Abstract

Burns are caused by several mechanisms including flame, scald, chemical, electrical, and ionizing and non-ionizing radiation. Approximately half a million burn cases are registered annually, of which 40 thousand patients are hospitalized and receive definitive treatment. Burn care is very resource intensive as the treatment regimens and length of hospitalization are substantial. Burn wounds are classified based on depth as superficial (first degree), partial-thickness (second degree), or full-thickness (third degree), which determines the treatment necessary for successful healing. The goal of burn wound care is to fully restore the barrier function of the tissue as quickly as possible while minimizing infection, scarring, and contracture. The aim of this review is to highlight how tissue engineering and regenerative medicine strategies are being used to address the unique challenges of burn wound healing and define the current gaps in care for both partial- and full-thickness burn injuries. This review will present the current standard of care (SOC) and provide information on various treatment options that have been tested pre-clinically or are currently in clinical trials. Due to the complexity of burn wound healing compared to other skin injuries, burn specific treatment regimens must be developed. Recently, tissue engineering and regenerative medicine strategies have been developed to improve skin regeneration that can restore normal skin physiology and limit adverse outcomes, such as infection, delayed re-epithelialization, and scarring. Our emphasis will be centered on how current clinical and pre-clinical research of pharmacological agents, biomaterials, and cellular-based therapies can be applied throughout the continuum of burn care by targeting the stages of wound healing: hemostasis, inflammation, cell proliferation, and matrix remodeling.

Highlights

  • Reviewed by: Heather Powell, The Ohio State University, United States Ashley Carson Brown, North Carolina State University, Specialty section: This article was submitted to Integrative and Regenerative

  • In the event of a large total body surface area (TBSA) injury or in an attempt to reduce autograft requirements, a variety of epidermal and dermal products have been discussed in this article that may facilitate wound closure

  • Proper wound bed preparation including adequate debridement, hemostasis, and infection control is paramount prior to autografting in order to prevent graft failure; this is true with the skin substitutes

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Summary

Introduction

Reviewed by: Heather Powell, The Ohio State University, United States Ashley Carson Brown, North Carolina State University, Specialty section: This article was submitted to Integrative and Regenerative. The aim of this review is to highlight how tissue engineering and regenerative medicine strategies are being used to address the unique challenges of burn wound healing and define the current gaps in care for both partial- and full-thickness burn injuries. This review will present the current standard of care (SOC) and provide information on various treatment options that have been tested pre-clinically or are currently in clinical trials. This review investigates treatment modalities for thermal burns that are currently in clinical trials and pre-clinical animal testing. To accomplish this and illustrate the challenges that remain unmet, it is important to understand the current standard of care (SOC) for burn wound injuries.

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