Burn Therapy Research Articles

Biosynthetic Sesame Oil and Nano Titanium Dioxide As a Therapy For Second Degree Burns

As the healing of burn wounds delay that affect the skin and lead to tearing and damage to its parts, as well as the remaining traces and scars on the skin because of exposure to heat, radiation, radioactivity, electricity, friction, or contact with chemicals, it has become necessary to investigate and discover effective medicines. Burns that affect the skin have an important purpose, Therefore, it is important to continue studying and experimenting with new and effective medicines, including effective nanomaterials, to reach efficient treatments to treat such injuries. In the current study, nanoparticles of titanium dioxide (TiO2) were prepared, and this material was examined using a device a Field Emission Electron Scanning Microscope (FE-SEM). The results obtained were on the nanoscale, with sizes ranging from (31.52-69.08) nanometers. The effectiveness and effect of biosynthetic nanomaterials and sesame seeds were investigated in vivo at a concentration of 1% TiO2 and 20% sesame oil on burns in the skin of laboratory rats and compared with a control group of natural skin of the same type of laboratory rats. They were also compared with rats treated with Mebo ointment. Randomly, 18 rats were put into three equal groups and treated once daily for 28 days. The results of the study showed effective activity and a noticeable speed in the healing of burns that affected the skin of laboratory rats using a nano-titanium dioxide preparation supported by sesame seed extract whose burn mean amounted to 0.005 compared to the control treatment, whose burn mean was 2.443. According to the current study's findings, using biosynthetic nano-titanium dioxide and sesame oil together results in better burn wound healing than using each of them separately.

A Randomized Controlled Trial of Home-Based Virtual Rehabilitation to Improve Adherence to Prescribed Home Therapy after Burn Injury: A Northwest Regional Burn Model System Trial.

Daily rehabilitation after burn injury is vital for prevention of function-limiting contractures. However, adherence to prescribed therapy following acute burn hospitalization has historically been low and not well-studied. Studies involving virtual reality technology have demonstrated an association with improved functional outcomes in burn therapy. We conducted a five-year randomized controlled trial comparing 12 weeks of a home-based virtual rehabilitation (HBVR) system with standard burn therapy. Our primary outcome was adherence to prescribed home therapy, measured by e-diary self-report. Secondary outcomes included steps walked daily and patient-reported outcomes regarding stiffness, upper extremity function, and mobility. We enrolled 50 subjects, of which 48 provided data for analysis (23 HBVR, 25 control). Overall adherence to prescribed home therapy was low, 37.2% in the HBVR group and 60.0% in the control group. Reasons for non-adherence in the HBVR group included lack of time, engagement, and replacement of therapy with other physical activity. However, some subjects enjoyed HBVR and believed it aided their recovery. There was no difference in daily steps walked between the two groups. Daily walking gradually improved from 3,500 steps per day in the first week after baseline and plateaued at 6,000 steps per day at week five. There were no differences in stiffness, upper extremity function, and mobility between the two groups at baseline and 3-, 6-, and 12-month follow-up. Subjects demonstrated improved upper extremity function and mobility in the first year after discharge that coincided with increasing stiffness.

Update burn surgery: overview of current multidisciplinary treatment concepts

Abstract The treatment of severe burn injuries is an essential part of plastic-reconstructive surgery. Severe burned patients are treated in burn centers, which have highly specialized technical and personnel equipment. In addition to clear recommendations for prehospital management, intensive care therapy is usually required for extensive burn wounds. Shock therapy in burns primarily involves balanced fluid resuscitation according to hemodynamic monitoring, vasopressor support, pain management, temperature regulation, oxygen therapy, and comprehensive supportive care to stabilize the patient’s condition. Surgical treatment is still based on wound debridement and the gold standard of autologous split-thickness skin grafting. Besides skin transplantation, surgical management of burns may also involve the application of various topical therapies to promote wound healing, reduce pain, and prevent infection. These therapies may include antimicrobial dressings, skin substitutes, growth factors, or specialized wound care products. Once the acute treatment has been completed, multidisciplinary rehabilitation treatment takes place, which begins in the acute hospital and continues in the outpatient and inpatient rehabilitation areas. Surgical treatment of the secondary complications of burns and scars is also an important component of burn care. Comprehensive knowledge of the various components and players involved in the care of severely burned patients is, therefore, required in order to achieve the best possible outcome for the patient.

تأثير مستخلص نبات Hypericum perforatumعلى التركيب النسجي للكلى وبعض المعايير الفسلجية و الدور الوقائي لأوميكا3 في الجرذان البيضاء (albino rats)

St. John's Wort, or Hypericum perforatum, is a flowering plant that is a member of the hypericaceae family, which has around 55 genera and over 1,000 species (1). Because the St. John's wort flower is thought to have a rich source of bioactive chemicals, including naphthoidiantrone, acylphloroglucinol, phenols, flavonoids, and essential oils, it has been used medicinally since ancient times. It has therefore gained popularity as a therapy for burns, wounds, anxiety, and depression. According to available research, this herb can effectively cure a variety of additional conditions, including cancer, bacterial and viral infections, inflammatory disorders, and kidney preservation in addition to acting as an antioxidant and vascular disease preventative (2, 3).

Hyperbaric oxygen (HBO2) therapy in thermal burn injury revisited. Pressure does matter. Review.

ABSTRACT Smolle C, Auinger D, Lindenmann J, Smolle J, Smolle-Juettner FM, Kamolz LP. Hyperbaric oxygen (HBO2) therapy in thermal burn injury revisited. Pressure does matter. Review. Undersea Hyperb Med. 2024 Second Quarter; 51(2):115-127. For over five decades, many experimental and clinical studies have shown predominantly positive but controversial results on the efficacy of hyperbaric oxygen (HBO2) therapy in burns. The study aimed to define a common denominator or constellations, respectively, linked to the effects of HBO2 in burns with a special focus on dosage parameters. Based on original work since 1965, species, number of individuals, type of study, percentage of total body surface area (TBSA), region, depth of burn, causative agent, interval between burn and first HBO2 session, pressure, duration of individual session, number of HBO2 sessions per day, cumulative number of HBO2 sessions and type of chamber were assessed. Out of 47 publications included, 32 were animal trials, four were trials in human volunteers, and 11 were clinical studies. They contained 94 experiments whose features were processed for statistical evaluation. 64 (67.4%) showed a positive outcome, 16 (17.9%) an ambiguous one, and 14 (14.7%) a negative outcome. The only factor independently influencing the results was pressure with ATA (atmospheres absolute) lower than 3 ATA being significantly associated with better outcomes (p=0.0005). There is a dire need for well-designed clinical studies in burn centers equipped with hyperbaric facilities to establish dedicated treatment protocols.

Scar outcomes for conservatively managed children post burn injury: A retrospective study.

Hypertrophic scarring is a significant complication post burn injury, especially for delayed healing after 3 weeks. Burn injuries healing prior to 3 weeks also have the potential to develop hypertrophic scarring, even when prescribed prophylactic conservative scar interventions. A retrospective chart audit reviewed 326 burn patients treated at a paediatric tertiary hospital from 2014 to 2019 who sustained a partial thickness burn, healed >14 days and did not receive skin grafting. A scar was deemed hypertrophic if >1 mm in height. Early hypertrophic scar prevalence was defined as 3-6 months post burn, while persistent hypertrophic scarring was defined as 12-18 months post burn. Median days to wound closure was 18. The prevalence of early and persistent hypertrophic scarring was 56.1% and 16.3%, respectively. Seventeen (5.2%) children underwent medical interventions for scar modulation. Early signs of hypertrophic scarring were seen in just over half the patients presenting to burn therapy and despite scar intervention, persistent hypertrophic scarring was seen in 16.3%. At both time points, just over half of the children presenting healed between 14 and 21 days. Therefore, children healing prior to 21 days have potential to develop hypertrophic scarring.

Amnion as an Innovative Antiseptic Carrier: A Comparison of the Efficacy of Allogeneic and Xenogeneic Transplantations in the Context of Burn Therapy.

Background and Objectives: The amniotic membrane is widely used in the treatment of chronic wounds, in toxic epidermal necrolysis (TEN), and in the treatment of burns. In our clinical practice, we use amniotic dressings on shallow skin wounds caused by burns. Counteracting infections is an important aspect of working with burn wounds. Therefore, the main goals of this work are to demonstrate the usefulness of amniotic membrane soaked in antiseptics for the prevention of wound infections and to compare the antibacterial efficacy of selected variants of allogeneic and xenogeneic amniotic membrane grafts soaked in specific antiseptic agents. Materials and Methods: The studied material consisted of human and pig placenta. The human and animal amnions were divided in two parts. The first part consisted of amniotic discs placed on rigid mesh discs and preparing the fresh amnion. The second part of the amnion was frozen at a temperature of -80 °C for 24 h. Then, it was radio-sterilized with a dose of 35 kGy. The amniotic discs were placed on rigid mesh to prepare the radiation-sterilized amnion. The amniotic discs were placed in a 12-well plate and immersed in 3 mL of the appropriate antiseptic solutions: Prontosan, Braunol, Borasol, Microdacyn, Octenilin, Sutrisept, and NaCl as a control. The amniotic discs were incubated in antiseptics for 3 h. The microbiological tests were conducted by placing the antiseptic-infused amniotic discs on microbiological media inoculated with hospital strains. Results: The largest average zone of growth inhibition was observed in dressings soaked with Sutrisept, Braunol, and Prontosan. The greatest inhibition of bacterial growth was achieved for radiation-sterilized porcine amnion impregnated with Braunol and Sutrisept, as well as for radiation-sterilized human amnion impregnated with Braunol. Conclusions: Human and porcine amniotic membrane is effective in carrying antiseptics. Radiation-sterilized amnion seems to inhibit the growth of microorganisms better than fresh amnion.

Evaluation of Virtual Reality in the Reduction of Pain During Dressing Changes in Patients With Burn Wounds: A Pilot Study.

Burn injuries are among the most common life-threatening injuries for which medical attention is sought, and are accompanied by intense, severe pain, particularly during treatment. Burn therapy pain management with opioid and nonopioid analgesics is often insufficient when administered alone. Virtual reality (VR) interfaces provide an immersive experience that has demonstrable therapeutic benefits, including distraction from, and reduction of, pain. In this interventional pilot study, we assessed the correlation between VR and passive distraction and pain tolerance during burn wound treatment. This pilot study assessed patients undergoing burn wound dressing changes while receiving both pharmacological and VR intervention. Questionnaires and evaluation forms were subjectively completed by both patients and medical staff before and after treatment, and clinical metrics were recorded throughout the treatment. Forty-one patients ≥18 years old and 76.9% male that had primarily undergone ≥4 dressing changes before the study were included. Correlations were found between VR engagement during treatment and a decrease in subjective levels of nausea, anxiety, and pain sensation. Furthermore, high levels of VR engagement were correlated with high levels of VR enjoyment. These results suggest that highly engaging and enjoyable VR interfaces may reduce sensations of anxiety and pain in burn patients during dressing changes. Furthermore, these data suggest that VR technology may be applied as an adjunct therapy to pharmacological treatment in the standardization of burn wound care management. Further studies with control groups and larger sample populations are needed for better quantification of these benefits.

Thermal Transport Phenomena in PEGDA-Based Nanocomposite Hydrogels Using Atomistic and Experimental Techniques.

Poly(ethylene glycol) diacrylate (PEGDA) hydrogel is a very peculiar, fascinating material with good chemical stability and biocompatibility. However, the poor thermal transport phenomenon in PEGDA, limits its performance in cartilage replacement and developing therapies for treating burns. In this article, a combined experimental and atomistic approach was adopted to investigate the thermal transport phenomena in PEGDA hydrogel with different weight concentrations of boron nitride nanoplatelets as a function of water content. The incorporation of boron nitride nanofillers helps in enhancing the thermal conductivity of PEGDA hydrogels, and the reinforcement effect was more dominating at lower water content. Experimental investigation was complemented with molecular dynamics-based studies to capture the effect of defective (bicrystalline) boron nitride nanosheets on the interfacial thermal conductance in PEGDA hydrogels. It can be concluded from the simulations that defective nanosheets are superior reinforcement for enhancing the thermal transport in PEGDA hydrogels, and this is independent of the water content. These biocompatible boron nitride nanoparticle (BNNP)-incorporated PEGDA hydrogels with enhanced thermal conductivity are promising materials in addressing locally overheating tissues such as cartilage replacement. They may have comprehensive utility for biomedical applications such as tissue engineering, drug delivery, biosensors, and burn therapy.

Application of green synthesized silver nanoparticles in Burn therapy: a review.

Silver nanoparticles (AgNPs), owing to their unusual characteristics, have been used in various pharmaceutical, cosmetic, and healthcare products. AgNPs, with their exceptional biological potential, exhibit antibacterial, antifungal, antiviral, anti-inflammatory, anticancer, and wound healing properties and have been extensively used in burn therapy. Several studies have established the use of silver nanoparticles in the treatment of burn injuries, resulting in reduced inflammation, quick tissue regeneration, and the remarkable creation of collagen fibers. Conventional physical and chemical techniques have synthesized AgNPs, but they appear to be highly costly and hazardous. Recently, there has been considerable interest in the synthesis of AgNPs using the green chemistry approach because of its tremendous benefits, including being non-toxic, low energy consumption, pollution-free, economical, environmentally friendly, and more sustainable. This review emphasizes the green synthesis of AgNPs using bacteria, fungi, plants, and other microorganisms and the current research related to the application of green synthesized AgNPs in burn therapy, including the biological aspects of AgNPs, their mode of action, and any possible detrimental effects.

A Meta-Analysis of the Mortality and the Prevalence of Burn Complications in Western Populations.

Management of burn injuries is complex, with highly variable outcomes occurring among different populations. This meta-analysis aims to assess the outcomes of burn therapy in North American and European adults, specifically mortality and complications, to guide further therapeutic advances. A systematic review of PubMed, Web of Science, and Cochrane was performed. Random-effect meta-analysis of proportions was conducted to assess the overall prevalence of the defined outcomes. In total, 54 studies were included, pooling 60 269 adult patients. A total of 53 896 patients were in North America (NA, 89.4%), and 6373 were in Europe (10.6%). Both populations experienced similar outcomes. The overall pooled prevalence of mortality was 13% (95% CI, 8%-19%) for moderate burns, 20% (95% CI, 12%-29%) for severe burns in the NA region, and 22% (95% CI, 16%-28%) for severe burns in Europe. Infectious complications were the most common across both regions. European studies showed an infection rate for patients with moderate and severe burns at 8% and 76%, respectively, while NA studies had rates of 35% and 54%. Acute kidney injury (39% vs 37%) and shock (29% vs 35%) were the next most common complications in European and NA studies, respectively. The length of stay was 27.52 days for patients with severe burns in Europe and 31.02 days for patients with severe burns in NA. Burn outcomes are similar between Western populations. While outcomes are reasonably good overall, infectious complications remain high. These findings encourage the development of further therapeutic strategies disclosing respective costs to enable cost/efficiency evaluations in burn management.

Mobilization With Femoral Catheters in the Burn ICU: A Retrospective Review Following Change in Practice Guidelines.

Femoral catheters are commonly viewed as a barrier to Burn ICU mobility progression due to anatomical location and potential risk of complications. The purpose of this review was to examine outcomes and complication rates following implementation of femoral catheter mobilization guidelines, as well as determine safety and feasibility of mobilization with femoral catheters in place within the burn population. A retrospective review was completed on 17 patients prior to and following the implementation of new femoral catheter mobility guidelines, 34 patients total. Burn therapy notes were reviewed for burn admissions with at least 1 femoral catheter in place, including arterial, central, and dialysis catheters. Demographic data, admission statistics, line placement timelines, and active mobility achieved during therapy sessions were recorded for both the nonmobilization group (NMG) and mobilization group (MG). The 34 patients reviewed had 99 total lines placed (30 NMG, 69 MG). Change in mobility protocols for the MG resulted in more therapy sessions (n = 516 vs 281) and a significant increase in active mobility sessions (n = 83 vs 5, P < .001), including 146 total mobility activities such as transitions to chairs, tilt table, sitting edge of bed, standing, active chair transfers, ambulation, and cycle ergometry. No catheter-associated adverse events occurred during active mobility sessions and no complications were associated with participation in mobility. This review supports that the presence of femoral catheters alone should not limit the progression of mobility interventions with the use of clinical judgment in specialty-trained burn therapists.

The Costs of Caring: Quantifying Compassion Fatigue and Compassion Satisfaction in Burn Therapists.

Recovery from a severe burn injury requires early and aggressive therapy, which is often painful and distressing to the patient. Burn therapists who guide these interventions may be prone to experiencing secondary trauma and compassion fatigue through repeated exposure to difficult situations. At the same time, therapists may gain a sense of purpose and altruism from their work, fostering compassion satisfaction. Despite being well documented in other health professions, compassion fatigue and compassion satisfaction have not been sufficiently explored among burn therapists. This study aimed to quantify and characterize burn therapists' compassion fatigue and satisfaction using the Professional Quality of Life scale and to answer the question of what job-related factors may impact these outcomes. A total of 143 burn therapists participated in this study. Results revealed compassion fatigue subsale scores of burnout and secondary traumatic stress in the low or moderate range and compassion satisfaction scores in the moderate or high ranges for all participants. This study presents new knowledge for the field of burn care in its quantification of professional quality of life in burn therapists. While burn therapists experienced moderate-to-high levels of compassion satisfaction in their work, burnout and stress also approached moderate levels. Years of practice was a significant predictor of compassion. Although the reasons for this are not clear, it may be related to increased competence or confidence in practice and may suggest a need for different support strategies for practitioners at each stage of their burn therapy career.

Retrospective Review of Outcomes Related to Early Therapy Intervention Following Application of Cultured Epidermal Autografts in Severely Burned Patients.

Cultured epidermal autografts (CEA) have since become more prevalent in the treatment of burn-injured patients with limited available donor sites for adequate wound closure, resulting in decreased mortality rates and an increased number of these patients requiring burn therapy services to achieve optimal functional outcomes at discharge. However, the use and postoperative management of CEA continue to be controversial due large to the physiological fragility and expense of CEA, leading to variable postoperative treatment practices across burn centers. As such, minimal research is available regarding patient outcomes following CEA application, specifically related to burn therapy intervention. Thus, a retrospective chart review was conducted on a series of 10 patients, 18 years of age or older, admitted to a single, American Burn Association verified burn center, between April 2015 and April 2023, who required CEA and received pre- and postoperative treatment by burn therapists in accordance with center-specific burn rehabilitation guidelines. The resulting patient outcomes, in response to early implementation of therapy interventions post-CEA surgery, demonstrated optimal functional status for patients upon discharge and positive long-term implications.

(262) Virtual Reality for Improved Vasectomy Experience: Insights from a Single-Center Clinical Trial

Abstract Introduction Vasectomy is a widely performed procedure for male sterilization, with an estimated 33 million procedures conducted annually worldwide. Although vasectomy is generally safe and associated with minimal complications, concerns over procedural pain and anxiety can deter patients from pursuing the procedure. To address these concerns, innovations such as no-needle and no-scalpel techniques have been adopted to minimize pain during vasectomy. However, anticipated pain and anxiety remain significant barriers for patients. Therefore, optimizing patient comfort during procedures performed under local anesthesia is crucial for improving outcomes and satisfaction. Virtual reality (VR) devices have emerged as a promising non-pharmacological intervention for pain modulation in various medical fields. VR technology has demonstrated pain reduction and anxiety alleviation in pediatric burn therapy, physical therapy, dental procedures, and more. The adult urologic community has also embraced VR, with positive results observed in surveillance cystoscopy and office-based prostate biopsy procedures. However, limited research exists on the use of VR headsets during vasectomy, with only one previous non-randomized trial reporting high patient satisfaction but no improvement in pain or anxiety. In this ongoing single-center, randomized, open-label clinical trial, we present interim data evaluating the effectiveness of the SmileyScope VR device in reducing anxiety and pain during in-office vasectomy performed with local anesthesia. Objective The primary objective of this study is to evaluate the efficacy of virtual reality (VR) devices in alleviating peri-procedure anxiety and pain during in-office vasectomy performed with local anesthesia. The secondary goal of this study is to compare the effectiveness of interactive VR, enabling patient control of the experience, with static VR, which does not provide patient control. Methods The study enrolled patients who were scheduled for in-office vasectomy with a single urologist. The patients were randomly assigned to one of three groups: the control group receiving standard in-office vasectomy without a VR headset, the static VR intervention group, or the interactive VR intervention group. The primary outcome measures included patient-reported pain and anxiety levels before and after the procedure, along with heart rate measurements recorded using a wearable device. Results Interim analysis of this ongoing study includes data from a total of 58 men. 20 men were in the control group, 19 in the static VR arm, and 19 in the interactive VR arm. There was no observed difference in subjective pain scores or heart rate variability during the procedure. However, patients who wore a VR headset reported a significantly lower level of pre-procedure anxiety (P = 0.0700). Conclusions Anticipation of periprocedural pain and anxiety are barriers to vasectomy utilization. Initial results from our ongoing randomized clinical trial indicate that the utilization of virtual reality is feasible, safe, and effective in reducing pre-procedure anxiety in patients undergoing vasectomy. Disclosure No.

Semi-industrial Bio-fabrication of ZnO/MnO2 Nanocomposite Using Endophytic Streptomyces coelicolor: Characterization, Statistical Design, Exponential Pulse Fed-Batch Fermentation, and Its Antimicrobial Application

In our study, we examined how well six Streptomyces strains bio-fabricated ZnONPs, MnONPs, and/or ZnO/MnO2 nanocomposite. The most potent strain that generated efficient antimicrobial nanoparticles was then picked to increase the production of those particles in a semi-industrial pilot plant unit. Consequently, the intracellular extract of endophytic Streptomyces coelicolor strain E72 was used to achieve the bio-fabrication reaction of the spherical ZnO/MnO2 nanocomposite (6–18 nm). The bio-fabricated ZnO/MnO2 nanocomposite was validated and characterized using FTIR, XRD, SEM, TEM, TGA, and EDS analyses. Additionally, the production of this ZnO/MnO2 nanocomponent was scaled up to a pilot plant unit with a semi-industrial size. The Plackett–Burman experimental method was used to maximize the production of ZnO/MnO2 nanocomposites, which had increased 2.7-fold from their initial state. The bio-fabricated ZnO/MnO2 nanocomposite was subsequently scaled up 31.25 times using an exponential pulse-feeding fermentation technique in a 70-L bioreactor. This ZnO/MnO2 nanocomposite exhibited effective antimicrobial efficacy against all tested antibiotic-resistant human pathogens. The antimicrobial effects against Salmonella paratyphi (53.17 ± 2.8 mm) and Candida albicans (50.2 ± 1.01 mm) were the most potent at 90 and 130 µg/ml of ZnO/MnO2 nanocomposite, respectively. This is the first full explanation of the ZnO/MnO2 nanocomposite bio-fabrication at a semi-industrial scale employing endophytic strain E72 extract as a reducing/capping agent that reacted with MnCl2·4H2O and Zn (CH3COO)2·2H2O as precursors. This bio-fabricated ZnO/MnO2 nanocomposite has the potential to be utilized in the development of pharmaceuticals, cosmetics, wound dressings, and burn therapy due to its powerful antimicrobial capabilities.

Autologous Skin Cell Suspension for Full-Thickness Skin Defect Reconstruction: Current Evidence and Health Economic Expectations.

Despite differing etiologies, acute thermal burn injuries and full-thickness (FT) skin defects are associated with similar therapeutic challenges. When not amenable to primary or secondary closure, the conventional standard of care (SoC) treatment for these wound types is split-thickness skin grafting (STSG). This invasive procedure requires adequate availability of donor skin and is associated with donor site morbidity, high healthcare resource use (HCRU), and costs related to prolonged hospitalization. As such, treatment options that can facilitate effective healing and donor skin sparing have been highly anticipated. The RECELL® Autologous Cell Harvesting Device facilitates preparation of an autologous skin cell suspension (ASCS) for the treatment of acute thermal burns and FT skin defects. In initial clinical trials, the approach showed superior donor skin-sparing benefits and comparable wound healing to SoC STSG among patients with acute thermal burn injuries. These findings led to approval of RECELL for this indication by the US Food and Drug Administration (FDA) in 2018. Subsequent clinical evaluation in non-thermal FT skin wounds showed that RECELL, when used in combination with widely meshed STSG, provides donor skin-sparing advantages and comparable healing outcomes compared with SoC STSG. As a result, the device received FDA approval in June of 2023 for treatment of FT skin defects caused by traumatic avulsion or surgical excision or resection. Given that health economic advantages have been demonstrated for RECELL ± STSG versus STSG alone when used for burn therapy, it is prudent to examine similarities in the burn and FT skin defect treatment pathways to forecast the potential health economic advantages for RECELL when used in FT skin defects. This article discusses the parallels between the two indications, the clinical outcomes reported for RECELL, and the HCRU and cost benefits that may be anticipated with use of the device for non-thermal FT skin defects.

BODY SURFACE AREA AND USAGE AREAS

Body surface area is an anthropometric parameter used in many areas like drug dose adjustment, burn treatment, and determination of fluid requirement, as well as to calculate the basal metabolic rate. It is critical for many medical specialties, such as chemotherapy, transplantology, burn therapy, and toxicology. Until the 19th century, researchers looked for easy ways to calculate body surface area and developed various formulas. There were several different formulas derived from height and weight measurements to predict body surface area. Historically, the DuBois &amp;amp; DuBois formula is the most used, but Mosteller's formula is more popular due to its simplicity. The accuracy of the body surface area formulas, which are still in use today, is still being debated because they are determined by a few sample studies, and different sizes such as children and adults are not taken into consideration in sample selection. New and practical calculation methods are tried to be determined. This review aims to investigate the emergence of the body surface area and where it is used.

The effectiveness of negative pressure therapy in burns: scoping review

The effectiveness of negative pressure therapy in burns: scoping review

Investigation of some properties of a composite biomaterial based on betulin treat infected wounds and burns

An urgent problem of modern medicine is the problem of treatment of infected wounds, which is associated with the prevalence of wounds of various etiologies, purulent complications, high mortality, and high material costs of treatment. For the treatment of wounds most often used local effects of drugs, in particular, use a variety of coatings and dressings. Types of these dressings are quite diverse. They can be created on the basis of bioresorbable materials, contain other therapeutic substances such as enzymes, anesthetics, antibiotics in order to have a complex effect on the wound healing process. The choice of optimal local wound coatings or their effective combinations with physiotherapeutic methods of treatment of local superficial and deep wounds and prevention of wound infection remains an unsolved problem. In this regard, the creation of new wound healing preparations and wound coatings based on them seems to be very relevant. At the moment, there are many biologically active substances suitable for the therapy of wounds and burns. These substances can have a variety of origins - both synthetic and natural. Recently, the attention of specialists to drugs of natural origin is constantly growing. Interest in the use of such drugs is justified by their high efficiency, the lack of the need for complex synthesis, a wide range of pharmacological activity, as well as the possibility of using them for a long time without complications and side effects. The specific weight and volume of production of medicines obtained by synthetic transformations of substances extracted from wild and cultivated plants is increasing worldwide. Substances of plant origin are now increasingly being used in medical products for a wide range of purposes. One of such substances are derivatives of natural pentacyclic triterpenoid betulin extracted from birch bark. Betulin and its derivatives have high biological activity. This substance and its derivatives exhibit a complex of biologically active properties such as wound healing, antibacterial, antitumor, hypolipidemic, hepatoprotective, antiviral and others. Betulin, overcoming resistance, induces apoptosis of malignized cells in various human cancers. It should also be noted that sufficient raw material base and biological activity of betulin put it in a number of valuable natural sources for use both in the native state and in the form of various transformation products, which makes it relevant to develop drugs based on it.