Second-degree Burns Research Articles

Effects of Diallium and Ziziphus honey in Second-Degree Burns on Wistar Rats

Background: Nowadays, the use of honeys in the treatment of burns and wounds has aroused growing interest due to its anti-inflammatory, antioxidant and healing properties. Aim: The aim of this study was to evaluate the effects of Diallium and Ziziphus honey in second degree burns on wistar rats. Methodology: A metal cylinder with a diameter of 3 cm was heated for five minutes. In order to cause experimental burns, the rats' shaved skin was lightly pressed with the cylinder for twenty seconds so as to induce second-degree burns. Results: The daily application of honey induces a healing dependent on typology and concentration. The healing rate is higher with DZ, with a score of 1.00 ± 0.63 vs 1.25 ± 0.43 for JUJ which induces almost complete tissue repair after 21 days of treatment. Conclusion: Findings from the research confirm the use of traditional honeys for burns and wound healing.

Using Range of Motion Exercises and Smartphone Thermography to Evaluate Wound Healing in Second-Degree Burns

BackgroundBurn injuries can lead to devastating functional impairments and reduced quality of life. An important component of rehabilitation programs is the range of motion exercises, which can accelerate wound healing and prevent contractures. The present study sought to evaluate the effects of a range of motion exercises validated by thermal imagining on patients with second-degree burns. Patients and methodsThis quasi-experimental study included 47 adult patients diagnosed with second-degree burns. Data was collected using a Structured Interview Questionnaire, modified Abbreviated Burn Severity Index (ABSI), the Bates-Jensen Wound Assessment Tool (BWAT), and mobile thermal imaging to assess wound healing. ResultsThe ABSI levels showed that 46.8% of patients had moderate-severity burns, 38.3% had very low severity, and 14.9% had moderately severe burns. While the BWAT scores were 28.9 ± 4.6SD at baseline, 30.1 ± 4.7SD after one week, 19.2 ± 6.5SD after the 2nd week, and finally 17.1 ± 4.3SD on the 3rd week. The FLIR thermal imaging scores over three weeks were statistically significant (p<0.001, Kruskal-Wallis test). The study revealed high statistically significant differences in range of motion and wound healing mean scores. ConclusionsThis study demonstrated that range of motion exercises improved burn wound healing. Additionally, thermal imaging showed high validity for evaluating wound healing potential and progression. It provides viable triage technology while benefiting clinical assessment. Overall, range of motion and smartphone thermography are two evidence-based modalities that can enhance burn management, decrease healing time, lower costs, and improve outcomes.

Cubosomes hydrogel containing silver based organometallic compounds for enhanced wound healing of burns: In vitro and in vivo studies

The aim of this study is to investigate the treatment of burn wounds and bacterial infections, specifically focusing on silver(I) N-heterocyclic carbene (Ag-NHC) loaded into cubosomes. Ag-NHC is an organometallic complex of silver (Ag) and can be considered an active pharmaceutical ingredient for the topical treatment of burns. A novel nanoparticle system, cubosome dispersions, was formulated using high pressure homogenization methods with different concentrations of lipid phase glyceryl monooleate (GMO), surfactants such as poloxamer 407 (F-127), and polyvinyl alcohol (PVA). The optimized formulation (U6) was characterized by in vitro drug release profile (90.54 ± 1.17 %), particle size (126.7 ± 0.98 nm), zeta potential (−21.6 ± 6.83 mV), entrapment efficiency (89.30 ± 1.46 %), and morphology as observed by transmission electron microscopy (TEM). The U6 formulation was incorporated into a hydrogel containing Carbopol 940 to form a cubosomal hydrogel (cubogel). The cubogel was characterized by the in vitro release of Ag-NHC (92 %), entrapment efficiency (>90 %), pH (5.3), viscosity (1.2 cP), spreadability, and TEM. From the in vitro drug release pattern, it was concluded that the U6 formulation showed slow and sustained drug release over 24 h, and demonstrated superior burn healing compared to marketed products. The in vivo wound healing study revealed that the cubogel demonstrated a superior burn healing rate compared to commercially available products (Quench® and Clotrimazole®). The in vivo histopathological results showed that the prepared cubogel was effective in treating second-degree burns, with no side effects or skin irritation, compared to commercial products. Additionally, Ag-NHC-loaded cubogel facilitated sustained release for treating burn wounds without any bacterial infections. The current findings provide a strong basis for the initiating phase 0 clinal trials, highlighting significant potential for the further research to benefit the pharmaceutical industry.

Virtual reality based rehabilitation and upper limb dysfunction post burn

Purpose. To evaluate the effectiveness of virtual reality based rehabilitation in improving upper limb functions and ADL of burned patients. Methods. Randomized controlled trial. Overall, 42 patients of both genders with age ranged from 20-45 years with with second-degree burn were selected from outpatient clinic in the faculty of physical therapy, Cairo university and randomly distributed into two equal groups. Their ages ranged from 20 to 45 years. Group A (virtual reality) received virtual reality (VR)-based rehabilitation in addition to conventional rehabilitation: inform of (Stretching exercises, ROM exercises, strength training) for four weeks. Group B (traditional physical therapy) received traditional physiotherapy (Stretching exercises, ROM exercises, strength training) for four weeks. They were assessed with Arabic quick dash, goniometer and hand dynamometer. Results. There was a significant improvement in DASH, hand grip strength and shoulder ROM post-treatment, compared to pre-treatment (P-value ≤ 0.001) in both groups. There was significant difference between groups in the improvement in DASH, hand grip strength and shoulder ROM at post-treatment (P-value &lt; 0.01), in favor of group A. Conclusion. Virtual reality based rehabilitation were proven effective on improving upper limb functions and ADL of burned patients.

The Role of Pectin Hydrogel Systems Plus Iodine and Phyto Extract in Second-Degree Burn in Rats

The Role of Pectin Hydrogel Systems Plus Iodine and Phyto Extract in Second-Degree Burn in Rats

Polysaccharide-Based Injectable Hydrogel Loaded with Quercetin Promotes Scarless Healing of Burn Wounds by Reducing Inflammation.

Moisture loss, infection, and severe inflammatory reactions are the primary factors affecting burn wound healing and leading to scar formation. Herein, we developed a quercetin-loaded polysaccharide-based injectable hydrogel (named PECE). The PECE consists of oxidized sodium alginate (OAlg) coupled with chitosan (CS) via Schiff bases and electrostatic interactions, while Que is incorporated via hydrogen bonding. Benefiting from the hydroxyl and carboxyl groups, PECE features distinguished moisturizing ability. Additionally, the sustained release of Que imparts remarkable antibacterial activity against Escherichia coli and Staphylococcus aureus. Likewise, PECE demonstrates favorable in vitro anti-inflammatory capacity as released Que significantly downregulates pro-inflammatory factors (IL-6 and TNF-α) secreted by RAW 264.7 macrophages. More importantly, in a rat model of deep second-degree burn wounds, PECE effectively inhibits wound infection, reduces inflammation, and promotes angiogenesis and collagen deposition, ultimately minimizing scar formation. Overall, this work presents a promising strategy for scarless healing of burn wounds.

Wound Healing Activity of Two Honeys from the Southern Regions of Senegal (Casamance)

Aim: The aim of this study was to evaluate the healing activity of two honeys from Casamance (Senegal) in a second-degree experimental burn model in the Wistar strain rat. Methodology: Experimental burns were induced using a metal cylinder 3 cm in diameter and heated for 5 min. The cylinder was applied for 20 seconds, pressing lightly on the surface of the rats' shaved skin to induce second-degree burns. Results: The daily application of honey induces a healing dependent on concentration and typology. The healing rate is higher with AF, with a score of 0.60 ± 0.48 vs 1.00 ± 0.00 for MZ which induces almost complete tissue repair after 21 days of treatment. Conclusion: The results of this study demonstrate the use of traditional honey in wound healing and burns.

The impact of an open-label design on human amniotic membranes vs. silver sulfadiazine dressings for second-degree burns: a randomized controlled clinical trial

BackgroundBurn wounds require optimal medical management due to associated psycho-emotional and socioeconomic impacts and severe pain. The use of synthetic and biological dressings improves healing and reduces burn wound complications. The present study aimed to compare the outcomes of using human amniotic membrane (hAM) dressings and conventional silver sulfadiazine (SSDZ) ointment dressings in the management of second-degree burn wounds.MethodsFifty patients who participated in this clinical trial were divided into two groups via simple randomization. All the enrolled patients, who had burnt in the last 24 h, had thermal damage mechanisms and were suffering from less than 20% second-degree heat-burn wounds on the skin surface. The target group (n = 25) was treated with hAM, and the control group (n = 25) was treated with SSDZ ointment. The researcher-designed checklist was used to determine the clinical performance in the follow-up assessments on days 7, 14, and 30.ResultsNo significant differences were detected in terms of sex, age, or percentage of burn wounds (p > 0.05). Wound epithelialization at days 7, 14, and 30, scar formation, wound pigmentation, pain severity, analgesia requirements, and hospital stay length (on day 30) were significantly lower in the target group (treated with hAM) than in the control group (treated with SSDZ ointment) (p < 0.05). However, treatment costs in the target group ($170) were significantly higher than those in the control group ($71) (p < 0.001).ConclusionDespite its higher cost, hAM, as a technology-based therapy dressing, demonstrates superiority over SSDZ ointment in terms of wound healing and pain management.

Silver loaded functionalized calix [4]arene nanofibers and evaluation in burn wound healing

Burn treatments with gene therapy and healing factors requires highly cost techniques. Instead, topical formulations including plant extract or pharmaceuticals are offered for wound-healing effect. However, these have low water solubility and cannot uptake into cells sufficiently. To overcome disadvantages, new effective treatment approaches should have been accessible. This study aimed to develop nanofiber-based wound coverings using four different Ag(I)-calixarene derivatives. Their nanofibers were produced by the electrospin method, and evaluated in vivo in rats with a second-degree burn model. Biochemical analysis has been maintained to exmine the effects of formulations on such as growth factors and some cytokines that are effective in wound healing process. In addition, histopathological analyzes has been performed to evaluate the presence and density of granulation tissue, inflammation, epithelial thickness and fibrosis. All data were compared with a commercial topical, silver sulfadiazine, whose usage is limited due to various disadvantages in the treatment processes of burn wounds. In this study, four different calixarene derivatives were synthesized their nanofibers were produced by the electrospin method, and their effectiveness was evaluated in vivo in rats with a second-degree burn model. Then, various biochemical and histopathological analyses were done to elucidate the possible wound-healing mechanism. When considering both pathological and biochemical data, the nanofibers of CLX-SAMD-Ag (5,11,17,23‐tetra‐tert‐butyl‐25,27‐bis(Sulfadiazine)‐26,28‐propylcalix (Xie and Unser, 2013) [4]arene - Ag) and CLX-MORF- Ag (5,11,17,23‐tetra‐tert‐butyl‐25,27‐bis(3-Morpholinopropil)‐26,28‐dihydroxycalix (Xie and Unser, 2013) [4]arene-Ag) were found to be more effective than silver sulfadiazine -silver content application, also known as traditional burn treatment for wound healing.

PAM material that instantly gives ordinary fabrics excellent flame retardant and thermal insulation properties for fire rescue

To effectively reduce the damage caused by flame burns or heat transfer to the human body during fire, we used PAM aqueous solution as the matrix, XG as the thickener, HPMC as the water-retaining agent to form the basic material system, and added different functional particles (APP, PTW, HCB) to prepare a fire-proof and heat-insulating PAM flame-retardant material for fire emergency rescue. Ordinary cotton fabrics were impregnated into PAM flame-retardant materials using a simple impregnation process. After the impregnation, the test was performed in a non-dropping state (simulating the thermal protection effect of PAM flame retardant materials directly acting on the outside of the human body at the fire scene). The results show that the PAM flame retardant material prepared by adding 4 wt% HCB has the best comprehensive performance. TPP test shows that spraying PAM flame retardant material on the outside of the fabric can instantly give the fabric a higher thermal protection performance. Under the total heat flux of 84 kW/m2, the thermal performance protection value of the fabric is 2641.8 kW·s/m2, and the second-degree burn time can reach 31.45 s. PAM flame retardant material does not damage the fabric. After soaping, the air permeability of the fabric decreases slightly, the moisture permeability and wettability are improved, and the breaking strength is almost unchanged. The CCT test showed that the thermal radiation flux was 50 KW/m2, the PHRR value of PAM flame retardant material was 10.64552 KW/m2, the THR was 6.9 MJ/m2, and the flame retardant performance was excellent. The PAM flame retardant material prepared in this project can be applied to the fire scene and directly sprayed on the outside of the clothing of rescuers and recipients, giving the fabric a better thermal protection effect. It can also be used to extinguish fires in the external environment. This material offers a novel solution for enhancing fire rescuers' and victims' safety protection levels.

Efficacy of Nano-Silver Dressing Combined with Silver Sulfadiazine Cream in the Treatment of Second-Degree Burn Wounds

Efficacy of Nano-Silver Dressing Combined with Silver Sulfadiazine Cream in the Treatment of Second-Degree Burn Wounds

Influence of copper ion cross-linked CMC-PVA film on cell viability and cell proliferation study

In this study, films composed of carboxymethyl cellulose and polyvinyl alcohol were fabricated using the solution casting method. Citric acid (4 %) was employed as a cross-linking agent, while glycerol (3 %) as a plasticizer. Cupric chloride (CuCl2·2H2O) was used for cross-linking at concentrations 0.5 %, 1 %, and 3 % over different times. The cross-linking with copper ions led to a noticeable reduction in elasticity, with the breaking strain ranging from 17.9 %–52.9 %. The ion hydration phenomenon increased the contact angle and swelling ratio. Fourier-transform infrared (FTIR) spectroscopy confirmed esterification reactions and copper ion cross-linking with sodium carboxymethyl cellulose (Na-CMC). The films showed antibacterial activity against Staphylococcus aureus and Escherichia coli. The ion-released mechanism followed was the non-Fickian super case-II type. The concentration and duration of cross-linking significantly influenced cell viability and proliferation. FE-SEM analysis revealed that effective concentrations of CuCl2.2H2O were 0.5 % and 1 %, and cross-linking times were 5–15 min, facilitating cell attachment and proliferation. Films are non-adhesive with water vapor permeation 800–900 g/m2/day. These results indicate the potential use of the films in treating second-degree burn wounds with low to medium exudate levels. This study provides valuable insights into the development of copper-infused materials for advanced wound healing applications.

A comparative study of the healing effects of sesame oil and TiO2 nanoparticles gel on second-degree burn

Burns, a severe form of soft tissue injury, can cause significant damage and, in extreme cases, be fatal. They also lead to considerable mental and emotional distress due to excessive scarring and skin contractures. Despite various treatment methods, burn care remains a challenging medical issue. In this study, titanium dioxide (TiO2) nanoparticles were synthesized and characterized using Field Emission Scanning Electron Microscopy (FE-SEM), revealing particle sizes ranging from 31.52 to 69.08 nanometers. The impact of biosynthetic nanomaterials and sesame seed oil on burn healing in laboratory rats was investigated. The study compared the effects of a 1% TiO2 solution and 20% sesame oil on burned skin with a control group of rats having natural skin. Fifteen rats were divided into three groups, each receiving daily treatment for 28 days. The results indicated that the TiO2 treatment significantly accelerated healing compared to the sesame seed oil group, which had a slower healing rate of 0.12 points per day. The TiO2 treatment demonstrated a marked improvement in healing speed and effectiveness.

Photo-Crosslinked Pro-Angiogenic Hydrogel Dressing for Wound Healing.

Severe burns are one of the most devastating injuries, in which sustained inflammation and ischemia often delay the healing process. Pro-angiogenic growth factors such as vascular endothelial growth factor (VEGF) have been widely studied for promoting wound healing. However, the short half-life and instability of VEGF limit its clinical applications. In this study, we develop a photo-crosslinked hydrogel wound dressing from methacrylate hyaluronic acid (MeHA) bonded with a pro-angiogenic prominin-1-binding peptide (PR1P). The materials were extruded in wound bed and in situ formed a wound dressing via exposure to short-time ultraviolet radiation. The study shows that the PR1P-bonded hydrogel significantly improves VEGF recruitment, tubular formation, and cell migration in vitro. Swelling, Scanning Electron Microscope, and mechanical tests indicate the peptide does not affect the overall mechanical and physical properties of the hydrogels. For in vivo studies, the PR1P-bonded hydrogel dressing enhances neovascularization and accelerates wound closure in both deep second-degree burn and full-thickness excisional wound models. The Western blot assay shows such benefits can be related to the activation of the VEGF-Akt signaling pathway. These results suggest this photo-crosslinked hydrogel dressing efficiently promotes VEGF recruitment and angiogenesis in skin regeneration, indicating its potential for clinical applications in wound healing.

Stereological Investigation of the Effects of Hypericum Perforatum L. Plant on Skin Tissue in Second Degree Burns in Rats

The aim of this study was to examine stereologically the effect of Hypericum perforatum L. oil on skin injuries resulting from burns. Experimental groups were selected 18 healthy rats with an average weight of 250-300 grams as material. The rats were divided into 3 groups: control, burn and burn+treatment, with 6 in each group. In the control group, second-degree burns were created and the rats were perfused. Control group rats were kept in formaldehyde for a week. Burns were applied to the burn and burn+treatment groups with 100ºC water. 4gr/kg of Hypericum perforatum L. oil was given via gavage to the burn+treatment group only for 21 days. The burn group was not intervened. At the end of the process, rats in both the burn and burn+treatment groups were perfused. The skin of the animals, which were kept in formaldehyde for a week, and where second-degree burns occurred were dissected. After tissue tracking and tissue embedding procedures for all animals in the group, 5µm thick sections were taken to obtain 8-10 sections at a ratio of 1/75. Volume values were calculated using stereological methods from the sections photographed with an x4 objective. Calculations were made using the Shtereom I program in accordance with the Cavalieri Principle. Non-parametric tests and Kruskal Wallis test were used in statistical evaluations. When the results were analyzed, it was observed that the administration of Hypericum Perforatum L. oil by gavage had an effect on the healing process of second degree burn wounds.

Evolutionary clinical characteristics of single application of calcium alginate in second-degree burns

Evolutionary clinical characteristics of single application of calcium alginate in second-degree burns

Healing Potential of the Marine Polysaccharides Carrageenan and Ulvan on Second-Degree Burns.

The treatment of second-degree burn wounds presents a significant clinical challenge, often characterized by prolonged healing times and risk of complications. In this study, the wound healing potential of bioactive marine sulfated polysaccharides ulvan and carrageenan formulated in gels at concentrations of 1.5%, 5.0%, and 10% w/w was evaluated. Hairless female SKH-hr2 mice (n = 7 per treatment) with burn-inflamed skin were treated with the polysaccharide-based gels, and the therapeutic efficacy was assessed using a comprehensive array of evaluation methods, including a histopathological analysis, clinical observation, photo-documentation, an image analysis, an evaluation of biophysical skin parameters, and FT-IR spectroscopy. Our findings indicate that the 10% w/w carrageenan gel exhibited significant enhancement in wound healing, particularly in the early stages of the healing process. This was evidenced by the restoration of the α-helix structure of collagen and the configuration of glycosaminoglycans, as demonstrated by FT-IR absorption bands of the skin both in vivo and ex vivo. Furthermore, the 5% w/w ulvan gel also demonstrated notable efficacy in promoting wound healing, particularly in the later stages of the healing process. These results suggest that carrageenan and ulvan gels hold promise for improving the efficiency of wound healing in second-degree burn wounds. Our study contributes to the understanding of the therapeutic potential of marine polysaccharides and provides insights into their mechanism of action in promoting wound healing.

Potential therapeutic effects of topical recombinant human erythropoietin on burn wound healing: A preliminary randomized double-blind controlled clinical trial

BackgroundBurn injuries can cause significant mortality and morbidity. This study aimed to evaluate the efficiency of topical recombinant human erythropoietin (rhEPO) on enhancing burn wound healing. MethodsIn this randomized double-blind controlled clinical trial, we enrolled 40 participants aged 18 years and older who were referred to a burn center during the first 24 h of burning. The participants with no concurrent comorbidities had superficial and deep second-degree burns, no respiratory burns, no face and perineum burns, no keloid formation, or a healed, fully epithelialized, hypertrophic burn scar. Topical rhEPO or nitrofurazone/Vitamin A was administered every other day, and the patients were scheduled for follow-up visits to receive wound cleansing, debridement, and dressing changes. Burn wound healing response to treatment was measured as the study main outcome. ResultsAt the second follow-up visit, all parameters were significantly lower in the rhEPO group compared with the control group except for itchiness. The results of the next two follow-up sessions were also the same. The total value of the modified Vancouver Scar Scale (VSS) at days 5, 7, and 14 was significantly lower in the rhEPO group compared with the routine of care group.Trial Registry Date: 2022–03-02, Trial Registry number: IRCT20190810044500N23 ConclusionsThe results of the present study suggested that topical rhEPO is a potential option in burn wounds and patient satisfaction, without causing intolerable side effects.

Formulation and evaluation of ointment containing hydroalcoholic extract derived from the bark of Moringa oleifera for wound healing activity in rat model

Background: This study aimed to assess the effectiveness of a hydroalcoholic extract derived from the bark of Moringa oleifera in facilitating the healing process of second-degree burns wounds. Moreover, a comprehensive assessment was carried out on standardized M. oleifera bark to ascertain its physiochemical characteristics, botanical compound layout, and antioxidant activity, all of which play a crucial role in its capacity to facilitate the healing process of burns. Methods: For 14 days, the efficacy of ointments containing a hydroalcoholic extract of M. oleifera bark at concentrations of 5% and 10% was evaluated for treating second-degree burns in rats. Additionally, histological analysis was conducted on skin tissue samples. Results: The M. oleifera bark extract exhibited TPC (52.56 mg/gm of dried extract) and TFC (84.33 mg/gm of dried extract) value along with antioxidant activity (IC50 value of 0.98 µg/ml) for radical scavenging, in the presence of several phytochemicals. The most favorable outcomes were achieved using a 10% ointment composition, demonstrating a wound closure and tissue repair rate of 83.04 ± 0.89%, along with a noteworthy decrease in tissue oxidative stress indicators. Histological investigations have verified the wound-healing properties of M. oleifera bark extract. Conclusion: Due to its significant antioxidant properties and its capacity to create a moist environment for wounds, M. oleifera has the potential to serve as a natural treatment for burns. Additional clinical trials are recommended to validate the efficacy of M. oleifera bark extract as a therapeutic agent for wound healing.

Wound care used topical ointment made from a combination of cherry leaf extract (Muntingia calabura L) and manuka honey on the healing process of superficial second-degree burns: a case report

Background: Burns are one of the most common accidental injuries in the community. Improper treatment of burns can lead to disability and even death. Applying topical therapy aims to reduce excessive collagen repositioning and accelerate healing. We tried treating burn wounds with an ointment that uses a combination of cherry leaf extract and manuka honey to test the effectiveness of wound healing.Case presentation: We report two cases of superficial burns that underwent wound treatment using an ointment containing cherry leaf extract and manuka honey.Conclusion: Wound treatment with an ointment containing cherry leaf extract and manuka honey can speed up the healing process in patients with superficial second-degree burns.