Dermal Nanoemulsion Treatment Reduces Burn Wound Conversion and Improves Skin Healing in a Porcine Model of Thermal Burn Injury

2021 ◽  
Author(s):  
Vladislav A Dolgachev ◽  
Susan Ciotti ◽  
Emma Liechty ◽  
Benjamin Levi ◽  
Stewart C Wang ◽  
...  
Keyword(s):  
Burn Injury ◽  
Hair Follicles ◽  
Silver Sulfadiazine ◽  
Histological Evaluation ◽  
Full Thickness ◽  
Burn Wound ◽  
Thermal Burn ◽  
Burn Wounds ◽  
Partial Thickness ◽  
Mediators Of Inflammation

Abstract Objective Burn wound progression is an inflammation driven process where an initial partial-thickness thermal burn wound can evolve over time to a full-thickness injury. We have developed an oil-in-water nanoemulsion formulation (NB-201) containing benzalkonium chloride for use in burn wounds that is antimicrobial and potentially inhibits burn wound progression. We used a porcine burn injury model to evaluate the effect of topical nanoemulsion treatment on burn wound conversion and healing. Methods Anesthetized swine received thermal burn wounds using a 25cm 2 surface area copper bar heated to 80 oC. Three different concentrations of NB-201 (10%, 20%, or 40% nanoemulsion), silver sulfadiazine cream or saline were applied to burned skin immediately after injury and on days 1, 2, 4, 7, 10, 14, and 18 post-injury. Digital images and skin biopsies were taken at each dressing change. Skin biopsy samples were stained for histological evaluation and graded. Skin tissue samples were also assayed for mediators of inflammation. Results Dermal treatment with NB-201 diminished thermal burn wound conversion to a full-thickness injury as determined by both histological and visual evaluation. Comparison of epithelial restoration on day 21 showed that 77.8% of the nanoemulsion treated wounds had an epidermal injury score of 0 compared to 16.7% of the silver sulfadiazine treated burns (p=0.01). Silver sulfadiazine cream and saline treated wounds (controls) converted to full-thickness burns by day 4. Histological evaluation revealed reduced inflammation and evidence of skin injury in NB-201 treated sites compared to control wounds. The nanoemulsion treated wounds often healed with complete regrowth of epithelium and no loss of hair follicles (NB-201: 4.8±2.1, saline: 0±0, silver sulfadiazine: 0±0 hair follicles per 4mm biopsy section, p<0.05). Production of inflammatory mediators and sequestration of neutrophils were also inhibited by NB-201. Conclusions Topically applied NB-201 prevented the progression of a partial-thickness burn wound to full-thickness injury and was associated with a concurrent decrease in dermal inflammation.

scholarly journals Formation of Pseudomonas aeruginosa Biofilms in Full-thickness Scald Burn Wounds in Rats

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Kenneth S. Brandenburg ◽  
Alan J. Weaver ◽  
S. L. Rajasekhar Karna ◽  
Tao You ◽  
Ping Chen ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Burn Injury ◽  
Infection Model ◽  
Myeloperoxidase Activity ◽  
Full Thickness ◽  
Sprague Dawley ◽  
Burn Wound ◽  
Bacterial Gene ◽  
Burn Wounds ◽  
Cell Counts

Abstract Using Sprague-Dawley rats (350–450 g; n = 61) and the recently updated Walker-Mason rat scald burn model, we demonstrated that Pseudomonas aeruginosa readily formed biofilms within full-thickness burn wounds. Following the burn, wounds were surface-inoculated with P. aeruginosa in phosphate-buffered saline (PBS), while sterile PBS was used for controls. On post-burn days 1, 3, 7, and 11, animals were euthanized and samples collected for quantitative bacteriology, bacterial gene expression, complete blood cell counts, histology, and myeloperoxidase activity. Robust biofilm infections developed in the full-thickness burn wounds inoculated with 1 × 104 CFU of P. aeruginosa. Both histology and scanning electron microscopy showed the pathogen throughout the histologic cross-sections of burned skin. Quantigene analysis revealed significant upregulation of alginate and pellicle biofilm matrix genes of P. aeruginosa within the burn eschar. Additionally, expression of P. aeruginosa proteases and siderophores increased significantly in the burn wound environment. Interestingly, the host’s neutrophil response to the pathogen was not elevated in either the eschar or circulating blood when compared to the control burn. This new full-thickness burn biofilm infection model will be used to test new anti-biofilm therapies that may be deployed with soldiers in combat for immediate use at the site of burn injury on the battlefield.

555 Early Application of a Water-soluble Surfactant Dressing for Partial-thickness Burn Wounds to Reduce Wound Conversion

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S126-S126
Author(s):  
David M Hill ◽  
Ammar O Mahmood ◽  
Matthew B Mitchell ◽  
Jakob H Allen ◽  
William L Hickerson ◽  
...  
Keyword(s):  
Case Series ◽  
Water Soluble ◽  
Wound Dressings ◽  
Protective Mechanism ◽  
Full Thickness ◽  
Burn Wound ◽  
Early Application ◽  
Burn Wounds ◽  
Partial Thickness ◽  
Soluble Surfactant

Abstract Introduction Surfactant-based wound dressings have been utilized in chronic, non-healing wounds and small burn wounds to soften and aid removal of wound debris. In vitro data suggest enhanced healing properties are due to the ability to stabilize and potentially reseal plasma membranes, thereby, retaining cellular integrity and enhance wound healing. Further, surfactant-based wound dressings are non-ionic and may facilitate removal, sensitize, or prevent bacterial biofilms. Biofilms are an evolved, protective mechanism bacteria utilize to reduce antimicrobial efficacy. Removal or penetration of biofilms is essential for bacterial eradication. This case series presents outcomes from use of a water-soluble surfactant dressing (WSD) is used at hospital admission for treating partial thickness (PT) burn wounds. Methods This retrospective, single-center, electronic health record review, included patients, if they were admitted between August 1, 2019 - January 31, 2020, at least 18 years old, and sustained a PT burn wound treated with WSD on admission. Pregnant or incarcerated patients were excluded. The WSD was applied following initial wound debridement, and then twice daily until either discharge or it was deemed burn wound excision would be required. PT tissue salvage was calculated from body mass index (BMI), PT total body surface area (TBSA) burned, and cm2 requiring autografting. SigmaPlot 11.0 was utilized for statistical analysis. Results Thirty-two patients were included. All but one patient had a TBSA burned less than 20% with median (IQR) of 6% (3.5,9). Fifteen also had some full thickness injuries. Seventy-eight percent had flame injuries; 19% contact. Two had inhalation injuries. All but four had a significant past medical and/or social history. Fifty-nine percent had a history of substance abuse and 22% had diabetes. Nine patients had a delayed admission. The median BMI was 26 (24.3,34.2). There were no deaths. Seven patients were discharged within 48 hours to complete outpatient treatment. Median length of stay was 7 days (4.8,12.8). There was lack of any full thickness conversion to the applied areas in 69% of patients; 91% demonstrated either complete or some tissue salvage. Median % PT tissue salvage was 100 (75.3,100). The WSD was well tolerated and no patients developed a wound infection to the applied area. Conclusions Understanding inherent design limitations, this case series demonstrates feasibility of early application, and potential efficacy preventing wound conversion in a complex population with comorbidities and polysubstance abuse.

556 The Use of a Concentrated Surfactant Based Gel to Promote Burn Wound Healing

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S126-S127
Author(s):  
Rebecca Coffey ◽  
Rachel Penny
Keyword(s):  
Wound Healing ◽  
New Product ◽  
Ease Of Use ◽  
Burn Injuries ◽  
Full Thickness ◽  
Burn Wound ◽  
Burn Wounds ◽  
Burn Care ◽  
Product Trial ◽  
Burn Wound Healing

Abstract Introduction Strategies to remove necrotic tissue from burn wounds include excisional and non-excisional debridement. Alternative treatments could promote burn wound healing while minimizing patient discomfort and the need for surgery. We evaluated the usage of a concentrated surfactant gel (CSG) to promote burn wound healing in those with indeterminate depth and full thickness burn injuries. Methods An IRB approved retrospective study was conducted during a 10-patient new product trial period with enrollment between September and October 2019. Patients included in this study had indeterminate or full thickness burn wounds and were treated with a concentrated surfactant-based gel. Patients with non-burn diagnoses were excluded. Data collected included demographic information, injury descriptors, and additional burn wound characteristics. Results A total of 10 patients were included in this study as part of a new product trial. The subjects were 80% male with an average TBSA of 7.5%. 40% had indeterminate and 60% had full thickness burn wounds. Prior to initiation of the CSG, the burn wounds had been open for an average of 41 days. There were no infections or complications with usage of the CSG. 90% of patients reported less pain than the standard of care topical agents for burns. Average duration of treatment with the CSG until healing was 28 days. After usage of the CSG, no patients required surgery. Conclusions Our findings support the usage of a concentrated surfactant-based gel in patients with burn wounds. Patients reported decreased pain during dressing changes and ease of use compared to the standard topical agent in burn care. It also prevented surgical debridement in those with indeterminate and full thickness burn injuries.

670 Delayed Enzymatic Debridement of Burn Wounds using the Proteolytic Gel SN514

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S191-S192
Author(s):  
Angela R Jockheck-Clark ◽  
Randolph Stone ◽  
Michelle Holik ◽  
Lucy Schaffer ◽  
Shanmugasundaram Natesan ◽  
...  
Keyword(s):  
Burn Injury ◽  
Vehicle Control ◽  
Surrounding Tissue ◽  
Burn Wound ◽  
Burn Wounds ◽  
Delayed Treatment ◽  
Medical Evacuation ◽  
Contamination Levels

Abstract Introduction Thermal burns account for 5–10% of casualties sustained in present-day conflicts and are expected to be one of the most common wounds to occur in future conflicts. In prolonged field care (PFC) situations, medical evacuation could be delayed for days. During this time, burn wounds can become infected, detrimentally impact neighboring tissue, and cause systemic immune responses. Therefore, it is essential to test and evaluate non-surgical debridement agents that could be implemented prior to reaching a Role 3 military treatment facility. This work details how the proprietary proteolytic gel SN514 impacts burn debridement when applied within a PFC-like timeline. SN514 contains an enzyme formulation that is thermostable, easy to apply, and selectively degrades non-viable tissue in vitro and in vivo. Methods Deep-partial thickness contact burns were created using an established porcine model and covered with gauze or an antimicrobial incise drape. Four days later, the burns were treated with one of five treatments: 0.2% SN514, 0.8% SN514, a vehicle control, gauze, or an antimicrobial silver dressing. Treatments were re-applied every 24 hours for 72 to 96 hours. The effects of the treatment regiments were compared histologically. Biopsies were also taken to monitor bacterial contamination levels. Results Burns treated with SN514 were partially debrided and visually distinct from those treated with gauze, the silver dressing, or the vehicle control. Preliminary analyses suggest that SN514-treated burns that had been covered with “dry” gauze had a much lower debridement efficiency than those treated with the incise drape. This suggests that SN514 debridement efficiency may depend on the presence of a moist eschar. Preliminary analyses also suggest that there was little difference in burn wound bacterial counts among the five treatment groups. Conclusions SN514 is able to debride burns that experienced delayed treatment, without any evidence of harm to the surrounding tissue or evidence of exacerbating the original burn injury. SN514-treated wounds displayed little to no blood loss and did not increase burn wound infection levels compared to wounds treated with gauze or an antimicrobial silver dressing.

scholarly journals EFFECT OF HEALOL OIL ON WOUND HEALING IN WISTAR RATS: A NOVEL STUDY

2018 ◽  
Vol 11 (3) ◽  
pp. 152
Author(s):  
Sujith V ◽  
Poornima G ◽  
Balaji O ◽  
Bairy Kl ◽  
Praveen K ◽  
...  
Keyword(s):  
Wound Healing ◽  
Wistar Rats ◽  
Chronic Wounds ◽  
Statistical Significance ◽  
Silver Sulfadiazine ◽  
Histopathological Analysis ◽  
Burn Wound ◽  
Excision Wound ◽  
Burn Wounds ◽  
Wound Model

 Objective: Wound healing is a complex process, and various plant extracts have been used to study the effect of medicinal plants on wound healing. Healol oil is used in some tribal areas for ulcer healing and treatment of burn wounds. There are no animal studies done so far using healol oil to find out its role in the treatment of wounds. Hence, the aim of our study is to find the effect of healol oil in excision as well burn wounds in Wistar rats.Methods: Thirty-six Wistar rats were used, 18 rats in excision wound model and remaining in burn wound model. Each model consists of three groups of six rats each. Povidone-iodine was used as a standard control in excision wound model and silver sulfadiazine was used as a standard control in burn wound model. Healol oil was used as test drug in both the models. Period of epithelization and wound contracture rates were analyzed. Histopathological analysis of the skin tissue was done. One-way analysis of variance was used followed by Tukey’s post hoc test for statistical analysis using SPSS version 23 software, P value of <0.05 was taken as statistical significance.Results: Both standard and test groups showed significantly faster wound healing (p<0.001) compared to control rats treated with paraffin wax in both the models. In excision model standard povidone was significantly (p<0.001) better compared to healol oil whereas in burn model, silver sulfadiazine and healol oil showed comparable results with respect to period of epithelization without statistical significance (p>0.05).Conclusion: Wound healing property of healol oil is proved, and further clinical trial can be done to find out the effect of healol oil on chronic wounds due to various etiologies.

scholarly journals A 3D In Vitro Model for Burn Wounds: Monitoring of Regeneration on the Epidermal Level

Biomedicines ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1153
Author(s):  
Verena Schneider ◽  
Daniel Kruse ◽  
Ives Bernardelli de Mattos ◽  
Saskia Zöphel ◽  
Kendra-Kathrin Tiltmann ◽  
...  
Keyword(s):  
Wound Healing ◽  
Inflammatory Response ◽  
Healing Process ◽  
Three Dimensional ◽  
Source Model ◽  
Burn Wound ◽  
Thermal Burn ◽  
Burn Wounds

Burns affect millions every year and a model to mimic the pathophysiology of such injuries in detail is required to better understand regeneration. The current gold standard for studying burn wounds are animal models, which are under criticism due to ethical considerations and a limited predictiveness. Here, we present a three-dimensional burn model, based on an open-source model, to monitor wound healing on the epidermal level. Skin equivalents were burned, using a preheated metal cylinder. The healing process was monitored regarding histomorphology, metabolic changes, inflammatory response and reepithelialization for 14 days. During this time, the wound size decreased from 25% to 5% of the model area and the inflammatory response (IL-1β, IL-6 and IL-8) showed a comparable course to wounding and healing in vivo. Additionally, the topical application of 5% dexpanthenol enhanced tissue morphology and the number of proliferative keratinocytes in the newly formed epidermis, but did not influence the overall reepithelialization rate. In summary, the model showed a comparable healing process to in vivo, and thus, offers the opportunity to better understand the physiology of thermal burn wound healing on the keratinocyte level.

726 The Use of Xeroform Dressings for Partial Thickness Scald Burn Injuries in a Verified Pediatric Burn Center

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S194-S195
Author(s):  
Lisa C Vitale ◽  
Jennifer Livingston ◽  
Erica Curtis ◽  
Katherine Oag ◽  
Christina M Shanti ◽  
...  
Keyword(s):  
Burn Injury ◽  
Wound Care ◽  
Total Body Surface Area ◽  
Burn Injuries ◽  
Wound Complications ◽  
Burn Wound ◽  
Burn Center ◽  
Partial Thickness ◽  
Partial Thickness Burn ◽  
At Home

Abstract Introduction For children who have suffered a burn injury one of the greatest challenges is managing pain with an adequate yet practical burn wound dressing that will ultimately be managed at home. Medical product companies have created a variety of wound care products available on the market. These products are advertised to be more superior over one another in categories such as decrease in wound infections, minimization of pain, ease of dressing application, increased dressing wear time, and better wound healing. With all the options for burn wound care there are many factors to consider when choosing a burn dressing such as cost, ease of dressing for families at home, comfort, and efficacy. At our ten year verified pediatric burn center we have tried many different burn wound care products, however we have found Xeroform and bacitracin to be the most practical and easy to use for our patient population. Methods A retrospective chart review was performed from 2016–2018 of all cascading scald injuries to children 0–5 years of age treated at our verified pediatric burn center. 179 patients were included in this review. Of those patients a total of 52 patients were excluded, 28 patients had no follow up, 21 patients received alternate dressings, and 3 patients had full thickness injuries requiring a split thickness skin graft (STSG). Charts were reviewed for total body surface area (TBSA), length of stay (LOS), discharge dressing type, complications, and time to healing. All patients included routinely received consistent application of the Xeroform and bacitracin. Results 127 patients discharged with Xeroform dressings were included in this study with an average age of 1.4 years old (range 0–5 years) and average TBSA of 2.5% (range 0.25–13%). The average LOS was 1.6 days (range 1–10 days). In this sample 32 (25%) patients were healed within 7 days. 77 (61%) patients were healed within 7–14 days. 11 (9%) patients were healed within 14–21 days. 7 (5%) patients were healed in greater than 21 days. There were no wound complications identified within this study group. Conclusions Using Xeroform as our standard of practice has streamlined the care provided to our patients. We have demonstrated consistent effective re-epithelization, protection from infection, and ease of dressings for families and burn providers. In our experience Xeroform has provided a versatile way to care for partial thickness burn injuries. Applicability of Research to Practice We suggest Xeroform and bacitracin dressings be used for partial thickness burn injuries in patients under 5 years of age. This dressing may be superior to other products because it allows for bathing while providing good wound epithelization and is easy to use.

Comparison Among Bone Marrow and Wheat Flour’s Mixture and Standard Treatment on Healing Second-Degree Burn Wound in Rats

2020 ◽  
Author(s):  
Saboreh Jafari ◽  
Rostam Jalali ◽  
Cyrus Jalili ◽  
Tahereh Jamshidpoor
Keyword(s):  
Bone Marrow ◽  
Blood Vessels ◽  
Wheat Flour ◽  
Standard Treatment ◽  
Treated Group ◽  
Hair Follicles ◽  
Silver Sulfadiazine ◽  
Male Rats ◽  
Control Group ◽  
Burn Wound

Abstract The treatment of extensive skin burns remains as a challenge for health care personnel. This study aimed to compare the combination of bone marrow and wheat flour with standard treatment on animal models. In this experimental study, 45 male rats were randomly assigned into three groups as follows: The first group was control (no treatment), the second group received bone marrow and wheat flour combination topically, and the third group received standard treatment (1% silver sulfadiazine). The treatment lasted for up to 21 days. On the 22nd day, the rats were killed. The number of blood vessels and hair follicles was measured in the burn wound bed. The area and depth of the wound were also measured. Data were analyzed using SPSS software version 16. The results showed that, complete closure of the wound was better in the bone marrow treated group compared with the group receiving the silver sulfadiazine and the control group. Furthermore, the wound healing was better in the silver sulfadiazine group compared with the control group. Microscopic examination revealed a significant increase in the number of hair follicles and blood vessels in the bone marrow and silver groups compared with the control group. The results showed that, the group treated with bone marrow, because of the presence of mesenchymal and stem cells can cause stimulating angiogenesis and producing vegetative tissue, hence it improved maturation, shrinkage, and contraction of the wound in comparison with the silver sulfadiazine and control groups

Effect of Tephrosia purpurea (L) Pers. on Partial Thickness and Full Thickness Burn Wounds in Rats

2010 ◽  
Vol 7 (1) ◽  
Author(s):  
Santram Lodhi ◽  
Rajesh Singh Pawar ◽  
Alok Pal Jain ◽  
Avijeet Jain ◽  
Abhay K Singhai
Keyword(s):  
Full Thickness ◽  
Burn Wounds ◽  
Tephrosia Purpurea ◽  
Partial Thickness

scholarly journals Evaluation of chitosan gel with 1% silver sulfadiazine as an alternative for burn wound treatment in rats

2009 ◽  
Vol 24 (6) ◽  
pp. 460-465 ◽  
Author(s):  
Ednaldo Gomes do Nascimento ◽  
Tarcísio Bruno Montenegro Sampaio ◽  
Aldo Cunha Medeiros ◽  
Eduardo Pereira de Azevedo
Keyword(s):  
Healing Process ◽  
Healing Time ◽  
Silver Sulfadiazine ◽  
Topical Formulation ◽  
Burn Wound ◽  
Burn Wounds ◽  
Group Iii ◽  
Group I ◽  
New Formulation ◽  
Chitosan Gel

PURPOSE: Evaluation of the rheological, biological and therapeutic properties of a new topical formulation consisting of chitosan gel containing 1% silver sulfadiazine, as an alternative for the treatment of burn wounds. METHODS: An experimental study was done with 21 Wistar rats divided into three groups. Group I was treated with chitosan gel without the antimicrobial, group II was treated with chitosan gel with 1% silver sulfadiazine and group III was treated with commercially available 1% silver sulfadiazine cream. RESULTS: Due to its pseudoplastic characteristic and good bioadhesiveness, the chitosan gels showed a satisfactory retention time over the wounds. No statistical difference was found in the amount of drug released from the chitosan gel and commercially available cream, as well as in the healing time among the groups. Wounds treated with chitosan gel with silver sulfadiazine showed a higher fibroblast production and a better angiogenesis than in the other groups, which are important parameters on the evolution of the healing process. CONCLUSION: The topical use of chitosan gel in association with silver sulfadiazine ameliorated the neovascularization and inflammatory reaction in burn wounds. This new formulation showed advantageous rheological properties and efficient release of the drug.

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