DOES BURN WOUND EXCISION AFTER THERMAL INJURY ATTENUATE SUBSEQUENT MACROPHAGE HYPERACTIVITY AND IMMUNOSUPPRESSION?

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.

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Burns Management In Tertiary Health Care Centre

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v12i1.4188 ◽

2021 ◽

Vol 12 (1) ◽

pp. 544-550

Author(s):

Ajitsingh .P. Chadha ◽

Nehadeepkaur A Chadha ◽

Kshirsagar A Y

Keyword(s):

Health Care ◽

Skin Grafting ◽

Cost Effective ◽

Surgical Excision ◽

Burn Wound ◽

Health Care Centre ◽

Burn Scar ◽

Wound Excision ◽

Contracture Formation ◽

Rural Places

In rural places of our country, burns have become frequent accidents due to the use of floor-based stoves & kerosene lamps. Suicides due to burns are also quite usual in our country. The objective of this study is to evaluate the necessity of early excision of the burn wound and skin grafting to decrease the morbidity, mortality, complications of burns and stay at the hospital. Calculate pressure garment efficacy in preventing burn scar and contracture formation. To lay out cost-effective management for patients at rural hospitals. 50 patients were included in this study presenting with burn injuries, admitted in the department of plastic surgery from June 2019 to December 2020. In a recent study, Females (52%) suffered more as compared to males. Scalds were the prime root cause of the burns constituting the 52% of the cases. Infections of Burn wound was seen in 20 patients (40%). Pseudomonas was prime organism isolated. Wound excision was required in 19 patients (38%). Around 6 to 12 days, elapsed between the injury to the surgical excision. 19 patients required (38%) covering of wound permanently with STSG. The mean admission period in hospital for burns of 41-60% was 62 days, 33.4 days for 21-40% burns and 19.6 days for <20%. Amongst 50 patients, 3 died accounting to 6% of overall cases. This study concluded that initiation of resuscitation with untimely wound excision and permanent coverage with grafting can bring significant fall in mortality, painful debridements, limiting complications, decreasing the duration of stay at a hospital, curtailing the cost of health care and time apart from work.

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

Art of Medicine ◽

10.21802/artm.2021.3.19.81 ◽

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.

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