Degree Thermal Burn Research Articles

The Effect of Liposomes of Various Compositions on the Skin and Its Derivatives After II-IIIA Degree Thermal Burns.

This study examines the pathological processes and conditions arising from an experimental modeling of II-IIIA degree thermal burns in laboratory animals. These conditions are characterized by skin structure defects, diminished skin functions, especially the barrier function, and damage to skin derivatives like hair follicles and sebaceous glands. We compared the effect of liposomes composed of soybean lecithin of 90% phosphatidylcholine content and liposomes composed of lecithin of 26% phosphatidylcholine content on the epidermis, dermis and its capillaries, hair follicles, and the sebaceous glands of the laboratory animals 24 h after experimental modeling of II-IIIA degree thermal skin burns. We discuss the dependency of liposome effects on the skin and its derivatives on the fatty acid composition of the lecithin used, with particular focus on phosphatidylinositol, phosphatidic acids, as well as oleic and linoleic acids.

Cutaneous burn injury represents a major risk factor for the development of traumatic ectopic bone formation following blast-related extremity injury

Blast-related traumatic heterotopic ossification (tHO) impacts clinical outcomes in combat-injured patients, leading to delayed wound healing, inflammatory complications, and reduced quality of life. Blast injured patients often have significant burns. This study investigated whether a partial thickness thermal burn injury exacerbates blast-related tHO in a clinically relevant polytrauma animal model. Adult male Sprague Dawley rats were subjected to an established model involving a whole-body blast overpressure exposure (BOP), complex extremity trauma followed by hind limb amputation (CET) followed by the addition of a 10 % total body surface area (TBSA) second degree thermal burn (BU). Micro-CT scans on post-operative day 56 showed a significant increase in HO volume in the CET + BU as compared to the CET alone injury group (p < .0001; 22.83 ± 3.41 mm3 vs 4.84 ± 5.77 mm3). Additionally, CET + BU concomitant with BOP significantly increased HO (p < .0001; 34.95 ± 7.71 mm3) as compared to CET + BU alone, confirming BOP has a further synergistic effect. No HO was detectable in rats in the absence of CET. Serum analysis revealed similar significant elevated (p < .0001) levels of pro-inflammatory markers (Cxcl1 and Il6) at 6 h post-injury (hpi) in the CET + BU and BOP + CET + BU injury groups as compared to naïve baseline values. Real-time qPCR demonstrated similar levels of chondrogenic and osteogenic gene expression in muscle tissue at the site of injury at 168 hpi in both the CET + BU and BOP+CET + BU injury groups. These results support the hypothesis that a 10 % TBSA thermal burn markedly enhances tHO following acute musculoskeletal extremity injury in the presence and absence of blast overpressure. Furthermore, the influence of BOP on tHO cannot be accounted for either in regards to systemic inflammation induced from remote injury or inflammatory-osteo-chondrogenic expression changes local to the musculoskeletal trauma, suggesting that another mechanism beyond BOP and BU synergistic effects are at play. Therefore, these findings warrant future investigations to explore other mechanisms by which blast and burn influence tHO, and testing prophylactic measures to mitigate the local and systemic inflammatory effects of these injuries on development of HO.

Мануальная диагностика термических ожогов кожи. Сообщение первое

The aim of the study is to assess the possibility of studying the depth and area of high-temperature skin lesions in burns by manual methods. Materials and methods: 99 patients with II-III degree thermal skin burns with a lesion area of up to 10% of the body surface were examined at admission to hospital as well as in dynamics. Clinical (palpation diagnostics), instrumental (laser Doppler fluorometry), analytical, and statistical methods of research were used. The study result is the substantiation of the manual (palpation) diagnosis method for determining the true depth and area of the burn wound, the condition of the underlying tissues, the involvement of which in the burn process in the projection of the burn wound affects the course and prognosis of II-III degree thermal burns in patients and their quality of life in the future. The novelty, informativeness, and efficiency of the manual method of diagnosis are shown.

Мануальная диагностика термических ожогов кожи. Сообщение второе

The novelty of this study lies in the application of manual (osteopathic) approach to the diagnosis of thermal skin burns in patients in the acute period (1-3 days) of burn injury in order to study the depth and area of high-temperature skin lesions in burns. Materials and methods: 24 patients with II-III degree thermal burns with a lesion area up to 10% were examined by clinical, osteopathic, and instrumental methods. Clinical (palpation diagnostics), instrumental (laser Doppler fluorometry), analytical, and statistical methods of research were used. The study result is the substantiation of the palpation diagnostics method for determining the true depth and area of the burn wound, the condition of the underlying tissues, the involvement of which in the burn process in the projection of the burn wound affects the course and prognosis of II-III degree thermal burns in patients and their quality of life in the future. The novelty, informativeness, and efficiency of the manual method of diagnosis are shown (Russian Patent for the invention No. 2339300 “A method for diagnosing the depth of a burn wound”)

Burn depth assessment using hyperspectral imaging in a prospective single center study

The assessment of thermal burn depth remains challenging. Over the last decades, several optical systems were developed to determine burn depth. So far, only laser doppler imaging (LDI) has been shown to be reliable while others such as infrared thermography or spectrophotometric intracutaneous analysis have been less accurate. The aim of our study is to evaluate hyperspectral imaging (HSI) as a new optical device. Patients suffering thermal trauma treated in a burn unit in Germany between November 2019 and September 2020 were included. Inclusion criteria were age ≥18 years, 2nd or 3rd degree thermal burns, written informed consent and presentation within 24 h after injury. Clinical assessment and hyperspectral imaging were performed 24, 48 and 72 h after the injury. Patients in whom secondary wound closure was complete within 21 days (group A) were compared to patients in whom secondary wound closure took more than 21 days or where skin grafting was indicated (group B). Demographic data and the primary parameters generated by HSI were documented. A Mann Whitney-U test was performed to compare the groups. A p-value below 0.05 was considered to be statistically significant. The data generated using HSI were combined to create the HSI burn index (BI). Using a logistic regression and receiver operating characteristics curve (ROC) sensitivity and specificity of the BI were calculated. The trial was officially registered on DRKS (registration number: DRKS00022843). Overall, 59 patients with burn wounds were eligible for inclusion. Ten patients were excluded because of a poor data quality. Group A comprised 36 patients with a mean age of 41.5 years and a mean burnt body surface area of 2.7%. In comparison, 13 patients were allocated to group B because of the need for a skin graft (n = 10) or protracted secondary wound closure lasting more than 21 days. The mean age of these patients was 46.8 years. They had a mean affected body surface area of 4.0%. 24, 48, and 72 h after trauma the BI was 1.0 ± 0.28, 1.2 ± 0.29 and 1.55 ± 0.27 in group A and 0.78 ± 0.14, 1.05 ± 0.23 and 1.23 ± 0.27 in group B. At every time point significant differences were demonstrated between the groups. At 24 h, ROC analysis demonstrated BI threshold of 0.95 (sensitivity 0.61/specificity 1.0), on the second day of 1.17 (sensitivity 0.51/specificity 0.81) and on the third day of 1.27 (sensitivity 0.92/specificity 0.71). Changes in microcirculation within the first 72 h after thermal trauma were reflected by an increasing BI in both groups. After 72 h, the BI is able to predict the need for a skin graft with a sensitivity of 92% and a specificity of 71%.

Second degree thermal burn in a Lakhimi calf and its successful management: A case report

Second degree thermal burn in a Lakhimi calf and its successful management: A case report

Second Degree Burn Healed in 10 Days with Herbal Formulated HLQ Ointment

The challenge in the second degree thermal burn wound healing is the risk of infection and Hypertrophic scarring. We administered herbal formulated HLQ ointment on second degree. Burn wound, it produced zero pain of daily dressing changes and achieved complete re epithelialization in 7-14 days.

Исследование противовоспалительной активности лапчатки гусиной (Potentilla anserina L) на ожоговых ранах у мышей

The aim of the research. To investigate the anti-infl ammatory eff ect of Cinquefoil on a model of a thermal wound. Material and methods. A liquid extract in 70 % ethyl alcohol was obtained from dry crushed goose cinquefoil by the percolation method. Th e resulting extracts were evaporated under vacuum at a temperature of 50 °C. Th e dry residue was dissolved in water immediately before treatment at a dose of 250 mg / kg. Th e evaluation of anti-infl ammatory activity was carried out in an experiment on 20 white male mice. Th ermal skin burns were simulated in all animals. Th e burns were healed in an open way. During the entire experiment, the general condition of the experimental animals was assessed, body weight and temperature were determined, the appearance of wounds, appetite, and activity were assessed. For histological examination, a section of the skin was taken, including the burn zones and intact tissues. Paraffi n sections were stained with hematoxylin and eosin. Results. An analysis of the results of the experimental study showed that all experimental animals, under the infl uence of high temperatures, developed a third degree thermal burn of the skin, characterized by damage to the entire thickness of the skin with complete death of hair follicles, sweat and sebaceous glands. At the site of the burn, the skin was dense, motionless and insensitive to painful stimuli. Th e appearance of the wounds did not diff er between groups of animals. Comparative microscopy of the control and experimental groups showed that the depth of damage to the epidermis and dermis was more pronounced in the experimental group. In addition, in the same group, lymphocytic infi ltration of the dermis, hypodermis, the presence of a pronounced vascular reaction and edema of the dermis are more pronounced, which indicates a more pronounced infl ammatory. Conclusion. Th e analysis of the results obtained shows that in the treatment of burn wounds, the local application of the preparation Potentilla goose on the 4th day in the experiment does not lead to a pronounced anti-infl ammatory eff ect. However, the revealed lymphocytic infi ltration of the dermis and other histological parameters indicate more active processes in the tissues, which may subsequently lead to more accelerated wound cleansing and faster regeneration

Calcium Homeostasis Comparison in Thermal Burn Patients–Early Tangential Excision and Grafting versus Conservative Management

Introduction With the advent of better burn wound management protocols, early excision and grafting, increased number of burns patients are surviving and entering the struggle of prolonged rehabilitation. Calcium homeostasis and its influence on bone mineralization plays an important role, but it is adversely influenced by the proinflammatory state in burns, leading to hypocalcemia and paradoxical hypercalciuria which, in turn, leads to excessive bony resorption and pathological fractures. The role of early excision in the overall metabolism of calcium is being investigated in the study. Method This study was undertaken in a tertiary level government-run hospital from February 2018 to August 2019. A total of 28 patients with second degree thermal burns were included. For all patients, fasting serum parathormone levels along with various serum electrolytes like Ca 2+ , Mg 2+ , PO 4 3- and urinary calcium levels were serially measured from day of admission to 2 months. The first group of 14 patients (Group A) underwent early tangential excision and skin grafting, whereas another 14 patients (Group B) underwent conservative management. All categorical variables were analyzed with the help of Chi square test. A p value of < 0.05 was considered statistically significant. Result There was a statistically significant improvement in serum parathormone and other electrolytes’ levels in the tangential excision group. Similarly, urinary excretion of calcium also showed favorable results in the group. Conclusion Early tangential excision and grafting in burns plays an important role in maintaining serum parathormone and calcium levels, leading to prevention of hypercalciuria and optimization of other factors affecting calcium homeostasis.

Pharmacological assessment of immunotropic activity of new gel metabiotic on cellular and humoral immunity in experimentally modeled thermal skin burns

Thermal skin burns were experimentally modeled in laboratory animals revealed immunotropic effects of new gel metabiotic consisting of complex biological active substances produced by Bacillus subtilis B-3679 strain as part of three gel transcutaneous bases: tizol, eftiderm and organosilicon glycerohydrogel on cellular and humoral immunity. The aim of the study was to evaluate immunotropic activity of a new gel metabiotic on cellular and humoral immunity in experimentally modeled thermal skin burns in 60 white laboratory Wistar rats, weighed 180-220 g, for metabiotic consisting of a complex biologically active substances produced by Bacillus subtilis B-3679 strain containng the three gel transcutaneous bases: tizol, ephtiderm and organosilicon glycerohydrogel (KTGG). Registered, standardized antimicrobial and wound-healing ointment levosin was used as a control. The experimental data obtained confirm the effectiveness of using the drugs studied for treatment of first and second degree thermal burns revealed by faster decreased area of affected area compared to experimental animals treated with levosin. While evaluating therapeutic effectiveness of experimental samples of metabiotic-based gel preparations, their influence on various parameters of cellular and humoral immunity in modeled thermal skin burn was examined. We assessed phagocytic activity of blood neutrophils and peritoneal macrophages, quantified T and B lymphocytes, as well as antibody-forming cells and immunoglobulins of various classes. It was found that in experimental animals reproducing models of traumatic skin injuries, there is an increase in the level of all the studied parameters of humoral immunity. Concentration of immunoglobulin M, circulating immune complexes and immunoglobulin E, as well as various cytokines, increased larger. The level of α-interferon and the receptor antagonist interleukin-1 was elevated. Thus, the study of the humoral status of experimental animals that received test metabiotic-based gel preparations in modeled thermal skin burns, allows to conclude that they significantly influenced various arms both cellular and humoral immunity. More marked effects were observed for metabiotic-based drugs containing tizol and KTGG. In general, based on the experimental data we can conclude that the relatively high therapeutic effectiveness of examined drugs in the treatment of thermal skin burn wounds in experimental animals, use of which provided earlier removal of necrotic masses, accelerated regeneration processes, and prevented development of secondary wound infection in burns.

Immune histochemical study of KI-67 level and ribonucleic acid in the process of healing of burn wounds after treatment with drugs containing dexpanthenol and ceramide

Ceramides are structural components of the stratum corneum that regulate cell proliferation and differentiation. The study of the effect of the cream containing dexpanthenol and ceramide on the proliferation processes and regeneration of burn wounds in rats. Experimental rats with III-A degree thermal burn were treated separately with the following preparations: cream with ceramides, cream with dexpanthenol and ceramides and cream "Bepanten". The proliferative-regenerative activity of the drugs was investigated by studying the content of the Ki-67 producing cells and the content of ribonucleic acid (RNA) in the cytoplasm of the granulation tissue fibroblasts. Ceramides contributed to wounds healing, increasing the content of Ki-67 antigenpositive cells, accelerating the formation of scar in the wound. The therapeutic effect of creams with ceramides exceeds the efficacy of the reference preparation “Bepanten” cream. The addition of ceramides to dexpanthenol increases the quality and reduces the wound healing time.

Nucleic Acid Metabolism in Patients with Severe Burn Injury and the Possibility of Its Correction

Purpose. To assess changes in nucleic acid (NA) metabolism in severe burn injury and to develop recommendations for correction of the alimentary status taking into account changes in the NA metabolism. Materials and methods. All patients (37 patients with II–III degree thermal burns and a burn area of more than 40%) were divided into 2 groups: Group I included survivors (23 patients), group II consisted of the deceased. The intensity of the NA metabolism was assessed based on the dynamics of the of uric acid (UA) and oligonucleotides serum concentrations. Results. In the acute period of burn injury, marked decrease in UA levels (less than 100 μmol/l), with gradual stabilization in survivors is typical. In addition, a 2–3-fold increase in the concentration of serum oligonucleotides compared to the normal limit is typical for survivors in the acute period, and these changes were significantly different from the group of deceased patients starting from day 5. Taking into account the data obtained, the level of serum UA can be recommended in clinical practice for the assessment of alimentary status in burn disease, as well as a criterion for f the prescription of glutamine administration in critically ill patients. In patients with burn disease a decrease in the UA level to less than 100 μmol/l was regarded as an absolute indication for the use of L-glutamine products. The use of glutamine in patients with significant decrease in UA levels was accompanied by a significant increase in the intensity of NA metabolism, which was demonstrated by both an increase in uric acid levels (by 85% by day 10 after the start of glutamine administration, P&lt;0.01) and restoration of repair processes. Conclusion. Therefore, there was a marked alteration of NA metabolism in both groups of patients with severe burn injury. At the same time, surviving patients are characterized by rapid recovery of NA metabolism. Glutamine was employed as a pharmacological agent that effectively abrogates the depression of NA metabolism.

PATHOGENETIC MECHANISMS OF THE DEVELOPMENT OF MORPHOLOGICAL CHANGES IN THE SKIN OF RATS IN THE MODELLING OF A THERMAL BURN

Aim. The study was designed to perform a complex examination of the dynamics of the activity of protease inhibitor system along with the morphological study of cell and tissue components of the skin regeneration in the modelling of the 2nd degree thermal burn in rats.Materials and methods. The studies were conducted on 40 mature male Wistar rats. We determined the trypsin-like, elastase-like, antitrypsin activity and acid-stable inhibitors of proteinases in supernatants of homogenates of the skin of rats after the modelling of a burn injury by the enzymatic methods. The wound healing process was evaluated based on the macroscopic, histological examination with the general staining by hematoxylin and eosin, van Gieson’s picrofuchsin, and transmission electron microscopy.Results. The complex analysis of the skin regeneration revealed the role of the enzymatic reactions and the inflammatory microenvironment in the development of pathogenetic and morphological tissue changes in the dynamics of wound healing. The homeostasis of proteinase-inhibitory system was accompanied by both local and systemic disorders. The nonspecific proteinases occupied the key positions among the mediators of the biochemical alteration. The dynamics of changes was characterized by a powerful proteolysis with a progressive depletion of the inhibitory potential, which caused the development of a secondary-alterative process. The launch of the cascade of the inflammatory responses led to the disruption of the microcirculation and the damage of the blood-tissue barriers, the proteolytic destruction of the connective fibers, the formation of an edema and the disruption of the regenerative capacity of a damaged tissue. Morphological destructive changes in the skin remained up to 7-14 days, a decreased regenerative ability of the skin was manifested by a violation of the proliferation and differentiation of the epidermis. According to the electron microscopy, the phenomenon of tissue and intracellular edema, lesions of the microcirculatory bed, leukocyte-macrophage infiltration persisted up to 14 days of the experiment. The disruptions of the structure of the intercellular contacts between epidermocytes, macrophages in the dermis and many newly formed collagen fibers were still noticeable by the 14th day. Conclusion. The results of the study showed the progressive development of the destructive reactions after the modelling of 2nd degree thermal burn. There was an increase in the level of proteolytic activity on the background of depletion of the inhibitory potential. There was the persistence of the alterative changes in the skin up to 7-14 days and the complication of the reparative processes with suppuration, impaired proliferation and differentiation of the epidermis. The performed investigation is important for the determination of further ways of pathogenetic correction.

First degree burns after 1-year of post total knee replacement: Case report

Introduction: There are reported thermal injuries after prolonged use of laptops in the literature. Now for the first time, we report on a case, in which thermal injuries secondary to laptop over the scar of total knee arthroplasty. We report a case of a 69-year-old lady with a background history of left total knee replacement, who sustained a first degree thermal burn over the scar and lateral aspect of the thigh of the replaced knee after prolonged use of her laptop. To date this is the only case where a laptop burn happened to a patient after having total knee replacement. Conclusion: This case report highlights the management of such cases and can be used to educate other arthroplasty surgeons how to emphasise to patients about this possible risk associated with prolonged use of laptops in their consultation and consent.&#x0D; Keywords: First degree burns, laptop, total knee replacement.

P 157 - Potential Healing Properties of Bee Products to Thermal and Sun Burns

Burn injuries are to be considered and treated as a disease. They cause severe damage on skin tissue and affect all the systems of the human body. Bee products, such as honey and propolis, are known for their healing and antibacterial properties when applied on injured skin. In order to explore the possibility of other bee products having similar properties, royal jelly, bee cocoons, and beeswax are isolated and tested on 64 lab mice type SKH-1. Half of them are exposed to 8 MED of UV radiation, causing severe sun burn, and on the other half a second degree thermal burn is induced using a metal rod heated up to 60 °C. The parameters which are studied to evaluate their pharmacological action are hydration, transepidermal waster loss, elasticity, skin thickness, antioxidants (ascorbic acid, uric acid, GSH) and oxidative stress, as well as histological analysis. Based on the results, royal jelly and bee cocoons showed significant effects on the burned skin, while all three of them improved the visual outcome of the scar tissue. Further studies are to be made on the properties of their mixtures.

Naringenin improves the healing process of thermally-induced skin damage in rats.

ObjectiveTo evaluate the effect of the phenolic compound naringenin on thermal burn-induced inflammatory responses and oxidative stress in rats.MethodsFirst degree thermal burn injuries were induced in shaved rats by 10 s immersion of the back surface in water at 90℃. Naringenin treatment (25, 50 and 100 mg/kg/day) was initiated 24 h following burn injury, and continued for 7 days. On treatment day 7, serum tumour necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, nitric oxide (NO), prostaglandin (PG)E2, caspase-3, leukotriene (LT)-B4 and nuclear factor (NF)-κB levels were quantified. Skin sample glutathione (GSH) and thiobarbituric acid reactive substances (TBARS) levels, and catalase, superoxide dismutase (SOD), glutathione-S-transferase (GST) and glutathione peroxidase (GPx) activities, were also measured.ResultsSerum inflammatory biomarkers were significantly increased in thermal-burn injured rats versus uninjured controls. Naringenin significantly inhibited the increased proinflammatory markers at day 7 of treatment. Increased TBARS levels and decreased GSH levels in wounded skin were significantly restored by naringenin treatment at day 7. SOD, catalase, GPx and GST activities were markedly inhibited in wounded skin tissues, and were significantly increased in naringenin-treated rats.ConclusionNaringenin treatment showed anti-inflammatory and antioxidant effects in rats with thermal burn-induced injury.

The Regenerative Effects of Hemostatic Plant Extract in Second Degree Burn Wound

Introduction: The effects of Ankaferd Blood Stopper (ABS), a hemostatic herbal agent, on wound healing of experimental second degree thermal burn model were analyzed in this study. Material and Methods: 24 wistar albino rats were used. All rat subjects were divided into 4 equal groups as control, burn control, Ankaferd Blood Stopper and serum physiologic. In all rats except for those in negative control group, second degree thermal burn was formed with metal plates heated on their backs. Biopsies were taken on 0th,7th,14th and 21st days. In tissue samples; they were evaluated in terms of fibroblast increase histopathologically, congestion, inflammatory cell increase and epithelization findings and they were also scored. The values obtained were compared statistically. Results: No significant difference was observed between groups with regard to fibroblast increase (p>0.05). On the 7th day, congestion values in burn control group was determined higher than ABS group (p

Aerobic exercise training in modulation of aerobic physical fitness and balance of burned patients.

[Purpose] This study aimed to determine the impact of aerobic exercise on aerobic capacity, balance, and treadmill time in patients with thermal burn injury. [Subjects and Methods] Burned adult patients, aged 20–40 years (n=30), from both sexes, with second degree thermal burn injuries covering 20–40% of the total body surface area (TBSA), were enrolled in this trial for 3 months. Patients were randomly divided into; group A (n=15), which performed an aerobic exercise program 3 days/week for 60 min and participated in a traditional physical therapy program, and group B (n=15), which only participated in a traditional exercise program 3 days/week. Maximal aerobic capacity, treadmill time, and Berg balance scale were measured before and after the study. [Results] In both groups, the results revealed significant improvements after treatment in all measurements; however, the improvement in group A was superior to that in group B. [Conclusion] The results provide evidence that aerobic exercises for adults with healed burn injuries improve aerobic physical fitness and balance.

Thermal burns on lower limb resulting from laptop use: A case report and review of literature

We report a case of a 29-year-old man with a background history of incomplete quadriplegia, who sustained a second degree thermal burn of the lower limb from prolonged proximity to the extractor fan of his laptop. We have also reviewed all other reported cases of thermal burns associated with laptop use. This literature review highlights the variability in the extent of injury and the subsequent management of laptop induced burns.

Comparison of the nutritional status and outcome in thermal burn patients receiving vegetarian and non-vegetarian diets

Background:The importance of adequate nutritional support in burned patients cannot be overemphasised. For adequate long-term compliance by the patients, diet should be formulated in accordance with their pre-burn dietary habits, religious beliefs, and tastes.Patients and Methods:A study was conducted in 42 consecutive patients suffering from 10% to 50% of 2nd and 3rd degree thermal burns with the aim to compare nutritional status, clinical outcome, and cost-effectiveness of vegetarian and non-vegetarian diets. The patients were divided into two groups depending upon their pre-injury food habits. Total calories were calculated by Curreri formula. Both groups were compared by various biochemical parameters, microbiological investigations, weight, status of wound healing, graft take, and hospital stay and they were followed for at least 60 days postburn.Results:The results were comparable in both groups. Vegetarian diet was found to be more palatable and cost-effective.Conclusion:Vegetarian diet is a safe and viable option for the patients suffering from burn injury. The common belief that non-vegetarian diet is superior to vegetarian diet is a myth.