Hyperdry human amniotic membrane application as a wound dressing for a full-thickness skin excision after a third-degree burn injury

Abstract Background Severe burn injuries create large skin defects that render the host susceptible to bacterial infections. Burn wound infection often causes systemic sepsis and severe septicemia, resulting in an increase in the mortality of patients with severe burn injuries. Therefore, appropriate wound care is important to prevent infection and improve patient outcomes. However, it is difficult to heal a third-degree burn injury. The aim of this study was to investigate whether hyperdry human amniotic membrane (HD-AM) could promote early granulation tissue formation after full-thickness skin excision in third-degree burn injury sites in mice. Methods After the development of HD-AM and creation of a third-degree burn injury model, the HD-AM was either placed or not placed on the wound area in the HD-AM group or HD-AM group, respectively. The groups were prepared for evaluation on postoperative days 1, 4 and 7. Azan staining was used for granulation tissue evaluation, and estimation of CD163, transforming growth factor beta-1 (TGF-β1), vascular endothelial growth factor (VEGF), CD31, alpha-smooth muscle actin (α-SMA) and Iba1 expression was performed by immunohistochemical staining. Quantitative reverse-transcription polymerase chain reaction (PCR) was used to investigate gene expression of growth factors, cell migration chemokines and angiogenic and inflammatory markers. Results The HD-AM group showed significant early and qualitatively good growth of granulation tissue on the full-thickness skin excision site. HD-AM promoted early-phase inflammatory cell infiltration, fibroblast migration and angiogenesis in the granulation tissue. Additionally, the early infiltration of cells of the immune system was observed. Conclusions HD-AM may be useful as a new wound dressing material for full-thickness skin excision sites after third-degree burn injuries, and may be a new therapeutic technique for improving the survival rate of patients with severe burn injuries.

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Assessment of wound healing activity of ethanolic extracts of Pistacia lentiscus L. leaves and Quercus ilex L. bark in full thickness skin excision in rats

Advances in Traditional Medicine ◽

10.1007/s13596-021-00557-8 ◽

2021 ◽

Author(s):

Houari Hemida ◽

Koula Doukani ◽

Abdelkader Zitouni ◽

Brahim Miloud ◽

Houcine Beggar ◽

...

Keyword(s):

Wound Healing ◽

Quercus Ilex ◽

Pistacia Lentiscus ◽

Full Thickness ◽

Full Thickness Skin ◽

Thickness Skin ◽

Ethanolic Extracts ◽

Skin Excision ◽

Wound Healing Activity

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The rise of factor X level in blood plasma of patients at severe burn injuries

Journal of Burn Care & Research ◽

10.1093/jbcr/irab235 ◽

2021 ◽

Author(s):

George P Kozynets ◽

Volodymyr P Tsyhankov ◽

Daria S Korolova ◽

Olga V Gornytska ◽

Olexiy M Savchuk ◽

...

Keyword(s):

Protein C ◽

Antithrombin Iii ◽

Burn Injury ◽

Activated Partial Thromboplastin Time ◽

Burn Injuries ◽

Factor X ◽

Severe Burn ◽

Clotting Factors ◽

Thrombotic Complications ◽

Severe Burn Injuries

Abstract This work is dedicated to the detection of imbalance between the pro- and anti-coagulant branches of hemostasis at severe burn injuries by evaluating the content or activity of individual clotting factors. To select the targets for accurate diagnostics we measured the concentrations of soluble fibrin monomeric complexes and fibrinogen, levels of total prothrombin, factor X, protein C and antithrombin III, and recorded the time of clotting in activated partial thromboplastin time and prothrombin time tests. Factor X level was increased in 26 % of patients on the first day after the burn and it rose further in 62 % patients on the 14 th day of recovery. Increasing factor X level is assumed to be a risk factor of thrombotic complications. We propose to use it as a marker of predisposition to thrombosis at severe burn injury.

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A31P NMR study of extracted phospholipid composition of human skin: full thickness skin, dermis, epidermis and granulation tissue

Skin Research and Technology ◽

10.1111/j.1600-0846.1998.tb00089.x ◽

1998 ◽

Vol 4 (2) ◽

pp. 71-78 ◽

Cited By ~ 2

Author(s):

Patricio Meneses ◽

Julie M. Crane ◽

William J. Ennis

Keyword(s):

Human Skin ◽

Granulation Tissue ◽

Phospholipid Composition ◽

Full Thickness ◽

Full Thickness Skin ◽

Nmr Study ◽

Thickness Skin

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Expansion potential of skin grafts with novel I-shaped auxetic incisions

Biomedical Physics & Engineering Express ◽

10.1088/2057-1976/ac3b72 ◽

2021 ◽

Author(s):

Vivek Gupta ◽

Arnab Chanda

Keyword(s):

Skin Grafting ◽

Burn Injuries ◽

Skin Grafts ◽

Severe Burn ◽

Thickness Skin ◽

Split Thickness Skin Grafting ◽

Shape Pattern ◽

Severe Burn Injuries ◽

Poisson's Ratios ◽

Poisson’S Ratios

Abstract Severe burn injures lead to millions of fatalities every year due to lack of skin replacements. While skin is a very limited and expensive entity, split thickness skin grafting, which involves the projection of a parallel incision pattern on a small section of healthy excised skin, is typically employed to increase the expansion and cover a larger burn site. To date, the real expansion capacity of such grafts are low (<3 times) and insufficient for treatment of severe burn injuries. In this study, novel I-shaped auxetic incision patterns, which are known to exhibit high negative Poisson’s ratios, have been tested on the skin to investigate their expansion potential. Fourteen two-layer skin graft models with varying incision pattern parameters (i.e., length, spacing, and orientation) were developed using finite element modelling and tested under uniaxial and biaxial tensile loads. The Poisson’s ratio, meshing ratios, and induced stresses were quantified across all models. Graft models tested uniaxially along the orthogonal directions indicated opposite trends in generated Poisson’s ratios, as the length of the I-shape incisions were increased. Biaxially, with a symmetric and closely spaced I-shape pattern, graft meshing ratios up to 15.65 were achieved without overstressing the skin. Overall, the findings from the study indicated that expansion potentials much higher than that of traditional skin grafts can be achieved with novel I-shaped auxetic skin grafts, which would be indispensable for covering large wounds in severe burn injuries.

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Efficacy and Safety of High Vs Standard Daptomycin Doses Examined in Chinese Patients With Severe Burn Injuries by Pharmacokinetic Evaluation

Journal of Burn Care & Research ◽

10.1093/jbcr/iraa020 ◽

2020 ◽

Vol 41 (3) ◽

pp. 705-713

Author(s):

Yingzi Huang ◽

Guozhong Lv ◽

Linlin Hu ◽

Yunfu Wu ◽

Nan Guo ◽

...

Keyword(s):

Mass Spectrometry ◽

Burn Injury ◽

Standard Dose ◽

Burn Injuries ◽

Chinese Patients ◽

High Dose ◽

Severe Burn ◽

Serious Adverse Events ◽

Severe Burn Injuries ◽

High Doses

Abstract Previous studies and the concentration-dependent antibacterial actions of daptomycin suggested that a high dose would be needed for difficult-to-treat infections in burn patients. Here, we evaluated the effects of administration of low and high doses of daptomycin in patients with severe burn injuries. The study retrospectively analyzed 10 patients with severe burn injuries, using pharmacokinetic (PK) and pharmacodynamic (PD) evaluations of daptomycin doses given to combat serious infections. Daptomycin was administered as a single dose or by multiple doses intravenously at a standard dose of 6 mg/kg/d or a high dose of 12 mg/kg/d for 7 to 14 days. The serum concentrations of daptomycin from patients were analyzed by liquid chromatography–mass spectrometry/mass spectrometry (LC-MS/MS). Burn injury patients treated with high-dose daptomycin had a linear PK profile and a negative correlation between the AUC0–24 and Baux score (R2 = .953 and R2 = .801). The Cmax, AUC0–24, and t(h)½ increased significantly compared with patients given a standard dose. The efficacy of daptomycin against Staphylococcus aureus showed significantly higher rates of (AUC0–24)/MIC and Cmax/MIC after high-dose daptomycin compared with the standard dose, reflected in a significant correlation between a high dose and the Baux score (r = .976, P < .001). Positive S. aureus cultures from two of three high-dose and none of two daptomycin low-dose patients converted from positive to negative after therapy. No serious adverse events or discontinuation of the drug occurred during the treatment period. Daptomycin doses up to 12 mg/kg/d were well tolerated in Chinese patients with severe burn injuries, which were complicated by infections with S. aureus.

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A ZnO–curcumin nanocomposite embedded hybrid collagen scaffold for effective scarless skin regeneration in acute burn injury

Journal of Materials Chemistry B ◽

10.1039/c9tb01097a ◽

2019 ◽

Vol 7 (38) ◽

pp. 5873-5886 ◽

Cited By ~ 3

Author(s):

Cheirmadurai Kalirajan ◽

Thanikaivelan Palanisamy

Keyword(s):

Burn Injury ◽

Collagen Scaffold ◽

Skin Regeneration ◽

Burn Injuries ◽

Severe Burn ◽

Severe Burn Injuries

A nano-engineered hybrid collagen scaffold enables healing of severe burn injuries without the formation of scars by stimulating key bio-factors.

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854 Modified Millard Forked-flap for Complete Nasal Stenosis After Smoking While on Home Oxygen

Journal of Burn Care & Research ◽

10.1093/jbcr/iraa024.422 ◽

2020 ◽

Vol 41 (Supplement_1) ◽

pp. S265-S265

Author(s):

Sagar Mulay ◽

Roger L Simpson ◽

Ahmed Nasser ◽

Basil Nwaoz

Keyword(s):

Cleft Lip ◽

Burn Injury ◽

Full Thickness ◽

Upper Lip ◽

Nasal Vestibule ◽

Full Thickness Skin ◽

Thickness Skin ◽

Initial Symptoms ◽

Cleft Lip Repair ◽

The Aesthetic

Abstract Introduction Nasal stenosis is an uncommon burn scar deformity which can result in breathing obstruction. The reconstruction of nasal stenosis secondary to burns can be challenging due to the limitation of localized tissue, rate of recurrence, and burn injury to the surrounding areas. A vascularized composite flap of local composite tissue (forked flap) from the lip can reliably reconstruct the nasal vestibule and nasal sill diminishing the risk of recurrent nasal stenosis. We describe our use of a modified Millard forked flap, a cleft lip repair technique. Methods A 52-year-old female presented with complete stenosis of the right nares secondary to burn contracture of the nostril, vestibule, and upper lip. She had suffered a flash burn to her face while smoking on home oxygen requiring prolonged ventilatory support and only received topical dressings. Three months after her burn injury she was referred for the reconstruction of her contractures. A lateral rhinotomy was performed to define the nasal floor defect. Scar release of the remaining vestibule and ala and the aesthetic units of the lip were defined. A supple unburned area of the upper lip was harvested as a vascularized composite forked flap and rotated into the vestibule defining the vestibule floor. The ala was rotated outward and full-thickness skin grafts was used to resurface the vestibular portion. The lateral aesthetic subunit of the lip was then resurfaced as a complete unit with a full-thickness skin graft. She later required fabricated nasal splint for nighttime stenting and serial daytime nostril dilatation with Hegar dilators. Results At nine months post-reconstruction, the patient maintains a patent nasal airway with limited vertical lip contraction, resolution of her initial symptoms of sinus congestion, and no further difficulty breathing. Conclusions In 1955, Ralph Millard presented the rotation-advancement technique for cleft lip repair. The Procedure was designed to create a softer, more natural-looking reconstructed lip. In the cleft lip repair, he suggested preserving the prolabial tissue lateral to the central segment as forked flaps that were rotated and banked on the nasal vestibule floor. Had that principle not been appreciated, that tissue might have been discarded in order to respect the aesthetic unit of the lip. The surgeon must utilize reliable principles to restore and retain form and function. The use of this modified forked flap incorporated composite vascularized tissue for the nostril floor reconstruction while respecting the subunit reconstruction of the lip. Applicability of Research to Practice Reconstruction of the injury needs to restore both functional and aesthetic deformities. Utilization of a local vascularized composite graft, taken from an area to be discarded within the upper lip subunit, provided quality tissue that significantly reduces the risk of secondary nasal contracture.

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