Burn Infection Research Articles

Strictosamide promotes wound healing through activation of the PI3K/AKT pathway

Nauclea officinalis, as a Chinese medicine in Hainan province, had the effect of treating lower limb ulcers, burn infections. In this paper, we studied the effect of Strictosamide (STR), the main bioactive compound in Nauclea officinals, on wound healing and explored its internal mechanism. Firstly, the wound healing potential of STR was evaluated in a rat model, demonstrating its ability to expedite wound healing, mitigate inflammatory infiltration, and enhance collagen deposition. Additionally, immunofluorescence analysis revealed that STR up-regulated the expression of CD31 and PCNA. Subsequently, target prediction, protein-protein interaction (PPI), gene ontology (GO), and pathway enrichment analyses were used to obtain potential targets, specific biological processes, and molecular mechanisms of STR for the potential treatment of wound healing. Furthermore, molecular docking was conducted to predict the binding affinity between STR and its associated targets. Additionally, in vivo and in vitro experiments confirmed that STR could increase the expression of P-PI3K, P-AKT and P-mTOR by activating the PI3K/AKT signaling pathway. In summary, this study provided a new explanation for the mechanism by which STR promotes wound healing through network pharmacology, suggesting that STR may be a new candidate for treating wound.

Intelligent bacteria‐targeting ZIF‐8 composite for fluorescence imaging‐guided photodynamic therapy of drug‐resistant superbug infections and burn wound healing

AbstractInfected burn wounds are characterized by persistent drug‐resistant bacterial infection coupled with an inflammatory response, impeding the wound‐healing process. In this study, an intelligent nanoparticle system (CCM+TTD@ZIF‐8 NPs) was prepared using curcumin (CCM), an aggregation‐induced emission luminogens (TTD), and ZIF‐8 for infection‐induced wound healing. The CCM+TTD@ZIF‐8 NPs showed multiple functions, including bacteria targeting, fluorescence imaging and pH response‐guided photodynamic therapy (PDT), and anti‐inflammatory. The positive charges of ZIF‐8 NPs allowed the targeting of drug‐resistant bacteria in infected wounds, thereby realizing fluorescence imaging of bacteria by emitting red fluorescence at the infected site upon blue light irradiation. The pH‐responsive characteristics of the CCM+TTD@ZIF‐8 NPs also enabled controllable CCM release onto the infected wound site, thereby promoting the specific accumulation of ROS at the infected site, with outstanding bactericidal efficacy against drug‐resistant Staphylococcus aureus (S. aureus) and Pseudomonas aeruginosa (P. aeruginosa) strains in vitro/in vivo. Additionally, due to the excellent bactericidal effect and anti‐inflammatory properties of CCM+TTD@ZIF‐8 NPs combined with blue light irradiation, the regeneration of epidermal tissue, angiogenesis, and collagen deposition was achieved, accelerating the healing process of infected burn wounds. Therefore, this CCM+TTD@ZIF‐8 NPs with multifunctional properties provides great potential for infected burn wound healing.

Local Phage Therapy During Surgical Treatment of Burn Wounds Reduces the Risk of Colonization of the Skin of the Periwound Area by Pathogens of the ESKAPE Group

Aim of study To study the effect of local phage therapy alone and in combination with systemic antibiotic therapy on the dynamics of microflora colonizing the skin of the periwound area during surgical treatment of infected burn wounds.Material and methods Scientific hypothesis: the use of local phage therapy in monotherapy in the treatment of burn wound infections reduces the risk of colonization of the skin of the periwound area by bacteria of the ESKAPE group. The experimental study analyzed the results of microbiological studies of washings from the skin surface of 40 animals with infected burn wounds, in the course of phage therapy in monotherapy and in combination with systemic antibiotic therapy.Results In the group of animals receiving phage therapy alone, the proportion of ESKAPE group bacteria colonizing the skin of the periwound area at the time of completion of the course of antimicrobial therapy was 9%, while in the group receiving phage therapy in combination with systemic antibiotic therapy it was 43% (p=0.011).Conclusion The use of local phage therapy in single mode during the surgical treatment of infected burn wounds reduces the risk of colonization of the skin of the peri-wound area by pathogens of the ESKAPE group. At the same time, systemic antibiotic therapy causes an imbalance of resident and transient skin microbiota in the periwound area and an increase in the frequency of its colonization by pathogens of the ESKAPE group.

Exosome/antimicrobial peptide laden hydrogel wound dressings promote scarless wound healing through miR-21-5p-mediated multiple functions

Mesenchymal stem cell (MSC)-based therapy is an effective strategy for regenerative therapy. However, safety and ease of use are still issues to be overcome in clinical applications. Exosomes are naturally derived nanoparticles containing bioactive molecules, which serve as ideal cell-free therapeutic modalities. However, issues such as delivery, long-term preservation and activity maintenance of exosomes are other problems that limit their application. In this study, we proposed the use of rapid freeze-dry-thaw macroporous hydrogels for the encapsulation of HucMSC-derived exosomes (HucMSC-Exos) combined with an antimicrobial peptide coating. This exosome-encapsulated hyaluronic acid macroporous hydrogel HD-DP7/Exo can achieve long-term storage and transport by lyophilization and can be rapidly redissolved for treatment. After comprehensively comparing the therapeutic effects of HucMSC-Exos and HucMSC-loaded hydrogels, we found that HucMSC-Exos could also effectively regulate fibroblasts, vascular endothelial cells, and macrophages and inhibit myofibroblast-mediated fibrosis, thus promoting tissue regeneration and inhibiting scar formation in a mouse model of deep second-degree burn infection healing. These properties of lyophilized storage and whole-process-repair make HD-DP7/Exo have potential application value and application prospects.

Alkaloid rich hydroponic chili for AgNPs synthesis against multidrug resistant Staphylococcus aureus infected burn wounds

Hydroponic plant cultivation is expected to replace soil cultivation owing to an increased plant yield and rapid turnover. A number of medicinal plants have been successfully grown in hydroponic system. Effect of hydroponic cultivation on phytochemical content of medicinal plants needs to be investigated for efficient phytomedicine production. Herein, we quantify the bioactive compounds of medicinal importance in hydroponic and soil grown chili for green silver nanoparticles (AgNP) based formulation preparation. The end product has been evaluated as an alternate treatment for skin and soft tissue infections caused by Multidrug Resistant Staphylococcus aureus (MDRSA). Comparable phytochemical profile of soil grown chili extract (CESoil) and hydroponically grown chili extract (CEHydro) for increased production of plant sourced medicinally important compounds has been studied. Stable phytosynthesized CE NPs, confirmed by UV visible spectroscopy (UV) Fourier Transform Infrared (FTIR), Dynamic Light Scattering (DLS) and Scanning Electron Microscopy (SEM) analysis, showed enhanced anti-MDRSA activity in vitro with MIC and MBC at 0.312 and 0.625 mg/ml respectively. Hydrogel based CE NPs formulation successfully eliminated burn wound MDRSA infection in vivo while also regenerating the skin. Enhanced CE NPs activity in vitro and in vivo suggests their potential use in combating AMR infections that can further be evaluated in clinical trials.

Detection of Pseudomonas aeruginosa infection using a sustainable and selective polydopamine-based molecularly imprinted electrochemical sensor

Pyocyanin, a redox-active secondary metabolite produced by Pseudomonas aeruginosa, serves as a crucial virulence factor. Detection and quantification of pyocyanin can aid early diagnosis of infection. A selective and sensitive molecularly imprinted electrochemical sensor was constructed by using a green polymerization technique to deposit an ultrathin polydopamine film on an electrode modified with gold nanoparticles and chitosan. Target recognition was facilitated by specific binding sites within the imprinted polymer matrix that are complementary to the structure of pyocyanin. Various techniques, including cyclic voltammetry, electrochemical impedance spectroscopy, and square wave voltammetry, were employed to characterize the electrochemical behavior of the sensor. We investigated the influence of fabrication components, including chitosan concentration, monomer concentration, electro-polymerization conditions, pH, and rebinding time. Demonstrating a high degree of specificity and sensitivity, the sensor showcased a broad linear detection range of 1–100 µM and a low detection limit of 0.74 µM for pyocyanin. Moreover, the sensor successfully detected pyocyanin in real bacterial culture samples, exhibiting a recovery of the spiked standard ranging from 93 to 103 %. The electrochemical sensor displayed satisfactory stability lasting for at least 5 weeks. We demonstrated the sensor's applicability for clinical measurements by detecting pyocyanin in infected burn wounds using an ex vivo porcine skin model. Leveraging the synergistic advantages of molecularly imprinted polymer and the specific redox window for pyocyanin detection, the electrochemical sensor presents a promising approach for early-stage infection identification, thus contributing to enhanced treatment and more effective healthcare for patients.

Bactericidal Efficacy of the Combination of Maresin-like Proresolving Mediators and Carbenicillin Action on Biofilm-Forming Burn Trauma Infection-Related Bacteria.

Biofilm-associated bacterial infections are the major reason for treatment failure in many diseases including burn trauma infections. Uncontrolled inflammation induced by bacteria leads to materiality, tissue damage, and chronic diseases. Specialized proresolving mediators (SPMs), including maresin-like lipid mediators (MarLs), are enzymatically biosynthesized from omega-3 essential long-chain polyunsaturated fatty acids, especially docosahexaenoic acid (DHA), by macrophages and other leukocytes. SPMs exhibit strong inflammation-resolving activities, especially inflammation provoked by bacterial infection. In this study, we explored the potential direct inhibitory activities of three MarLs on Gram-positive (Staphylococcus aureus) and Gram-negative (Pseudomonas aeruginosa and Escherichia coli) bacteria in their biofilms that are leading bacteria in burn trauma-related infections. We also examined the effects of MarLs on the bactericidal activities of a typical broad-spectrum antibiotic, carbenicillin (carb), on these bacteria in their preformed biofilms. The results revealed that MarLs combined with carbenicillin can inhibit the survival of Gram-positive and Gram-negative bacteria in their biofilms although MarLs alone did not exhibit bactericidal activity. Thus, our findings suggest that the combination of MarLs and carbenicillin can lower the antibiotic requirements to kill the bacteria in preformed biofilms.

A rapid interactive chitosan-based medium with antioxidant and pro-vascularization properties for infected burn wound healing

Large-pore hydrogels are better suited to meet the management needs of nutrient transportation and gas exchange between infected burn wounds and normal tissues. However, better construction strategies are required to balance the pore size and mechanical strength of hydrogels to construct a faster substance/gas interaction medium between tissues. Herein, we developed spongy large pore size hydrogel (CS-TA@Lys) with good mechanical properties using a simple ice crystal-assisted method based on chitosan (CS), incorporating tannic acid (TA) and ε-polylysine (Lys). A large-pore and mechanically robust hydrogel medium was constructed based on hydrogen bonding between CS molecules. On this basis, a pro-restorative functional platform with antioxidation and pro-vascularization was constructed using TA and Lys. In vitro experiments displayed that the CS-TA@Lys hydrogel possessed favorable mechanical properties and fast interaction performances. In addition, the CS-TA@Lys hydrogel possessed the capacity to remove intra/extracellular reactive oxygen species (ROS) and possessed antimicrobial and pro-angiogenic properties. In vivo experiments displayed that the CS-TA@Lys hydrogel inhibited wound inflammation and promoted wound vascularization. In addition, the CS-TA@Lys hydrogel showed the potential for rapid hemostasis. This study provides a potential functional wound dressing with rapid interaction properties for skin wound repair.

Molecular Identification and Detection of Virulence Genes Among Pseudomonas Aeruginosa Isolated from Burns Infections

Objective: Virulence factors are substances produced by pathogenic Pseudomonas aeruginosa that contribute significantly to the etiology of disease. These virulence factors are encoded by virulence genes found on the Pseudomonas aeruginosa chromosome. Methods: Between July 2021 and June 2022, 71 Pseudomonas aeruginosa isolates were identified from burn wounds at the Burn and Plastic Surgery Hospital in Duhok, Iraq. The lasB and toxA genes were identified using Polymerase Chain Reaction (PCR). Results: Only 26.36% (29/71) of the 71 Pseudomonas aeruginosa isolates were found in males, whereas 38.18% (42/71) were found in females. Furthermore, 76.06% (54/71) of the isolates were multidrug resistant. They demonstrated greater resistance to piperacillin, 98.59% resistance rates. Among the isolates analyzed, 35 (64.81%) were positive for toxA and 27 (50%) were positive for lasB genes. Conclusion: Due to the limited number of effective medications against this bacteria that are currently available, all isolates must undergo antimicrobial susceptibility testing. By doing this, you can help manage the treatment plan and stop the emergence of resistance in burn units.

Характеристика генів інтегронів клінічних ізолятів Pseudomonas aeruginosa, які реалізують резистентність до антибіотиків та біоплівкоутворення цими штамами

Pseudomonas aeruginosa is a bacterium that holds significant clinical and epidemiological significance. It serves as the principal etiological cause of opportunistic infections in individuals with impaired immune systems. Integrons are known to have a notable impact on Gram-negative bacteria, particularly in the context of P. aeruginosa, a bacterium recognized for its ability to develop resistance to antimicrobial drugs. Aim. To systematically characterize and detect integron genes (intI, intII, intIII) with antibiotic-resistant and biofilm-forming capabilities in isolated P. aeruginosa. Methods. A total of 209 samples were collected from Al Yarmouk Teaching Hospital in Baghdad City, Iraq to isolate P. aeruginosa. The process of bacterial identification was carried out phenotypically and by biochemical tests. Antibiotic susceptibility was measured using the Vitek2 system. Biofilm quantification was done by the microtiter method. The PCR approach was employed to assess the presence of class 1, 2, and 3 integrons. Results. P. aeruginosa was identified in 83 isolates by using a combination of morphological and biochemical examinations where all isolates showed the ability to grow a selective medium on cetrimide agar for P. aeruginosa. The results also showed significant variances (p < 0.05) among the percentage of a number of samples and isolated P. aeruginosa. The burn and wound infection scored the highest percentages (25% and 19%) based on the positivity of P. aeruginosa, whereas burn and ear sites scored the highest percentage (58% and 50%). Also, the isolates show the ability to form biofilm at a percentage of 68.7% with resistance to a high number of antibiotics. The multidrug-resistant and sensitive P. aeruginosa isolates scored high percentages (49.4% and 34.9%) whereas potentially pan drug-resistant and extensively drug-resistant isolates scored low percentages (2.4% and 13.3%). PCR results showed that integron I scored the highest percentage (100%) compared to integron 2 found in 3 (10%) isolates, and no intI3 gene was detected in any of the P. aeruginosa isolates. Conclusions. Overall, the findings of the present investigation indicate that integrons and biofilm development are recognized as significant factors contributing to antibiotic resistance in P. aeruginosa. The prevalence of class 1 integrons is shown to be significantly high in all bacterial isolates, with a complete occurrence rate of 100%. This high incidence of class 1 integrons is associated with the development of resistance to crucial antibiotics, including β-lactams, aminoglycosides, and cephalosporins.

Characterization of a new Pseudomonas aeruginosa Queuovirinae bacteriophage.

The ESKAPEE pathogen Pseudomonas aeruginosa is a common cause of chronic wound and cystic fibrosis lung infections, as well as acute burn and nosocomial infections. Many of these infections are recalcitrant to conventional antibiotic therapies due to both traditional antibiotic resistance mechanisms and antimicrobial tolerance. Recent successes with bacteriophage (phage) therapy to treat chronic human P. aeruginosa infections have led to a renewed interest in isolating and characterizing new P. aeruginosa phages. Here, we isolated and characterized a new lytic phage (termed PIP, pili-infecting phage) capable of infecting P. aeruginosa PA14. PIP is a tailed phage with an icosahedral head and flexible tail containing a genome that is 57,462 bp in length. Phylogenetic analysis reveals that PIP belongs to the subfamily Queuovirinae and genus Nipunavirus but is highly divergent in gene content from known Nipunaviruses. By isolating and characterizing a P. aeruginosa strain that spontaneously evolved resistance to PIP, we show that the receptor for PIP is Type IV pili. In summary, we isolated a new P. aeruginosa phage species with a unique genome, thus increasing the diversity of phages known to infect this important human pathogen.IMPORTANCEThe opportunistic pathogen Pseudomonas aeruginosa causes both acute and chronic human infections. These infections are notoriously difficult to treat due to both antibiotic resistance and antibiotic tolerance. The increasing frequency of antibiotic failure in P. aeruginosa infections has led scientists to explore other treatment options, including bacteriophage (phage) therapy. To this end, there has been a significant effort to identify new Pseudomonas phages. Here, we isolated and characterized a bacteriophage (termed PIP, pili-infecting phage) that infects P. aeruginosa PA14. Examination of the PIP genome revealed that this phage represents a new species in the subclass Queuovirinae. The isolation and characterization of spontaneous PA14 mutants that are resistant to PIP infection revealed Type IV pili as the PIP receptor. Ultimately, this study characterizes a new species of Pseudomonas phage, thus enhancing the known diversity of phages that infect this important pathogen.

Prevalence and antibiogram of Pseudomonas aeruginosa and Staphylococcus aureus clinical isolates from burns and wounds in Duhok City, Iraq.

this study aimed to isolate P. aeruginosa and S. aureus, investigate the antimicrobial resistance of collected isolates, and investigate the distribution of exoU and mecA genes in P. aeruginosa and S. aureus isolates. Out of 150 samples, 32 isolates were identified as P. aeruginosa, 48 isolates were identified as S. aureus. All isolates were checked for AST. Then, a PCR was applied to detect exoU and mecA genes in P. aeruginosa and S. aureus. 12.0% and 29.3% of the samples showed co-isolates and single isolates of studied pathogens, respectively. Regarding burn samples, S. aureus was the most prevalent pathogen (38.0%, 38/100) among males (41.8%, 23/55), followed by P. aeruginosa (27.0%, 27/100) among females (28.9%, 13/45). The highest burn infection rates of S. aureus (50.0%) and P. aeruginosa (32.7%) were recorded among age groups (≥ 50) and (18-49), respectively. Comparatively, wound samples were less infected with these pathogens. P. aeruginosa isolates usually exhibited high resistance to gentamicin, tobramycin, and netilmicin, whereas, imipenem showed low resistance at 46.87%. S. aureus isolates were susceptible to trimethoprim-sulphamethoxazole and rifampin. 56.25% of P. aeruginosa isolates were exoU positive and 37.5% of S. aureus isolates were mecA positive. Results of the cefoxitin inhibition zone with mecA gene amplification, 33.3% isolates were MRSA, 4.2% isolates were nmrMRSA, and 62.5% isolates were MSSA. Most of the resistant isolates of P. aeruginosa carried the exoU gene, 80% resistant isolates to imipenem were exoU positive. S. aureus was more predominant than P. aeruginosa in burns and wounds infections.

A Comparison of Teleburn to In-Person Consultation of Pediatric Patients in a Children's Emergency Department.

Pediatric burn care is an essential component of emergency care and there are disparities in access to regional burn centers. Teleburn is a tool that enables providers without a certified burn center to provide photos of a burn to experts and receive recommendations. The purpose of this study is to evaluate the effectiveness of a Teleburn system to the in-person consultation regarding burn infection rate, clinic follow-up rate, postburn admission rate, and 72-h bounce back rate. Data were collected from December 2019 to March 2022 through the electronic medical record. A total of 416 patient encounters that met the criteria were analyzed. A non-inferiority study was designed comparing proportional outcomes of Teleburn initial visits to emergency department visits regarding burn infection rate, clinic follow-up rate, postburn admission rate, and 72-h bounce back rate. The data were compared with a difference of greater than 10% being considered inferior. No differences were identified in rates of readmission-1.67% difference (95% CI -27%< x < 23.8%) and return within 72 h-0.7% difference (-18.4%< x < 19.7%). Teleburn patients were 12.6% less likely to follow-up (2.7%< x < 22.40%). Only one infection was identified, which was insufficient to conclude non-inferiority. While convenient, Teleburn consult could not be demonstrated to be non-inferior to in-person consultation. No differences in infection rates were identified, and differences in readmission and return were clinically insignificant. This study demonstrates that Teleburn may be effective and feasible for regional burn centers if follow-up can be improved.

Genomic analysis of vB_PaS-HSN4 bacteriophage and its antibacterial activity (in vivo and in vitro) against Pseudomonas aeruginosa isolated from burn

The most frequent infections caused by Pseudomonas aeruginosa are local infections in soft tissues, including burns. Today, phage use is considered a suitable alternative to cure infections caused by multi-drug-resistant (MDR) and extensively drug-resistant (XDR) bacteria. We investigated the potential of a novel phage (vB_PaS-HSN4) belonging to Caudoviricetes class, against XDR and MDR P. aeruginosa strains in vivo and in vitro. Its biological and genetic characteristics were investigated. The phage burst size and latent were 119 and 20 min, respectively. It could tolerate a broad range of salt concentrations, pH values, and temperatures. The combination with ciprofloxacin significantly enhanced biofilm removal after 24 h. The genome was dsDNA with a size of 44,534 bp and encoded 61 ORFs with 3 tRNA and 5 promoters. No virulence factor was observed in the phage genome. In the in vivo infection model, treatment with vB_PaS-HSN4 increased Galleria mellonella larvae survival (80%, 66%, and 60%) (MOI 100) and (60%, 40%, and 26%) (MOI 1) in the pre-treatment, co-treatment, and post-treatment experiments, respectively. Based on these characteristics, it can be considered for the cure of infections of burns caused by P. aeruginosa.

Catecholamines polymerization crosslinking for alginate-based burn wound dressings developed with ciprofloxacin and zinc oxide interactions

There is an increasing demand for stable and durable wound dressings to treat burn injuries and infections. Bioactive electrospun nanofibrous mats with antibacterial properties are promising for wound dressing usage. Electrospinning of biopolymers for wound dressing applications needs post-spinning crosslinking to prevent mat dissolution in moist wound environments. Here, we prepared durable wound dressing by using the Dopamine (DA) polymerization crosslinking in Alginate (ALG)/Polyvinyl alcohol (PVA) nanofibrous mats, which are developed by Ciprofloxacin (CIP) and Zinc oxide (ZO). The nanofibrous mats were investigated by FESEM, FTIR, mechanical strength, water contact angle, degradation, degree of swelling, and WVTR tests. The analyses demonstrate the nanofibrous mats with uniform and unbranched fibers, with a hydrophilic nature, which was porous, durable, and stable. Also, it showed the CIP and ZO addition enhanced their durability by crosslinking reinforcement. In addition, the drug release and antibacterial assays demonstrated the pH-sensitive release with more drug release at higher pH (bacterial invasion) and impressive antibacterial activity (up to 99 %). In the burn wound model in rats, the ALG/PVA/DA/CIP/ZO nanofibrous mats displayed excellent wound healing ability in wound closure and tissue regeneration. Also, complete re-epithelization and remodeling and highest collagen synthesis in histological assessment.

Polymyxin B-targeted liposomal photosensitizer cures MDR A. baumannii burn infections and accelerates wound healing via M1/M2 macrophage polarization

Multidrug-resistant (MDR) Acinetobacter baumannii infections pose a significant challenge in burn wound management, necessitating the development of innovative therapeutic strategies. In this work, we introduced a novel polymyxin B (PMB)-targeted liposomal photosensitizer, HMME@Lipo-PMB, for precise and potent antimicrobial photodynamic therapy (aPDT) against burn infections induced by MDR A. baumanni. HMME@Lipo-PMB-mediated aPDT exhibited enhanced antibacterial efficacy by specifically targeting and disrupting bacterial cell membranes, and generating increased intracellular ROS. Remarkably, even at low concentrations, this targeted approach significantly reduced bacterial viability in vitro and completely eradicated burn infections induced by MDR A. baumannii in vivo. Additionally, HMME@Lipo-PMB-mediated aPDT facilitated burn infection wound healing by modulating M1/M2 macrophage polarization. It also effectively promoted acute inflammation in the early stage, while attenuated chronic inflammation in the later stage of wound healing. This dynamic modulation promoted the formation of granulation tissue, angiogenesis, and collagen regeneration. These findings demonstrate the tremendous potential of HMME@Lipo-PMB-mediated aPDT as a promising alternative for the treatment of burn infections caused by MDR A. baumannii.

Synthetic solutions for re‐growing human corneas

Cornea blindness is still treated mainly by corneal transplantation, using donated allograft human corneas. However, a severe global shortfall leaves an estimated 12.7 million patients on waiting lists despite methods of using one cornea for two different partial‐thickness grafts. Even more individuals are not on waiting lists because they have no access to transplantation in their countries or regions. However, even if donor tissues were readily available, patients with inflamed, severely damaged corneas are at high risk of rejecting conventional transplantation. Various solutions have been proposed as alternatives to corneal allografting, including the development of keratoprostheses and stem cell grafting. We posited using cell‐free implants that mimic the extracellular matrix of the human cornea to recapitulate the environment during corneal development and stimulate the endogenous cells within the patient's eyes to affect regeneration. We used cell‐free corneal implants made from chemically crosslinked recombinant human collagen to promote in situ tissue regeneration in pathologic corneas, including high‐risk ones. We successfully developed and tested recombinant human solid collagen‐based implants that promoted stable regeneration in inflamed human patient corneas based on phosphorylcholine (MPC). However, solid corneas require a full operating theatre and staffing, which is costly and not accessible to more remote regions in Canada and globally. Burns and severe infections that can lead to perforations are medical emergencies that require immediate methods to seal the eye. In many centres, cyanoacrylate glue is used as a sealant, but this is toxic and kills surrounding cells, often necessitating follow‐on transplantation. We developed a synthetic, biocompatible, and adhesive liquid hydrogel (LiQD Cornea), which would replace these toxic cyanoacrylate glues. LiQD cornea is applied as a liquid but quickly adheres and gels within corneal tissue defects like a dental filling. It can be used to fill ulcers and other damaged areas. Then its similarity at a molecular level to a natural tissue framework promotes tissue regeneration, treating corneal perforations effectively without transplantation. Further, due to the synthetic nature of the material, risks associated with disease transmission are reduced compared to natural products. We see LiQD Cornea potentially used in outpatient clinics instead of operating theatres, maximizing practicality and minimizing health care costs.

Human breast milk isolated lactic acid bacteria: antimicrobial and immunomodulatory activity on the Galleria mellonella burn wound model.

Managing burn injuries is a challenge in healthcare. Due to the alarming increase in antibiotic resistance, new prophylactic and therapeutic strategies are being sought. This study aimed to evaluate the potential of live Lactic Acid Bacteria for managing burn infections, using Galleria mellonella larvae as an alternative preclinical animal model and comparing the outcomes with a common antibiotic. The antimicrobial activity of LAB isolated from human breast milk was assessed in vitro against Pseudomonas aeruginosa ATCC 27853. Additionally, the immunomodulatory effects of LAB were evaluated in vivo using the G. mellonella burn wound infection model. In vitro results demonstrated the antimicrobial activity of Lactic Acid Bacteria against P. aeruginosa. In vivo results show that their prophylactic treatment improves, statistically significant, larval survival and modulates the expression of immunity-related genes, Gallerimycin and Relish/NF-κB, strain-dependently. These findings lay the foundation and suggest a promising alternative for burn wound prevention and management, reducing the risk of antibiotic resistance, enhancing immune modulation, and validating the potential G. mellonella as a skin burn wound model.

CASE-3: Dr. Hani Ajrina Zulkeflee, Dr Wan Nur Aimi Wan Mohd Zamri, Dr Siti Nadirah Ab Rahim, Dr Wan Nor Fazila Hafizan Wan Nik and Dr Razan Hayati Zulkeflee

A 31-year-old lady presented with infected burn injuries. Her past medical history was unremarkable. During the admission, her laboratory results showed persistent hyperkalaemia while the patient remained asymptomatic. The serial laboratory results were:

Development of quercetin loaded silk fibroin/soybean protein isolate hydrogels for burn wound healing

Hydrogel networks composed of naturally derived polymers offer a promising solution for the development of wound dressings due to their biodegradable, biocompatible, and renewable properties. In this study, silk fibroin (SF) and soybean protein isolate (SPI) were used as the main components to create a natural SF/SPI hydrogel. To further enhance its bioactivity, quercetin was loaded into the hydrogel to form a SF/SPI-Q hydrogel. The resulting SF/SPI-Q hybrid hydrogels possessed a unique combination of advantages derived from both the natural polymers (such as excellent biocompatibility, biodegradability, and promotion of cell migration) and therapeutic drugs (including antibacterial properties and antioxidant capacity). As a result, the hydrogel effectively accelerated wound healing in an infected burn wound model. The SF/SPI-Q hydrogels accelerated epidermal regeneration, collagen deposition, and angiogenesis, facilitating the healing process of burn wounds. Moreover, they also exhibited anti-inflammatory properties, which contributed to a reduction in inflammation. Thus, the SF/SPI-Q hydrogels showed great potential as a highly effective treatment option for wound healing applications.