1
|
Davies A, Spickett-Jones F, Jenkins A, Young A. A systematic review of intervention studies demonstrates the need to develop a minimum set of indicators to report the presence of burn wound infection. Burns 2020; 46:1487-1497. [DOI: 10.1016/j.burns.2020.03.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 12/15/2019] [Accepted: 03/20/2020] [Indexed: 01/29/2023]
|
2
|
Vacaras S, Baciut M, Lucaciu O, Dinu C, Baciut G, Crisan L, Hedesiu M, Crisan B, Onisor F, Armencea G, Mitre I, Barbur I, Kretschmer W, Bran S. Understanding the basis of medical use of poly-lactide-based resorbable polymers and composites – a review of the clinical and metabolic impact. Drug Metab Rev 2019; 51:570-588. [DOI: 10.1080/03602532.2019.1642911] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- Sergiu Vacaras
- Department of Cranio-Maxillofacial Surgery, “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Mihaela Baciut
- Department of Oral Rehabilitation, Maxillofacial Surgery and Implantology, “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Ondine Lucaciu
- Department of Oral Rehabilitation, Maxillofacial Surgery and Implantology, “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Cristian Dinu
- Department of Cranio-Maxillofacial Surgery, “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Grigore Baciut
- Department of Cranio-Maxillofacial Surgery, “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Liana Crisan
- Department of Cranio-Maxillofacial Surgery, “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Mihaela Hedesiu
- Department of Cranio-Maxillofacial Surgery, “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Bogdan Crisan
- Department of Oral Rehabilitation, Maxillofacial Surgery and Implantology, “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Florin Onisor
- Department of Cranio-Maxillofacial Surgery, “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Gabriel Armencea
- Department of Cranio-Maxillofacial Surgery, “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Ileana Mitre
- Department of Oral Rehabilitation, Maxillofacial Surgery and Implantology, “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Ioan Barbur
- Department of Oral Rehabilitation, Maxillofacial Surgery and Implantology, “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Winfried Kretschmer
- Department of Oral Rehabilitation, Maxillofacial Surgery and Implantology, “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Simion Bran
- Department of Oral Rehabilitation, Maxillofacial Surgery and Implantology, “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| |
Collapse
|
3
|
Satish L, Gallo PH, Johnson S, Yates CC, Kathju S. Local Probiotic Therapy with Lactobacillus plantarum Mitigates Scar Formation in Rabbits after Burn Injury and Infection. Surg Infect (Larchmt) 2016; 18:119-127. [PMID: 27788042 DOI: 10.1089/sur.2016.090] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Infection is the most common complication in burn-injured patients and is believed to contribute to the hypertrophic scarring frequently observed in such injury. Pseudomonas aeruginosa is a common pathogen in burn wound infection. We examined the effect of local probiotic therapy with Lactobacillus plantarum on the severity of the scarring following burn wounding and infection with P. aeruginosa in a rabbit model. METHODS Full-thickness burn wounds were inoculated with control vehicle or L. plantarum; wounds were then challenged with bioluminescent P. aeruginosa. The time course of the ensuing infection was monitored by quantification of the emitted light. After allowing wounds to contract to near completion, they were harvested and analyzed for markers of scar formation. RESULTS Application of L. plantarum curtailed both the severity and the length of the pseudomonal infection. Probiotic therapy significantly reduced both Type I collagen mRNA concentrations and total collagen protein accumulation in infected wounds, consistent with reduced scarring. Surprisingly, the probiotic showed a nearly equivalent effect in uninfected wounds. Masson's trichrome staining confirmed these findings histologically. CONCLUSIONS Lactobacillus plantarum shows exciting potential as a therapeutic agent to both counteract burn wound infection and to alleviate scarring even in the absence of infection.
Collapse
Affiliation(s)
- Latha Satish
- 1 McGowan Institute for Regenerative Medicine , Pittsburgh, Pennsylvania.,2 Department of Plastic and Reconstructive Surgery, University of Pittsburgh , Pittsburgh
| | - Phillip H Gallo
- 2 Department of Plastic and Reconstructive Surgery, University of Pittsburgh , Pittsburgh
| | - Sandra Johnson
- 2 Department of Plastic and Reconstructive Surgery, University of Pittsburgh , Pittsburgh
| | - Cecelia C Yates
- 1 McGowan Institute for Regenerative Medicine , Pittsburgh, Pennsylvania.,3 Department of Health Promotion and Development, School of Nursing, University of Pittsburgh , Pittsburgh.,4 Department of Pathology, School of Medicine, University of Pittsburgh , Pittsburgh
| | - Sandeep Kathju
- 1 McGowan Institute for Regenerative Medicine , Pittsburgh, Pennsylvania.,2 Department of Plastic and Reconstructive Surgery, University of Pittsburgh , Pittsburgh
| |
Collapse
|
4
|
Argenta A, Satish L, Gallo P, Liu F, Kathju S. Local Application of Probiotic Bacteria Prophylaxes against Sepsis and Death Resulting from Burn Wound Infection. PLoS One 2016; 11:e0165294. [PMID: 27780258 PMCID: PMC5079594 DOI: 10.1371/journal.pone.0165294] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 10/05/2016] [Indexed: 12/22/2022] Open
Abstract
Objective To determine if local prophylactic application of probiotic bacteria to burn wounds will prevent death in a mouse model of burn wound sepsis. Background Infection remains the most common complication after burn injury and can result in sepsis and death, despite the use of topical and systemic antibiotics. Pseudomonas aeruginosa is a frequently implicated pathogen. Local application of probiotics directly to burn wounds is an attractive novel intervention that avoids the pitfalls of standard antibiotic therapies. Methods A burn-sepsis model was established using a sub-eschar injection of bioluminescent P. aeruginosa; infection was tracked using a charge-coupled camera. Full-thickness burn injuries were placed on the dorsums of adult mice; the injured sites were then treated with vehicle (burn wound control), probiotics (Lactobacillus plantarum only), pathogenic bacteria (Pseudomonas aeruginosa only), or probiotics plus pathogen (Lactobacillus plus Pseudomonas). Animals were monitored until death/moribundity or for one week, then sacrificed. Harvested tissues were subjected to imaging and molecular assays. Results Control and probiotic-only animals showed no mortality (100% survival) at one week. Pseudomonas-only animals showed > 90% mortality within 40 hours of infection. In contrast, animals treated with probiotics plus Pseudomonas showed less than 10% mortality. Use of bioluminescent Pseudomonas bacteria demonstrated that probiotic therapy inhibited septicemic accumulation of the pathogen in remote organs. In addition, probiotic therapy successfully suppressed the infection-dependent induction of TNF-α and interleukins 6 and 10 in the liver. Conclusions Local probiotic therapy shows great potential as a valuable adjunct in the management of complicated burn injury.
Collapse
Affiliation(s)
- Anne Argenta
- Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, United States of America
| | - Latha Satish
- Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, United States of America
- McGowan Institute for Regenerative Medicine, Pittsburgh, PA, United States of America
| | - Phillip Gallo
- Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, United States of America
| | - Fang Liu
- Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, United States of America
| | - Sandeep Kathju
- Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, United States of America
- McGowan Institute for Regenerative Medicine, Pittsburgh, PA, United States of America
- * E-mail:
| |
Collapse
|
5
|
Isitt CE, McCloskey KA, Caballo A, Sharma P, Williams A, Leon-Villapalos J, Vizcaychipi MP. An analysis of surgical and anaesthetic factors affecting skin graft viability in patients admitted to a Burns Intensive Care Unit. Scars Burn Heal 2016; 2:2059513116642089. [PMID: 29799557 PMCID: PMC5965314 DOI: 10.1177/2059513116642089] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
After large burns injuries, patients require fluid to be given via an IV drip.
This is often very large volumes of fluid, much higher than would normally be
required in other medical conditions. When the area of burn is very large
multiple operations are often required and during these operations, IV fluids
are again used to keep the blood pressure normal and keep the patient hydrated.
We looked at the hospital records of 35 patients to see if there was any link
between the drugs and fluids given during these operations and the success of
the skin grafts performed in these operations. We found that using a particular
type of fluid called a colloid fluid, which allows smaller volumes to be given
for the same effect on blood pressure and hydration, was more common in patients
whose skin grafts subsequently required further surgery due to poor healing. A
larger study would now be required to see if this type of fluid is causing poor
healing or whether it is a coincidental finding only.
Collapse
Affiliation(s)
- Catherine E Isitt
- Department of Anaesthetics and Intensive Care, Chelsea and Westminster Hospital NHS Trust, London SW10 9NH, UK
| | - Kayleigh A McCloskey
- Department of Anaesthetics and Intensive Care, Chelsea and Westminster Hospital NHS Trust, London SW10 9NH, UK
| | - Alvaro Caballo
- Department of Plastics and Burns Surgery, Chelsea and Westminster Hospital NHS Trust, London SW10 9NH, UK
| | - Pranev Sharma
- Department of Anaesthetics and Intensive Care, Chelsea and Westminster Hospital NHS Trust, London SW10 9NH, UK
| | - Andrew Williams
- Department of Plastics and Burns Surgery, Chelsea and Westminster Hospital NHS Trust, London SW10 9NH, UK
| | - Jorge Leon-Villapalos
- Department of Plastics and Burns Surgery, Chelsea and Westminster Hospital NHS Trust, London SW10 9NH, UK
| | - Marcela P Vizcaychipi
- Department of Anaesthetics and Intensive Care, Chelsea and Westminster Hospital NHS Trust, London SW10 9NH, UK.,Faculty of Medicine, Imperial College London, London SW7 2AZ, UK
| |
Collapse
|
6
|
Negative pressure wound therapy of chronically infected wounds using 1% acetic Acid irrigation. Arch Plast Surg 2015; 42:59-67. [PMID: 25606491 PMCID: PMC4297808 DOI: 10.5999/aps.2015.42.1.59] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 12/03/2014] [Accepted: 12/15/2014] [Indexed: 11/08/2022] Open
Abstract
Background Negative-pressure wound therapy (NPWT) induces angiogenesis and collagen synthesis to promote tissue healing. Although acetic acid soaks normalize alkali wound conditions to raise tissue oxygen saturation and deconstruct the biofilms of chronic wounds, frequent dressing changes are required. Methods Combined use of NPWT and acetic acid irrigation was assessed in the treatment of chronic wounds, instilling acetic acid solution (1%) beneath polyurethane membranes twice daily for three weeks under continuous pressure (125 mm Hg). Clinical photographs, pH levels, cultures, and debrided fragments of wounds were obtained pre- and posttreatment. Tissue immunostaining (CD31, Ki-67, and CD45) and reverse transcription-polymerase chain reaction (vascular endothelial growth factor [VEGF], vascular endothelial growth factor receptor [VEGFR]; procollagen; hypoxia-inducible factor 1 alpha [HIF-1-alpha]; matrix metalloproteinase [MMP]-1,-3,-9; and tissue inhibitor of metalloproteinase [TIMP]) were also performed. Results Wound sizes tended to diminish with the combined therapy, accompanied by drops in wound pH (weakly acidic or neutral) and less evidence of infection. CD31 and Ki-67 immunostaining increased (P<0.05) post-treatment, as did the levels of VEGFR, procollagen, and MMP-1 (P<0.05), whereas the VEGF, HIF-1-alpha, and MMP-9/TIMP levels declined (P<0.05). Conclusions By combining acetic acid irrigation with negative-pressure dressings, both the pH and the size of chronic wounds can be reduced and infections be controlled. This approach may enhance angiogenesis and collagen synthesis in wounds, restoring the extracellular matrix.
Collapse
|
7
|
Hajská M, Slobodníková L, Hupková H, Koller J. In vitro efficacy of various topical antimicrobial agents in different time periods from contamination to application against 6 multidrug-resistant bacterial strains isolated from burn patients. Burns 2014; 40:713-8. [DOI: 10.1016/j.burns.2013.09.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Revised: 09/02/2013] [Accepted: 09/03/2013] [Indexed: 11/26/2022]
|
8
|
Selig HF, Keck M, Lumenta DB, Mittlböck M, Kamolz LP. The use of a polylactide-based copolymer as a temporary skin substitute in deep dermal burns: 1-year follow-up results of a prospective clinical noninferiority trial. Wound Repair Regen 2013; 21:402-9. [DOI: 10.1111/wrr.12050] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2012] [Accepted: 01/30/2013] [Indexed: 11/29/2022]
Affiliation(s)
| | - Maike Keck
- Vienna Burn Center; Division of Plastic and Reconstructive Surgery; Department of Surgery; Medical University of Vienna; Vienna; Austria
| | - David B. Lumenta
- Division of Plastic, Aesthetic and Reconstructive Surgery; Department of Surgery; Medical University Graz; Graz; Austria
| | - Martina Mittlböck
- Informatics and Intelligent Systems; Section for Clinical Biometrics; Medical University Vienna; Vienna; Austria
| | - Lars P. Kamolz
- Division of Plastic, Aesthetic and Reconstructive Surgery; Department of Surgery; Medical University Graz; Graz; Austria
| |
Collapse
|