647 Development of a Cerium (III) Nitrate-containing Electrospun Dressing for Mitigating Delayed Eschar Removal

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S169-S170
Author(s):  
Angela R Jockheck-Clark ◽  
Cortes Williams ◽  
Christine Kowalczewski ◽  
Jahnabi Roy ◽  
Marc A Thompson ◽  
...  
Keyword(s):  
Room Temperature ◽  
Thermal Injury ◽  
Storage Stability ◽  
Wound Dressings ◽  
High Rate ◽  
Burn Wound ◽  
Burn Treatment ◽  
N Application ◽  
Surgical Interventions ◽  
N Release

Abstract Introduction During periods of delayed burn treatment, cells within the eschar leach toxic and immunomodulatory metabolites that can profoundly impact neighboring tissue. Therefore, to reduce the burn-related morbidities and mortalities that are the result of delayed surgical interventions, electrospinning was utilized to generate a novel cerium (III) nitrate (Ce(III)N) dressing. Previously published work has demonstrated that topical Ce(III)N application changes the eschar morphology, and that tissue beneath the treated eschar was generally healthy and had a high rate of graft acceptance. Methods Ce(III)N was dissolved with polyethylene oxide and spun onto a grounded rotating mandrel. The uni-axially spun mesh was compared to a co-axially electrospun dressing that contained a Ce(III)N core. Dressings were evaluated for topography/morphology, porosity and oxygen permeation using scanning electron microscopy, helium pycnometry, and a gas exchange chamber, respectively. Ce(III)N release rates were evaluated, as well as 60-day storage stability. Results All electrospun dressings contained functional Ce(III)N, with the co-axially spun dressing containing three times the amount of Ce(III)N as the traditionally spun dressing. Uni-axially and co-axially spun nanofibers had diameters of 1487±560 nm and 1071±147 nm, and porosities of 83.9% and 74.1%, respectively. Scaffolds released the majority of Ce(III)N within the first hour of wetting. Conclusions All dressings were capable of a burst of Ce(III)N release and maintained stability when stored at room temperature for 60 days. Applicability of Research to Practice Despite advancement in protective equipment worn by military personnel, the incidence of thermal injury is expected to rise in future conflicts. There are no burn wound dressings that can mitigate the pathophysiological processes associated with delayed burn wound treatment.

scholarly journals Clinical and experimental studies of tissues in thermal injuries

2019 ◽  
Keyword(s):  
Tissue Damage ◽  
Thermal Injury ◽  
Burn Injury ◽  
Experimental Studies ◽  
Immunohistochemical Method ◽  
Burn Wound ◽  
Differentiation Markers ◽  
Dielectric Parameters ◽  
Doppler Flowmetry ◽  
Surgical Interventions

The article is devoted to studies used in the clinic and in the experiment in the study of tissue damage caused by exposure to high temperature. Determining the area and depth of tissue damage during thermal injury is of fundamental importance not only for treatment, but also for prognosis. The use of laser Doppler flowmetry, magnetic resonance imaging, pH-metry, contactless infrared thermometry of burn wounds, the method of assessing tissue viability based on the study of dielectric parameters allows to evaluate the viability and the state of damaged tissues in dynamics. The importance of tissue research methods for establishing an accurate diagnosis, assessing the readiness of wounds for autodermoplasty and determining the extent of surgical interventions is shown. The use of morphological methods in experimental studies and in the treatment of victims with burns is substantiated. Using histological and cytological methods, the condition of the burn wound is monitored, the efficacy of surgical interventions and the use of therapeutic agents is evaluated, the wound process phase is determined, and medical tactics is planned. The histochemical method is used to study the composition and state of the tissues of a burn wound paranecrosis area, and the immunohistochemical method is used to assess the intensity of regeneration processes by determining the tissue proliferation and differentiation markers. Ultramicroscopic examination of tissues at different times after thermal injury is informative for understanding the dynamics of pathomorphological changes in burns. Review of the pathogenesis of burn disease, taking into account the data of ultramicroscopic studies, creates the prospect of developing methods for targeted correction of the condition of patients with burns at the subcellular level. The role of experimental studies in the investigation of thermal damage, preclinical trials of medicinal products used to influence the wound process, improving the existing methods and developing the new ones for treatment of burn injury has been determined.

Polymer-Based Nanotherapeutics for Burn Wounds

2021 ◽  
Vol 22 ◽  
Author(s):  
Rewati Raman Ujjwal ◽  
Awesh Yadav ◽  
Shourya Tripathi ◽  
S.T.V. Sai Krishna
Keyword(s):  
Wound Healing ◽  
Research Effort ◽  
Synthetic Polymers ◽  
Wound Dressings ◽  
High Porosity ◽  
Natural Polymers ◽  
Burn Wound ◽  
Burn Treatment ◽  
Mortality And Morbidity ◽  
Burn Wounds

: Burn wounds are complex and intricate injuries that have become a common cause of trauma leading to significant mortality and morbidity every year. Dressings are applied to burn wounds with the aim of promoting wound healing, preventing burn infection and restoring skin function. The dressing protects the injury and contributes to recovery of dermal and epidermal tissues. Polymer-based nanotherapeutics are increasingly being exploited as burn wound dressings. Natural polymers such as cellulose, chitin, alginate, collagen, gelatin and synthetic polymers like poly (lactic-co-glycolic acid), polycaprolactone, polyethylene glycol, and polyvinyl alcohol are being obtained as nanofibers by nanotechnological approaches like electrospinning and have shown wound healing and re-epithelialization properties. Their biocompatibility, biodegradability, sound mechanical properties and unique structures provide optimal microenvironment for cell proliferation, differentiation, and migration contributing to burn wound healing. The polymeric nanofibers mimic collagen fibers present in extracellular matrix and their high porosity and surface area to volume ratio enable increased interaction and sustained release of therapeutics at the site of thermal injury. This review is an attempt to compile all recent advances in the use of polymer-based nanotherapeutics for burn wounds. The various natural and synthetic polymers used have been discussed comprehensively and approaches being employed have been reported. With immense research effort that is currently being invested in this field and development of proper characterization and regulatory framework, future progress in burn treatment is expected to occur. Moreover, appropriate preclinical and clinical research will provide evidence for the great potential that polymer-based nanotherapeutics hold in the management of burn wounds.

scholarly journals Wound Healing Composite Materials of Bacterial Cellulose and Zinc Oxide Nanoparticles with Immobilized Betulin Diphosphate

Nanomaterials ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 713
Author(s):  
Nina Melnikova ◽  
Alexander Knyazev ◽  
Viktor Nikolskiy ◽  
Peter Peretyagin ◽  
Kseniia Belyaeva ◽  
...  
Keyword(s):  
Wound Healing ◽  
Zinc Oxide ◽  
Bacterial Cellulose ◽  
Zinc Oxide Nanoparticles ◽  
Wound Dressings ◽  
Oxide Nanoparticles ◽  
Burn Wound ◽  
Zno Nps ◽  
Wound Model ◽  
And Oxidative Stress

A design of new nanocomposites of bacterial cellulose (BC) and betulin diphosphate (BDP) pre-impregnated into the surface of zinc oxide nanoparticles (ZnO NPs) for the production of wound dressings is proposed. The sizes of crystalline BC and ZnO NPs (5–25%) corresponded to 5–6 nm and 10–18 nm, respectively (powder X-ray diffractometry (PXRD), Fourier-infrared (FTIR), ultraviolet (UV), atomic absorption (AAS) and photoluminescence (PL) spectroscopies). The biological activity of the wound dressings “BC-ZnO NPs-BDP” was investigated in rats using a burn wound model. Morpho-histological studies have shown that more intensive healing was observed during treatment with hydrophilic nanocomposites than the oleophilic standard (ZnO NPs-BDP oleogel; p < 0.001). Treatment by both hydrophilic and lipophilic agents led to increases in antioxidant enzyme activity (superoxide dismutase (SOD), catalase) in erythrocytes and decreases in the malondialdehyde (MDA) concentration by 7, 10 and 21 days (p < 0.001). The microcirculation index was restored on the 3rd day after burn under treatment with BC-ZnO NPs-BDP wound dressings. The results of effective wound healing with BC-ZnO NPs-BDP nanocomposites can be explained by the synergistic effect of all nanocomposite components, which regulate oxygenation and microcirculation, reducing hypoxia and oxidative stress in a burn wound.

scholarly journals The Design, Characterization and Antibacterial Activity of Heat and Silver Crosslinked Poly(Vinyl Alcohol) Hydrogel Forming Dressings Containing Silver Nanoparticles

Nanomaterials ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 96
Author(s):  
John Jackson ◽  
Helen Burt ◽  
Dirk Lange ◽  
In Whang ◽  
Robin Evans ◽  
...  
Keyword(s):  
Silver Nanoparticles ◽  
Antibacterial Activity ◽  
Silver Nitrate ◽  
Vinyl Alcohol ◽  
Unmet Need ◽  
Chemical Characterization ◽  
Wound Dressings ◽  
Poly Vinyl Alcohol ◽  
Burn Wound

The prompt treatment of burn wounds is essential but can be challenging in remote parts of Africa, where burns from open fires are a constant hazard for children and suitable medical care may be far away. Consequently, there is an unmet need for an economical burn wound dressing with a sustained antimicrobial activity that might be manufactured locally at low cost. This study describes and characterizes the novel preparation of a silver nitrate-loaded/poly(vinyl alcohol) (PVA) film. Using controlled heating cycles, films may be crosslinked with in situ silver nanoparticle production using only a low heat oven and little technical expertise. Our research demonstrated that heat-curing of PVA/silver nitrate films converted the silver to nanoparticles. These films swelled in water to form a robust, wound-compatible hydrogel which exhibited controlled release of the antibacterial silver nanoparticles. An optimal formulation was obtained using 5% (w/w) silver nitrate in PVA membrane films that had been heated at 140 °C for 90 min. Physical and chemical characterization of such films was complemented by in vitro studies that confirmed the effective antibacterial activity of the released silver nanoparticles against both gram positive and negative bacteria. Overall, these findings provide economical and simple methods to manufacture stable, hydrogel forming wound dressings that release antibiotic silver over prolonged periods suitable for emergency use in remote locations.

MORPHOLOGICAL EVALUATION OF EFFECTIVENESS OF NECROFASCIOTOMY AND INFILTRATION WITH OZONATED SALINE AREA OF DEEP CIRCULAR BURN OF SKIN WITH UNDERLYING TISSUES COMPLICATED BY COMPARTMENT SYNDROME

2020 ◽  
pp. 28-33
Author(s):  
Teimur Ahaliievich Kurbanov ◽  
O. V. Kravtsov ◽  
M. S. Myroshnychenko ◽  
Yu. I. Isaev
Keyword(s):  
Compartment Syndrome ◽  
Physiological Solution ◽  
Burn Wound ◽  
Local Pressure ◽  
Tissue Pressure ◽  
Surgical Interventions ◽  
Morphological Evaluation ◽  
General Pathology ◽  
Saline Area ◽  
The One

Compartment syndrome is one of the complications of tissue damage of various origins, the basis of which is the compression of blood vessels and disruption of blood supply to tissues due to an increased local pressure in the closed space of the fascial sheath. The consequences of compartment syndrome can be local and general. An effective treatment of compartment syndrome in burns is to perform a necrotomy, which due to decompression helps to reduce intra−tissue pressure and diminish the scale of necrotic changes in tissues. In order to morphologically evaluate the effectiveness of necrofasciotomy, as well as the one in combination with infiltration of ozonated saline area of deep circular skin burns with underlying tissues, complicated by compartment syndrome, an experimental study was conducted. Circular deep burns, complicated by the formation of compartment syndrome, were simulated in 18 WAG rats. To reduce the pressure in the burned and surrounding tissues, surgical interventions such as necrofasciotomy were performed, which provided a notable reduction in pressure. In parallel, infiltration of damaged tissues with ozonated saline was performed, which was bubbled for 15 minutes at a dissolved ozone concentration of 4.0±0.2 mg / l, which improved microcirculation and reduced tissue hypoxia. The findings indicate that the compartment syndrome is characterized by a significant severity of general pathology. Performance of necrofasciotomy of a burn wound with its infiltration by ozonated physiological solution in comparison with just necrofasciotomy has more positive medical effect, and efficiency of these medical measures increases when they are performed at early terms (day 1) of formation of a burn wound in comparison with late terms (day 3). Key words: burns, surgical treatment, compartment syndrome, histological examinations.

Stenosis at the area of Transposition – An Under-Recognized Complication of Transposed Brachiobasilic Fistulas

2007 ◽  
Vol 8 (4) ◽  
pp. 268-274 ◽  
Author(s):  
M.C. Beaulieu ◽  
C. Gabana ◽  
C. Rose ◽  
P.S. Macdonald ◽  
J. Clement ◽  
...  
Keyword(s):  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
High Rate ◽  
Secondary Patency ◽  
Basilic Vein ◽  
Av Fistula ◽  
Surgical Interventions ◽  
Secondary Patency Rate ◽  
One Year ◽  
The Impact

Background With an increased focus on native AV fistula creation in hemodialysis patients, a transposed brachiobasilic fistula (tBBF) is becoming an increasingly utilized option. This study describes the outcomes of tBBFs in a chronic hemodialysis population. In particular, we focus on the incidence and location of stenosis, and review the impact of angioplasty on these lesions. Methods A retrospective cohort study using all patients with a tBBF created between January 2001 and December 2004. Results Of the 543 fistulas created during the study period, 93 were tBBFs. The mean age of patients was 65 years, 56% were male and 55% were diabetic. Stenosis occurred in 54% (46/85) of fistulas; the location of stenosis in the majority (74%) was at or near the area of basilic vein transposition and 50% of fistulas with stenosis in this location required three or more angioplasties. Primary (unassisted) patency was 42% at one year in this cohort. Secondary patency was 68% at 1 year and 58% and 53% at 2 and 3 years respectively. Conclusion In a cohort of hemodialysis patients who received a tBBF, we describe a reasonable primary and secondary patency rate and a high rate of stenosis at the point of transposition of the basilic vein. Such stenosis usually requires multiple percutaneous or surgical interventions to ensure or reestablish conduit patency. Further study is required regarding the optimal surgical technique, monitoring, and treatment of stenosis of this fistula type including the utility of repeat angioplasty.

Innovative Burn Treatment Using Tilapia Skin as a Xenograft: A Phase II Randomized Controlled Trial

2020 ◽  
Vol 41 (3) ◽  
pp. 585-592 ◽  
Author(s):  
Edmar Maciel Lima Júnior ◽  
Manoel Odorico De Moraes Filho ◽  
Bruno Almeida Costa ◽  
Andréa Vieira Pontes Rohleder ◽  
Marina Becker Sales Rocha ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Phase Ii ◽  
Controlled Trial ◽  
Skin Substitutes ◽  
Burn Wound ◽  
Burn Treatment ◽  
Randomized Controlled ◽  
Nile Tilapia Oreochromis Niloticus ◽  
Occlusive Dressings ◽  
Skin Xenograft

Abstract Skin substitutes are considered a useful alternative for occlusive dressings in the treatment of superficial burns as they reduce the frequency of dressing replacement. This phase II randomized controlled trial aimed to evaluate the efficacy of Nile tilapia (Oreochromis niloticus) skin as an occlusive xenograft dressing for the treatment of burn wounds in humans. In order to assess the use of tilapia skin, the following variables were evaluated: number of days for wound healing, the number of times the occlusive dressing was changed, use of anesthetics or analgesics, pain assessment using the Visual Analogue Scale, and evaluation of burn improvement on the day of dressing removal. In total, 62 participants completed the study. It was found that in participants treated with tilapia skin, complete reepithelialization occurred in significantly fewer days; reported pain intensity was lower (study arms B and C), the amount of anesthetics/analgesics required was lower (study arms B and C), and the necessity of dressing changes was significantly reduced in comparison with volunteers treated with silver sulfadiazine. In our study, the tilapia skin xenograft showed good efficacy as an occlusive biological dressing for burn wound treatment in humans.

scholarly journals Prophylaxis of infection in region of the surgical intervention performance in laparoscopic cholecystectomy

2020 ◽  
Vol 87 (3-4) ◽  
pp. 22-25
Author(s):  
V. V. Kryzhevskii ◽  
N. A. Mendel ◽  
A. P. Brodskaya ◽  
Yu. V. Pavlovych
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Infection Rate ◽  
Microbial Contamination ◽  
Surgical Intervention ◽  
High Rate ◽  
Simultaneous Application ◽  
Surgical Interventions ◽  
The Third ◽  
Wound Protector ◽  
Combined Application

Objective. To estimate the efficacy of prophylactic method for regional infection while performance of laparoscopic cholecystectomy, using simultaneous application of container for removal of the specimen and a two-ring wound protector of the wound. In accordance to the literature data, the infection rate in laparoscopic cholecystectomy conduction constitutes 2.4 - 9.6%. Materials and methods. The work was based on experience of performance of 759 laparoscopic cholecystectomies during the period of 2015 - 2018 yrs. There were performed 679 operations with the second class of microbial contamination, 17 - with the third one and 6 - with the fourth. In 21 patients the conversion into laparotomy was applied. The patients with third and fourth classes of microbial contamination of wounds were divided into two groups: the first - 61 patients, in whom a container was used for the specimen removal, and the second - 19 patients, in whom the method of combined application of container and the wound protector was applied for removal of the specimen. Results. Infection of region of the surgical intervention performance in laparoscopic cholecystectomy was revealed in 41 (5.40%) of 759 patients.In surgical interventions In surgical interventions, referring to second class of microbial contamination , the infection rate in the surgical intervention region have constituted 2,5%, while referring to the third class - 11.76%, and the fourth class - 34.92%. Conversion in laparoscopic cholecystectomy is accompanied with high rate of the wound infection - 38.09%. Conclusion. Application of the method of combined usage of container for removal of preparation and a two-ring protector of the wound in the third and the fourth classes of the wounds while performance of laparoscopic cholecystectomy have permitted to lower the infection rate in region of the surgical intervention performance from 37.70 to 5.26%.

scholarly journals PECULIARITIES OF THE WOUND PROCESS DEVELOPMENT IN PATIENTS WITH THERMAL INJURY WHEN USED SILVER PREPARATIONS IN BURN WOUNDS SURGICAL TREATMENT

2021 ◽  
pp. 81-87
Author(s):  
N. V. Tuzyuk
Keyword(s):  
Metabolic Activity ◽  
Functional Activity ◽  
Thermal Injury ◽  
Thermal Damage ◽  
Main Group ◽  
The Body ◽  
Metabolic Reaction ◽  
Neutrophilic Granulocytes ◽  
Burn Wound ◽  
Significant Activation

Fundamental research in the field of burn wound development process highlights new pathogenetic mechanisms that underlie the improvement of medical practice, the main purpose of which is to create optimal conditions for early regeneration of the affected skin, as well as to eliminate the development of local and general complications. Irrational general and local treatment of wounds contribute to the slowing down of regenerative processes, thereby worsening the prognosis and consequences of thermal injury. It was found out that in patients of both study groups in the first period of the study the characteristics of the cellular composition of the wound impressions of the wound bottom of the area of thermal damage correspond to the degenerative type. In patients of the main group in the second term of the study in the area of thermal damage cells with high levels of functional and metabolic activity begin to appear, which increase antimicrobial resistance and reduce the risk of generalization of the infectious process which is the main source of burns. In patients of the main group, an increase in the activity of neutrophilic granulocytes in the induced test was found in the second term of the study, which, in our opinion, indicates the involvement of neutrophilic granulocytes with high functional and metabolic activity. Under conditions of significant activation of resident monocytes in response to injury in patients of the main group in the second and third term, the area of thermal damage migrates functionally effective monocytes. In patients of the main group the preservation of the activity of myeloperoxidase - the main enzyme of the oxygen-dependent phase of phagocytosis at the minimum subcompensated level, which leads to the preservation of the oxygen-dependent metabolic reaction of neutrophilic granulocytes in the subsequent study, Increases in the content of PAS-positive substances in neutrophilic granulocytes indicate the preservation of the functional reserve for activation and completion of the oxygen-independent phase of phagocytosis. The use of the developed treatment promotes the involvement of functionally active phagocytic cells in the burn wound, reduces the toxic load on monocytes and neutrophils, which helps to maintain their functional activity at the subcompensated level. These trends in patients of the main group reduce the risk of both local and general infectious complications of burn disease. It was found that the level of spontaneous functional activity in the HCT test is associated with the activity of resident monocytes. They form the primary barrier that protects the body from infection or harmful macromolecular complexes. Monocytes - "inflammatory", which constantly come from the free pool and their functional activity against microbial antigens is much higher than resident monocytes. An indicator of the activity of monocytes - "inflammatory" is an indicator of functional activity in the induced HCT test. The results of the study indicate that under conditions of significant activation of resident monocytes in response to injury in patients of the main group in the second and third terms of the area of thermal damage migrate functionally effective monocytes.

scholarly journals The New Pharmaceutical Compositions of Zinc Oxide Nanoparticles and Triterpenoids for the Burn Treatment

2020 ◽  
Vol 13 (9) ◽  
pp. 207
Author(s):  
Nina Melnikova ◽  
Olga Vorobyova ◽  
Alyona Balakireva ◽  
Darina Malygina ◽  
Anna Solovyeva ◽  
...  
Keyword(s):  
Zinc Oxide ◽  
Zinc Oxide Nanoparticles ◽  
Malonic Dialdehyde ◽  
Oxide Nanoparticles ◽  
Burn Wound ◽  
Zno Nps ◽  
Burn Treatment ◽  
Violet Emission ◽  
Doppler Flowmetry ◽  
Lupane Triterpenoids

We studied oleogels containing zinc oxide nanoparticles (ZnO NPs) and lupane triterpenoids in sunflower oil for the treatment of burns. The modification of ZnO was carried out by treatment with alcohol solutions of betulin, betulonic acid, betulin diacetate and betulin diphosphate. The properties of modified ZnO NPs were studied by powder XRD (average sizes of 10–20 nm), FTIR (νZnO 450 cm−1), UV–vis (345–360 nm), and blue–violet emission (380–420 nm). The identification and assay of modified ZnO NPs and triterpenoids were estimated. The treatment by oleogels of deep II-degree burns was studied on rats using histological studies, Doppler flowmetry and evaluation of enzymes activity and malonic dialdehyde (MDA) level. After the action of oleogels, burn wound area, and the necrosis decreased twice on the 10th day in comparison with the 1st day after burn. The microcirculation index in the near-wound zone by 20–30% improved compared with the group without treatment. Evaluation of the enzyme activity and the MDA level after treatment by oleogels during the course of 10 days showed them returning to normal. The improvement of antioxidant biochemical indexes, as well as wounds’ healing, was mainly determined by the influence of zinc oxide nanoparticles.

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