Skin Surface Area Research Articles

Thermal Absorptivity Model of Knitted Rib Fabric and its Experimental Verification

Abstract Thermal absorptivity is an indicator of warm and cool feeling of textile materials. An equation based on thermal absorptivity of polyester in solid form, porosity of a fabric, and relative contact area of human skin and fabric surface has been developed to characterize thermal absorptivity of fabric. For verification of suggested model, 15 knitted rib fabrics were produced using 100% polyester yarn and having different surface profile. ALAMBETA semiautomatic non-destructive instrument has been used for measuring the effective thermal absorptivity of knitted rib fabric. It was found that the suggested simple theoretical model exhibits significant agreement with the measured thermal absorptivity values of knitted rib fabric, which endorsed the approach applied.

Three-Dimensional Photography for Measuring Volumetric Changes After Submental Cryolipolysis

High-resolution 3-dimensional photography offers unparalleled advantages in objective and detailed skin contour characterization, quantification, volumetric and surface area analysis. This study aims to illustrate the benefits of 3-dimensional photography through analysis of noninvasive reduction of submental fat using cryolipolysis. A nonrandomized prospective analysis was performed of 14 selected patients who underwent treatment with cryolipolysis (CoolSculpting System; Zeltiq) between February and June 2016. The benefits of 3-dimensional photography (Vectra; Canfield Scientific) are presented. High-quality 3-dimensional images are presented to illustrate the utility of 3-dimensional photography as a means to quantitatively evaluate changes in submental volume, fat thickness, and surface area reduction, thereby exemplifying the broad applicability of this imaging technique. Three-dimensional photography technology provides clinicians with enhanced options that extend beyond simple 2-dimensional photography. Our study illustrates the benefits of the technology for accurately measuring volumetric changes after submental cryolipolysis treatment.

Acne in late adolescence is not associated with a raised risk of subsequent malignant melanoma among men

BackgroundTo evaluate the association of acne in late adolescence with the risk for subsequent malignant melanoma (MM) in men. MethodsSwedish register-based cohort study of 242,096 males born between 1952 and 1956, who took part in compulsory assessments for Swedish military conscription in late adolescence between 1969 and 1975, with subsequent diagnoses of MM (n=1,058) up to December 31, 2009. Covariates included measures of childhood circumstances and information from adolescence on presence of acne, physical fitness, cognitive function, body mass index (BMI), and a summary of diagnoses. Cox regression was used for the analysis. ResultsIn total 1,058 men were diagnosed with MM. Acne was not associated with subsequent MM, with an adjusted hazard ratio (and 95% confidence interval) of 0.95 (0.61 to 1.49). Men with parents who were agricultural workers, and men who lived in northern Sweden, had lower physical fitness, or lower cognitive function had a lower risk of MM. Overweight and obesity was associated with a raised risk, with an adjusted hazard ratio of 1.39 (1.14, 1.71). ConclusionsAcne in late adolescence is unlikely to represent a raised risk for subsequent MM in men. Overweight or obesity was identified as a raised risk for MM, possibly due to the associated increased skin surface area.

Tbx3-dependent amplifying stem cell progeny drives interfollicular epidermal expansion during pregnancy and regeneration

The skin surface area varies flexibly in response to body shape changes. Skin homeostasis is maintained by stem cells residing in the basal layer of the interfollicular epidermis. However, how the interfollicular epidermal stem cells response to physiological body shape changes remains elusive. Here, we identify a highly proliferative interfollicular epidermal basal cell population in the rapidly expanding abdominal skin of pregnant mice. These cells express Tbx3 that is necessary for their propagation to drive skin expansion. The Tbx3+ basal cells are generated from Axin2+ interfollicular epidermal stem cells through planar-oriented asymmetric or symmetric cell divisions, and express transit-amplifying cell marker CD71. This biased division of Axin2+ interfollicular epidermal stem cells is induced by Sfrp1 and Igfbp2 proteins secreted from dermal cells. The Tbx3+ basal cells promote wound repair, which is enhanced by Sfrp1 and Igfbp2. This study elucidates the interfollicular epidermal stem cell/progeny organisation during pregnancy and suggests its application in regenerative medicine.

A Novel Approach to Overcome Movement Artifact When Using a Laser Speckle Contrast Imaging System for Alternating Speeds of Blood Microcirculation

The laser speckle contrast imager (LSCI) provides a powerful yet simple technique for measuring microcirculatory blood flow. Ideal for blood dynamic responses, the LSCI is used in the same way as a conventional Laser Doppler Imager (LDI). However, with a maximum skin depth of approximately 1 mm, the LSCI is designed to focus on mainly superficial blood flow. It is used to measure skin surface areas of up to 15 cm x 20 cm. The new technique introduced in this paper accounts for alternating speeds of microcirculations; i.e. both slow and fast flow flux measurement using the LSCI. The novel technique also overcomes LSCI's biggest shortcoming, which is high sensitivity to artifact movement. An adhesive opaque patch (AOP) is introduced for satisfactory recording of microcirculatory blood flow, by subtracting the LSCI signal from the AOP from the laser speckle skin signal. The optimal setting is also defined because the LSCI is most powerful when flux changes are measured relative to a reference baseline, with blood microcirculatory flux expressed as a percentage change from the baseline. These changes may be used for analyzing the status of the blood flow system.

A Novel Approach to Overcome Movement Artifact When Using a Laser Speckle Contrast Imaging System for Alternating Speeds of Blood Microcirculation.

The laser speckle contrast imager (LSCI) provides a powerful yet simple technique for measuring microcirculatory blood flow. Ideal for blood dynamic responses, the LSCI is used in the same way as a conventional Laser Doppler Imager (LDI). However, with a maximum skin depth of approximately 1 mm, the LSCI is designed to focus on mainly superficial blood flow. It is used to measure skin surface areas of up to 15 cm x 20 cm. The new technique introduced in this paper accounts for alternating speeds of microcirculations; i.e. both slow and fast flow flux measurement using the LSCI. The novel technique also overcomes LSCI's biggest shortcoming, which is high sensitivity to artifact movement. An adhesive opaque patch (AOP) is introduced for satisfactory recording of microcirculatory blood flow, by subtracting the LSCI signal from the AOP from the laser speckle skin signal. The optimal setting is also defined because the LSCI is most powerful when flux changes are measured relative to a reference baseline, with blood microcirculatory flux expressed as a percentage change from the baseline. These changes may be used for analyzing the status of the blood flow system.

국내 어린이 위해성평가를 위한 노출계수 연구

Objectives: Children may be more exposed to certain environmental contaminants because they react with greater sensitivity and have different food intakes and breathing rate per unit of body weight compared to adults. The aim of this study was to determine general exposure factors such as skin surface area, period and frequency of exposure, and others among Korean children aged <TEX>${\leq}18$</TEX> years old. This study was carried out as the first of its kind in Korea. Methods: We developed 23 recommended exposure factors for Korean children aged 0 to 18 years by reclassifying raw data from the National Health and Nutrition Examination Survey and the National Statistical Information Service, as well as through investigation by experiments in the absence of related data. Results: Reflecting the activity patterns of about 9,000 children, the daily inhalation rates for long-term exposure ranged from <TEX>$9.49m^3/day$</TEX> for children from birth to <2 years to <TEX>$14.98m^3/day$</TEX> for children aged 16 to <18 years. The research found that Korean children spent an average of 22.21 hours indoors, 0.67 hours outdoors, and 1.12 hours in-transit every day. Young children (<TEX>${\leq}2$</TEX> years old) spent approximately 34 more minutes outdoors on weekends than they did on weekdays. Conclusion: Various physiological variables in the human body reflect characteristics of children that can directly influence risk exposure. Therefore, the identification of general exposure factors based on Korean children is required for appropriate risk assessment.

Adequacy of the default values for skin surface area used for risk assessment and French anthropometric data by a probabilistic approach

The notes of guidance for the testing of cosmetic ingredients and their safety evaluation by the Scientific Committee on Consumer Safety (SCCS) is a document dedicated to ensuring the safety of European consumers. This contains useful data for risk assessment such as default values for Skin Surface Area (SSA).A more in-depth study of anthropometric data across Europe reveals considerable variations. The default SSA value was derived from a study on the Dutch population, which is known to be one of the tallest nations in the World. This value could be inadequate for shorter populations of Europe.Data were collected in a survey on cosmetic consumption in France. Probabilistic treatment of these data and analysis of the case of methylisothiazolinone, a sensitizer recently evaluated by a deterministic approach submitted to SCCS, suggest that the default value for SSA used in the quantitative risk assessment might not be relevant for a significant share of the French female population. Others female populations of Southern Europe may also be excluded.This is of importance given that some studies show an increasing risk of developping skin sensitization among women. The disparities in anthropometric data across Europe should be taken into consideration.

Tbx3-dependent proliferation of transit-amplifying cells drives interfollicular epidermal expansion during pregnancy and regeneration

The skin surface area varies flexibly in response to body shape changes. Despite the growing evidence implicating that the interfollicular epidermis (IFE) of adult skin consists of slow-cycling stem cells and short-lived transit-amplifying (TA) cells, little is known about the dynamicity of IFE stem and TA cells during physiological body shape changes. By tracing IFE stem cell division using the Wnt-responsive gene Axin in mice, here we show that in pregnant mother mice the abdominal IFE stem cells are predisposed to planar-oriented asymmetric or symmetric cell division into TA cells. Microarray and genetic deletion analysis show that transcription factor Tbx3 is expressed in TA cells in the abdominal IFE of pregnant mice to drive their proliferation, enabling rapid skin expansion to accommodate foetal growth. The IFE stem/TA cell dynamicity of pregnant mice is induced by the dermal-derived secreted frizzled-related protein 1 (Sfrp1) and insulin-like growth factor binding protein 2 (Igfbp2). On wounding, Tbx3 positive-TA cells play a pivotal role in tissue repair, which is reinforced by topical administration of Sfrp1 and Igfbp2 proteins. Our findings demonstrate a fine-tuned IFE stem/TA cell orchestration during pregnancy and implicate its application for regenerative medicine.

Regulation of mitotic spindle orientation during epidermal stratification.

The epidermis is a stratified epithelium that serves as a barrier to infection from environmental pathogens and prevents water loss. Epidermal stratification is tightly controlled during embryogenesis. Progenitor cells in the developing epidermis undergo both symmetric and asymmetric cell divisions to balance the growth of the skin surface area against the generation of differentiated cell layers. Therefore, understanding the relationship between oriented divisions of progenitor cells and the development and stratification of the epidermis is of paramount importance in the field of skin biology and pathology. We provide here an integrated view of recent studies implicating that improper orientation of the mitotic spindle contributes to disorders associated with abnormal epidermal stratification and suggesting that spindle orientation could serve as a potential therapeutic target in skin diseases.

Accurate Measurements of the Skin Surface Area of the Healthy Auricle and Skin Deficiency in Microtia Patients.

Background:The limited cranial skin covering auricular implants is an important yet underrated factor in auricular reconstruction for both reconstruction surgery and tissue engineering strategies. We report exact measurements on skin deficiency in microtia patients and propose an accessible preoperative method for these measurements.Methods:Plaster ear models (n = 11; male:female = 2:1) of lobular-type microtia patients admitted to the University Medical Center Utrecht in The Netherlands were scanned using a micro-computed tomographic scanner or a cone-beam computed tomographic scanner. The resulting images were converted into mesh models from which the surface area could be calculated.Results:The mean total skin area of an adult-size healthy ear was 47.3 cm2, with 49.0 cm2 in men and 44.3 cm2 in women. Microtia ears averaged 14.5 cm2, with 15.6 cm2 in men and 12.6 cm2 in women. The amount of skin deficiency was 25.4 cm2, with 26.7 cm2 in men and 23.1 cm2 in women.Conclusions:This study proposes a novel method to provide quantitative data on the skin surface area of the healthy adult auricle and the amount of skin deficiency in microtia patients. We demonstrate that the microtia ear has less than 50% of skin available compared with healthy ears. Limited skin availability in microtia patients can lead to healing problems after auricular reconstruction and poses a significant challenge in the development of tissue-engineered cartilage implants. The results of this study could be used to evaluate outcomes and investigate new techniques with regard to tissue-engineered auricular constructs.

Allometric relationships determined for skin area and fleece production of Angora goats

This study aimed to determine the relationships between skin surface area, animal size and mohair physical properties using estimates of skin area determined on animals prior to slaughter and to compare these with skin weight and skin area determined after slaughter. Angora kids born in late winter were shorn at 18 weeks of age. Prior to slaughter at 20 weeks of age, 15 kids of each sex were identified to cover the entire range of live weights. Body girth, body length circumference and body condition score were determined. Following slaughter, skins were weighed and skin area determined. Clean fleece weight and mean fibre diameter (MFD) were determined. Parsimonious general linear models were developed to determine the relationships between measured skin area, estimated skin area, live weight and skin weight, clean fleece weight and MFD both with and without log10 transformation. Live weights ranged from 8.3 to 23.1kg, skin weight from 796 to 2262g and measured skin area 0.23 to 0.59m2. The weight of the skin represented 9.6% of the average live weight of the goats. Predicting measured skin area using body dimensional measurements accounted for 83.7% of the variance in measured skin area. Measured skin area was a constant 0.057m2 greater than the estimated skin area. It was more accurate to use live weight to estimate measured skin area as the regression between estimated skin area and live weight accounted for 93.7% of the variance. Measured skin area and clean fleece weight were proportional to live weight 0.67, which is the general allometric relationship expected between the surface area of a shape and its volume. Both clean fleece weight and MFD were proportional to measured skin area but were better predicted by live weight. Predicting skin surface area using live weight 0.67 was more reliable than using body dimensional measurements.

Autologous Stem Cell Transplantation Promotes Mechanical Stretch Induced Skin Regeneration: A Randomized Phase I/II Clinical Trial

BackgroundMechanical stretch, in term of skin expansion, can induce effective but limited in vivo skin regeneration for complex skin defect reconstruction. We propose a strategy to obtain regenerated skin by combining autologous stem cell transplantation with mechanical stretch. MethodsThis randomized, blinded placebo-controlled trial enrolled 38 adult patients undergoing skin expansion presenting with signs of exhausted regenerative capacity. Patients randomly received autologous bone marrow mononuclear cell (MNC) or placebo injections intradermally. Follow-up examinations were at 4, 8weeks and 2years. The primary endpoint was the volume achieved in relation to the designed size of the expander (expansion index, EI). Secondary endpoints were surface area, thickness and texture of expanded skin. This trial is registered with ClinicalTrial.gov, NCT01209611. FindingsThe MNC group had a significantly higher EI at 4weeks (mean difference 0.59 [95% CI, 0.03–1.16]; p=0.039) and 8weeks (1.05 [95% CI, 0.45–1.66]; p=0.001) versus controls. At 8weeks, the MNC group had significantly thicker skin (epidermis: p<0.001, dermis: p<0.001) and higher subjective scores for skin quality/texture (24.8 [95% CI, 17.6–32.1]; p<0.001). The MNC group had more skin surface area (70.34cm2 [95% CI, 39.75–100.92]; p<0.001). Patients in the MNC group gained up to the quadrupled surface area of expanded skin compared to pre-expansion at the end of expansion. No severe adverse events occurred. InterpretationIntradermal transplantation of autologous stem cells represents a safe and effective strategy to promote in vivo mechanical stretch induced skin regeneration, which can provide complex skin defect reconstruction with plentiful of tissue.

Inactivation of Salmonella Typhimurium and quality preservation of cherry tomatoes by in-package aerosolization of antimicrobials

The purpose of the present study was to investigate the efficacy of in-package aerosolized aqueous sanitizers in reducing populations of Salmonella enterica serovar Typhimurium on tomato fruit and in maintaining fruit quality. Cherry tomatoes were inoculated with a cocktail of attenuated S. Typhimurium ATCC 53647 and 53648 strains on the smooth skin surface and stem scar area. Next, 200 ppm free chlorine, and peroxyacetic acid (PAA) and aqueous ClO2 at different concentrations, 2% lactic acid + 2% acetic acid + 2% levulinic acid, and 3% acetic acid + 3% lactic acid were aerosolized into a clamshell container containing cherry tomatoes. Results showed that S. Typhimurium populations on smooth tomato surfaces were reduced by more than 5 log CFU/fruit with 400 ppm PAA, 2% lactic acid + 2% acetic acid + 2% levulinic acid, 3% acetic acid + 3% lactic acid, and aqueous ClO2 (100 and 400 ppm). On the stem scar area, 400 ppm aqueous ClO2 was more effective in reducing S. Typhimurium populations than other treatments, achieving 4.89 log CFU/fruit reduction, followed by 400 ppm PAA (2.62 log CFU/fruit). The efficacy of ClO2 and acid combination treatments increased during 3-week storage at 10 °C, achieving >3 log CFU/fruit inactivation with the acid combination and ca. 6 log with for 400 ppm with ClO2. None of the treatments significantly (p > 0.05) affected color, appearance, firmness, vitamin C, lycopene or antioxidant values of tomatoes during 3 weeks of storage; although, an acidic odor was detected for samples treated with the organic acids in the earlier period of the storage. These results suggest that in-package aerosolized sanitizers can be used as a novel method for the inactivation of Salmonella on tomato fruit.

Developmental Changes in Skin Barrier and Structure during the First 5 Years of Life

The structure of the stratum corneum (SC) and the corresponding skin barrier develops from before birth up to about 4 years of age. Large subject-to-subject variability within an age group requires a large population to observe trends in skin barrier properties over time. Barrier function, quantified by transepidermal water loss (TEWL) and SC thickness, was measured on the upper inner arm and dorsal forearm in subjects aged 3 months to 4 years (n = 171) and a subset of mothers (n = 44). The rate of skin surface area expansion as a function of age peaked before birth (∼90 cm²/week) and declined to a steady plateau (∼10 cm²/week) by 1 year of age. SC thickness increased and TEWL decreased, but did not reach adult values until 3-4 years of age. A better understanding of how skin hydration changes after birth suggests that barrier function may be related mechanistically to skin surface area expansion.

Perforator anatomy of the radial forearm free flap versus the ulnar forearm free flap for head and neck reconstruction

The aim of this study was to investigate the vascular anatomy of the distal forearm in order to optimize the choice between the radial forearm free flap and the ulnar forearm free flap and to select the best site to harvest the flap. The radial and ulnar arteries of seven fresh cadavers were injected with epoxy resin (Araldite) and the perforating arteries were dissected. The number of clinically relevant perforators from the radial and ulnar arteries was not significantly different in the distal forearm. Most perforators were located in the proximal half of the distal one third, making this part probably the safest location for flap harvest. Close to the wrist, i.e. most distally, there were more perforators on the ulnar side than on the radial side. The ulnar artery stained 77% of the skin surface area of the forearm, showing the ulnar forearm free flap to be more suitable than the radial forearm free flap for the restoration of large defects.

Cardiovascular adaptations supporting human exercise-heat acclimation.

This review examines the cardiovascular adaptations along with total body water and plasma volume adjustments that occur in parallel with improved heat loss responses during exercise-heat acclimation. The cardiovascular system is well recognized as an important contributor to exercise-heat acclimation that acts to minimize physiological strain, reduce the risk of serious heat illness and better sustain exercise capacity. The upright posture adopted by humans during most physical activities and the large skin surface area contribute to the circulatory and blood pressure regulation challenge of simultaneously supporting skeletal muscle blood flow and dissipating heat via increased skin blood flow and sweat secretion during exercise-heat stress. Although it was traditionally held that cardiac output increased during exercise-heat stress to primarily support elevated skin blood flow requirements, recent evidence suggests that temperature-sensitive mechanisms may also mediate an elevation in skeletal muscle blood flow. The cardiovascular adaptations supporting this challenge include an increase in total body water, plasma volume expansion, better sustainment and/or elevation of stroke volume, reduction in heart rate, improvement in ventricular filling and myocardial efficiency, and enhanced skin blood flow and sweating responses. The magnitude of these adaptations is variable and dependent on several factors such as exercise intensity, duration of exposure, frequency and total number of exposures, as well as the environmental conditions (i.e. dry or humid heat) in which acclimation occurs.

High-speed line-focus Raman microscopy with spectral decomposition of mouse skin

Line-focus Raman microscope system was designed and constructed for high speed quantitative analysis of Raman spectral maps. Laser line generator lens was used for formation of homogeneous laser power distribution thought the line. Three-dimensional Raman maps of mouse skin were obtained using point and line illumination modes. It was shown that laser line illumination can provide Raman spectrum with signal to noise ratio comparable to point illumination mode. The speed of scanning in line-focus mode achieved is two orders of magnitude faster compared to the point illumination mode, which enables ex vivo measurements of large areas of skin surface during a few minutes. Non-negative least squares (NNLS) decomposition of mouse skin spectral maps was done using keratin, lipids, water, lactate, urea and natural moisture factor (NMF) components as library spectra. Fluorescence background of measured spectra was corrected using the fluorescence profile obtained from time-lapse Raman skin measurements, which was used as additional component in NNLS decomposition procedure. The lateral and depth distribution of major skin components obtained from Raman maps mainly correlates with histological information. High-quality line-focus Raman maps from large sample area expand the possibilities of studying skin chemical components distribution.

Effects of deviation from focal plane on lesion geometry for ablative fractional photothermolysis.

Fractional Photothermolysis (FP) is a method of skin treatment that generates a thermal damage pattern consisting of multiple columns of thermal damage, also known as microscopic treatment zones (MTZs). They are very small in diameter and are generated by application of highly focused laser beams. In order to obtain the smallest spot size, the treatment should be performed in the focal plane. Any deviation from the focal plane (DFP) results in an increase of spot size. FP devices typically utilize distance holders in order to facilitate exposures at this specific location. In spite of the use of distance holders, DFP can occur. In particular, variations of contact pressure to the skin surface and anatomical treatment areas of high surface curvature may be prone to DFP during FP treatments. The impact of such distance variation on lesion geometry, such as depth and diameter of the thermal injury, has not previously been evaluated. The objective of this study was to investigate the relation between DFP and the resulting lesion geometry for a selected ablative fractional device. A handpiece of an ablative fractional laser (DeepFX, UltraPulse Encore, Lumenis, Yokneam, Israel) was mounted to a rigid stand. Full thickness human skin obtained from abdominoplasty was mounted to a separate stand perpendicular to the handpiece. The tissue stand allowed the distance between the handpiece and the tissue to be adjusted to produce a variation up to ±3 mm from the focal plane. A 1 × 1 cm(2) scanning area of 169 MTZs, 50 mJ energy per MTZ, 120 μm nominal spot size, was applied at -3, -2, -1, 0, +1, +2, and +3 mm deviated from the focal plane. Minus (-) and plus (+) signs indicate decreasing and increasing distance between the handpiece and the tissue, respectively. Depth and diameter of the laser induced tissue lesions were assessed and quantified. DFPs produced a significant alteration of the lesion geometry. DFPs of -3, -2, -1, 0, +1, +2, +3 mm resulted in average lesion depths of 1,020 (-40%), 1,180 (-31%), 1,400 (-18%), 1,700 (0%), 1,620 (-5%), 780 (-55%), 680 (-60%) µm, and average lesion diameters of 314 (+26%), 311 (+25%), 273 (+10%), 248 (0%), 256 (+3%), 316 (+27%), 359 (+44%) µm, respectively. The underlined values represent the focal plane. The percentage changes relative to values at focal plane are in parentheses. A relatively minor DFP has a marked impact on the thermal injury profile, including lesion depth and diameter, of the laser-exposed tissue. Such marked changes of the thermal injury profile might affect the wound healing, safety, and efficacy of ablative fractional resurfacing procedures. Clinicians should carefully maintain the focal plane during ablative fractional treatment for reproducible results. The presented data are device specific and the clinical impact of such alteration of thermal injury profile warrants further investigation. Lasers Surg. Med. 48:555-561, 2016. © 2016 Wiley Periodicals, Inc.

Bacteriological profiles in burn patients within first twenty-four hours of injury

Background: Infection and sepsis are the main confounders of mortality and morbidity of burn injury. Burn wound surface thought to be sterile for few hours immediately after injury. Eventually microorganisms from skin surface area or hospital environment colonize the wound. The aim of this study is to observe the bacteria profile (i.e. form the first day of burn) and their subsequent changes. Materials and Methods: Fifty patients attending Burn emergency care Department with history of burn injury within 24hours was enrolled in this study. To observe the microbial profile at the site, three swabs (1ston 0 day i.e. the day of admission, 2nd after 24-48hours, and 3rd after 72-96 hours) were collected from the burn wound. Once collected, they were immediately transferred to a sterile test tube and transported to the Department of Microbiology for further processing and identification of bacterial flora. Results: Eighty percent of samples collected on day 0 were observed sterile. Staphylococcus aureus found to be commonest isolate among the isolates in the day 0 in comparison to gram-negative bacteria in 2nd and 3rd sample. Discussion and conclusion: Burn wound remains sterile for first few hours after injury. It subsequently colonized with the multidrug resistant microorganisms transmitted from the hospital environment or from the hospitalized patients in the same set up. Prompt effective treatment and regular hospital surveillance is necessary to reduce the infection of burn wound. Key words: Burn wound, Sterile, Bacterial flora