efficiency, facilitating a greater AMP potency. Wound matrices are often applied in parallel or sequentially with the use of standard wound care with biocides, therefore the presence and effect of biocides on pleurocidin potency was tested. It was revealed that combinations displayed additive or modestly synergistic effects depending on the biocide and pathogens which should be considered during the therapy. Taken together, we show that electrospun, pleurocidin-loaded wound matrices have potential to be investigated for wound infection treatment.
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Affiliation(s)
- Celia Ramos
- Institute of Pharmacy, University of Tartu, Nooruse 1, 50411 Tartu, Estonia; Technology Development Group, UK Health Security Agency, Research and Evaluation, Porton Down, Salisbury SP4 0JG, United Kingdom; Institute of Pharmaceutical Science, School of Cancer & Pharmaceutical Science, King´s College London, Franklin-Wilkins Building 150 Stamford Street, London SE1 9NH, United Kingdom
| | - Kairi Lorenz
- Institute of Pharmacy, University of Tartu, Nooruse 1, 50411 Tartu, Estonia
| | - Marta Putrinš
- Institute of Pharmacy, University of Tartu, Nooruse 1, 50411 Tartu, Estonia; Institute of Technology, University of Tartu, Nooruse 1, 50411 Tartu, Estonia
| | - Charlotte K Hind
- Technology Development Group, UK Health Security Agency, Research and Evaluation, Porton Down, Salisbury SP4 0JG, United Kingdom
| | - Andres Meos
- Institute of Pharmacy, University of Tartu, Nooruse 1, 50411 Tartu, Estonia
| | - Ivo Laidmäe
- Institute of Pharmacy, University of Tartu, Nooruse 1, 50411 Tartu, Estonia
| | - Tanel Tenson
- Institute of Technology, University of Tartu, Nooruse 1, 50411 Tartu, Estonia
| | - J Mark Sutton
- Technology Development Group, UK Health Security Agency, Research and Evaluation, Porton Down, Salisbury SP4 0JG, United Kingdom; Institute of Pharmaceutical Science, School of Cancer & Pharmaceutical Science, King´s College London, Franklin-Wilkins Building 150 Stamford Street, London SE1 9NH, United Kingdom
| | - A James Mason
- Institute of Pharmaceutical Science, School of Cancer & Pharmaceutical Science, King´s College London, Franklin-Wilkins Building 150 Stamford Street, London SE1 9NH, United Kingdom
| | - Karin Kogermann
- Institute of Pharmacy, University of Tartu, Nooruse 1, 50411 Tartu, Estonia.
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24. Adv Skin Wound Care 2024; 37:6. [PMID: 38117164 DOI: 10.1097/asw.0000000000000084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
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Hermans MHE. An Introduction to Burn Care: The Sequel. Adv Skin Wound Care 2024; 37:9-18. [PMID: 38117166 DOI: 10.1097/asw.0000000000000081] [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: 12/21/2023]
Abstract
GENERAL PURPOSE To review burn care, with an emphasis on burn-specific issues and treatment. TARGET AUDIENCE This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES After participating in this educational activity, the participant will:1. Select the appropriate treatment guidelines for patients who have burn injuries.2. Identify common complications of major burns.3. Choose the recommended pharmacologic approaches to burn care.
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Affiliation(s)
- Michel H E Hermans
- Founder and President, Hermans Medical Consulting, Hoorn, the Netherlands
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Radzikowska-Büchner E, Łopuszyńska I, Flieger W, Tobiasz M, Maciejewski R, Flieger J. An Overview of Recent Developments in the Management of Burn Injuries. Int J Mol Sci 2023; 24:16357. [PMID: 38003548 PMCID: PMC10671630 DOI: 10.3390/ijms242216357] [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: 09/25/2023] [Revised: 11/09/2023] [Accepted: 11/13/2023] [Indexed: 11/26/2023] Open
Abstract
According to the World Health Organization (WHO), around 11 million people suffer from burns every year, and 180,000 die from them. A burn is a condition in which heat, chemical substances, an electrical current or other factors cause tissue damage. Burns mainly affect the skin, but can also affect deeper tissues such as bones or muscles. When burned, the skin loses its main functions, such as protection from the external environment, pathogens, evaporation and heat loss. Depending on the stage of the burn, the patient's condition and the cause of the burn, we need to choose the most appropriate treatment. Personalization and multidisciplinary collaboration are key to the successful management of burn patients. In this comprehensive review, we have collected and discussed the available treatment options, focusing on recent advances in topical treatments, wound cleansing, dressings, skin grafting, nutrition, pain and scar tissue management.
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Affiliation(s)
- Elżbieta Radzikowska-Büchner
- Department of Plastic, Reconstructive and Maxillary Surgery, National Medical Institute of the Ministry of the Interior and Administration, Wołoska 137 Street, 02-507 Warszawa, Poland;
| | - Inga Łopuszyńska
- Department of Plastic, Reconstructive and Maxillary Surgery, National Medical Institute of the Ministry of the Interior and Administration, Wołoska 137 Street, 02-507 Warszawa, Poland;
| | - Wojciech Flieger
- Department of Human Anatomy, Medical University of Lublin, Jaczewskiego 4 Street, 20-090 Lublin, Poland;
| | - Michał Tobiasz
- Department of Plastic Surgery, Reconstructive Surgery and Burn Treatment, Medical University of Lublin, Krasnystawska 52 Street, 21-010 Łęczna, Poland;
| | - Ryszard Maciejewski
- Faculty of Medicine, University of Warsaw, Żwirki i Wigury 101 Street, 02-089 Warszawa, Poland;
| | - Jolanta Flieger
- Department of Analytical Chemistry, Medical University of Lublin, Chodźki 4A Street, 20-093 Lublin, Poland
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Cogo A, Bignozzi AC, Hermans MHE, Quint BJ, Snels JP, Schultz G. A desiccation compound as a biofilm- and necrosis-removing agent: a case series. J Wound Care 2022; 31:816-822. [DOI: 10.12968/jowc.2022.31.10.816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
Objective: A new compound, Debrichem (DEBx Medical BV, the Netherlands), a topical desiccation agent (TDA), is an active gel that contains an acidic species with a potent hygroscopic action. When in contact with microorganisms and necrosis, rapid desiccation and carbonisation of the proteins in these microorganisms, as well as of the extracellular matrix of biofilms and necrosis, occurs. The resulting ‘precipitate’ rapidly dislodges from the wound bed, resulting in a clean wound which granulates, which is a prerequisite for healing by secondary intention. Method: In a retrospective study, a series of mostly large and hard-to-heal lesions of different aetiologies were treated with a one-time application of the TDA, followed by weekly dressing changes. Results: Of the total of 54 lesions included in this case series, 22 were diagnosed as venous leg ulcers (VLUs), 20 as diabetic foot ulcers (DFUs), nine as post-traumatic, hard-to-heal lesions, two as vascular ulcers and one as an ischaemic ulcer. All of the VLUs, 75% of the DFUs and all of the other lesions reached complete granulation. Conclusion: The use of a TDA may contribute to the consistent, fast and easy removal of both biofilms and necrosis, and hence to wound healing.
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Sabeti S, Ochtli CR, Tay-Lasso E, Whelton M, Burton K, Bernal NO, Joe VC, Chin TL. The Effects of the COVID-19 Pandemic on Burn Clinic. J Burn Care Res 2022; 43:766-771. [PMID: 35488371 PMCID: PMC9047216 DOI: 10.1093/jbcr/irac041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
The COVID-19 pandemic has led to anxiety and fears for the general public. It is unclear how the behavior of people with acute burns and the services available to them has changed during the pandemic. The aim of our observational study was to evaluate our clinic’s experience with patients presenting with burns during the first ten months of the COVID-19 pandemic and determine if delays in presentation and healthcare delivery exist within our burn population. Patients referred to our clinic from March 1, 2020 to Dec 15, 2020 were reviewed for time of presentation after injury. We defined a true delay in presentation of >5 days from date of injury to date of referral for patients who were not inpatients at our facility or received initial care elsewhere prior to referral. Of the 246 patients who were referred to our clinic, during this time period, 199 patients (80.89%) attended their appointments. Our in-person clinic volume from referrals increased in July 2020 with a sharp decrease in August 2020. Our total clinic volume decreased in 2020 from 2019 by about 14%. Referrals to our clinic decreased in 2020 from 2019 by about 34%. Video telehealth visits did not account for the decrease in visits. There was low incidence of delays in presentation to our clinic during the pandemic. Additional investigation is necessary to see if the incidence of burn injury decreased. Despite the pandemic, our clinic remained ready and open to serve the burn population.
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Affiliation(s)
- Sara Sabeti
- Department of Surgery, University of California at Irvine, USA
| | - Ché R Ochtli
- Department of Surgery, University of California at Irvine, USA
| | - Erika Tay-Lasso
- Department of Surgery, University of California at Irvine, USA
| | - Melissa Whelton
- Department of Surgery, University of California at Irvine, USA
| | - Kimberly Burton
- Department of Surgery, University of California at Irvine, USA
| | - Nicole O Bernal
- Department of Surgery, University of California at Irvine, USA
| | - Victor C Joe
- Department of Surgery, University of California at Irvine, USA
| | - Theresa L Chin
- Department of Surgery, University of California at Irvine, USA
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AlAlwan MA, Almomin HA, Shringarpure SD, Habiba NU, Albess AH, Thangavel A, Youssef NN, Al Jabr FA, Alrashid AH, Buhalim RA, Almulhim FK. Survival From Ninety-Five Percent Total Body Surface Area Burn: A Case Report and Literature Review. Cureus 2022; 14:e21903. [PMID: 35265426 PMCID: PMC8898555 DOI: 10.7759/cureus.21903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2022] [Indexed: 11/05/2022] Open
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Strashilov SA, Vasileva P, Kostov S, Yordanov A. TREATMENT WITH THERESIENöL OF SURGICAL DISEASES OF THE SKIN. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2022; 75:2157-2162. [PMID: 36256946 DOI: 10.36740/wlek202209120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Theresienöl is a 100 % natural product representing a mixture of animal and vegetable raw materials from Tyrol. Its exact recipe has been preserved untouched and in deep secret for more than six centuries yet, and has been passed down from generation to generation. Six patients were included in this case series one patient with malignant melanoma of the skin after re-excision with subsequent non-free skin surgical plastic, two patients with III degree skin burning and three patients with infected wound successfully treated with Theresienöl. All of them - before the application of Theresienöl - were treated with different operative methods. The treatment of scars from operative interventions with Theresienöl is very effective. That is why it must start directly after the operative intervention. The therapeutic effect of Theresienöl for postoperative scars is commensurable with and even better than the one of all applied until now local medicines, which makes it an agent of choice in those cases. Theresienöl represents a good alternative to the free skin surgical plastic for small burns of III degree. The local treatment of infected wounds with Theresienoil is more effective and economically sound than the treatment with all the rest types of dressings. The effects from the treatment of different surgical diseases with Theresienöl occur very rapidly, while there is a very good response to local hematomas, pain, and itchiness by the medicine, and there are no side effects from its administration.
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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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da Costa PTL, Echevarría-Guanilo ME, Gonçalves N, Girondi JBR, Gonçalves ADC. Subjective Tools for Burn Scar Assessment: An Integrative Review. Adv Skin Wound Care 2021; 34:1-10. [PMID: 33979826 DOI: 10.1097/01.asw.0000749732.09228.a9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To review the clinical and scientific literature on the subjective ways of assessing burn scars and describe their main characteristics. DATA SOURCES The Latin American, Caribbean Health Sciences Literature, Nursing Database, PubMed, CINAHL, and Scopus and Web of Science databases were used to search for studies published between 2014 and 2018 using descriptors in Portuguese, Spanish, and English. STUDY SELECTION After establishing the research question and the location and definition of the studies, as well as accounting for differences among databases and application of filters based on inclusion and exclusion criteria, 886 references remained. DATA EXTRACTION Investigators reviewed the titles and abstracts of the sample and selected 188 relevant studies for full review. DATA SYNTHESIS Twenty-six subjective forms of assessment were found; most research concerned the Patient and Observer Scar Assessment Scale and the Vancouver Scar Scale. CONCLUSIONS The Patient and Observer Scar Assessment Scale and the Vancouver Scar Scale are the most common scales for assessing burn scars and have similar evaluation points such as vascularization, pliability, pigmentation, and height, which are the main parameters that contribute to the general assessment and severity of a scar. There is a need to improve instructions for application of the scales to facilitate better understanding and improve agreement among evaluators.
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Affiliation(s)
- Pollyana Thays Lameira da Costa
- At the Department of Nursing, Universidade Federal de Santa Catarina, Florianópolis, Brazil, Pollyana Thays Lameira da Costa, MSN, RN, is a Doctorate Student and Maria Elena Echevarría Guanilo, DNP, RN; Natália Gonçalves, PhD, RN; and Juliana Balbinot Reis Girondi, PhD, RN, are Professors. Adriana da Costa Gonçalves, PhD, is Professor of Physical Therapy, Centro Universitário Barão de Mauá de Ribeirão Preto, Brazil. Acknowledgment: This study was completed as part of a scholarship funded by the Higher Education Personnel Improvement Coordination (Coordenação Aperfeiçoamento Pessoal do Nível Superior). The authors have disclosed no other financial relationships related to this article. Submitted September 3, 2020; accepted in revised form November 5, 2020
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Effect and Nursing Satisfaction of Bedside Nursing Combined with Detail Nursing in Clinical Nursing of Gastroenterology Department. JOURNAL OF ONCOLOGY 2021; 2021:6839555. [PMID: 34194497 PMCID: PMC8184348 DOI: 10.1155/2021/6839555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 05/25/2021] [Indexed: 11/17/2022]
Abstract
Objective The purpose of the study was to investigate the therapeutic effect and nursing satisfaction of bedside nursing combined with detail nursing in the gastroenterology department. Methods 112 patients with gastrointestinal diseases admitted to our hospital from November 2018 to November 2019 were selected as the study subjects and randomly divided into a research group (n = 56) and reference group (n = 56). The reference group received routine clinical nursing, while on this basis, the research group received bedside nursing combined with detail nursing. After that, the clinical nursing effects of the two groups were compared. Results There were no significant differences in sex ratio, age, BMI, smoking history, drinking history, marital status, and disease types between the two groups (P > 0.05). The VAS scores in the two groups after intervention were significantly lower than those before intervention (P < 0.01), and the VAS scores in the research group after intervention were significantly lower than those in the reference group (P < 0.01). The nursing ability, nursing skills, and nursing responsibility in the research group were significantly higher than those in the reference group (P < 0.01). There were no significant differences between the two groups in the number of patients who were satisfied and needed improvement (P > 0.05). Besides, the number of very satisfied cases in the research group was significantly higher than that in the reference group (P < 0.05), and the number of unsatisfied cases was significantly lower than that in the reference group (P < 0.05). The total incidence of clinical adverse events in the research group was significantly lower than that in the reference group (P < 0.01). The gastrointestinal diseases related knowledge scores after intervention were significantly higher than those before intervention (P < 0.01), and the gastrointestinal diseases related knowledge scores after intervention in the research group were significantly higher than those in the reference group (P < 0.01). The GQOLI-74 scores after intervention in the two groups were significantly higher than those before intervention (P < 0.01), and the GQOLI-74 scores after intervention in the research group were significantly higher than those in the reference group (P < 0.01). Conclusion The application of bedside nursing mode combined with detail nursing in gastrointestinal diseases can effectively reduce patients' pains, as well as the incidence of clinical adverse events, and improve patients' life quality, with definite curative effect, which is worthy of promotion and application.
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Gao C, Diao J, Jia J, Zhang L. Investigation on Potential of Novel Carrier System Containing Silver and Gold Nanoparticles for Burn Surgery: Evaluation in Rat Model. J BIOMATER TISS ENG 2021. [DOI: 10.1166/jbt.2021.2538] [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
The main aim of the study was to optimization and evaluation of a suitable dosage form i.e., tropical gel containing silver and gold nanoparticles which are synthesized by green synthesis as this is the rapid and better alternative to chemical synthesis. For burn injury systemic route
of administration is not suitable due to damaged skin hence tropical route selected to provide controlled effects, low systemic toxicity and easy application. Silver nanoparticles were synthesized by green synthesis by use of neem leaves and gold nanoparticles by Aloe vera. Characterization
was done by UV spectroscopy, particle size distribution, TEM and zeta potential. Gel was formulated by simple mixing and stirring method and evaluated for color, homogeneity, Spreadability, viscosity, in vitro release, antimicrobial study and in vivo study. In this study, the
combination of Carbopol 934 P and HPMC (ratio 1:3) was found to be ideal formulation (Formulation F5) with optimum viscosity and Spread-ability i.e., 4459 cP and 5.7 gmcm/sec resp. in vitro release was found to be 98.66% in 12 hours. in vitro antimicrobial study and in vivo
study on rat showed maximum effects than standard formulations. From this study it can be concluded that, tropical gel is the superior dosage form containing silver and gold nanoparticles which acts as the antimicrobial agents and is effective in treatment of burn surgery.
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Affiliation(s)
- Cong Gao
- Department of Burn Rehabilitation, Jinan Central Hospital, Cheeloo College of Medicine, Shandong University, Jinan City, 250013, China
| | - Jianjun Diao
- Department of Medical Records Management, Jinan Central Hospital, Cheeloo College of Medicine, Shandong University, Jinan City, 250013, China
| | - Jun Jia
- Department of Burn Rehabilitation, Jinan Central Hospital, Cheeloo College of Medicine, Shandong University, Jinan City, 250013, China
| | - Lei Zhang
- Department of Burn Rehabilitation, Jinan Central Hospital, Cheeloo College of Medicine, Shandong University, Jinan City, 250013, China
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Ercan G, Altinel Y, Karagulle OO, Yiğitbaş H, Hacım NA, Meriç S, Buğdaycı N, Tartar RI, Biltekin B, Yavuz E, Gulcicek OB, Solmaz A, Çelik A. Cordycepin prevents the esophageal stricture formation in the alkali-burn rat model by exerting anti-inflammatory and antifibrotic effects. Acta Cir Bras 2021; 36:e360302. [PMID: 33729331 PMCID: PMC7968946 DOI: 10.1590/acb360302] [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: 11/06/2020] [Accepted: 02/07/2021] [Indexed: 11/25/2022] Open
Abstract
Purpose To investigate the efficacy of cordycepin, an adenosine analogue, on
prevention of esophageal damage and stricture formation due to esophageal
caustic burns in rat model comparing with prednisolone. Methods Caustic esophageal burn was introduced by 37.5% of NaOH to distal esophagus.
Thirty-two Wistar albino rats were divided in four groups: sham rats
undergone laparotomy, treated with 0.9% NaCl; control rats injured with NaOH
without cordycepin treatment; cordycepin group injured with NaOH, treated
with 20 mg/kg cordycepin; prednisolone group injured with NaOH, treated with
1 mg/kg prednisolone for 28 days. Efficacy was assessed by histopathological
and immunohistochemical analysis of esophageal tissues. Results Cordycepin treatment significantly decreased inflammation, granulation tissue
and fibrous tissue formation and prevented formation of esophageal
strictures shown by histopathological damage score and stenosis indexes
compared to control group (p < 0.01). These effects are relatively more
substantial than prednisolone, probably based on attenuation of elevation of
proinflammatory cytokines hypoxia-inducible factor 1-alpha (HIF-1?), tumor
necrosis factor alpha (TNF-?), proliferative and fibrotic factor fibroblast
growth factor 2 (FGF2) and angiogenic factor vascular endothelial growth
factor A (VEGFA) (p < 0.05). Conclusions The findings suggest that cordycepin has a complex multifactorial healing
process in alkali-burned tissue, more successful than prednisolone in
preventing the formation of esophageal strictures and may be used as a
therapeutic agent in the acute phase of esophageal alkali-burn.
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Pittinger TP, Curran D, Hermans MHE. The treatment of paediatric burns with concentrated surfactant gel technology: a case series. J Wound Care 2020; 29:S12-S17. [DOI: 10.12968/jowc.2020.29.sup6.s12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Objective: To assess the safety and efficacy of a surfactant-based technology for the management of burns. Method: In a retrospective review, paediatric patients with different types of burns were treated with the gel technology. In some patients, the treatment was combined with a topical antimicrobial agent. Primary objectives of the review were the assessment of healing, healing times and ease of use of the material. Results: The wounds of 15 paediatric patients with different types of burns, particularly with regard to depth and anatomical location, were evaluated using a retrospective chart review. It was found that the surfactant gel technology, with or without the topical antimicrobial agent, assisted in autolytic debridement, and that time to re-epithelialisation was short and within the range of those obtained with other established treatments. Conclusion: The number of patients and wounds in this evaluation is small but the study indicates that the gel technology provides a safe and effective way to treat smaller burns in paediatric patients.
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Effects of Fibroblast Growth Factor 2 on Burn Injury and Repair Process: Analysis Using a Refined Mouse Model. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e2757. [PMID: 32440425 PMCID: PMC7209900 DOI: 10.1097/gox.0000000000002757] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 02/11/2020] [Indexed: 11/26/2022]
Abstract
Background Burn injury is one of the most debilitating traumas, which induces multiple organ dysfunctions, resulting in high levels of morbidity and mortality. Fibroblast growth factor 2 (FGF2) has been applied to burn injury, whose precise mechanisms underlying facilitating the healing have not been fully understood. Although various animal models have been developed in pigs, rabbits, rats, and mice, no mouse model that creates burns consistent in their extent and depth have not been developed. Here, we developed a mouse burn model, and investigated details of the burn process, and elucidated the mechanisms of FGF2 effects. Methods A device with an 8-mm metal probe and a temperature controller was developed, which controls the temperature of the probe. Using the device, 1 or 2 of full-thickness burn injuries were generated on the back under catagen/telogen of 6-month-old C57BL/6 male mice. After 24 hours, FGF2 or phosphate-buffered saline was injected into the injured region, and at days 3, 5, and 7, histological and immunohistochemical analysis was performed to observe the injury and repair process. Results The device constantly generated a mouse full-thickness burn injury. The repair was initiated on the bottom of the burn as well as the margin. Local treatment with FGF2 displayed higher levels of immunostaining for both CD31+ and alpha-smooth muscle actin. Conclusions The device we developed is useful to generate a mouse burn injury model. FGF2 facilitates tissue repair with an increased number of both CD31+ and αSMA+ cells.
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