Pediatric Burn Treatment Using Tilapia Skin as a Xenograft for Superficial Partial-Thickness Wounds: A Pilot Study

Author(s):  
Edmar Maciel Lima Júnior ◽  
Manoel Odorico de Moraes Filho ◽  
Antonio Jorge Forte ◽  
Bruno Almeida Costa ◽  
Francisco Vagnaldo Fechine ◽  
...  

Abstract This study aims to evaluate the efficacy of Nile tilapia skin as a xenograft for the treatment of partial-thickness burn wounds in children. This is an open-label, monocentric, randomized phase II pilot study conducted in Fortaleza, Brazil. The study population consisted of 30 children between the ages of 2 and 12 years with superficial “partial-thickness” burns admitted less than 72 hours from the thermal injury. In the test group, the tilapia skin was applied. In the control group, a thin layer of silver sulfadiazine cream 1% was applied. Tilapia skin showed good adherence to the wound bed, reducing the number of dressing changes required, the amount of anesthetics used, and providing benefits for the patients and also for healthcare professionals, by reducing the overall work load. The number of days to complete burn wound healing, the total amount of analgesics required throughout the treatment, burn improvement on the day of dressing removal, and pain throughout the treatment were similar to the conventional treatment with silver sulfadiazine. Thus, tilapia skin can be considered an effective and low-cost extra resource in the therapeutic arsenal of pediatric superficial partial thickness burns.

Author(s):  
Edmar Maciel Lima Júnior ◽  
Manoel Odorico de Moraes Filho ◽  
Bruno Almeida Costa ◽  
Francisco Vagnaldo Fechine ◽  
Marina Becker Sales Rocha ◽  
...  

Abstract Glycerolized Nile tilapia skin (NTS) showed promising results when used for burn treatment in phases II and III randomized controlled trials. This pilot study aims to evaluate the effectiveness of lyophilized NTS (LNTS) as a temporary skin substitute for superficial partial-thickness burns by comparing it with silver-impregnated sodium carboxymethylcellulose dressing. This was a randomized, prospective, open-label, and controlled pilot study conducted in Fortaleza, Brazil, from April 2019 to December 2019. The 24 participants had ≥18 and ≤70 years of age and superficial partial-thickness burns affecting up to 10% of TBSA. Primary outcomes were the number of dressings performed and pain intensity, assessed via the Visual Analogue Scale and the Electronic von Frey. Secondary outcomes were the level of pain-related anxiety, assessed via the Burns Specific Pain Anxiety Scale, and analgesic consumption. In the test group, the number of dressings and the patient-reported pain after dressing-related procedures were lower. Analgesic intake, pain-related anxiety, and both patient-reported and objectively measured pain before dressing-related procedures were similar for the treatment groups. No adverse effects were detected. LNTS shares the same characteristics of an “‘ideal’” wound dressing demonstrated by glycerolized NTS in previous studies. Also, it demonstrated noninferiority for burn management when compared with silver-impregnated sodium carboxymethylcellulose dressing. The safety and efficacy of LNTS demonstrated in this pilot study may allow the development of larger phases II and III RCTs in a near future.


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.


2016 ◽  
Vol 50 (3) ◽  
pp. 522-528 ◽  
Author(s):  
Michel Marcos Dalmedico ◽  
Marineli Joaquim Meier ◽  
Jorge Vinícius Cestari Felix ◽  
Franciele Soares Pott ◽  
Francislene de Fátima Cordeiro Petz ◽  
...  

Abstract OBJECTIVE To evaluate the effectiveness of hyaluronic acid in the healing of partial thickness burns. METHOD Systematic review of randomized controlled trials on the use of hyaluronic acid for the topical treatment of skin burns, based on recommendations of the Cochrane Handbook for Systematic Reviews of Interventions. RESULTS Two randomized controlled trials that analyzed 143 patients with partial thickness burns and/or deep partial thickness burns were selected. They compared the application of hyaluronic acid 0.2% associated to silver sulfadiazine 1% 5g/cm2 versus silver sulfadiazine 1% 5g/cm2 alone for the outcome of complete healing. CONCLUSION This review emphasizes the need for new well-designed randomized controlled trials to establish the therapeutic relevance of hyaluronic acid with respect to the healing of burns of partial thickness or deep partial thickness.


2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
D. Poranki ◽  
C. Goodwin ◽  
M. Van Dyke

Partial thickness burns can advance to full thickness after initial injury due to inadequate tissue perfusion and increased production of inflammatory cytokines, which has been referred to as burn wound progression. In previous work, we demonstrated that a keratin biomaterial hydrogel appeared to reduce burn wound progression. In the present study, we tested the hypothesis that a modified keratin hydrogel could reduce burn wound progression and speed healing. Standardized burn wounds were created in Yorkshire swine and treated within 30 minutes with keratin hydrogel (modified and unmodified), collagen hydrogel, or silver sulfadiazine (SSD). Digital images of each wound were taken for area measurements immediately prior to cleaning and dressing changes. Wound tissue was collected and assessed histologically at several time points. Wound area showed a significant difference between hydrogels and SSD groups, and rates of reepithelialization at early time points showed an increase when keratin treatment was used compared to both collagen and SSD. A linear regression model predicted a time to wound closure of approximately 25 days for keratin hydrogel while SSD treatment required 35 days. There appeared to be no measurable differences between the modified and unmodified formulations of keratin hydrogels.


2017 ◽  
Vol 16 (1) ◽  
pp. 45-50 ◽  
Author(s):  
Saruta Wattanaploy ◽  
Kusuma Chinaroonchai ◽  
Nantaporn Namviriyachote ◽  
Pornprom Muangman

Silver sulfadiazine is commonly used in the treatment of partial-thickness burns, but it sometimes forms pseudo-eschar and delays wound healing. Polyhexanide/betaine gel, a new wound cleansing and moisturizing product, has some advantages in removing biofilm and promotes wound healing. This study was designed to compare clinical efficacy of polyhexanide/betaine gel with silver sulfadiazine in partial-thickness burn treatment. From September 2013 to May 2015, 46 adult patients with partial-thickness burn ≥10% total body surface area that were admitted to the Burn Unit of Siriraj Hospital within 48 hours after injury were randomly allocated into 2 groups. One group was treated with polyhexanide/betaine gel, and the other group was treated with silver sulfadiazine. Both groups received daily dressing changes and the same standard care given to patients with burns in this center. Healing times in the polyhexanide/betaine gel group and silver sulfadiazine group were 17.8 ± 2.2 days and 18.8 ± 2.1 days, respectively ( P value .13). There were no significant differences in healing times, infection rates, bacterial colonization rates, and treatment cost in both groups. The pain score of the polyhexanide/betaine gel group was significantly less than the silver sulfadiazine group at 4 to 9 days after treatment ( P < .001). The satisfactory assessment result of the polyhexanide/betaine gel group was better than that in the silver sulfadiazine group. These data indicate the need for adequately designed studies to elicit the full potential of polyhexanide gel as a wound dressing for partial-thickness burn wounds.


Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 432
Author(s):  
Herbert L. Haller ◽  
Sigrid E. Blome-Eberwein ◽  
Ludwik K. Branski ◽  
Joshua S. Carson ◽  
Roselle E. Crombie ◽  
...  

Background and Objectives: Porcine xenografts have been used successfully in partial thickness burn treatment for many years. Their disappearance from the market led to the search for effective and efficient alternatives. In this article, we examine the synthetic epidermal skin substitute Suprathel® as a substitute in the treatment of partial thickness burns. Materials and Methods: A systematic review following the PRISMA guidelines has been performed. Sixteen Suprathel® and 12 porcine xenograft studies could be included. Advantages and disadvantages between the treatments and the studies’ primary endpoints have been investigated qualitatively and quantitatively. Results: Although Suprathel had a nearly six times larger TBSA in their studies (p < 0.001), it showed a significantly lower necessity for skin grafts (p < 0.001), and we found a significantly lower infection rate (p < 0.001) than in Porcine Xenografts. Nonetheless, no significant differences in the healing time (p = 0.67) and the number of dressing changes until complete wound healing (p = 0.139) could be found. Both products reduced pain to various degrees with the impression of a better performance of Suprathel® on a qualitative level. Porcine xenograft was not recommended for donor sites or coverage of sheet-transplanted keratinocytes, while Suprathel® was used successfully in both indications. Conclusion: The investigated parameters indicate that Suprathel® to be an effective replacement for porcine xenografts with even lower subsequent treatment rates. Suprathel® appears to be usable in an extended range of indications compared to porcine xenograft. Data heterogeneity limited conclusions from the results.


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


2016 ◽  
Vol 5 (12) ◽  
pp. 546-552 ◽  
Author(s):  
Justine S. Kim ◽  
Alexander J. Kaminsky ◽  
J. Blair Summitt ◽  
Wesley P. Thayer

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