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This study utilized CiteSpace software to conduct a bibliometric analysis of the literature related to the use of growth hormones in treating burns. The results showed that the research on this topic has attracted increasing attention from scholars worldwide, with the number of publications increasing annually. The research teams and institutions involved in this field are mainly concentrated in China, followed by the United States, Russia, and other countries. The analysis also revealed the prominent co-cited literature and the most influential authors in the field, such as D. N. Herndon and Y. Li. The main research themes identified in the literature included the effects of growth hormones on wound healing, tissue repair and regeneration, inflammatory responses, and cell proliferation. In addition, the research on the clinical applications of growth hormone in burn treatment has been expanded to include areas such as metabolic regulation, immune function, and the prevention of infections. The findings of this study provide useful insights into the current status and future directions of research in the field of growth hormone treatment of burns. [ABSTRACT FROM AUTHOR]

Burns in children represent a significant challenge in the global health domain. The research aims to analyze the profile of children in Romania affected by burns, focusing on demographic characteristics, severity of burns, applied treatment, and impact on parents. Through this analysis, we aim to better understand the factors involved in these cases and provide relevant information for improving the management and care of children with burns. This study aims to explore various aspects related to the healing of burn injuries in pediatric patients in Romania, analyzing data collected through a questionnaire administered to 107 parents. The profile of children in Romania affected by burns is primarily composed of relatively young children, with an average age of 8.7 years and an even distribution between genders. Most come from rural areas, and the degree of burns ranges from first to fourth degree, reflecting a wide range of severity of injuries. Treatment is diverse, with a tendency towards conservative approaches and a significant proportion of cases without complications. Parental satisfaction is not significantly influenced by the type of treatment, indicating a similar perception regardless of the mode of medical intervention. Improving the management and care of children with burns is achieved through adopting a multidisciplinary and integrative perspective. This involves the use of non-pharmacological therapies such as hypnosis and regional anesthesia for pain and anxiety control. Additionally, the inclusion of adjunctive therapies, such as the use of mesenchymal stromal cells and tilapia skin xenograft, contributes to improving the healing process. [ABSTRACT FROM AUTHOR]

Copyright of Nővér is the property of Chamber of Hungarian Health Care Professionals and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Burn injuries in childhood create serious trauma for both children and their caregivers. Burn injuries require extensive nursing care to reduce complications and to restore optimal functional health conditions. When children receive burn treatment and their caregivers are migrants with different languages, religions, and habits, nurses must adopt a cultural approach while caring for such patients. This descriptive qualitative study aimed to reveal the challenges, expectations, and cultural care experiences of nurses regarding migrant children receiving burn treatment and their caregivers. Purposive sampling was used to recruit the nurses (n = 12). Semi-structured face-to-face interviews were conducted with nurses using an interview guide, and the interviews were recorded. Thematic analysis was used to create themes in the study. The data were gathered around three main themes: " challenges " with the subcategories "communication," "trust relationship," and "care burden"; " expectations for better care " with the subcategories "translator support" and "hospital environment"; and " intercultural care " with the subcategories "cultural-religious differences" and "intercultural sensitivity." The results of this study provide a novel insight into nurses' experiences with migrant child patients and their caregivers, and can be used to develop action plans to provide effective cultural care for patients receiving burn treatment and their caregivers. • Little is known about the experiences of nurses regardıng mıgrant children receiving burn treatment and their caregivers. • In the study, three main themes were determined as "challenges", "expectations for better care" and "intercultural care". • This study provide a novel insight into the nurses' experiences of migrant child patients and their caregivers. • The results of this study can be used to develop action plans to provide effective cultural care in burn units. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Faculty of Pharmacy of Ankara University / Ankara Üniversitesi Eczacilik Fakültesi Dergisi is the property of Ankara University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Autologous cultured epidermis (CE) is an effective approach for overcoming the deficiency of donor sites to treat extensive burns. However, the production of autologous CE takes 3–4 weeks, which prevents its use during the life-threatening period of severe burns. In contrast, allogeneic CE can be prepared in advance and used as a wound dressing, releasing several growth factors stimulating the activity of recipient cells at the application site. Dried CE is prepared by drying CEs under controlled temperature and humidity conditions until all the water is completely removed and no viable cells are present. Dried CE accelerates wound healing in a murine skin defect model and is potentially a new therapeutic strategy. However, the dried CE safety and efficacy have not yet been studied in large animal models. Therefore, we studied the safety and efficacy of human-dried CE in wound healing using a miniature swine model. Methods: Human CE was manufactured using Green's method from donor keratinocytes. Three types of CEs (Fresh, Cryopreserved, and Dried) were prepared, and the ability of each CE to promote keratinocyte proliferation was confirmed in vitro. Extracts of the three CEs were added to keratinocytes seeded in 12-well plates, and cell proliferation was evaluated using the WST-8 assay for 7 days. Next, we prepared a partial-thickness skin defect on the back of a miniature swine and applied three types of human CE to evaluate wound healing promotion. On days 4 and 7, the specimens were harvested for hematoxylin-eosin, AZAN, and anti-CD31 staining to assess epithelialization, granulation tissue, and capillary formation. Results: The conditioned medium containing dried CE extract significantly enhanced keratinocyte proliferation compared to the control group (P

Nano- and microemulsions are colloidal systems that are widely used in various fields of biomedicine, including wound and burn healing, cosmetology, the development of antibacterial and antiviral drugs, oncology, etc. The stability of these systems is governed by the balance of molecular interactions between nanodomains. Microemulsions as a colloidal form play a special important role in stability. The microemulsion is the thermodynamically stable phase from oil, water, surfactant and co-surfactant which forms the surface of drops with very small surface energy. The last phenomena determines the shortage time of all fluid dispersions including nanoemulsions and emulgels. This review examines the theory and main methods of obtaining nano- and microemulsions, particularly focusing on the structure of microemulsions and methods for emulsion analysis. Additionally, we have analyzed the main preclinical and clinical studies in the field of wound healing and the use of emulsions in cancer therapy, emphasizing the prospects for further developments in this area. [ABSTRACT FROM AUTHOR]

Background and Objectives: Skin scaffolding can be done using allografts and autografts. As a biological allograft, the skin of Oreochromis niloticus (ON) has been used due to its high type I and III collagen content. Oreochromis mossambicus (OM) is also a member of the Oreochromis family, but not much is known regarding its collagen content. As such, this study aimed to assess and compare the collagen content of the two fish species. Materials and Methods: This is a crossover study comparing the skin collagen contents of the two fish. Young fish were chosen, as they tend to have higher collagen concentrations. The skin samples were sterilized in chlorhexidine and increasing glycerol solutions and analyzed histochemically with Sirius red picrate under polarized light microscopy. Results: 6 young ON and 4 OM specimens were used. Baseline type I collagen was higher for OM, but at maximum sterilization it was higher for ON, with no differences in between Type III collagen was higher for OM across all comparisons with the exception of the last stage of sterilization. Generally, collagen concentrations were higher in highly sterilized samples. Conclusions: OM skin harvested from young fish, with its greater collagen III content may be a better candidate for use as a biological skin scaffold in the treatment of burn wounds, compared to ON. [ABSTRACT FROM AUTHOR]

Introduction and aim. The World Health Organization (WHO) reports that around 11 million people experience burn injuries each year.1,2 Burn injuries occur when tissue damage is caused by various factors such as UV radiation, heat, chemicals, or electric current.3,4 While burns primarily affect the skin, they can also extend to deeper tissues like bones or muscles. When the skin is burned, its vital functions, including protection against the external environment, pathogens, and evaporation, are compromised.1 The appropriate treatment method must be chosen based on the burn stage, the patient's condition, and the cause. The aim of this paper is to provide a comprehensive review based on literature, concerning superficial burns and sunburns treatment, with a focus on nature-derived topical treatment methods. Material and methods. PubMed database was searched for the following terms: “burns”, “burn treatment”, “aloe vera”, “sunburn”, “centella asiatica”, “climate change”, “wound healing” for the articles published between 2005-2023 and written in the English language. Conclusion. Herbal-derived compounds, with their diverse mechanisms of action, antibacterial activity, and safety profiles present a competitive alternative to conventional treatment of burns and sunburns, however, there are still not enough clinical trials to assess the effectiveness and safety profiles of nature-derived compounds.

In burns, reactive oxygen species (ROS) imbalance can lead to elevated oxidative damage and increase the difficulty of skin repair. However, rough removal of ROS will inevitably affect its' normal physiological function, leading to antibacterial failure and slow wound healing. To solve this problem, we developed a multifunctional AC-AuLA supramolecular polymer by combining medication therapy of asiaticoside (AC), photothermal therapy (PTT) of gold nanostars (AuNSs), and ROS-mediated of α-lipoic acid (LA). The AC-AuLA could create a normal ROS microenvironment for burns by regulating the balance between oxidants and antioxidants. At the same time, the AuNSs endow AC-AuLA with an excellent antibacterial effect, and the AC of AC-AuLA can promote wound repair through robust cell proliferation and angiogenesis. Importantly, in burn models infected with S. aureus, AC-AuLA achieves dense vascular formation and uniform collagen alignment, accelerating wound closure. These results indicate that this novel redox-sensitive supramolecular polymer has a broad application prospect in burn wound repair platforms.

Background: The older adult population continues to rapidly expand in number, with a projection by the United States (US) Census Bureau that there will be more individuals older than > 65 years (77.0 million) than those younger than 65 years) are susceptible to severe burn injury (deep-partial thickness and full-thickness), which is associated with significant morbidity and mortality. Conclusion: A better understanding of the effects of age-related changes regarding wound healing in older adult patients who incur severe burn injuries may provide insight into clinical strategies to improve outcomes among this population.

• Prospective, standardized data collections can store a huge amount of specific patient information. • Medical registries are important for quality assurance and scientific work. • Prospective, randomized clinical trials are difficult to achieve in burn medicine. • Registries provide a huge amount of cases generating high statistical power. • Registries in burn medicine are essential because of the heterogenic patient collective. From 1991–2014, all major burn centers of the German-speaking countries participated in a multicenter study in which essentially demographic data were collected. Individual patient data was located at the particular burn centers and only cumulated data were summarized annually for presentation. Retrospective statistical analysis of the entire data collection and identification of subgroups was not possible. In 2015 the German Burn Registry was established for prospective collection of individual patient data as a tool for quality management (QM) and for scientific analyses. A working group was formed to ensure the development and administration of the registry. From the official start of the German Burn Registry at the beginning of the year 2015 prospective data collection was realized with an individualized, web-based data collection software in a pseudonymized way. Selected data analysis was performed for the first 5 years of data collection. Severely burned adults and all hospitalized children with burn injuries were documented in the registry. The German Burn Registry was successfully established. 64 burn divisions have already been registered. 18,891 patients were documented over 5 years, of which 58% where children (<16 years). Mean ABSI Score was 4 (children: 3, adults: 6) with a mortality rate of 3.8.0% (children: 0.2%, adults: 9.3%). Children were hospitalized for an average of 7 days, whereas adults were discharged after 18 days. A registry is mandatory for quality assurance in burn medicine, since realization of randomized studies is difficult due to the heterogeneity of burn injuries. The German Burn Registry already is one of the biggest burn registries in Europe. Several scientific projects, based on the registry database, are in working process or have already been published. [ABSTRACT FROM AUTHOR]

Zinc oxide nanoparticles (ZnO NPs) modified by oxopyrymidine alcohol, also known as xymedone (Xym), were obtained and studied using FTIR, UV-vis, and fluorescent spectroscopy, and SEM, BET, powder XRD, and DLS analysis. A formulation of thixotropic hydrophilic gels containing Carbopol-based Xym and ZnO NPs was developed. A vertical Franz cell with a cellulose acetate membrane was used as a model to investigate the passive diffusion of the gel components by AAS. The gel components—Xym and ZnO NPs—were shown to penetrate through acetyl cellulose membrane within 5–7 h depending on an initial amount, and its values were in the range of 56–77%. The penetration of modified ZnO NPs by Xym was more effective in contrast to ZnO NPs without modification. The burn wound healing activity of ZnO NPs–Xym gel was demonstrated on a thermal burn wound model on rats. SOD and GR activity was increased by 30–35% during ZnO NPs–Xym gel treatment, the burn area on 10 postburn day decreased by 10% in contrast to a positive control, Methyluracyl®® ointment. [ABSTRACT FROM AUTHOR]

Scarring is caused by excessive medical treatment in the tissue remodeling stage; hence, the need for medication is not constant throughout the stage of burn recovery. In this study, we construct a nano self-adaption release system (Cur-ZIF8-HA) using hyaluronic acid (HA)-modified zeolite-imidazole-frame-8 (ZIF-8) as the nano-vehicle and curcumin (Cur) as the bioactive compound for the treatment of burns. The release of Cur within 48 h in the media of pH 8.5, pH 6.0, and pH 7.4 was 13.94, 54.05, and 20.17%, which could realize antibacterial functions in the inflammation stage, wound healing in the tissue proliferation/formation stage, and prevention of excessive fibroblast development and aberrant extracellular matrix deposition in the remodeling stage. Based on this property, Cur-ZIF8-HA has superior efficacy in healing bacterially infected burn wounds in vivo. This work provides a self-adaption release system with antibacterial wound-healing properties and prevents scarring functional based on the ZIF8-HA nano-vehicle, which opens a new way for the clinical application of curcumin for burn healing. [ABSTRACT FROM AUTHOR]

The goal of this review is to explain how to design a biomaterial approach to control the adaptive response to injury, with an emphasis on skin wounds. The strategies will be selected based on whether they have a reasonable probability of meeting the desired clinical outcome vs. just comparing the pros and cons of different strategies. To do this, the review will look at the normal adaptive response in adults and why it does not meet the desired clinical outcome in most cases. In addition, the adaptive response will be looked at in cases where it does meet the clinical performance requirements including animals that regenerate and for fetal wound healing. This will lead to how biomaterials can be used to alter the overall adaptive response to allow it to meet the desired clinical outcome. The important message of the review is that you need to use the engineering design process, not the scientific method, to design a clinical treatment. Also, the clinical performance requirements are functional, not structural. The last section will give some specific examples of controlling the adaptive response for two skin injuries: burns and pressure ulcers. For burns, it will cover some preclinical studies used to justify a clinical study as well as discuss the results of a clinical study using this system. For pressure ulcers, it will cover some preclinical studies for two different approaches: electrical stimulation and degradable/regenerative scaffolds. For electrical stimulation, the results of a clinical study will be presented. [ABSTRACT FROM AUTHOR]

One of the critical areas in the medical field is the burn treatment management that helps to rescue patient’s life by dramatically minimizing the after-burn progression and severity. Initial acute burn treatment involves intravenous fluid resuscitation, which must be administered meticulously to restore fluid loss and maintain essential organ function. A number of factors must be addressed quickly to make a decision for determining the required rate of intravenous fluid. Traditional methods with manual calculation reflects slow response and inaccurate estimation in most of the cases, thus requires random adjustments. Some automated and artificially intelligent systems can be found which still use the traditional formulas showing high fluctuation in the calculation of required rate. Therefore, this research proposes a fuzzy logic based model to predict the adequate intravenous fluid resuscitation rate for a burn patient. Fuzzy systems are treated as intelligent system close to human reasoning capabilities and for this application it ensures smooth transition of required rate without showing any high fluctuations for any adjustment. To attain the objective, a fuzzy logic system has been developed aggregating the clinical burn protocol as the knowledge base of the fuzzy inference engine where the %TBSA and HUO measurements are considered as inputs and intravenous fluid rate is the output. Multiple forms of fuzzy membership functions and different types of defuzzification methods have been applied to the proposed system to compile a comparative study. To explore the best approach, ten different test cases have been simulated employing both the manual calculation and the proposed fuzzy model. Results have presented that the proposed fuzzy based system shows to predict the optimum amount of intravenous fluid rate necessary for burn patient’s resuscitation.

Objective: The aim of this study is to examine epidemiologically the records of burn patients treated in our burn center from January 2011 to the end of December 2020. Method: This descriptive and cross-sectional study was carried out retrospectively in Dicle University Medical Faculty Hospital Burn Center. Burn cases were obtained and analyzed from electronic patient records between 2011 and 2020. Statistical analyzes were performed with the Statistical Package for Social Sciences for IBM 25 package program. Descriptive statistical methods and chi-square test were used in data evaluation. Results: The 3227 burn patients that constituted the sample of our study 55.3% of the burn patients were between the ages of 1-5, 52.5% were male, 42.7% of the cases occurred between 2011 and 2013. It was determined that 64.1% of the burns were hot liquid burns and 50.4% were second-degree burns. The most burn cases were seen in 2011-2013 and decreased towards 2020. It was determined that the age range most affected by burn injury was 1-5 years and the most common cause of burns was hot liquids (χ² =5.560, p<0.01). Conclusion: Examining the characteristics of burn cases is the basis for its complete prevention. In this context, the data of our study has the feature of being an important source of information. The fact that burn patients occur mostly in aged 1-5 years children indicates the need for support from parents and help in child care. [ABSTRACT FROM AUTHOR]

Background: No epidemiological information is available of the number of burns treated in the past 30 years in Romania. The aim of the present study is to investigate the extent of burn injuries in Romania, as well as to detect and analyze the essential epidemiological characteristics.Methods: A comprehensive retrospective study was conducted over a period of 10 years (1.01.2006 to 31.12.2015). Patient-related data were obtained from the Diagnosis-related group (DRG) Center of National School of Public Health, Management and Professional Development, which is the only official national structure that collects and manages data concerning all the hospitalized patients in Romania.Results: Included in this study were all 92,333 patients with burn injury as the main International Classification of Diseases (ICD-10) code of discharge from Romanian hospitals. The data was analyzed using SPSS V.24, IBM Statistics Package. The annual number of burns decreased gradually from 10,547 in 2006 to 7313 in 2015, reaching statistical significance (p = 0.001). The incidence decreased from 47 cases per 100,000 in 2006 to 36.93 per 100,000 in 2015. The seasonal evolution showed that the number of burns increases in July-August (8.8% and 9.1% of annual burns). The mean length of stay (LoS) was 10.59 days, with the highest value in 2012 (11.00) and the lowest in 2014 (10.30). The median LoS and the mean LoS values during the 10 years period have a plateau-type evolution, with no tendency for improvement. We found a significant correlation (r = 0.708, p = 0.0118) between increased mortality and the year of study.Conclusions: This is the first nationwide epidemiological study concerning hospitalized burns in Romania. It provides insight in demographical characteristics but also uncovers a worrying trend of increasing mortality rates, which requires further investigation. This study cannot make any reference to the severity of burns (surface and depth) or towards major burns events which unfolded during the studied period, due to lack of data. Consequently, it should raise awareness towards policymakers and caregivers that for a durable burns management strategy in Romania, it would be extremely useful to implement a national burn registry. [ABSTRACT FROM AUTHOR]

Background and Objectives: Skin scaffolding can be done using allografts and autografts. As a biological allograft, the skin of Oreochromis niloticus (ON) has been used due to its high type I and III collagen content. Oreochromis mossambicus (OM) is also a member of the Oreochromis family, but not much is known regarding its collagen content. As such, this study aimed to assess and compare the collagen content of the two fish species. Materials and Methods: This is a crossover study comparing the skin collagen contents of the two fish. Young fish were chosen, as they tend to have higher collagen concentrations. The skin samples were sterilized in chlorhexidine and increasing glycerol solutions and analyzed histochemically with Sirius red picrate under polarized light microscopy. Results: 6 young ON and 4 OM specimens were used. Baseline type I collagen was higher for OM, but at maximum sterilization it was higher for ON, with no differences in between Type III collagen was higher for OM across all comparisons with the exception of the last stage of sterilization. Generally, collagen concentrations were higher in highly sterilized samples. Conclusions: OM skin harvested from young fish, with its greater collagen III content may be a better candidate for use as a biological skin scaffold in the treatment of burn wounds, compared to ON.

Introduction: devere burns negatively affect all organ systems, especially in children. Objective: to collect and detail the evolution of pediatric patients with more than 30% of total burn body surface (BBS) Methods: descriptive, observational, retrospective, cross-sectional study, carried out in the burn unit of the Dr. Roberto Gilbert Elizalde Children's Hospital in the city of Guayaquil, Ecuador, between January 2014 and January 2020. Results: 46 pediatric patients with > 30% of BBS were included in the study, predominantly males, with 26 (57%) patients and 20 (43%) female patients, being the age range from 1 to 15 years, with more frequency in the age group of 1 to 5 years with a total of 26 (55.5%) patients. The most frequent mechanism of injury was direct flame, affecting 22 (47.83%) kids, 21 (45.65%) presented combined burns Between II-III degree. the BBS range was from 30% to 70%, with an average of 40.7%, the treatment performed was an average of 3,6 scarectomies per patient, dressings were placed on 42 (91%) of them, 40 (87%) required grafts, the average hospital stay was 43,6 days (range: 2-126 days). Complications occurred in 29 (63%), sepsis being the most frequent, in 8 (17%), and 5 (11%) patients died. Conclusion: 89% of the Pediatric patients seen in our burn unit with more than 30% of BBS were mostly treated with autograft or with a flap, obtaining good results and being discharged. [ABSTRACT FROM AUTHOR]

The initial care of burn wounds and choice of dressing are pivotal to optimally support the healing process. To ensure fast re‐epithelialisation within 10–14 days and prevent complications, an optimal healing environment is essential. An innovative dressing based on nanocellulose was used for the treatment of burns in children. Children (0–16 years) with clean, partial‐thickness burn wounds, 1 to 10% of the total body surface area were included. Complete re‐epithelialisation was achieved within 7–17 days, with 13 patients showing re‐epithelialised >95% by day 10. Satisfying results concerning time to re‐epithelialisation and material handling were obtained. The possibility to leave the dressing on the wounds for 7 days showed a positive effect in the treatment of children, for whom every hospital visit may cause massive stress reactions. The nanocellulose‐based dressing is a promising tool in conservative treatment of burns. Reducing the frequency of dressing changes supports a fast and undisturbed recovery; moreover, the dressing provides an optimal moist healing environment. The time to re‐epithelialisation is comparable to frequently used materials, and cost reduction effect can be achieved without loss of quality. Possible pain and distress levels are kept to a minimum; therefore, flexibility and compliance of the patients and their parents are enhanced. [ABSTRACT FROM AUTHOR]

Copyright of Farmacia is the property of Societatea de Stiinte Farmaceutice Romania and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: To share the first burn unit practice in Yozgat province and emphasize the importance of the "burns unit" in the treatment of burn injuries. Materials and Methods: The study was carried out retrospectively at Yozgat City Hospital between June 2020 and April 2021. The patients who were inpatient or outpatient in our burns unit during this period were included in the study. Patients' age, gender, cause of the burn, total burn surface area, burn location, length of hospital stay, treatment methods were determined from electronically recorded patient data. Results: A total of 107 patients were treated as outpatients or inpatients, 57 (53.3%) were male, 50 (46.7%) were female, and the median age was 24 (range, 1-88). Of all burn injuries, 85 (79.4%) were caused by scalding, 21 (19.6%) from flame, and 1 (0.9%) from electricity. In terms of the burn severity, the most common was second-degree burns and were determined in 58 (54.2%) patients. The trunk was the most frequently affected area and was seen in 47 (45.8%) patients. Of the burn injuries, 43 (40.2%) were treated by hospitalization and the median length of stay was 3 days (1-90). Of the inpatients, 24 (55.8%) were scalded, 18 (41.9%) had flame burns, and 1 (2.3%) had electrical burns. It was found that standard medical dressing treatment was applied to 33 (76.7%) of the hospitalized patients, graft treatment was applied to 4 (9.3%), and placenta application was applied to the burned area in 6 (14%) patients. No mortality was seen in any of the patients. Conclusions: A successful treatment of many burn injuries in "burns room" units with a competent team will significantly decrease unnecessary referrals to advanced burn centers. Thus, the workload of these centers will be reduced and the country's resources will be used more efficiently. [ABSTRACT FROM AUTHOR]

This research was conducted to develop the three-dimensional (3D) finite element model of human skin for bio-heat transfer analysis. The skin burn was analyzed using Penne's bio-heat equation, which has been adopted in many commercial finite element software. Burn injuries mostly occur due to heat transfer from hot object, hot liquids, cooking flames, and sometimes due to exposure to chemicals, electricity, and ionizing radiation. Depending upon the condition and duration of exposing, thermal burn may cause severe skin damage. The burn effect on human skin under the contact with a hot object or hot fluid was analyzed in this paper. The burn intensity in terms of degrees of burn was measured with different burning conditions and their corresponding time was graphically shown. Using the temperature profile obtained from the analysis, various methods of burn treatment were evaluated and compared. The results from this analysis will help to understand human skin burn under different burning conditions and treatment of different burn injuries. [ABSTRACT FROM AUTHOR]

Fibroblast growth factor 2 (FGF-2) is a multifunctional protein that has major roles in wound healing, tissue repair, and regeneration. This therapeutic protein is widely used for burn treatment because it can stimulate cell proliferation and differentiation, angiogenesis, and extracellular matrix remodeling. In this study, we developed a simple method using a controlled heated brass rod to create a homogenous third-degree burn murine model and evaluated the treatment using recombinant human FGF-2 (rhFGF-2). The results indicated that the wound area was 0.83 ± 0.05 cm2 and wound depth was 573.42 ± 147.82 μm. Mice treated with rhFGF-2 showed higher rates of wound closure, granulation tissue formation, angiogenesis, and re-epithelialization than that of phosphate-buffered saline (PBS)-treated group. In conclusion, our lab-made rhFGF-2 could be a potentially therapeutic protein for burn treatment as well as a bioequivalent drug for other commercial applications using FGF-2. [ABSTRACT FROM AUTHOR]

Advancements in burn treatment, in the last decades, resulted in a reduction of mortality among burn victims. Increased funding and the creation of regional burn treatment facilities focused on comprehensive therapy of severe burns resulted in improvement of treatment outcomes. Effective functioning and usage of resources in burn centers depends on the organization of prehospital care, proper segregation of patients, triage and prompt transfer to a place where highly specialized care is available. Initial care of a burn injury patient includes actions taken by witnesses of the event and by the emergency medical team during transfer to the emergency department. After evaluating and stabilizing the patient, a decision is made whether or not he should be treated at a specialized burn treatment center to which he may be transferred by land or by air. This paper presents burn patient treatment protocols at each of the following stages: at the burn scene, during transportation, initial hospital treatment and criteria for referring the patient to a burn treatment center. [ABSTRACT FROM AUTHOR]

Burn treatment is such an ancient science as human conflicts, and it has had to be refined and adapted to the improvements in military technology throughout history. Fire has probably been one of the first double sided weapons developed by humanity during its technologic development. This element has both served to improve life conditions of societies, and to destroy them causing terrible suffering. In this article, we perform a chronological exposition of the evolution of burn treatment, presenting the more relevant scientific figures of each time, and their contributions. Also, conflicts and disasters that coincided with these scientists are described, as in most cases, the work developed during those catastrophes eased the advancement of this field. The objective of this historical review is to provide the reader with certain knowledge about the path this science has followed until reaching its actual state. The first existing reference to burn treatment goes back to an egyptian papyrus written around the year 1500 b.C. Since then, each relevant figure in the field of Medicine of their time proposed their own treatment for burns; which in most cases, had no scientific basis according to current paradigms. However, since the 16th century, certain advancements in different fields of burn care were described, reaching an important development during the 19th and 20th centuries, when industrial and scientific revolution coexisted with the Great Wars, which provided wide experimental and observational fields. Therefore, and thank to scientific discoveries of the last centuries, burned patients present survival rates that were unconceivable years ago. We remark that highlighting that adversity, studied through scientific methodology, might serve as an opportunity to improve quality of life of upcoming generations. [ABSTRACT FROM AUTHOR]

• NPWT significantly reduced length of hospitalization. • Also had minimal complication. • This procedure can be an alternative treatment for burn patients. Burn injuries continue to be a global burden. Burn wound treatment often requires a long treatment time and often results in high morbidity and mortality. Until now, there is still no ideal burn wound treatment for all patients. Here we report 3 cases of burn patients. Every patient underwent wound debridement and followed by installation of Negative Pressure Wound Therapy (NPWT) on the site of burn injuries. All of patients was discharged in a good condition. NPWT is an application of sub-atmospheric pressure that is placed on the wound. Today, the use of negative pressure therapy is a new strategy in managing burn injuries. NPWT can reduce the length of stay of burn patients that can be associated with faster wound healing, and reduce bacterial levels in burns. The combination of debridement and NPWT in burn patients can be an alternative procedure because it can promote faster wound healing and reduce the length of hospitalization. Furthermore, this is the first report of NPWT usage for the treatment of burn patients in Indonesia. [ABSTRACT FROM AUTHOR]

Hypertrophic scars are a common complication of burns treated both conservatively and surgically. The etiology of their formation depends on many factors. The location of the affected area, depth, surface area, individual predispositions, age, nutritional status and therapeutic actions play a crucial role here. A particular tendency to develop hypertrophic scars was found in patients with deep burns whose treatment process was prolonged for more than 2-3 weeks. The risk of occurrence of hypertrophic scars in burns is defined in a wide range between 32-94%. Early treatment of burns, appropriate surgical techniques that minimize damage to healthy tissues; the use of modern dressings and appropriate preventive measures minimizes the risk of hypertrophic scars. The following article presents the stories of two patients in whom a matrix was used for skin regeneration. In the first case, it was used to improve treatment - a massive hypertrophic scar on the neck causing head flexion due to contraction, therefore limiting function. In the second case, the use of a matrix for skin regeneration as prevention of hypertrophic scars was described. In both cases the desired effect was obtained - a flexible and pleasing in terms of aesthetics and functionality area of skin. [ABSTRACT FROM AUTHOR]

Infection following burn injury is critical, especially for patients with large total body surface area burns and in skin graft donor sites. Although various aspects of a-tocopherol acetate (a-TA) beneficial effects on wound healing have been validated, it appears that no study has specifically addressed its antimicrobial potential. The purpose of this study was to explore the therapeutic efficacy of topical application of a-TA in terms of bacterial load reduction. Between January 2018 and June 2018, 20 patients with mid-deep and deep burn wounds were included in the present study (average TBSA approximately 42%, range 25-67%). Patient average age was 47.75 years (range 25-72 years), 8 were male. In each patient two clinically similar areas were identified and treated every 24 hours with topical application of α-TA in the form of Filme Olio® (Group 1) and conventional medication (Group 2). All the patients had positive results for bacterial cultures before treatment. Despite the presence of initial bacterial infection, a quicker reduction of exudates and pain and a progressive and faster bacterial load reduction was observed in Group 1. Negative cultures were obtained after 3 days on average in Group 1 (range 1-6 days) and 8 days in Group 2 (range 5-9 days). This study clearly shows the importance of the therapeutic targeting of infection in the treatment of burns. α-TA may represent a safe, simple and inexpensive method for improving the healing of difficult wounds with local infection. [ABSTRACT FROM AUTHOR]

Objectives Studies suggest that a restrictive transfusion strategy is safe in burns, yet the efficacy of a restrictive transfusion policy in massive burn injury is uncertain. Our objective: compare outcomes between massive burn (≥60% total body surface area (TBSA) burn) and major (20–59% TBSA) burn using a restrictive or a liberal blood transfusion strategy. Methods Patients with burns ≥20% were block randomized by age and TBSA to a restrictive (transfuse hemoglobin <7 g/dL) or liberal (transfuse hemoglobin <10 g/dL) strategy throughout hospitalization. Data collected included demographics, infections, transfusions, and outcomes. Results Three hundred and forty-five patients received 7,054 units blood, 2,886 in massive and 4,168 in restrictive. Patients were similar in age, TBSA, and inhalation injury. The restrictive group received less blood (45.57 ± 47.63 vs. 77.16 ± 55.0, p < 0.03 massive; 11.0 ± 16.70 vs. 16.78 ± 17.39, p < 0.001) major). In massive burn, the restrictive group had fewer ventilator days (p < 0.05). Median ICU days and LOS were lower in the restrictive group; wound healing, mortality, and infection did not differ. No significant outcome differences occurred in the major (20–59%) group (p > 0.05). Conclusions: A restrictive transfusion strategy may be beneficial in massive burns in reducing ventilator days, ICU days and blood utilization, but does not decrease infection, mortality, hospital LOS or wound healing. [ABSTRACT FROM AUTHOR]

An alternative to cultured skin cell grafts usage in burn treatment is the graft of allogenic stem cells. We verified whether amniotic stem cells are better than the present therapeutic standard: grafts of autologous keratinocytes and fibroblasts along with autologous adipose-derived stem cells, and whether amniotic stem cells can support the growth of autologous keratinocytes and fibroblasts in the culture. The study was performed on the material from 18 amnia. Skin cells were obtained from 3 patients. In order to assess the influence of stem cells on keratinocytes and fibroblasts, the following experiments were performed: impact on viability and cell cycle, wound healing capability, angiogenesis capability, influence on the proliferation speed and capability to differentiate into skin cells. We demonstrated that human amniotic membrane-derived mesenchymal stem cells (hAMMSCs) share amniotic proteins with skin cells. Amniotic stem cells may replace skin fibroblasts in grafts due to the close similarity in their surface antigens, with significantly larger proliferative potential and ability to stimulate wound healing. It was shown that adding amniotic cells to both keratinocytes and fibroblast cultures accelerates directional migration by ≥ 40%. We confirmed in this study the influence of amniotic cells on the proliferation and cell cycle of fibroblasts and keratinocytes. Amniotic stem cells can be successfully used not only as a first choice graft but also to replace 3T3 line cells, supporting the proliferation of the cells during the culturing, as well as a supplementary graft supporting an autologous graft of keratinocytes and fibroblasts. [ABSTRACT FROM AUTHOR]

Background: With the increase of antimicrobial resistance in recent decades, other methods of preventing and fighting infections must be considered. Burn patients, whose wound areas are often extensive, are especially prone to wound infections. The loading of bacterial nanocellulose (BNC) with antiseptics has already been successfully performed but unfortunately, the described procedure is time-consuming and thus not applicable in a clinical emergency setting. Therefore, a clinically feasible approach was established.Material and Methods: Sheets of BNC-based wound dressings were placed into antiseptic solutions containing PHMB (Prontosan® and LAVANID® 2) and were left to soak for up to two hours. At different time points, samples were analysed for their concentration of PHMB and antiseptic efficacy.Results: Within 30min, clinically relevant concentrations of PHMB were achieved in the BNC-based wound dressing. The 30-min PHMB uptake for Prontosan® and LAVANID® 2 resulted in concentrations of 0.05% and 0.019%, respectively. Samples from the PHMB loaded dressing showed a dose dependent antiseptic efficacy for Staphylococcus aureus.Conclusion: This experiment showed that the loading of BNC-based wound dressings with PHMB-containing antiseptics was achieved by a simple and quick procedure. According to studies a PHMB concentration of 0.001% can already inhibits all bacterial growth, indicating that the concentrations of PHMB in the BNC-based wound dressings after 30min are higher than the minimal inhibitory concentration and the antiseptic efficacy after 120min loading analysed by an standardized bacterial disk diffusion assay was shown to be comparable to the clinically used Suprasorb® X+PHMB wound dressing. [ABSTRACT FROM AUTHOR]

Stem cells are increasingly being used in the course of burn treatment. As several different types of stem cells are available for the purposes, it is important to chose the most efficient and the most practicable stem cell type. The aim of this study was to compare the potential of heterogeneous amnion cell mixture with the presently used standard therapy, the adipose tissue-derived stem cells. The placenta was collected during a Cesarean section procedure. Adipose tissue tissue-derived cells were isolated using the Cytori's Celution® System. Cells were tested for fulfillment of the minimum criteria for stem cells. The efficiency of cell cultures was tested by an analysis of population doubling, cell proliferation, cell cycle and cell migration. Amniotic cells presented a higher ability for differentiation to chondrocytes and osteocytes than adipose-derived regenerative cells but a lower ability for differentiation toward adipocytes. Additionally, in vitro experiments have demonstrated a higher applicability of amniotic cells than adipose tissue-derived stem cells. Amniotic cells show several advantages: easy access to placenta, low costs and a lack of ethical dilemmas related to stem cell harvesting. The main disadvantage is, however, their availability, as isogenic treatment would only be possible for women around children-bearing age, unless personalized banks for amniotic cells would be established. [ABSTRACT FROM AUTHOR]

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Medical air-fluidized bed had its history and present situation in foreign countries and China introduced at first, and its application, possible complications and adverse events were described in detail when used for clinical treatment of extensive burn patients. The future development of medical air-fluidized bed was analyzed, and it's suggested that the bed be improved or replaced to decrease the hidden risks to the patient. [ABSTRACT FROM AUTHOR]

Objective: Our objective was to compare outcomes of a restrictive to a liberal red cell transfusion strategy in 20% or more total body surface area (TBSA) burn patients. We hypothesized that the restrictive group would have less blood stream infection (BSI), organ dysfunction, and mortality. Background: Patients with major burns have major (>1 blood volume) transfusion requirements. Studies suggest that a restrictive blood transfusion strategy is equivalent to a liberal strategy. However, major burn injury is precluded from these studies. The optimal transfusion strategy in major burn injury is thus needed but remains unknown. Methods: This prospective randomized multicenter trial block randomized patients to a restrictive (hemoglobin 7-8 g/dL) or liberal (hemoglobin 10-11 g/dL) transfusion strategy throughout hospitalization. Data collected included demographics, infections, transfusions, and outcomes. Results: Eighteen burn centers enrolled 345 patients with 20% or more TBSA burn similar in age, TBSA burn, and inhalation injury. A total of 7054 units blood were transfused. The restrictive group received fewer blood transfusions: mean 20.3±32.7 units, median=8 (interquartile range: 3, 24) versus mean 31.8±44.3 units, median = 16 (interquartile range: 7, 40) in the liberal group (P < 0.0001, Wilcoxon rank sum). BSI incidence, organ dysfunction, ventilator days, and time to wound healing (P > 0.05) were similar. In addition, there was no 30-day mortality difference: 9.5% restrictive versus 8.5% liberal (P = 0.892, x² test). Conclusions: A restrictive transfusion strategy halved blood product utilization. Although the restrictive strategy did not decrease BSI, mortality, or organ dysfunction in major burn injury, these outcomes were no worse than the liberal strategy (Clinicaltrials.gov identifier NCT01079247). [ABSTRACT FROM AUTHOR]

Chitin and its deacetylated derivative chitosan are natural polymers composed of randomly distributed β-(1-4)-linked d-glucosamine (deacetylated unit) and N-acetyl- d-glucosamine (acetylated unit). Biopolymers like chitin and chitosan exhibit diverse properties that open up a wide-ranging of applications in various sectors especially in biomedical science. The latest advances in the biomedical research are important emerging trends that hold a great promise in wound-healing management products. Chitin and chitosan are considered as useful biocompatible materials to be used in a medical device to treat, augment or replace any tissue, organ, or function of the body. A body of recent studies suggests that chitosan and its derivatives are promising candidates for supporting materials in tissue engineering applications. This review article is mainly focused on the contemporary research on chitin and chitosan towards their applications in numerous biomedical fields namely tissue engineering, artificial kidney, skin, bone, cartilage, liver, nerve, tendon, wound-healing, burn treatment and some other useful purposes. [ABSTRACT FROM AUTHOR]

Burns are a common cause of preventable morbidity and mortality in children. Thermal and chemical burns are the most common types of burns. Their clinical appearance can be similar and the treatment is largely similar. Thermal burns in children occur primarily after exposure to a hot surface or liquid, or contact with fire. Burns are typically classified based on the depth and total body surface area, and the severity and onset of the burn can also depend on the temperature and duration of contact. Chemical burns are caused by chemicals--most commonly acids and alkalis--that can damage the skin on contact. In children, the most common cause of chemical burns is from household products such as toilet bowl cleaners, drain cleaners, detergents, and bleaches. Mild chemical burns generally cause redness and pain and can look similar to other common rashes or skin infections, whereas severe chemical burns are more extreme and may cause redness, blistering, skin peeling, and swelling. [ABSTRACT FROM AUTHOR]

INTRODUCTION: The estimation of the burned surface area has a huge importance for the acute management and prognosis of the burn victim It has been revised the different methods available for the assessment of the burn extent and some resuscitation basic concepts. MATERIALS AND METHODS: A retrospective descriptive study was made based on the information took from medical records of patients from the burn unit of the San Vicente de Paul University Hospital in Medellín (Col) during 2004. The initial diagnosis of the burn extension made by the remittent clinician was compared with the ones made by experience clinicians at the emergency room and by the plastic surgeon at the Burn Unit. The results obtained were processed with the package Statistic 6.0 (Stafsoft Inc) and it was considered significant a p value < 0.05. The variables are presented as absolute values and with their respective percentages. RESULTS AND CONCLUSIONS: There were 329 attended patients. 60% of them had mistaken or incomplete diagnosis, and 39.3% of the diagnosis made at our emergency room were incomplete or incorrect. We found more frequently overestimation than underestimation of the burn surface area. In most of the cases mistakes were made that modified the burn category (mild, moderate, and severe). It is necessary to improve basic knowledge about burn care in the inexperience clinicians. INTRODUCCIÓN: la evaluación de la superficie corporal quemada tiene gran importancia para el tratamiento inicial y el pronóstico del paciente quemado. Se revisan los diferentes métodos para evaluar la superficie corporal quemada y algunos conceptos básicos de reanimación. MATERIALES Y MÉTODOS: se realizó un estudio descriptivo, retrospectivo y transversal a partir de las historias clínicas de los pacientes quemados hospitalizados en el Hospital Universitario San Vicente de Paúl (HUSVP) de Medellín durante el año 2004. Se compararon los diagnósticos de extensión quemada emitidos por el médico remitente, el médico del servicio de urgencias pediátricas o de adultos del HUSVP en el momento del ingreso del paciente a esta institución, y el cirujano plástico de la unidad de quemados. Los datos obtenidos fueron procesados con el paquete EpiInfo 6,04 y se consideró como estadísticamente significativo un valor de p

The extensive loss of skin in burned patients is a critical clinical condition, and the choice of an effective technique to cover and protect the damaged area has always been a challenge in the surgical field. Despite its wide clinical use, there is little data in the literature on using the Alexander technique to treat severe burns, while several studies have focused on alternative approaches. The present study aims to evaluate the effectiveness of the Alexander surgical technique on 117 patients with severe burns. The characteristics of the burned patients, factors related to etiology of burns as well as adverse prognostic factors and their incidence in discharged versus deceased patients were also taken into account. Finally, a comparison is made with an alternative surgical procedure described in the literature. Our results show a satisfactory level of survival for patients with severe burns surgically treated with the Alexander technique, accounting for 63% of all clinical cases reported here. This treatment is also less expensive and more rapid than the alternative approach we compared it with. The Alexander technique is a lifesaving method for the treatment of severe burns that provides a satisfactory chance of survival at lower cost than the alternative surgical procedure examined. [ABSTRACT FROM AUTHOR]