The Efficacy of Five Different Wound Dressings on Some Histological Parameters in Children With Partial-Thickness Burns

2020 ◽  
Vol 41 (6) ◽  
pp. 1179-1187 ◽  
Author(s):  
Birsen Harma ◽  
Mehmet Gül ◽  
Mehmet Demircan

Abstract An ideal dressing should ensure that the wound remains moist with exudates but not macerated. Currently, there is no dressing available to suit all wounds, at all stages of the healing process. Although silver-containing dressings are the gold standard for burn wound care, few high-level trials have been completed comparing the clinical utilities of these dressings. In our study, five different types of wound dressings: carboxymethyl cellulose hydrofiber dressing with ionized silver (CMCH-Ag), polyethylene-polyethylene terephthalate aqua fiber dressing with elementary silver (PPAF-Ag), calcium alginate (CA), calcium + zinc alginate (CZA), and 0.2% nitrofurazone-embedded (NF) gauze dressings were compared in regard to histopathological parameters. Children aged between 0 and 18 years with small or middle-sized partial-thickness burns that affected less than 30% of the total body surface area were included in this study. The study groups (CMCH-Ag, PPAF-Ag, CA, and CZA) and the control group (NF) were randomly attained. Wound healing was evaluated by punch biopsies on the 21st day. The thickness of the stratum corneum and the epithelium, the number of papillae, and the papillary length were calculated and compared. The histological parameters of healing, except the stratum corneum thickness, did not show any statistical significance among the groups (P > .05). The dressings that included silver, calcium, or zinc showed useful and similar effects in noninfective burn wounds when compared with nitrofurazone-only dressings. Thus, it may be concluded that silver-containing wound dressings should not be considered as the gold standard in noninfective partial-thickness burn wounds in children.

2020 ◽  
Vol 41 (3) ◽  
pp. 657-662 ◽  
Author(s):  
Yanwei Sun ◽  
Yongqian Cao ◽  
Ran Zhao ◽  
Famei Xu ◽  
Dan Wu ◽  
...  

Abstract In this study, we aimed to evaluate the therapeutic effects of autologous platelet-rich plasma (PRP) on deep partial-thickness burns in Bama pigs. Deep partial-thickness burn wounds were created on the back of Bama pigs. The reepithelialization time was compared between the PRP and control groups. The mean score of Ki67 (+) cells and α-SMA (+) vessels, the mean thickness of epidermis and dermis of the healing wounds were determined via H&E staining and immunohistochemical assay. The levels of the growth factors epidermal growth factor (EGF), basic fibroblast growth factor (bFGF), and vascular endothelial growth factor (VEGF) were examined by ELISA. Our data showed that the time to wound reepithelialization was shorter in the PRP group compared with the control group. The thickness of the epidermis was larger in the PRP group compared with the control group. On the 7th and 14th days after the treatment, the mean score of Ki67 (+) cells and α-SMA (+) vessels were higher in the PRP group compared with the control group. The PRP group showed higher levels of growth factors (EGF, bFGF, and VEGF) compared with the control group by ELISA. The results indicated that PRP could improve wound healing process of deep partial-thickness burns in Bama pigs. The PRP increased the thickness of epidermis of the healed wounds, cell proliferation, and angiogenesis. We demonstrated that applying PRP had a greater potential for the treatment of deep partial-thickness burns.


2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S244-S245
Author(s):  
Suzanne Mitchell ◽  
Dhaval Bhavsar ◽  
Jessica Reynolds ◽  
Jessica Jones ◽  
Julia M Pena

Abstract Introduction In the U.S. about 450,000 people per year receive medical burn care through hospital emergency departments, hospital outpatient clinics, free-standing urgent care centers and private physician offices. Burns are generally classified in terms of depth and severity. Outpatient management of partial thickness burns normally involves the application of an ointment, which may contain an antibiotic and is widely used in burn care. This clinical study has been designed to prospectively evaluate potential benefits of an enzymatic debrider in partial thickness burn wounds compared to antibiotic only treatment. The primary purpose of this study is to compare an enzymatic debrider with a topical antibiotic ointment in the proportion healed at 3 weeks after initiation of treatment, and time to healing (in weeks). Methods A convenience sample of 20 subjects, aged 19–56, with an acute thermal burn injury less than 72 hours old, and less than 10% TBSA were randomly assigned to outpatient treatment with an enzymatic debrider or a topical antibiotic. The proportion of subjects healed after 3 weeks of treatment was analyzed using ANOVA. In addition, a t-test comparison between the enzymatic debrider and the topical antibiotic was performed. Results For partial thickness burns, the mean time to heal using an enzymatic debrider was 18 days compared to 28 days for the topical antibiotic. However, there was no statistical significance in burn wound closure between subjects receiving an enzymatic debrider compared to a topical antibiotic, t (13) = .677; p = .510. An analysis of variance comparing an enzymatic debrider and a topical antibiotic also showed no statistical significance in time to heal (F=.849, p=374). Conclusions Due to the small sample size, the results from this study do not support the use of an enzymatic debrider versus a topical antibiotic in treating partial thickness burn injuries to advance wound closure or shorten time to heal. The results of this study show clinical significance, with burn wounds healed in 18 days when an enzymatic debrider was used compared to 28 days when a topical antibiotic was used. The lack of statistical significance was due to an under-powered study. Furthermore, partial thickness burns should spontaneously heal within 7–14 days, regardless of the topical treatment, excluding concomitant co-morbidities. Applicability of Research to Practice Continued research is necessary, employing larger sample sizes to adequately compare the use of an enzymatic debrider compared to topical antibiotics in deep partial thickness burn wounds. In addition, outpatient management of deep thickness and full-thickness burn injuries, utilizing sharp debridement in conjunction with enzymatic debridement, in patients who decline surgical treatment of burn wounds should be explored, analyzing time to heal, scar evaluation, and cost analysis,


2020 ◽  
Vol 3 (2) ◽  
pp. 229-238
Author(s):  
Qutaiba Aldoori ◽  
Aasem Albyti ◽  
Muthanna Hussein

Background Dermal burns (partial thickness burns) are the most painful trauma with two types of pain background pain with additional procedural pain, one of the best tolerable mode of treatment that commonly used now adays is treatment with MEBT ointments to maintain the moist and warm wound environment suitable for regeneration of epidermal cells, and to reduces pain. Moist wound dressings retain moisture, heat, body fluids, and biofilm with medication. The assumption is that the polyethylene film will maintain the ointment and its effect more than to be used merely. Patients and methods Prospective study to evaluate treatment of patients with partial thickness burns conservatively with MEBT ointment as a control group and MEBT ointment + Cling Film, 63 patients being admitted to the burn center at Azadi teaching hospital during a period of one year starting from June 2018 till June 2019. The inclusion criteria including all patients between 10-95% partial thickness burns of various age, sex and skin types. Results Very much decrease in procedural and background pain, better joint movement in physiotherapy decrease in crust formation, increase maceration of eschar, better cost- effectiveness, less days of hospital stay. Aim; in Iraq circumstances we have to use the most cost effective measures to reach our goals in managing the burn wounds the moist trend which is now being proved it gives better healing with less pain, with best criteria of wound dressing . Conclusion Easily applicable, less painful, non-coasty over all, better condition of patient during course of management, reduced length of hospital stay and lower treatment costs, appropriate wound healing with living tissue , less joint stiffness problems


2022 ◽  
Vol 8 ◽  
pp. 205951312110523
Author(s):  
Matthias Waldner ◽  
Tarek Ismail ◽  
Alexander Lunger ◽  
Holger J Klein ◽  
Riccardo Schweizer ◽  
...  

Background Deep partial-thickness burns are traditionally treated by tangential excision and split thickness skin graft (STSG) coverage. STSGs create donor site morbidity and increase the wound surface in burn patients. Herein, we present a novel concept consisting of enzymatic debridement of deep partial-thickness burns followed by co-delivery of autologous keratinocyte suspension and plated-rich fibrin (PRF) or fibrin glue. Material and methods In a retrospective case study, patients with deep partial-thickness burns treated with enzymatic debridement and autologous cell therapy combined with PRF or fibrin glue (BroKerF) between 2017 and 2018 were analysed. BroKerF was applied to up to 15% total body surface area (TBSA); larger injuries were combined with surgical excision and skin grafting. Exclusion criteria were age <18 or >70 years, I°, IIa°-only, III° burns and loss of follow-up. Results A total of 20 patients with burn injuries of 16.8% ± 10.3% TBSA and mean Abbreviated Burn Severity Score 5.45 ± 1.8 were identified. Of the patients, 65% (n = 13) were treated with PRF, while 35% (n = 7) were treated with fibrin glue. The mean area treated with BroKerF was 7.5% ± 0.05% TBSA, mean time to full epithelialization was 21.06 ± 9.2 days and mean hospitalization time was 24.7 ± 14.4 days. Of the patients, 35% (n = 7) needed additional STSG, 43% (n = 3) of whom had biopsy-proven wound infections. Conclusion BroKerF is an innovative treatment strategy, which, in our opinion, will show its efficacy when higher standardization is achieved. The combination of selective debridement and autologous skin cells in a fibrin matrix combines regenerative measures for burn treatment. Lay Summary Patients suffering from large burn wounds often require the use of large skin grafts to bring burned areas to heal. Before the application of skin grafts, the burned skin must be removed either by surgery or using enzymatic agents. In this article, we describe a method where small areas of skin are taken and skin cells are extracted and sprayed on wound areas that were treated with an enzymatic agent. The cells are held in place by a substance extracted from patients’ blood (PRF) that is sprayed on the wound together with the skin cells. We believe this technique can be helpful to reduce the need of skin grafts in burned patients and improve the healing process.


2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S123-S124
Author(s):  
Waseem Diab ◽  
Elika Ridelman ◽  
Dawn Cloutier ◽  
Lisa C Vitale ◽  
Justin D Klein ◽  
...  

Abstract Introduction Silver-based treatments have seen widespread use for the management of burns. Recent literature, however, has demonstrated silver nanoparticles may negatively impact healing time due to its toxic effect on keratinocytes and fibroblasts at higher concentrations. At our institution, an ABA-verified pediatric burn center, the use of a silver sulfadiazine cream for management of post-discharge perineal and genital burn wounds has been replaced by a zinc-oxide/dimethicone spray-on solution initiated for its comparative ease of use. The dimethicone allows the spray to be occlusive without interfering with clothing, yet easily removed. We believed this would improve compliance with at-home treatments. Zinc-oxide’s antimicrobial activity has been demonstrated in vitro and the results from animal studies are promising for burn management. This is the first study of zinc-oxide’s efficacy as a burn management agent in humans. Our burn center’s experience with both silver sulfadiazine and zinc-oxide/dimethicone creates an opportunity to compare these products for the treatment of burn wounds. We sought to analyze the time to healing of burns treated by silver sulfadiazine against zinc-oxide/dimethicone in order to determine if zinc-oxide/dimethicone, in its easy-to-use form, is a viable alternative to silver sulfadiazine. Methods A retrospective review of medical records was conducted at a large pediatric verified burn center. Data on 98 patients was collected from the burn registry and electronic medical records. 58 patients received silver sulfadiazine while 40 received zinc-oxide/dimethicone. Four patients were removed from the silver sulfadiazine group due to incomplete data. All patients were initially treated by the burn team with follow up in burn clinic on a weekly basis until healing was achieved. Results Time to healing was significantly lower in the zinc-oxide/dimethicone intervention group (10.61 +/- .918 days) than the silver sulfadiazine control group (16.88 +/- 2.134 days). The silver sulfadiazine group contained patients with total body surface area burns significantly greater than the zinc-oxide/dimethicone group (mean: 11.57% versus 6.64%); likely due to selective treatment when zinc-oxide/dimethicone was first introduced at our facility. Differences in depth and size of burn wounds may have confound our results and negatively impacted healing time in the control group. No infection, allergic reaction, or other adverse events were noted in any patient. Conclusions Zinc-oxide/dimethicone had a significantly lower healing time than silver sulfadiazine in the treatment of at-home, post-discharge 2nd degree pediatric burns to the perineum, genitalia, suprapubis, and buttocks. Further study is needed to quantify its efficacy.


2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S193-S193
Author(s):  
Emre Karakaya ◽  
Aydincan Akdur ◽  
H Ebru ◽  
Ayvazoglu Soy ◽  
Alev Ok Atilgan ◽  
...  

Abstract Introduction Burn is one of the most severe traumas that causes coagulative destruction of the skin. The use of various products that accelerate wound healing in patients with burn may affect the patient’s survival and reduce the complications that may be seen. In the present study we aimed effects of subcutaneous ozone injection on second degree burn wound. Methods A total of 72 Sprague-Dawley male rats included in the study were divided randomly into three groups (control group (CG), silver sulfadiazine group (SG), ozone group (OG)) and each group was divided randomly two subgroups (as sacrificed on d7 and on d14).A deep second degree scald burns were created on the lower back. In CG subcutaneous 0.9% serum saline was injected daily into the burn area. In SG, burns were dressed with silver sulfadiazine daily and in OG subcutaneous ozone was injected daily into the burn area. Tissue hydroxyproline level measurement and histopathological evaluation were done. Results When the groups were compared in terms of weight change, no significant difference was found on the 7th and 14th days. In the evaluation made in terms of tissue hydroxyproline, tissue hydroxyproline level in OG was found to be significantly higher on both the 7th and 14th days (p &lt; 0.001). In histopathological evaluations, it was determined that wound healing in OG was significantly higher than in the other groups. Conclusions According to the results, subcutaneous ozone therapy is more effective than silver sulphadiazine in the healing process of second-degree burn wounds and it can be safely used in the treatment of burn wounds.


2015 ◽  
Vol 50 (1) ◽  
pp. 41-45
Author(s):  
Kazimierz Ulewicz ◽  
Przemysław Michniewski ◽  
Brunon Kierznikowicz ◽  
Bogdan Łokucijewski ◽  
Jan Stencel

Abstract Hyperbaric oxygenation therapy has found its application in the treatment of various types of burns. The presented work describes the use of this method in treating napalm burns in experimental animals. The researchers took particular interest in the immunological reactions occurring in animals, as well as the effect of the said therapy on the healing process. Two groups of rabbits, previously anaesthetised with Evipan and immunised with S. typhi phage F7 microorganisms, were burnt with the use of napalm. The tested group was subjected to a series of treatment sessions with 100% oxygen at the pressure of 2 atm, whereas the control group did not undergo such treatment. Six repeated tests on complement activity with 50% haemolysis method and heamagglutination reaction quantification with antigens O and H S.typhi phage F7 were carried out on all of the researched animals. Moreover, for the purpose of control of the healing process, a number of histopathological exams on the burn wounds were conducted in both groups of rabbits. The research showed an increase in complement activity in all tested animals; however, in the tested group it occurred later. Histopathological tests confirmed a more advanced healing process in the group subjected to hyperbaric oxygenation.


PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e10232
Author(s):  
Muniba Tariq ◽  
Hafiz Muhammad Tahir ◽  
Samima Asad Butt ◽  
Shaukat Ali ◽  
Asma Bashir Ahmad ◽  
...  

Background The present study aimed to prepare effective silk derived formulations in combination with plant extract (Aloe vera gel) to speed up the wound healing process in diabetic mice. Methods Diabetes was induced in albino mice by using alloxan monohydrate. After successful induction of diabetes in mice, excision wounds were created via biopsy puncture (6 mm). Wound healing effect of silk sericin (5%) and silk fibroin (5%) individually and in combination with 5% Aloe vera gel was evaluated by determining the percent wound contraction, healing time and histological analysis. Results The results indicated that the best biocompatible silk combination was of 5% silk fibroin and 5% Aloe vera gel in which wounds were healed in 13 days with wound contraction: 98.33 ± 0.80%. In contrast, the wound of the control group (polyfax) healed in 19 day shaving 98.5 ± 0.67% contraction. Histological analysis revealed that the wounds which were treated with silk formulations exhibited an increased growth of blood vessels, collagen fibers, and much reduced inflammation. Conclusion It can be concluded that a combination of Bombyx mori silk and Aloe vera gel is a natural biomaterial that can be utilized in wound dressings and to prepare more innovative silk based formulations for speedy recovery of chronic wounds.


2018 ◽  
Author(s):  
Yasuhiko Kaita ◽  
Takehiko Tarui ◽  
Hideaki Yoshino ◽  
Takeaki Matsuda ◽  
Yoshihiro Yamaguchi ◽  
...  

AbstractThe purpose of this study was to evaluate whether cryopreserved (frozen) adipose-derived regenerative cells (ADRCs) have a therapeutic effect on burn wound healing as well as freshly isolated (fresh) ADRCs.Full thickness burns were created on dorsum of nude mice and burn wound was excised. The wound was covered by artificial dermis with; (i) fresh ADRCs, (ii) frozen ADRCs, and (iii) PBS (control). The assessment for wound healing was performed by morphological, histopathological and immunohistochemical analyses.In vivo analyses exhibited the significant therapeutic effect of frozen ADRCs on burn wound healing up to the similar or higher level of fresh ADRCs. There were significant differences of wound closure, epithelized tissue thickness, and neovascularization between the treatment groups and control group. Although there was no significant difference of therapeutic efficacy between fresh ADRC group and frozen ADRC group, frozen ADRCs improved burn wound healing process in dermal regeneration with increased great type I collagen synthesis compared with fresh ADRCs.These findings indicate that frozen ADRCs allow us to apply not only quickly but also for multiple times, and the cryopreserved ADRCs could therefore be useful for the treatment of burn wounds in clinical settings.


2014 ◽  
Vol 47 (03) ◽  
pp. 370-374 ◽  
Author(s):  
Mohammad Javad Fatemi ◽  
Babak Nikoomaram ◽  
Amir Asadollah Khajeh Rahimi ◽  
Donya Talayi ◽  
Shahrzad Taghavi ◽  
...  

ABSTRACT Background: Various studies indicate that the green tea has anti-inflammatory and anti-oxidative properties. Moreover, a few studies have been carried out that demonstrate beneficial effects of green tea on burned patients. Materials and Methods: In this study, green tea, Vaseline, and silver sulfadiazine dressings were used as first-aid treatment to deep dermal contact burns in rats, compared with a control of nothing. After creating second-degree burn on the dorsum of rats, the treatments were applied for 15 min in four groups. Wound dressing changes were daily. Macroscopic study was performed on days 1, 3, 7, and 14 by using a digital camera and software processing of photos. Microscopic examination was done by pathologic evaluation of skin specimens on day 14. Results: We observed that green tea usage significantly decreased burn size in comparison to the control group (P = 0.004). Conclusion: Green tea is effective on healing process of second degree burn wounds.


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