Abstract
This preclinical study aimed to evaluate the tissue repair process of burns treated with human amniotic membrane (hAM) patches in rats. Twenty-four rats were subjected to superficial burns of partial thickness, and randomly allocated into two groups: Control and Treated Group, subdivided into two experimental periods of 7th and 14th days. The lesions were evaluated by digitalized images (macroscopy) and by the analysis of histological sections stained in H&E to quantify the number of inflammatory cells and fibroblasts present in the different experimental times (histomorphometry). The histomorphometric analyses were performed blindly. Statistical analysis employed Kolmogorov-Smirnov and Mann Whitney tests, with 95% confidence interval at 5% significance level (p <0.05). Macroscopically, the lesions of Treated group presented a crust formation before Control Group, and there were no signs of infection in both groups. Microscopically, the qualitative analysis showed a faster evolution in the healing process of the Treated groups compared to the Control, with reduction of the inflammatory infiltrate, intense fibroblasts proliferation and better organization of the collagen fibers. The quantitative analysis showed statistically significant results regarding the reduction of inflammatory cells (p<0.0001) at 7th and 14 th day and increased proliferation of fibroblasts at 14th day (p<0.0001) in lesions treated with hAM compared to Control group. The results of this preclinical study demonstrated that the application of hAM patches reduces the inflammatory process and accelerates the onset of the proliferative phase in burn injuries.
Highlights
Injuries resulting from burns demand complex and costly treatments, require assistance from specialized multidisciplinary teams, and present high morbidity and mortality rates, which makes them an important public health problem (Rowan et al, 2015; World Health Organization, 2018).Burns, caused by thermal, chemical, electrical or radioactive agents, are traumatic injuries with varying levels of tissue loss
The macroscopic analysis of the burn injuries was performed at 7th and 14th days (Figure 1), showing the early crust formation in the Treated Group compared to the Control Group
In the first experimental time (Figure 2), the results observed in the qualitative histological analysis showed that the Control Group presented inflammatory infiltrates, with a predominance of macrophages, young fibroblasts, rupture of blood vessels characterized by free red blood cells in the intracellular environment and disorganization of collagen fibers
Summary
Injuries resulting from burns demand complex and costly treatments, require assistance from specialized multidisciplinary teams, and present high morbidity and mortality rates, which makes them an important public health problem (Rowan et al, 2015; World Health Organization, 2018).Burns, caused by thermal, chemical, electrical or radioactive agents, are traumatic injuries with varying levels of tissue loss. Injuries resulting from burns demand complex and costly treatments, require assistance from specialized multidisciplinary teams, and present high morbidity and mortality rates, which makes them an important public health problem (Rowan et al, 2015; World Health Organization, 2018). The specific cause of a burn, as well as the classification of the injury according to severity (depth and size), guides the choice of an appropriate treatment (Jeschke et al, 2020). Partial-thickness burns are the most frequent ones, with their injuries reaching the dermis and epidermis, causing painful lesions, phlyctens, edema, erythema, and ulcerations (Lima et al, 2016). The treatment of burns has always been a challenge, both for its severity and for the multiplicity of complications that normally occur. The most frequently used drugs for the treatment of partial thickness burns are silver sulfadiazine, silver alginate, hydrogeal, and wet dressings
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