Keeping vesicular skin in wounds caused by second degree burns

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Vesicular wounds of small or medium size are one of the most popular acute traumas in the second degree burns. Although removing the vesicular skin lesion is a regular clinical treatment to create a clean healing surface, the role of vesicular skin and whether the patients should keep the lesion skin at the wounds surface is still unknown. In this study, 1890 second degree burns patients were recruited and randomly assigned to the test group (keeping vesicular skin, n=1020) and the control group (removing vesicular skin lesion, n=870). A healing scores system (including the healing time, recovery area, the scar scores, and the pathological scores) was used to estimate the healing status. The scores were recorded every 3 days until 30 days after the different treatments. The patients keeping vesicular skin at the wounded surface have a significant decrease in the closing healing time (8.5 d in superficial second degree burns and 12.5 d in the deep second degree burns) compared to the regular treatments with removing vesicular skin (12.5 d in superficial second degree burns and 25.5 d in the deep second degree burns). At Day 30, patients keeping vesicular skin at the wound surface have less scar scores (score 1) compared to those patients with removing vesicular skin (score 5). The pathological sections indicated that keeping vesicular skin has decreased inflammation score in the early healing time (Day 3) and more collagen formation in the wound healing edges at the later healing time (Day 12). In conclusion, keeping vesicular skin in wounds caused by second degree burns can benefit the wound healing by both decreasing the early inflammation and increasing the later collagen formation at wound healing edges.