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Shahrousvand M, Mirmasoudi SS, Pourmohammadi-Bejarpasi Z, Feizkhah A, Mobayen M, Hedayati M, Sadeghi M, Esmaelzadeh M, Mirkatoul FB, Jamshidi S. Polyacrylic acid/ polyvinylpyrrolidone hydrogel wound dressing containing zinc oxide nanoparticles promote wound healing in a rat model of excision injury. Heliyon 2023; 9:e19230. [PMID: 37654446 PMCID: PMC10466924 DOI: 10.1016/j.heliyon.2023.e19230] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 07/29/2023] [Accepted: 08/16/2023] [Indexed: 09/02/2023] Open
Abstract
Developing and designing efficient wound dressings have gained increasing attention and shown beneficial results in improved wound healing effects. This study was conducted to improve wound healing properties and introduce a novel potential wound dressing. A novel hydrogel based on polyvinylpyrrolidone/poly acrylic acid containing Zinc oxide nanoparticles was prepared as an antibacterial wound dressing and examined in a rat excisional wound model. This hydrogel prepared by free radical polymerization using potassium persulfate (KPS) as an initiator, N, N-methylene bisacrylamide (MBA) as a cross-linker, poly acrylic acid (PAA) as a monomer in the presence of polyvinylpyrrolidone (PVP) and Zinc oxide nanoparticles (ZnO NPs). Analyses such as Scanning Electron Microscope (SEM), Fourier-transform infrared spectroscopy (FTIR), X-ray diffraction analysis (XRD), and Thermal gravimetric analysis (TGA) were used to study morphology structure. After choosing the optimal sample, in vivo characterization of excisional wound injury on a rat model was done. The healing rate and histological analysis were calculated and compared among the groups. The therapeutic potential of the PAA-PVP-ZnO-%2 was investigated in a rat model of excisional injury compared to the control group. Results showed that the polyacrylic acid/polyvinylpyrrolidone hydrogel wound dressing containing zinc oxide nanoparticles accelerated wound contraction, had antibacterial effects, and promoted wound healing compared to other groups.
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Affiliation(s)
- Mohsen Shahrousvand
- Caspian Faculty of Engineering, College of Engineering, University of Tehran, Rezvanshahr, P.O. Box: 43841-119, Guilan, Iran
| | | | | | - Alireza Feizkhah
- Burn and Regenerative Medicine Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammadreza Mobayen
- Burn and Regenerative Medicine Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Mojtaba Hedayati
- Burn and Regenerative Medicine Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Mahsa Sadeghi
- Burn and Regenerative Medicine Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Mojdeh Esmaelzadeh
- Burn and Regenerative Medicine Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Fatemeh Beygom Mirkatoul
- Burn and Regenerative Medicine Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Solma Jamshidi
- Burn and Regenerative Medicine Research Center, Guilan University of Medical Sciences, Rasht, Iran
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Dargan D, Himmi G, Anwar U, Jivan S, Muthayya P. A comparison of the epidemiology of isolated and non-isolated hand burns. Burns 2023; 49:951-960. [PMID: 35760611 DOI: 10.1016/j.burns.2022.05.018] [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: 10/29/2021] [Revised: 04/21/2022] [Accepted: 05/17/2022] [Indexed: 11/02/2022]
Abstract
Hand burns are common and treatment individualized, however given large volumes in some centers, pattern recognition may help optimize service provision. We performed a single center retrospective review from 2014 to 2018 of hand burns in patients aged 16 and over. Burns confined to the hands were considered isolated. We found 1163 patients (790 male, 68%), with 853 isolated (9% bilateral) and 310 non-isolated (35% bilateral) hand burns, and 12% were sustained in industrial workplaces. Most isolated burns received first aid (72%) and were scalds (41%) or contact (23%). Many presented to hospital by car (73%) and most were treated as outpatients (92%). Non-isolated burns were mainly flash (38%) or flame burns (25%, p < 0.01), with 66% given first aid, 49% used ambulances (p < 0.01) and 54% underwent hospital admission (p < 0.01). Non-isolated injuries had more full thickness involvement (p < 0.01), 13% were resuscitation burns and 10% received intensive care. Isolated and non-isolated burns are distinct clinical entities, as are unilateral and bilateral injuries. Isolated burns are usually unilateral scalds or contact burns, suited to outpatient treatment. Non-isolated burns are often flash or flame, bilateral, often needing ambulances, admission, and interventions. First aid can be improved, and consideration given to inpatient rehabilitation of bilateral hand burns.
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Affiliation(s)
- Dallan Dargan
- Regional Burns Centre, Pinderfields General Hospital, Aberford Road, Wakefield WF1 4DG, United Kingdom.
| | - Ghita Himmi
- Hull York Medical School, University of York, Heslington, York YO10 5DD, United Kingdom
| | - Umair Anwar
- Regional Burns Centre, Pinderfields General Hospital, Aberford Road, Wakefield WF1 4DG, United Kingdom
| | - Sharmila Jivan
- Regional Burns Centre, Pinderfields General Hospital, Aberford Road, Wakefield WF1 4DG, United Kingdom
| | - Preetha Muthayya
- Regional Burns Centre, Pinderfields General Hospital, Aberford Road, Wakefield WF1 4DG, United Kingdom
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Mata-Ribeiro L, Vieira L, Vilela M. Epidemiology And Outcome Assessment Of Hand Burns: A 3-Year Retrospective Analysis In A Burn Unit. ANNALS OF BURNS AND FIRE DISASTERS 2022; 35:18-25. [PMID: 35582085 PMCID: PMC9020848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 04/18/2021] [Indexed: 06/15/2023]
Abstract
A great number of burns affect the hands, either as part of a more extensive burn or as an isolated injury. These injuries can lead to physical, social and psychological consequences that may reduce quality of life and make difficult the return to work. The goal of this study was to investigate the main epidemiologic characteristics of adult patients with hand burns admitted to a dedicated burn centre, evaluate the outcomes of the treatment, and identify the predictors associated with the worst outcomes. This study found that a considerable amount of burn victims admitted had hand burns (41.5%). Males are more likely to be injured in general, but females are more prevalent in burns by hot liquids. The most common comorbidity was hypertension, followed by dyslipidemia and type II diabetes. Cooking is the activity associated with more accidental victims. Most injuries did not require surgical intervention. Approximately two-thirds of the patients did not have any important sequelae. The most common complications were scar disturbances (26%) and scar contractures (14%). The need for surgery, a higher number of surgeries and higher surface area burn were associated with the worst outcomes. It is imperative to establish a burn prevention education program nationwide, encompassing water temperature control in households, the use of anti-burn equipment, and the replacement of old electrical/ heating equipment.
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Affiliation(s)
- L. Mata-Ribeiro
- Luís Mata Ribeiro
Hospital São José, Department of Plastic and Reconstructive SurgeryRua José António Serrano, 1150-199 LisbonPortugal.+351 967811556
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Galati V, Vonthein R, Stang F, Mailaender P, Kisch T. Split thickness skin graft versus application of the temporary skin substitute suprathel in the treatment of deep dermal hand burns: a retrospective cohort study of scar elasticity and perfusion. INTERNATIONAL JOURNAL OF BURNS AND TRAUMA 2021; 11:312-320. [PMID: 34557334 PMCID: PMC8449150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 06/30/2021] [Indexed: 06/13/2023]
Abstract
Two therapeutic options for deep dermal hand burns are autologous split-thickness skin graft (STSG) following tangential excision and the application of the temporary wound dressing Suprathel following removal of burn blisters. We compared elasticity and perfusion of burn scars after both types of therapy at least one year after completion of treatment. A case series of 80 patients of our department with deep dermal hand burns between 2013 and 2018 was examined in the year 2019 at least one year after completion of treatment (24 females and 56 males with a median age of 47.6 years). The clinical assessment of the scar was performed with the Vancouver Scar Scale (VSS) and Patient and Observer Scar Assessment Scale (POSAS) and the objective assessment with suction cutometry (MPA 580) and an O2C device on both hands. Our statistical analysis showed no statistically significant differences for the R2 and R5 elasticity values between the two types of therapy. The 95% confidence intervals for the ratios of elasticity, and microcirculatory perfusion parameters and scar scale scores of burn scars to respective healthy areas of skin after STSG and Suprathel-therapy mostly covered 1. Subgroup analysis of R2 viscoelasticity and analyses with adjustments for scar compression therapy, nicotine consumption, age, palmar or dorsal localization of the burn scar and interactions of age with smoking and localization gave similar results. The adjusted analysis of SO2 showed statistically significant lower SO2 values, 9% less, after STSG compared to Suprathel treatment. Split-thickness skin graft following tangential excision and the application of Suprathel following removal of burn blisters may be equivalent options for treatment of deep dermal hand burns. To detect possible small differences, further studies with larger samples are required.
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Affiliation(s)
- Virginia Galati
- Department of Plastic Surgery, Hand Surgery, Burn Care Unit, University Hospital Schleswig-Holstein, University of LuebeckLuebeck, Germany
| | - Reinhard Vonthein
- Institute of Medical Biometry and Statistics, University of LuebeckLuebeck, Germany
| | - Felix Stang
- Department of Plastic Surgery, Hand Surgery, Burn Care Unit, University Hospital Schleswig-Holstein, University of LuebeckLuebeck, Germany
| | - Peter Mailaender
- Department of Plastic Surgery, Hand Surgery, Burn Care Unit, University Hospital Schleswig-Holstein, University of LuebeckLuebeck, Germany
| | - Tobias Kisch
- Department of Plastic Surgery, Hand Surgery, Burn Care Unit, University Hospital Schleswig-Holstein, University of LuebeckLuebeck, Germany
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Dargan D, Kazzazi D, Limnatitou D, Cochrane E, Stubbington Y, Shokrollahi K, Ralston D. Acute Management of Thermal Hand Burns in Adults: A 10-Year Review of the Literature. Ann Plast Surg 2021; 86:517-531. [PMID: 33675628 DOI: 10.1097/sap.0000000000002755] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Advances in the evidence base of acute thermal hand burns help to guide the management of these common injuries. The aim of this literature review was to evaluate recent evidence in the field over 10 years. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols methodology was used as a guide for this literature review. PubMed, MEDLINE, EMBASE, CINAHL, and Google Scholar were searched for English language articles related to hand burns published between 2009 and 2018 inclusive, and the Cochrane Library was reviewed. Exclusion criteria were as follows: participants younger than 18 years, scar or contracture management, rehabilitation, outcomes assessment, late reconstruction, and electrical or chemical burns. RESULTS An initial search retrieved 6493 articles, which was narrowed to 403 full-text articles that were reviewed independently by 3 of the authors and categorized. Of 202 included articles, there were 8 randomized controlled trials and 2 systematic reviews. Six evidence-based guidelines were reviewed. Referral of hand burns to specialist centers, use of telemedicine, early excision and grafting, and immediate static splintage have been recommended. Enzymatic debridement results in earlier intervention, more accurate burn assessment, preservation of vital tissue, and fewer skin grafts, and ideally requires regional anesthesia. Guidance on escharotomy emphasizes indication, technique and adequate intervention, and potential for enzymatic debridement. Inclusion of topical negative pressure, dermal regenerative templates, acellular dermal matrices, and noncellular skin substitutes in management has helped improve scar and functional outcomes. DISCUSSION The results of this literature review demonstrate that multiple national and international societies have published burns guidelines during the decade studied, with aspects directly relevant to hand burns, including the International Society for Burn Injuries guidelines. There are opportunities for evidence-based quality improvement across the field of hand burns in many centers. CONCLUSIONS More than 200 articles globally in 10 years outline advances in the understanding of acute management of thermal hand burns. Incorporating the evidence base into practice may facilitate optimization of triage referral pathways and acute management for hand burns.
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Affiliation(s)
| | - Diana Kazzazi
- From the Sheffield Teaching Hospitals NHS Foundation Trust, Northern General Hospital
| | | | - Elliott Cochrane
- From the Sheffield Teaching Hospitals NHS Foundation Trust, Northern General Hospital
| | | | - Kayvan Shokrollahi
- Mersey Regional Burns Centre, St Helens and Knowsley Teaching Hospitals NHS Trust, Whiston Hospital, Merseyside, Prescot, United Kingdom
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Liu M, Zhu H, Yan R, Yang J, Zhan R, Yu X, Hu X, Zhang X, Luo G, Qian W. Epidemiology and Outcome Analysis of 470 Patients with Hand Burns: A Five-Year Retrospective Study in a Major Burn Center in Southwest China. Med Sci Monit 2020; 26:e918881. [PMID: 32417848 PMCID: PMC7222659 DOI: 10.12659/msm.918881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Background This retrospective study aimed to investigate the epidemiology of burns to the hand, including the causes, demographic data, management, and outcome in a single center in Southwest China between 2012 and 2017. Material/Methods A retrospective study included 470 patients with hand burns who were treated at a single hospital in Southwest China between 2012 and 2017. Demographic, injury-related, and clinical data were obtained from the clinical electronic data collection system. Results In 470 patients, men were more commonly admitted to hospital with hand burns (73.62%). Children under 10 years (29.57%) were the main patient group. Hospital admissions occurred in the coldest months, from December to March (55.11%). In 60.21% of cases, hand burns occurred outside the workplace. Fire (40.42%), electricity (30.85%), and hot liquids (20.21%) were the main causes of hand burns. Data from 428 patients showed that burns with a larger total body surface area and deeper burns were associated with surgery and amputation. Burn depth was a risk factor for skin grafting, and lack of burn cooling before hospital admission increased the risk of amputation. Data from 117 patients with localized burns showed that full-thickness burns and lack of cooling before admission were associated with an increased hospital stay. Conclusions The findings suggest that in Southwest China, prevention programs for children aged 0–9 years, injuries occurring in winter and non-workplace sites, and fire burns were imperative.
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Affiliation(s)
- Mian Liu
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Army Medical University (Third Military Medical University), People's Liberation Army (PLA), Chongqing, China (mainland)
| | - Haijie Zhu
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Army Medical University (Third Military Medical University), People's Liberation Army (PLA), Chongqing, China (mainland)
| | - Rongshuai Yan
- Department of Plastic and Cosmetic Surgery, Xinqiao Hospital, Army Medical University, People's Liberation Army (PLA), Chongqing, China (mainland)
| | - Jiacai Yang
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Army Medical University (Third Military Medical University), People's Liberation Army (PLA), Chongqing, China (mainland)
| | - Rixing Zhan
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Army Medical University (Third Military Medical University), People's Liberation Army (PLA), Chongqing, China (mainland)
| | - Xunzhou Yu
- Department of Burn and Plastic Surgery, 80th Group Military Hospital, Weifang, Shandong, China (mainland)
| | - Xiaohong Hu
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Army Medical University (Third Military Medical University), People's Liberation Army (PLA), Chongqing, China (mainland)
| | - Xiaorong Zhang
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Army Medical University (Third Military Medical University), People's Liberation Army (PLA), Chongqing, China (mainland)
| | - Gaoxing Luo
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Army Medical University (Third Military Medical University), People's Liberation Army (PLA), Chongqing, China (mainland)
| | - Wei Qian
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Army Medical University (Third Military Medical University), People's Liberation Army (PLA), Chongqing, China (mainland)
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HeydariKhayat N, Ashktorab T, Rohani C. Home care for burn survivors: A phenomenological study of lived experiences. Home Health Care Serv Q 2020; 40:204-217. [PMID: 32264786 DOI: 10.1080/01621424.2020.1749206] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: Burn injuries have negative impacts on all dimensions of the quality of life of burn victims. This study aimed to explore the lived experiences of burn survivors after a 6-month period of home care following hospital discharge.Method: This is a qualitative study with a phenomenological approach. Sixteen burn survivors from a university hospital in Kermanshah province participated in the study. Qualitative data were analyzed by Colaizzi's descriptive phenomenological approach.Results: "Rehabilitation in the process of life" was the main theme of the study with four sub-themes, including "conducting process", "caring bridge", "humanitarian commitment for human revival", and "healing care".Conclusions: Home care is necessary for burn survivors after discharge from the hospital. The connection of healthcare services between home and hospital, safety feeling in the patient and his/her family, cost-effectiveness of healthcare services, and encouraging the patient to perform self-care can be achieved by home care follow-ups.
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Affiliation(s)
- Nastaran HeydariKhayat
- Student Research Committee, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Tahereh Ashktorab
- Department of Medical Surgical Nursing, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Camelia Rohani
- Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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