scholarly journals Burn Injury Alters Epidermal Cholinergic Mediators and Increases HMGB1 and Caspase 3 in Autologous Donor Skin and Burn Margin

Shock ◽  
2017 ◽  
Vol 47 (2) ◽  
pp. 175-183 ◽  
Author(s):  
Casey J. Holmes ◽  
Jennifer K. Plichta ◽  
Richard L. Gamelli ◽  
Katherine A. Radek
Keyword(s):  
2010 ◽  
Vol 43 (S 01) ◽  
pp. S114-S120
Author(s):  
Madhuri A. Gore ◽  
Anuradha S. De

ABSTRACT Background: In the absence of xenograft and biosynthetic skin substitutes, deceased donor skin allografts is a feasible option for saving life of patient with extensive burn injury in our country. Aims: The first deceased donor skin allograft bank in India became functional at Lokmanya Tilak Municipal (LTM) medical college and hospital on 24th April 2000. The response of Indian society to this new concept of skin donation after death and the pattern of utilization of banked allografts from 2000 to 2010 has been presented in this study. Settings and Design: This allograft skin bank was established by the department of surgery. The departments of surgery and microbiology share the responsibility of smooth functioning of the bank. Materials and Methods: The response in terms of number of donations and the profile of donors was analyzed from records. Pattern and outcome of allograft utilization was studied from specially designed forms. Results: During these ten years, 262 deceased donor skin allograft donations were received. The response showed significant improvement after counselling was extended to the community. Majority of the donors were above 70 years of age and procurement was done at home for most. Skin allografts from 249 donors were used for 165 patients in ten years. The outcome was encouraging with seven deaths in 151 recipients with burn injuries. Conclusions: Our experience shows that the Indian society is ready to accept the concept of skin donation after death. Use of skin allografts is life saving for large burns. We need to prepare guidelines for the establishment of more skin banks in the country.


1999 ◽  
Vol 229 (6) ◽  
pp. 851 ◽  
Author(s):  
Kunitaro Fukuzuka ◽  
Jason J. Rosenberg ◽  
Gregory C. Gaines ◽  
Carl K. Edwards ◽  
Michael Clare-Salzler ◽  
...  
Keyword(s):  

2000 ◽  
Vol 278 (4) ◽  
pp. R1005-R1018 ◽  
Author(s):  
Kunitaro Fukuzuka ◽  
Carl K. Edwards ◽  
Michael Clare-Salzler ◽  
Edward M. Copeland ◽  
Lyle L. Moldawer ◽  
...  

Immune suppression and increased apoptotic loss of circulating lymphocytes have been reported after burn injury. However, little is known about the underlying mechanisms responsible for the increased apoptosis of lymphoid and parenchymal cells in solid organs and the role played by inflammatory mediators, such as tumor necrosis factor-α (TNF-α) and Fas ligand (FasL), as well as by glucocorticoids. To evaluate the role of endogenously produced glucocorticoids and FasL, mice subjected to a 20% steam burn were pretreated with a glucocorticoid receptor antagonist (mifepristone) or a neutralizing murine Fas fusion protein. Three and twenty-four hours after burn injury, histological analysis, caspase-3 activity, and in situ terminal deoxynucleotidyl transferase dUTP nick-end labeling staining and phenotyping of lymphocyte populations for apoptosis were evaluated. Burn injury increased the number of apoptotic cells and caspase-3 activity in thymus and spleen, but not in other solid organs. Increased apoptosis was seen in several T and B cell populations from both thymus and spleen. Mifepristone pretreatment significantly reduced the apoptosis and caspase-3 activity after burn injury, whereas blocking FasL activity had only minimal effects. We conclude that corticosteroids, and not FasL, are primarily responsible for the increased caspase-3 activity and apoptosis in thymus and spleen cell populations early after burn injury.


2014 ◽  
Vol 35 (2) ◽  
pp. e93-e98 ◽  
Author(s):  
Hong-Min Luo ◽  
Sen Hu ◽  
Hui-Ying Bai ◽  
Hai-Bin Wang ◽  
Ming-Hua Du ◽  
...  

2013 ◽  
Vol 257 (6) ◽  
pp. 1129-1136 ◽  
Author(s):  
Gaofeng Zhao ◽  
Yong-Ming Yu ◽  
Masao Kaneki ◽  
Ronald G. Tompkins ◽  
Alan J. Fischman

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S37-S38
Author(s):  
Jeffrey E Carter ◽  
Blake Platt ◽  
Charles T Tuggle

Abstract Introduction Burn injuries remain a surgical challenge with few recent innovations. Grafting with split-thickness skin grafts (STSGs) has been the standard of care for decades. Although shown to have mortality benefits, STSGs are associated with significant morbidity in the form of pain and additional open wounds. For years, surgeons have looked for ways to decrease this associated morbidity. To that end, autologous skin cell suspension (ASCS) is a recently FDA-approved point of care regenerative medicine technology that reduces donor skin requirements without compromising clinical outcomes. Our study evaluated the cost and length of stay comparing STSG alone versus ASCS. Methods We obtained IRB-approval for single institution, retrospective chart review of patients age >14 years admitted with burn injuries from March 2018 – September 2018. Primary outcome was length of stay/%TBSA for patients undergoing STSG alone as compared to patients undergoing ASCS. The 2016 American Burn Association National Burn Repository (NBR) was used to benchmark LOS/%TBSA. Age, percentage burn injury (TBSA), LOS, mortality, and number of surgeries were reviewed. Student’s t-test was used to assess statistical significance of intragroup analysis. Results 36 patients were treated with ASCS in combination with meshed autografts for full-thickness acute burn injuries. 37 patients were treated with STSGs at our center. Mean age and %TBSA was 45.2 years and 6.6% for the STSG group and 46.0 years and 18.6% for the ASCS group. The LOS/%TBSA for the STSG was 1.72 versus 1.19 for the ASCS patients (p-value=0.02). The NBR predicts a LOS/%TBSA of 3.38 and 3.42 for the STSG and ASCS groups. Patients in the STSG group and ASCS group had statistically similar surgeries and mortalities. Conclusions Burn injured patients treated with ASCS had a decreased LOS/%TBSA when compared to both the STSGs and NBR predictions. ASCS is a novel technology allowing for point-of-care treatment that may decrease LOS for burn injured patients and should be considered as an adjunct to traditional techniques for burn patients. Applicability of Research to Practice Reduced length of stay compared to traditional burn care.


2000 ◽  
Vol 279 (5) ◽  
pp. E1114-E1121 ◽  
Author(s):  
Shingo Yasuhara ◽  
Mary-Ellen Perez ◽  
Emi Kanakubo ◽  
Yoko Yasuhara ◽  
Yong-Sup Shin ◽  
...  

Critical illness is associated with muscle wasting and muscle weakness. Using burn injury as a model of local and systemic inflammatory response, we tested the hypothesis that thermal injury causes apoptosis in muscle. After a 40% body surface area burn to rats, abdominal muscles beneath the burn and limb muscles distant from the burn were examined for apoptosis at varying times after burn. Ladder assay, ELISA, and histological methods showed evidence of apoptosis in the abdominal muscles within 4–12 h with peak changes occurring at 3–7 days. Maximal apoptosis was also evident at distant limb muscles at 3–7 days. Investigation of proapoptotic pathways indicated mitochondrial membrane potential to be altered by 1 h after burn. Starting at 15 min after burn, cytochrome c was released from the mitochondria into the cytosol, followed by increased activity of caspase-3, starting at 6 h after burn. These studies suggest that mitochondria and caspase-mediated apoptotic pathways may be an additional mechanism of muscle weight loss in burns and may be potential therapeutic targets for prevention of muscle wasting.


Shock ◽  
2017 ◽  
Vol 48 (4) ◽  
pp. 441-448 ◽  
Author(s):  
Jennifer K. Plichta ◽  
Xiang Gao ◽  
Huaiying Lin ◽  
Qunfeng Dong ◽  
Evelyn Toh ◽  
...  

Author(s):  
Charis Kelly ◽  
David Wallace ◽  
Veronique Moulin ◽  
Lucie Germain ◽  
Jennifer Zuccaro ◽  
...  

Abstract There have been significant improvements in the technology available for treating extensive burns in the past decade. This case presents two unique, skin replacement technologies that were used to treat an 86% surface area flame burn in a pediatric patient. A temporary dermal replacement, known as “Novosorb™ Biodegradable Temporizing Matrix” was first used to stabilize the burn injury and remained in place for approximately three months. Given the large burn size and lack of available donor skin for grafting, a permanent skin replacement product known as “Self-Assembled Skin Substitute (SASS)” was then utilized to cover the burns. SASS is a novel technology that was developed to replace skin as an autologous skin graft and is currently available in Canada through a clinical trial for major burns. Ultimately, the concurrent use of these two technologies allowed for the unprecedented survival of a child following an extensive and life-threatening burn injury.


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