133 Oxidative Stress Can Be Significantly Influenced and Reduced by Polylactide-based Membrane Dressings
Abstract Introduction Oxidative stress is part of the physiological response to local thermal injuries and has systemic effects in more extensive burns, vascular hyperpermeability, burn edema, cellular damage, and functions of the heart, lung, liver, kidneys, muscles, and other organs. Free NO and OH radicals affect mitochondrial function, and lower energy delivery to other organelles releases thermal energy, leading to hypermetabolism. Antioxidant therapies have attempted to reduce the consequences of oxidative stress with limited effects; however, the effect of external dressings is unclear. This study aimed to investigate the positive effects of polylactide-based membranes (PLM) on oxidative stress and clinical outcomes in burns. Methods Herein, a prospective study assessed the correlation between oxidative stress and the severity of injuries by measuring serum malonaldehyde (MDA) and glutathione levels and the total oxidant and antioxidant capacities (TOC and TAC) among children with electrical injuries. Furthermore, a prospective randomized study evaluated the TOC and TAC, MDA, glutathione, IL-6, TNF-α, and TGF-β levels, and the ratio of telomerase positive staining in epidermal cells along the particle thickness of burns in children, when comparing polylactide dressings to Hydrofiber Ag(HFAg), autografts, and controls. Results Coherence between measured oxidative stress and injury severity was apparent herein. Application of PLMs significantly reduced oxidative stress in partial-thickness burns compared to HFAg. PLMs decreased the TOC (4,91 VS. 16,78 µmol/L, day 7) and increased the TAC (14,47 VS. 4,34 µmol/L, day 7). The healing duration was lesser than that of HFAg (13 VS. 21 d). Proinflammatory IL-6 levels were significantly lower in the PLM group and TNF-α values were significantly reduced from days 7 to 14. The anti-inflammatory levels of TGF-β was significantly elevated (days 3–21) in the PLM Group. Telomerase levels and the cell count were higher in healed skin in the PLM group. Conclusions Oxidative stress depends on injury severity and is potentially influenced by dressings. PLM mediates the regulation of oxidative stress, as evident from the TOC and TAC, and pro- and anti-inflammatory cytokines including IL-6, TNF-α, and TGF-β by PLMs might positively influence the healing duration and skin quality in burns. These results could show that oxidative stress can be significantly influenced and reduced by PLM dressings.