Degree Burn Wounds Research Articles

New possibilities for surgical treatment of borderline burns using biological wound coverings

Objective: selection of optimal biological wound coverings for the treatment of patients with borderline burns. Material and methods. The results of treatment of 30 patients aged 28-58 years were analyzed. All patients were diagnosed with second degree burn wounds of varying localization and area from 5 to 20% (according to International Classification of Diseases 10th Revision). Of these, 13 (43%) patients in group I (age 48 [39; 54] years) underwent surgical removal of necrosis, and ChitoPran® biological wound dressings were applied to the wounds. The remaining 17 (56%) patients in group II (age 42 [28; 58] years) also underwent early surgical treatment, but the grafts were covered with synthetic Voskopran™ wound coverings. Results. In group I, where the biological wound coating ChitoPran® was used, the epithelialization period was 10 (9.0; 10.0) days. In group II, where the synthetic wound coating Voskopran™ was used, the epithelialization period was 12 (11.0; 13.0) days (p=0.031). The data obtained show that biological wound coatings ChitoPran® demonstrate an advantage in accelerating the timing of wound epithelization compared with synthetic wound coatings Voskopran™. In group I, the duration of hospitalization was 10.5 (10.0; 11.0) days, for group II — 11.5 (10.0; 12.0) days (p=0.048). Conclusion. A comparative assessment of the effectiveness of biological wound coverings in the treatment of patients with borderline burns showed that, in contrast to the synthetic wound covering Voskopran™, the use of the biological wound covering ChitoPran® provides favorable conditions for regeneration, due to which the period of epithelization of wounds was reduced by an average of 1-2 days, and hospitalization time is on average up to 2 days.

Enhanced Third Degree Burn Wound Healing by Hypoxic Mesenchymal Stem Cells' Secretome: IL-10 Upregulation and TNF-α/PGE2 Suppression

Background: Severe third-degree burns pose a notable obstacle in clinical settings, frequently leading to hindered healing of wounds and the development of scars. In this research, we explored how the secretome of hypoxic mesenchymal stem cells (HS-MSCs) could be improved the healing of burn wounds. Methods: In this study, we used 20 male Wistar rats that induced third degree wound by metal 80 exposure for 10 s. These rats divided into 4 groups: Healthy, control, HS-MSCs 100 µL, and HS-MSCs 200 µL groups. We injected the HS-MSCs, which carry various beneficial molecules like IL-10, TGF-β, PDGF, and VEGF, directly into the skin in a third-degree burn rat model on day 1 after burn induction, and harvest on day 14. Results: Our research discovered that using HS-MSCs resulted in a dosage-related rise in IL-10, an anti-inflammatory cytokine, alongside a notable decrease in TNF-α and PGE2, pro-inflammatory cytokines. These effects quickened the healing process by improving re-epithelialization and minimizing scar formation. Conclusions: Our findings indicate that HS-MSCs show promise as a treatment for severe burns by potentially controlling inflammation and fostering a regenerative healing process. More investigation is needed to understand the exact mechanisms and to explore how HS-MSCs could be applied in clinical treatments. HIGHLIGHTS HS-MSCs suppress inflammation and promote regenerative healing in severe burns HS-MSCs accelerated re-epithelialization and reduced scarring GRAPHICAL ABSTRACT

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.

Effectiveness of Macrophage Hydrolyzed VCO Cream in Healing Second Degree Burns in Wistar Rats

Background: Burns are a global public health issue, with many studies on topical medications that are effective in second-degree burns. Hydrolyzed VCO (hVCO) contains lauric acid, polyferol and alpha tocopherol which are beneficial in wound healing. This study was conducted to determine the effectiveness of hVCO cream macrophage formation for second degree burn wound healing in Wistar rats. Methods: A parallel group study was conducted on thirty wistar rats randomly divided into six groups induced second degree burns. Basic cream was applied to two control groups on the 6th and 12th day, 70% hVCO was applied to two groups on the 6th and 12th day, and 100% hVCO was applied to two groups on the 6th and 12th day. Histopathological examination of macrophage formation was conducted in each treatment. Result: The groups with hydrolyzed VCO cream on day 12 (p=0,089) had higher macrophage formation than the same hVCO group on day 6 (p=0,354). The macrophage count of hVCO in each group showed an increase. Conclusion: 100% hVCO is effective in accelerating second degree burn wound healing in terms of macrophage count.

Burn Healing Activity of Siam Weed (Chromolaena odorata) leaf Ethanol Extract in Second Degree Burn Wound Induced in Rats

Burn Healing Activity of Siam Weed (Chromolaena odorata) leaf Ethanol Extract in Second Degree Burn Wound Induced in Rats

Chitosan based ethanolic Allium Sativum extract hydrogel film: a novel skin tissue regeneration platform for 2nd degree burn wound healing

This study investigated the potential of ethanolic garlic extract-loaded chitosan hydrogel film for burn wound healing in an animal model. The ethanolic garlic extract was prepared by macerating fresh ground garlic cloves in ethanol for 24 h, followed by filtration and concentration using a rotary evaporator. Hydrogels were then prepared by casting a chitosan solution with garlic extract added at varying concentrations for optimization and, following drying, subjected to various characterization tests, including moisture adsorption (MA), water vapor transmission rate (WVTR), and water vapor permeability rate (WVPR), erosion, swelling, tensile strength, vibrational, and thermal analysis, and surface morphology. The optimized hydrogel (G2) was then analyzed in vivo for its potential for healing 2nd degree burn wounds in rats, and histological examination of skin samples on day 14 of the healing period. Results showed optimized hydrogel (G2; chitosan: 2 g, garlic extract: 1 g) had MA of 56.8% ± 2.7%, WVTR and WVPR of 0.00074 ± 0.0002, and 0.000 498 946 ± 0.0001, eroded up to 11.3% ± 0.05%, 80.7% ± 0.04% of swelling index, and tensile strength of 16.6 ± 0.9 MPa, which could be attributed to the formation of additional linkages between formulation ingredients and garlic extract constituents at OH/NH and C=O, translating into an increase in transition melting temperature and enthalpy (ΔT = 238.83 °C ± 1.2 °C, ΔH = 4.95 ± 0.8 J g−1) of the chitosan moieties compared with blank. Animal testing revealed G2 formulation significantly reduced the wound size within 14 d of the experiment (37.3 ± 6.8–187.5 ± 21.5 mm2) and had significantly higher reepithelization (86.3 ± 6.8–26.8 ± 21.5 and 38.2% ± 15.3%) compared to untreated and blank groups by hastening uniform and compact deposition of collagen fibers at the wound site, cementing developed formulation a promising platform for skin regeneration.

Effects of montmorillonite on the loading and release of Piper betle L. extract applied for wound dressing based on chitosan/polyvinyl alcohol

In this study, we investigate the influence of montmorillonite (MMT) on the loading and release of Piper betle L. extract (PLE)–a medicinal herb containing active secondary metabolites with antibacterial, antioxidant, and anti–inflammatory effects. MMT (1 %, 3 %, 5 %) was blended into the chitosan/polyvinyl alcohol (CS/PVA) biocomposite film by the solution evaporation method, and then PLE was loaded onto this biocomposite using the immersion method. The tensile strength and the ability to absorb exudates of the CS/PVA film improved with the increase in MMT content. The MMT 3 % film was considered to have the best properties: good mechanical properties with a tensile strength of 27.44 ± 0.27 MPa and elongation at break of 14.57 ± 0.30 %, potential for wound dressing due to its ability to absorb wound exudate (swelling degree 61.70 ± 0.30 %) and a suitable water vapor transmission rate (1999 ± 47 g/m2·d). The presence of MMT (1 %, 3 %, 5 %) in the CS/PVA film led to an increase in the PLE loading efficiency of the films compared to the film without MMT, up to 1.65, 1.73, and 1.87 times, respectively. The MMT 3 % and 5 % films also exhibited a sustained PLE release effect for up to 24 h. MMT increased PLE bioavailability through bioactivity tests: antibacterial activity against both E. coli and S. aureus, antioxidant activity, effective healing of 2nd–degree burn wounds, and biocompatibility with the L929 fibroblasts cell line. The combination of physicochemical properties and biological activities proved that the MMT/PLE drug delivery system based on the CS/PVA biocomposite is promising for wound dressing.

Antibiotics in patients with severe burn injury—A modifiable variable in hypernatremia etiology

IntroductionHypernatremia is a common problem among patients with severe burn injuries and seems to be associated with an unfavorable clinical outcome. The current study was designed to evaluate the impact of antibiotics with a high proportion of sodium on this phenomenon. MethodsAll admissions to our burn center from 01/2017 till 06/2023 were retrospectively screened. All patients aged >18 years which suffered from at least 20 % total body surface burned area (TBSA) 2nd degree burn injuries or more than 10 % TBSA when including areas of 3rd degree burn injuries were included. The course of the serum Na-level was analyzed from two days before till two days after the start of the antibiotic treatment. Ampicillin/sulbactam, cefazoline and piperacillin/tazobactam were classified as high-dose sodium antibiotics (HPS), meropenem and vancomycin as low-dose sodium antibiotics (LPS). Results120 patients met the inclusion criteria. A significant increase of the serum Na was detectable in the HPS group on day 1 and 2 after initiating the antibiotic treatment (n = 64, day 1: 2,1 (SD 4,18) mmol/l, p < 0,001; day 2: 2,44 (SD 5,26) mmol/l, p < 0,001) while no significant changes were detectable in the LPS group (n = 21, day 1: 0,18 (SD 7,45) mmol/l, p = 0,91; day 2: −0,27 (SD 7,44) mmol/l, p = 0,87). This effect was further aggravated when analyzing only the HPS patients with a TBSA ≥30 % (n = 33; day 1: 2,93 (SD 4,68) mmol/l, p = 0,002; day 2: 3,41 (SD 5,9) mmol/l, p = 0,003). ConclusionThe amount of sodium in antibiotics seems to have a relevant impact on the serum Na during the early stages of severe burn injury. Therefore, this aspect should be taken into account when searching for the most appropriate antibiotic treatment for patients with severe burn injury, especially when being at acute risk for a clinical relevant hypernatremia.

Severe Burn Injuries - The Day the Sodium Starts Rising.

The current study was designed to evaluate the etiologies of hypernatremic episodes in patients with severe burn injuries in comparison to critically ill non-burn patients. The retrospective data acquisition was limited to the first 14 days and to patients with at least 20% total body surface area (TBSA) 2nd degree burn injuries or more than 10% TBSA when including areas of 3rd degree burn injuries. The results were compared to the results of a previously published study that analyzed the risk factors for hypernatremia in 390 non-burn intensive care unit patients. In total, 120 patients with a total of 50 hypernatremic episodes were included. Compared to non-burn injury patients, no significant differences were detectable except for a lower rate of hypokalemia and a higher rate of mechanical ventilation. The main trigger for hypernatremic episodes was the loss of free water, while 24% of the hypernatremic episodes seemed to be at least partly triggered by a surplus sodium influx. Patients with hypernatremic episodes had a significantly higher mortality rate. However, in none of the cases was hypernatremia the decisive cause of death. Besides the unique phenomenon of high volume internal and external volume shifts, the overall risk factors and etiologies of hypernatremia in patients with severe burn injury do not seem to significantly differ from other ICU patient collectives. Remarkably, a surplus of sodium influx and therefore a modifiable factor besides the specific burn injury volume resuscitation had an impact on the hypernatremic episodes in 24% of cases.

Use of autologous adipose tissue in acute burn wound management: A systematic review

Fat transfer is increasingly used as part of our reconstructive armamentarium to address the challenges encountered in burn wounds and reconstructive surgery. The present systematic review aimed to evaluate the effectiveness of autologous fat transfer for acute burn wound management. A systematic review of the US National Library of Medicine, Cochrane Library, Web of Science, and Embase was conducted on October 15, 2022 (registration number CDR42022369726). A database watch was performed until submission of the manuscript. The review focused on wound healing. All studies reporting fat transfer in adult patients (at least 5 patients reported) with deep 2nd degree burn wounds were included. The database search yielded a total of 720 records and 367 patients were included from 3 studies. A statistically significant improvement in scar texture, scar appearance, and time to healing was reported in one study in the fat transfer group versus control (P<0.001). Similarly, scores for scar color, scar thickness, scar stiffness, and scar regularity increased significantly. The small number of included studies and their heterogeneity did not allow a meta-regression to be performed. This systematic review emphasizes the limited evidence currently available regarding the use of autologous fat transfer to improve burn wound healing in adult patients, even though it seems promising. Future search should focus on randomized controlled trials with a larger number of participants.

Treatment of superficial and deep partial width second degree burn's wound with allogeneic cord blood platelet gel.

Burns are caused by a variety of mechanisms, including flames, hot liquids, metallurgy, chemicals, electric current, and ionizing and non-ionizing radiation. The most significant burn wound management involves complete repair and regeneration as soon as possible while minimizing infection, contraction, and scarring in the damaged tissue area. Some factors such as delivery of nutrients, growth factors, and oxygen are essential to promote and stimulate the wound healing progress in the burns area. When these factors are not provided, the burn wound undergoes a physiological crisis. The use of growth factors is a promising approach to overcoming this limitation. Umbilical cord blood platelet concentrates are a rich natural source of growth factors. This clinical trial used growth factors released from the lysis of umbilical cord blood platelet concentrates that have a key role in promoting re-epithelization and regeneration of damaged tissues by forming a fibrin network. This study evaluated the effectiveness of allogeneic cord blood platelet gel topical dressing in a group of patients diagnosed with superficial and deep partial thickness (second-degree) burn wounds. Clinical outcomes were compared between the intervention group and a control group of patients with superficial second-degree burn wounds who received the standard routine treatment including paraffin gauze wound dressing and silver sulfadiazine ointment. The study's results showed that the increased rate of recovery and tissue granulation completely promoted to wound healing and burn wound closure, decreased the recovery time, and reduced inflammation and scars caused by burn injuries. However, the use of cord blood platelet gel topical dressing is not currently a routine treatment method in patients suffering from burn wounds. However, the study's results showed that allogenic cord blood platelet gel could be used to treat superficial and deep second-degree burns as a routine treatment. It was also shown that allogenic cord blood platelet gel topical dressing could be a candidate for autograft or after autograft skin transplantation surgery (in donor and recipient sites) instead of skin surgery in some patients. Allogeneic topical wound dressing provides an effective treatment that offers a faster rate of epithelialization and healing of wounds and also decreases patients' scar and inflammation level as well as the length of recovery time. This, finally, leads to better burn wound management and the improved quality of burn wound treatment.

Eschar dissolution and the immunoregulator effect of keratinase on burn wounds

At present, enzyme debridement preparation has shown a good curative effect on eschar removal of burn wounds. Keratinase has shown great potential in enzymatic debridement because of its good fibrin-degrading ability. In this study, the debridement of keratinase was examined by using a third degree burn wound model in rats. We observed the wound, and keratinase shortened the time of eschar dissolution after debridement. Histopathology and immunofluorescence staining showed that the eschar in the keratinase group became thinner, inflammatory cell infiltration in the wound increased, the fluorescence intensity of the macrophage surface marker CD68 increased, and the CD163/CD86 ratio increased. In bone marrow-derived macrophages (BMDMs), there was no significant difference in the activity of CCK-8 in cells in the keratinase group compared with the control group. The fluorescence intensity of the keratinase group was higher than that of the control group. At 12 h, the cell scratches were obviously closed. The number of migrated Transwell cells increased. Flow cytometry and immunofluorescence analysis showed increased expression of CD206 and Arg-1 and decreased expression of CD86 and iNOS. The gene expression of the Arg-1, iNOS and IL-10 was increased, as shown by qPCR. The secretion of IL-10 was increased and TNF-α was decreased, as shown by ELISA. We concluded that keratinase dissolution of eschar not only has a hydrolytic effect on eschar but may also affect immune regulation to enhance the migration and phagocytosis of macrophages, promote the polarization of macrophages, and further enhance the effect of eschar dissolution. Therefore, keratinase may have good prospects for the debridement of burn wounds.

Effects of irradiated biological dressings on second-degree burn wounds.

To explore the effect of irradiated biological dressing (IBD) on second degree burn wounds. Eighty patients with second-degree burns who were treated in our department were selected and randomly divided into IBD group and traditional dressing (TD) group by random number table method. The dressing change, wound healing, comfort and adverse reactions of patients in the two groups were compared and analysed. The number of dressing changes in the IBD group was significantly less than that in the TD group, and the pain degree of dressing changes was significantly lower than that in the TD group (P<0.05). The dressing comfort of the IBD group was higher than that of the TD group, the secondary trauma score was lower than that of the TD group, the wound scar hyperplasia score was lower than that of the TD group, and the healing time was shorter than that of the TD group (P<0.05). There was no statistically significant difference in adverse reactions between the two groups (P>0.05). IBD can promote the healing of second-degree burn wounds, improve patient comfort, reduce secondary trauma and wound scarring, and improve patients' quality of life.

Investigating the Results of Amniocentesis in the Operating Room on Children's Acute Second Degree Burn Wounds in Patients Referred to Shahid Motahari Hospital in Tehran in 2021-2022

Investigating the Results of Amniocentesis in the Operating Room on Children's Acute Second Degree Burn Wounds in Patients Referred to Shahid Motahari Hospital in Tehran in 2021-2022

299 Donor Site Reduction with Combined Use of Bromelain Enzymatic Debridement and Autologous Skin Cell Suspension

Abstract Introduction The conventional treatment for deep 2nd and 3rd degree burn injuries has been excision and grafting, which was first described approximately 80 years ago. New techniques and technology in the field of burn surgery that facilitate “minimally invasive” donor site reduction include bromelain enzymatic debridement and autologous skin cell sprays (ASCS). Each of these techniques independently have been shown to decrease the need of autografting and reduce the donor site size. However, the use of both methods together was not possible until recently. The authors hypothesize that bromelain enzymatic debridement plus ASCS will result in donor site reduction compared to conventional excision and grafting. Methods A single institution retrospective review of patients who underwent treatment of deep 2nd and 3rd degree burns was performed. The patients were stratified into those that received conventional excision and autografting (CONTROL group), and those that received bromelain enzymatic debridement with autologous skin cell spray with or without a split thickness skin graft (TREATMENT group). Data collection included demographics, injury characteristics, length of stay (LOS)/%TBSA. Total surface area treated with ASCS, autograft, and donor site size was tabulated. A ratio of donor site to total area treated was calculated and compared to determine relative reduction in donor site size. Data was reported in medians+IQR and comparisons were done with a Mann Whitney test. Results Twenty-eight study patients were included over 18 months, 15 CONTROLS and 13 TREATMENT patients. Burns size was 1789 cm2 (IQR: 450, 2434) and 1463cm2 (IQR: 699, 2740.5) in the CONTROLS and TREATMENT groups, respectively. There were no differences in age and sex. The total area grafted and/or treated with ASCS was 1342 cm2 (IQR: 824, 2535) in the CONTROLS and 1404 cm2 (IQR: 1021.5, 2430.5) in the TREATMENT group (p=0.4354). The donor site area to total treatment area ratio for CONTROLS was 0.273 (IQR:0.18,0.47) while the TREATMENT group was 0.082 (IQR:0.039,0.241) (p=0.013). The O/E ratio for LOS was 1.35 days/%TBSA for the CONTROLS and 1.06 for the TREATMENT group (p= 0.2). No significantly differences were detected in comorbidities between groups. Each group had 1 unplanned readmission but no graft loss. There were no mortalities. Conclusions Bromelain based enzymatic debridement can be successfully utilized with ASCS to perform a “minimally invasive” skin graft. These patients received relatively smaller donor sites and showed a trend for lower LOS. Just as with all surgical therapies, appropriate patient selection and burn characteristics are imperative when utilizing minimally invasive burn surgery. Further larger scale studies are needed to adjust for confounders and determine the individual and synergistic effects of the component novel therapies. Applicability of Research to Practice Donor site reduction improves care paradigms

Comparison of healing effects of aloe vera gel and aloe vera leaf pulp extract on burn-wound rats

Aloe Vera has anti-inflammatory, anti-oxidant, anti-viral, and anti-microbial properties. It has been demonstrated that Aloe Vera use could accelerate healing of burn injuries in rats. The current study evaluates the effects of Aloe Vera gel and Aloe Vera leaf pulp extract (LPE) alone and together with silver sulfadiazine on third degree burn wound injuries in rats. In an experimental study, 70 male Wistar rats weighing 200–250 g were divided into 7 groups to receive topical placebo, silver sulfadiazine, Aloe Vera gel, Aloe Vera LPE and their combination. Treatment results were evaluated according to wound healing on days 3, 10, and 21 and according to pathologic findings on day 21. Wound size differed significantly between groups on day 3 (p= 0.001), day 10 (p= 0.001), and day 21 (p= 0.001). The study's findings indicate that Aloe Vera gel alone, compared to LPE, and the combination of Aloe Vera gel or LPE with silver sulfadiazine had a more significant reduction in wound size. The combined treatment of Aloe Vera LPE and silver sulfadiazine has shown several advantages, including enhanced epithelialization and reduced cell infiltration, granulation tissue formation, and vascularization in the treatment of burns. However, additional research is necessary to determine the most effective treatment for third-degree burns.

Effect of Aloe vera extract in post-burn skin repair in rats

Background: Burn injury is a global health problem that is most often caused by heat. A burn injury can cause high morbidity and mortality and requires high cost. Therefore, the use of plants as an herbal medicine has the potential to be developed in Indonesia. Aloe vera contains various active ingredients that help the wound healing process, such as glucomannan and acemannan which have the effects on the proliferation of macrophages, fibroblasts, and re-epithelialization. This study aimed to determine the effect of Aloe vera extract in repairing post-burn skin in rats that were analyzed from the number of macrophages, fibroblasts, and epidermal thickness. Methods: This is an experimental study with a posttest-only control group design using 54 Rattus norvegicus Wistar strain rats. The sampling method was simple random sampling consisting of 3 groups, i.e., I. standard group, which were normal rats; II. negative control group, which were given second-degree burns and treated with gel base (without Aloe vera extract); III. treatment groups, which were given second-degree burns and treated with Aloe vera extract gel. Each group was subdivided into three smaller groups (n = 6) according to the time the lesions were evaluated. Skin tissue samplings were carried out on days 3, 14, and 21 after injury to observe the number of macrophages, fibroblasts, and epidermal thickness. Results: There were significant differences in the mean number of macrophages, number of fibroblasts, and epidermal thickness in all groups (p&lt;0.05). Conclusion: Based on the result of the study, Aloe vera extract could fasten the healing process of 2nd degree burn wound in rats.

Mast Cells in Regeneration of the Skin in Burn Wound with Special Emphasis on Molecular Hydrogen Effect.

The mechanisms of regeneration for the fibrous component of the connective tissue of the dermis are still insufficiently studied. The aim of this study was to evaluate the effectiveness of the use of molecular hydrogen on the local therapy of a II degree burn wound with the intensification of collagen fibrillogenesis in the skin. We analyzed the involvement of mast cells (MCs) in the regeneration of the collagen fibers of the connective tissue using water with a high content of molecular hydrogen and in a therapeutic ointment for the cell wounds. Thermal burns led to an increase in the skin MC population, accompanied by a systemic rearrangement of the extracellular matrix. The use of molecular hydrogen for the treatment of burn wounds stimulated the regeneration processes by activating the formation of the fibrous component of the dermis, accelerating wound healing. Thus, the intensification of collagen fibrillogenesis was comparable to the effects of a therapeutic ointment. The remodeling of the extracellular matrix correlated with a decrease in the area of damaged skin. Skin regeneration induced by the activation of the secretory activity of MCs may be one of the possible points of implementation of the biological effects of molecular hydrogen in the treatment of burn wounds. Thus, the positive effects of molecular hydrogen on skin repair can be used in clinical practice to increase the effectiveness of therapy after thermal exposure.

The use of human-derived feeder layers for the cultivation of transplantable human epidermal cell sheet to repair second degree burn wounds.

Human epidermal cell sheet (human-ECS) is a feasible treatment option for wound injury. Traditionally, researchers often use murine 3T3 fibroblast cells as feeder layer to support human epidermal cell sheet grafts, thus increase risk to deliver animal-borne infection. To overcome the potential risks involved with xenotransplantation, we develop human foreskin fibroblast cell as feeder layer culture system and investigate the effects of human-ECS on second-degree burn wound healing in mini-pig in order to develop more effective and safer therapies to enhance wound healing in human. Human epidermal keratinocytes and fibroblasts were isolated from foreskin tissue and were co-cultured to manufacture human-ECS. The cell morphology was monitored with phase-contrast microscopy, the stem cell markers were assessed by flow cytometry, and by colony-forming efficiency (CFE) assay. The structure of human-ECS was observed by hematoxylin and eosin staining. Expression of cytokines in human-ECS was confirmed by enzyme-linked immunosorbent assay. Second-degree burn wounds were created on the dorsal of miniature pig to evaluate the effect of oil gauze, oil gauze combined with commercial epidermal growth factor (EGF) cream, and oil gauze combined with human-ECS. Wound healing rate, histological examination, and Masson staining were measured to observe the wound repair efficacy. Real-time PCR and Western blot were utilized to detect the expression level of EGF and interleukin 6 (IL-6). Stratified human-ECS with 6-7 layers of epidermal cells was successfully cultivated with human-derived feeder cells, in which epidermal cell highly expressed CD49f and CFE was 3%±0.45%. Application of human-ECS induced a higher wound healing rate than commerical EGF cream and oil gauze control. The expression of EGF in human-ECS group was higher than those in the other groups; however, the expression of IL-6 was significantly decreased at day14 by human-ECS treatment group. Human-derived feeder cells are suitable for cultivation of human-ECS, avoiding pathogen transmission. Human-ECS could enhance second-degree burn wound healing, and its promoting effect involved secreting a variety of cytokines to regulate tissue reparative process.

Retracted: Nanosilver Dressing in Treating Deep II Degree Burn Wound Infection in Patients with Clinical Studies.

[This retracts the article DOI: 10.1155/2021/3171547.].