Superficial Burns Research Articles

Algorithm of local conservative treatment of children with burns

Background. This article presents the results of using atraumatic wound dressings Branolind N and sorbing bandage Zetuvit. In research there were 10 children with superficial scalds (III degree) and parcial deep (IIIII degree) burns. Children were treated at the Burn Center of Speransky Pediatric City Hospital №9 in Moscow in June November 2021. The analysis of the conducted research testifies to the effectiveness and safety of the medical products listed above. The absence of local complications during treatment was revealed. The possibility of their simultaneous use in patients with exudating wounds has been established. Branolind N and Zetuvit bandage can be recommended for use both in a on- and outpatient cases in children with local burns. The results of treatment of children with burn injury depend on adequate diagnosis of the severity of the burn trauma, reliable determination of the depth of scald and local treatment of burn wounds. Tactics of local treatment depends on the phase of wound process, the age of the child and the presence of concomitant diseases.
 Aim. To assess the effectiveness and safety of using wound dressings ointment dressing Branolind N with Peruvian balsam and Zetuvit sorbent dressing in treatment children with burns.
 Materials and methods. Analysis of the using of Branolind N ointment dressing with Peruvian balsam and Zetuvit sorbent dressing in 10 children with burn injury was carried out. The study was completed in June November 2021. Inclusion and exclusion criteria were determined by the physicians participating in the study. The studies were carried out in accordance with Helsinki Declaration. The age of the patients ranged from 3 years 2 months up to 17 years 1 month. The depth of burn wounds in the studied patients was assessed according to the classification of the damage degree of European Burn Association: patients with superficial scalds (III degree) and partial deep burns (IIIII degree).
 Results. The absence of local skin complications during the application of the Branolind N ointment dressing with Peruvian balsam and Zetuvit sorbent dressing was revealed. The possibility of using. These wound dressings in patients with exuding wounds was established.
 Conclusion. The analysis of the conducted study testifies to the effectiveness and safety of the above medical products. Ointment bandage Branolind N with Peruvian balsam and sorbent bandage Zetuvit can be recommended for use both in out- and inpatients practice of treatment children with local skin burns.

The research on the treatment effects of nano Berberine gel on superficial burn thickness

Objectives: To evaluate the analgesic effect of nano Berberin gel in the treatment of superficial burns.Subjective and Method: Study on 32 pediatric burn patients, treated at the Pediatric Burn Department in Le Huu Trac National Burn Hospital from 1 January 2022 to 30 April 2022. The method of study is a Prospective study, a randomized controlled trial. with comparison before-after. In the same patient, the burn was divided into 2 areas of equal area and depth. Study area: burns treated with a gel containing nano Berberine and comparison area: burns treated with 1% SSD cream. Results: 1. Having an anti-inflammatory effect: Reduction of the degree and duration of inflammation and reduced significantly the exudation on the study burn wound compared to the control area. 2. Nano Berberin gel dries wet necrosis (obvious after 2 - 3 days of using the drug). 3. Gel has the effect of preventing infection. A significant reduction in the number of positive cultures and the number of bacteria after 1 - 2 weeks of treatment, (78.33 ± 46.69 vs 105.16 ± 91.28 p < 0.05). The number of infected wounds after 1 week also decreased significantly in the control area, (25% vs 61.5% in zone A; 33.3% vs 58.3% in zone B) p<0.05. 4. The time for 50% epithelialization, the treatment time in the study area is also shorter than in the control area, (6.9 ± 3.6 vs 8.1 ± 4.2; p < 0.05). Conclusion: Initial remarkable recognition of the treatment effect of Nano Berberin Gel on the pediatric superficial burn.

Histopathological changes of experimental burns in rabbits treated with Berberine nano gel

Berberin, isolated from Coscinium fenestratum and some plants in the family Ranunculaceae, has been shown to have healing effects on wounds, burns. Study to determine the effect of treatment of superficial burns in rabbits on the pathophysiology of burns of berberine nano gel produced by the National Burn Hospital.The study was conducted on 45 rabbits, creating circular burns with a diameter of 4cm on both sides of the rabbit's back skin; rabbits were divided into 3 groups (15 rabbits, 30 burns/group), study group (A): Treated site by Berberin nano gel; control group (B): Treatment with SSD; Standard group (C): Treatment with Natri Chloride 0.9%. Follow-up histopathology at the rabbit burn site until the end of the study. Results: Group A burns had a lower number of inflammatory cells and a higher number of fibroblasts and blood vessels than group B and C burns. Conclusion: Berberin nano gel for treatment of superficial burns has been shown to have anti-inflammatory effects and stimulate wound healing.

GL-FusionNet: Fusing global and local features to classify deep and superficial partial thickness burn.

Burns constitute one of the most common injuries in the world, and they can be very painful for the patient. Especially in the judgment of superficial partial thickness burns and deep partial thickness burns, many inexperienced clinicians are easily confused. Therefore, in order to make burn depth classification automated as well as accurate, we have introduced the deep learning method. This methodology uses a U-Net to segment burn wounds. On this basis, a new thickness burn classification model that fuses global and local features (GL-FusionNet) is proposed. For the thickness burn classification model, we use a ResNet50 to extract local features, use a ResNet101 to extract global features, and finally implement the add method to perform feature fusion and obtain the deep partial or superficial partial thickness burn classification results. Burns images are collected clinically, and they are segmented and labeled by professional physicians. Among the segmentation methods, the U-Net used achieved a Dice score of 85.352 and IoU score of 83.916, which are the best results among all of the comparative experiments. In the classification model, different existing classification networks are mainly used, as well as a fusion strategy and feature extraction method that are adjusted to conduct experiments; the proposed fusion network model also achieved the best results. Our method yielded the following: accuracy of 93.523, recall of 93.67, precision of 93.51, and F1-score of 93.513. In addition, the proposed method can quickly complete the auxiliary diagnosis of the wound in the clinic, which can greatly improve the efficiency of the initial diagnosis of burns and the nursing care of clinical medical staff.

Pediatric First-Degree Burn Management With Honey and 1% Silver Sulfadiazine (Ag-SD): Comparison and Contrast.

Background The cardinal area of managing fire wounds is guided by adequately evaluating the burn-induced lesion's profundity and size. Superficial second-degree burns are often treated through daily reinstating with fresh sterile bandagingwith appropriate topical antimicrobials to allow rapid spontaneous epithelialization. Around the world, a wide variety of substances are used to treat these wounds, from honey to synthetic biological dressings. Objective This study intended to determine honey's therapeutic potential compared with 1% silver sulfadiazine (Ag-SD) in arsenal-caused contusion medicament fulfillment. Methods A total of 70 cases were evaluated in this research work after fulfilling the required selection criteria during the study period of January 2014 to December 2014 and January 2017 to December 2017. Purposiveselection criteria were adopted in the studyto select research patients. The patients in Group-1 (n = 35) relied on honey as medication, while patients in Group-2 (n = 35) relied on 1% Ag-SD. Results In Group-1, exudation(68.4%) and sloughing(82.9%) were substantially reduced by Days3 and 5 of therapeutic intervention, respectively. However, in Group-2, a reduction of exudation(17.1%) and sloughing(22.9%) occurred after Days 3 and 5 of treatment, respectively. Completion of the epithelialization process was observed among Group-1 and Group-2 cases. It was detected after Days 7 and 10 of treatment at 36.3% and 77% (Group-1) and 27% and 67% (Group-2), respectively. Around 3 ml of 1% honey was required per body surface area per dressing in Group-1. On the other hand, in Group-2, 2 gm Ag-SD was needed per body surface area per dressing. Conclusion Patients treated with honey found better clinical outcomes in managing superficial partial-thickness burns.

Burns and donor site treatment using allogeneic type I collagen

Introduction. The search for methods to reduce the time of treatment of burns and wounds of the donor sites currently remains relevant.Aim. Objective of this retrospective study was to evaluate the effectiveness of local treatment of II–IIIA degree burns and donor site wounds with dressings based on allogeneic type I collagen.Material and methods. The study included 434 patients hospitalized in 2018–2021. Collagen dressings were used in 280 patients (234 with II–IIIA degree burns and 46 with donor site wounds); 154 patients of the comparison group received traditional treatment in accordance with the standards of care for burns. Patients did not differ statistically significantly in age and the area of burns (general, superficial, deep). Lyophilized, sterile dressings based on type I collagen (RC No. FSR 2009/06370 December 8, 2014) were manufactured in accordance with TU No. 9393-002-01967081-2008 by the Department for Tissue Preservation and Graft Manufacturing of our Institute. We compared the timing of wound epithelialization when using collagen dressings versus the conventional treatment, and the pain intensity in the donor sites as assessed by the visual analogue scale for pain.Results. The terms of complete epithelialization of II–IIIA degree burn wounds made 10 (7;12) days when collagenbased dressings were used, and 18 (14;20) days without collagen, the difference being statistically significant (p<0.001). Epithelialization of the donor site wounds took 9 (8;10) days with using collagen dressings, and 11 (10;12) days with conventional treatment (p<0.001). The visual analogue scale assessed pain intensity in the donor site wounds after collagen application was statistically significantly lower on days 1, 4, and 7 than in patients on conventional treatment (p<0.001, p<0.001, p=0.003, respectively).Conclusion. The use of dressings based on type I allogeneic collagen for the treatment of superficial burns and the donor sites reduces the time of re-epithelialization, decreases the pain intensity in the donor site wounds, which proves the greater efficacy of this treatment method.

Case Series of Ocular Injury with Firecracker During Diwali in North India

Objectives:- The primary aim of this case series is to evaluate and report the patients presenting at a tertiary care hospital with an ocular injury sustained due to firecrackers during the occasion of the Diwali festival and to report the pattern and severity of firecrackers associated ocular injury and to what extent this affects the visual acuity of these patients.
 Methods:- This study is a tertiary care teaching hospital-based prospective study that includes 14 eyes of 12 patients who suffered firecracker-associated ocular injuries. All of them were presented to the hospital’s emergency department within one week after the Diwali festival. A detailed history of all the patients was taken and their ocular examination was done. Out of 12 patients, 7 were admitted for further surgical management, and one patient who sustained a superficial facial burn, including periorbital area, without any eye injury was admitted to the department of plastic surgery 4 patients were given conservative treatment. The injuries were classified according to the ocular trauma scoring system (OTSS).
 Results:- Out of the 12 patients presented, all were males, all of age group 6 years to 42 years (mean age group 18 years). Eight of them sustained injuries from explosive firecrackers and four sustained injuries from bottle rockets. Six of them were involved in igniting firecrackers, while 5 patients were either bystanders or passersby. Out of 11 patients, the right eye (RE) was involved in 6, the Left eye (LE) was involved in 4 and both eyes (BE) were engaged in 1 patient. Out of 12 eyes, six eyes had open globe perforating injuries involving cornea or cornea and sclera both, two eyes had mild conjunctival congestion and superficial burn over the periorbital region, one eye had conjunctival injury and one eye had a vitreous hemorrhage, one eye had traumatic retinal detachment, one eye had optic nerve avulsion. The maximum number of affected eyes falls under OTSS score II, indicating poor prognosis regarding visual acuity.
 Conclusion:- Firecrackers may cause injuries in one or both eyes which may be grievous in nature resulting in an irreversible loss of vision in either or both eyes. Hence, it is a matter of serious concern. Directives should be formulated to register the ocular injury presented to the hospitals. The public should be educated regarding the safe handling of firecrackers. Firecracker manufacturing companies should be instructed to manufacture less explosive and safer firecrackers.

The results of bacterial contamination of dangerous and borderline cases of burns

The aim is to study the microbiological picture of purulent inflammation of superficial local burns in the center of thermal lesions of Samara.Material and methods. The etiological structure of local burn infection was analyzed in 29 patients with limited, borderline burns of I-II degree in all phases of the wound process. The collection of wound material was carried out in accordance with the requirements of the Methodological Guidelines of MU 4.2.2039-05 "Technique of collecting and transporting biomaterials to microbiological laboratories". The material was delivered to the laboratory in test tubes with a transport medium under isothermal conditions at a temperature of 20–22 °C within a day after collection.Results. The analysis of the etiological structure of burn infection showed that staphylococcus (St. aureus, St. warneri, St. gallinarium, St. spp, St. epidermidis) plays a leading role in microbiological examination – in 26 patients (89.6 %) and E. coli (E. coli) in 11 (37.9 %). There were no significant differences in the studied signs in the comparison groups (p > 0.05, p = 0.55, χ2 = 3.841).Conclusion. The obtained results of the etiological structure of purulent inflammation of limited burns are statistically reliable and can be used in the development of antibacterial agents for the treatment of burn infection.

A case of bowel perforation secondary to burn conversion

Burn conversion is a process by which superficial partial-thickness burns spontaneously progress into deep partialthickness or full-thickness wounds. Factors that influence this process centre around poor perfusion which can be related to either too much or too little fluid resuscitation, infection, free radical damage, and metabolic or nutritional derangements. Therein lies the role of preventative strategies, i.e., adequate fluid resuscitation, prompt identification and management of sepsis, correction of electrolyte derangements and early institution of feeds. Prevention of burn conversion could prevent the need for surgical intervention and improve the morbidity and mortality of burns patients.

Fish skin as a biological dressing for burn injuries

Background: Recently, biological dressings have become popular in treating burn injuries. Fish skin has non-infectious microbiota, high levels of type 1 and type 3 collagen, and a structural property similar to human skin, making it a promising xenograft for managing burn wounds. In this study, we aimed to evaluate the effectiveness of fish skin as a physiological dressing cover in patients with burn injuries. Method: From June 2017 to June 2021, 18 patients who were admitted to our center within 3 days from a thermal injury, burns with a partial thickness of approximately 20% of the total body surface area (TBSA) or complete partial-thickness burns ranging from 5% to 15% of the TBSA, and treated with the Shaour (Lethrinus lentjan) fish skin xenografts were enrolled in this retrospective study. The demographic characteristics of the participants, wound healing process, and final outcome were analyzed. Results: The mean age of the patients was 31.86 ± 9.14 years (range 19–46) which encompassed 12 (66.7%) men and 6 (33.3%) women. Superficial partial-thickness burns were seen in 13 (72.2%) patients, whereas full-thickness burns were seen in five (27.8%) patients. The mean time to 90% epithelialization and 100% epithelialization were 11.05 ± 2.57 days and 17.27 ± 2.05 days, respectively. The mean pain scores were 6.94 ± 0.72 and 5.22 ± 0.64 on days 7 and 15, respectively. Neither negative consequence nor allergic reaction was associated with using the fish skin grafts. The main reduction in the pain score from the first visit (7 days) to the second visit (15 days) was 1.72 ± 0.95 (p < 0.001). Conclusion: Acellular fish skin is a useful tool for wound healing treatment in complete and partial thickness burns. To validate this result, prospective cohort studies with long-term post-procedural follow-up are needed.

Concordance between coding sources of burn size and depth across Australian and New Zealand specialist burn services.

The percentage of total body surface area (%TBSA) burned and burn depth provide valuable information on burn injury severity. This study investigated the concordance between The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM) codes and expert burn clinicians in assessing burn injury severity. We conducted a retrospective population-based review of all patients who sustained a burn injury between July 1, 2009, and June 30, 2019, requiring admission into a specialist burn service across Australia and New Zealand. The %TBSA burned (including the percentage of full thickness burns) recorded by expert burn clinicians within the Burns Registry of Australia and New Zealand (BRANZ) were compared to ICD-10-AM coding. 20,642 cases (71.5%) with ICD-10-AM code data were recorded. Overall, kappa scores (95% confidence interval [CI]) for burn size ranged from 0.64 (95% CI 0.63-0.66) to 0.86 (95% CI 0.78-0.94) indicating substantial to almost perfect agreement across all %TBSA groups. When stratified by depth, the lowest agreement was observed for < 10% TBSA and < 10% full thickness (kappa 0.03; 95% CI 0.02-0.04) and the highest agreement was observed for burns of ≥ 90% TBSA and ≥ 90% full thickness (kappa 0.72; 95% CI 0.58-0.85). Overall, there was substantial agreement between the BRANZ and ICD-10-AM coded data for %TBSA classification. When %TBSA classification was stratified by burn depth, greater agreement was observed for larger and deeper burns compared with smaller and superficial burns. Greater consistency in the classification of burns is needed.

Practical Approach to Minor Burns

Most mild burns may be treated well in an outpatient environment and recover with little intervention. An precise categorization of burns is essential to ensuring effective treatment. Any non-superficial burn should be treated with a topical antibiotic to avoid infection. Although partial and full-thickness burns frequently require dressings, superficial burns typically do not. Especially in an emergency situation, a simple gauze patch offers enough burn protection. Increasing burn depth and contracture, monitoring for symptoms of infection, and providing appropriate analgesia are all parts of follow-up treatment. All suspected partial or full-thickness burn infections require prompt treatment, which may include hospitalization and parenteral antibiotics. Burn infections can increase the depth and breadth of a burn, turning a superficial partial-thickness burn into a deep partial-thickness or full-thickness burn in addition to producing sepsis.

Management of Facial Second-Degree Burns with Nanocellulose-Based Dressing: A Case Series and Systematic Review.

Previous studies have evaluated the effectiveness of bacterial nanocellulose (BNC) for the treatment of thermal injuries, but the synergic effect of platelet-rich plasma (PRP) with BNC-based dressing for burns still requires further investigation. Herein, we evaluated the effectiveness of BNC dressings in the management of facial burns using PRP. Patients with second-degree facial burns were treated with BNC-based wound dressings after debridement. The burn's depth and epithelialization were evaluated by clinical assessment. Besides using the dressings, we injected PRP subcutaneously into the left-hemifacial burns. The right hemiface was only treated with the dressings. Scar quality was assessed using the Patient and Observer Scar Assessment Scale (POSAS). Eight patients were included with superficial second-degree burns in 75% of the cases and deep second-degree burns in 25%. Overall, dressings were placed 3.25 days after the initial insult. None of the patients presented with complications after dressing placement. Dressing changes were not required, and no further surgical management was necessary. The mean time for epithelialization was 11.4 days. During subgroup analysis, we did not find a significant difference in the epithelialization time when comparing BNC-based dressings (11.8 days) to BNC-based dressings + PRP (11 days, p = 0.429). The mean POSAS scores from a patient (17 vs. 12.3, p = 0.242) and surgeon (13.5 vs. 11.3, p = 0.26) standpoint were not significantly different using BNC-based dressings versus BNC-based dressings + PRP. Nanocellulose-based dressings are effective to treat second-degree facial burns. It enhances reepithelialization with optimal esthetic outcomes with or without PRP.

Acute Microcirculatory Effects of Remote Ischemic Conditioning in Superficial Partial Thickness Burn Wounds.

Microcirculation is a critical factor in burn wound healing. Remote ischemic conditioning (RIC) has been shown to improve microcirculation in healthy skin and demonstrated ischemic protective effects on heart, kidney, and liver cells. Therefore, we examined microcirculatory effects of RIC in partial thickness burn wounds. The hypothesis of this study is that RIC improves cutaneous microcirculation in partial thickness burn wounds. Twenty patients with partial thickness burn wounds within 48 hours after trauma were included in this study. RIC was performed with an upper arm blood pressure cuff on a healthy upper arm using three ischemia cycles (5 min inflation to 200 mm Hg) followed by 10-minute reperfusion phases. The third and final reperfusion phase lasted 20 minutes. Microcirculation of the remote (lower/upper extremities or torso) burn wound was continuously quantified, using a combined Laser Doppler and white light spectrometry. The capillary blood flow in the burn wounds increased by a maximum of 9.6% after RIC (percentage change from baseline; P < .01). Relative hemoglobin was increased by a maximum of 2.8% (vs. baseline; P < .01), while cutaneous tissue oxygen saturation remained constant (P > .05). RIC improves microcirculation in partial thickness burn wounds by improving blood flow and elevating relative hemoglobin.

Ocular-periocular burns in a tertiary hospital: Epidemiologic characteristics

Ocular burns are ophthalmic emergencies that can cause devastating injuries. This study aimed to analyze the epidemiology, complications, and management of ocular-periocular burns. A total of 193 patients with ocular-periocular burns were admitted to our tertiary hospital from January 2018 to December 2020. The demographic characteristics of the patients, injury variables, complications, and treatments were evaluated. There were 142 male (73.6%) and 51 female (26.4%) patients with a mean age of 32.53±17.75 years. The average total body surface area was 12% (range, 1-80%). Injuries were most common at work (52.3%) and home (36.3%). Thermal burns were the most common injuries (74.6%), followed by chemical (14.5%) and electrical burns (10.9%). Alkaline agents (75.0%), mainly sodium hydroxide and lime, were common in chemical burns. Superficial lid burns were significantly higher in the thermal group (p<0.001), and grade III-IV corneal burns were significantly higher in the chemical group (p<0.001). Various complications were developed in 50 (13%) eyes. Medical treatment only was performed in 318 (82.4%) eyes, and additional surgical treatment was performed in 64 (17.6%) eyes; however, 54 (14.0%) underwent more than one surgery. The most common complications were corneal scars (7.3%), limbal deficiency (4.1%), and ectropion (3.9%). The most frequent procedures performed were amniotic membrane transplantation (AMT) (11.9%) and tarsorrhaphy (6.7%). Chemical burns, limbal and conjunctival ischemia, and full-thickness eyelid defects had a poor prognosis. The degree of limbal deficiency and ınjury of intraocular structures were found to have a great influence on the outcome of their visual acuity.

Radiofrequency in arthroscopic shoulder surgery: a systematic review.

Radiofrequency has seen an increase in use in orthopedics including cartilage lesion debridement in the hip and knee as well as many applications in arthroscopic shoulder surgery. The purpose of this systematic review is to evaluate the safety and usage of radiofrequency in the shoulder. This systematic review was registered with PROSPERO (international registry) and followed the preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) guidelines. Embase and PubMed were searched using: "shoulder," "rotator cuff," "biceps," "acromion" AND "monopolar," "bipolar," "ablation," "coblation," and "radiofrequency ablation." The title and abstract review were performed independently. Any discrepancies were addressed through open discussion. A total of 63 studies were included. Radiofrequency is currently utilized in impingement syndrome, fracture fixation, instability, nerve injury, adhesive capsulitis, postoperative stiffness, and rotator cuff disease. Adverse events, namely superficial burns, are limited to case reports and case series, with higher-level evidence demonstrating safe use when used below the temperature threshold. Bipolar radiofrequency may decrease operative time and decrease the cost per case. Shoulder radiofrequency has a wide scope of application in various shoulder pathologies. Shoulder radiofrequency is safe; however, requires practitioners to be cognizant of the potential for thermal burn injuries. Bipolar radiofrequency may represent a more efficacious and economic treatment modality. Safety precautions have been executed by institutions to cut down patient complications from shoulder radiofrequency. Future research is required to determine what measures can be taken to further minimize the risk of thermal burns.

LOCAL TREATMENT OF BURN WOUNDS WITH THE USE OF PROBIOTICS

Summary. Introduction. Burn injury remains one of the serious problems of clinical medicine. For successful spontaneous epithelization of surface burns in the prescribed time frame, it is necessary to create favorable conditions to reduce bacterial insemination and limit additional traumatization of dermal burns.&#x0D; Goal. Evaluation of the clinical effectiveness of Arederma spray with probiotics for the local treatment of superficial burns.&#x0D; Materials and methods. The results of complex local treatment of 26 patients with superficial burns are presented. Patients were divided into 2 clinical groups. The main group consisted of 14 patients who, before standard local treatment, underwent additional treatment of burn surfaces with a spray with probiotics. The comparison group consisted of 12 victims who underwent standard local therapy of burn surfaces. In patients of the main group, the burn area on average was (6.4 ± 1.8) % of body surface, in patients of the comparison group (5.9 ± 1.3) % of body surface. The effectiveness of the treatment was carried out on the basis of a microbiological study with the study of the wound process using cytological studies and visual assessment.&#x0D; Results and discussion. The obtained results testify to the effectiveness of the local application of probiotics in the complex treatment of superficial burns due to the reduction of infection of the burn surface and the positive effect of the drug on epithelization processes, which made it possible to shorten the terms of inpatient treatment of burned patients.&#x0D; Conclusions. The combined complex application of a neutral wound dressing and a spray containing probiotics optimizes the inflammatory process, reduces the infection of the burn surface with pathogenic microflora, which ensures epithelization of superficial burns in the prescribed time. The use of Arederma spray helped reduce the bacterial load on the burn surface at all stages of complex local treatment.

The Efficacy of Honey Compared to Silver Sulfadiazine for Burn Wound Dressing in Superficial and Partial Thickness Burns—A Systematic Review and Meta-Analysis

Burn dressings play a vital role in protecting the patient from infection and aiding in the wound healing process. At present, the best burn wound dressing remains unknown. This study aimed to assess the efficacy of honey versus silver sulfadiazine dressing (SSD) for the treatment of superficial and partial thickness burns. We performed a systematic review and meta-analysis using the PubMed, MEDLINE and Embase databases to find relevant randomised control trials (RCTs) for inclusion. The outcomes measures included complete burn wound healing time, the proportion of wounds rendered sterile and subjective pain relief associated with the respective dressing type. This review was completed in line with PRISMA guidelines and has been registered with PROSPERO (Study ID: CRD42022337433). All studies in the English language that assessed honey versus SSD for patients with superficial or partial thickness burns were included. Quality and risk of bias assessments were performed using the Cochrane RoB2 tool. Seven studies were identified: totalling a population of 582 patients. From three studies, meta-analysis showed no significant difference in complete wound healing time (p = 0.06). Meta-analysis from five studies highlighted an overall significant difference favouring honey dressing in the proportion of wounds rendered sterile at day 7 post-injury (OR 10.80; 95% CI [5.76, 20.26]; p &lt; 0.00001; I2 = 88%). We conclude that honey dressings may be as or more effective than SSD in the treatment of superficial and partial thickness burn injuries. However, due to the low quality of available studies in this field, further research is necessary to establish the optimum burn dressing. Ideally, this should be conducted in the form of prospective three-arm RCTs in accordance with the CONSORT statement.

Effectiveness of four topical treatment methods in a rat model of superficial partial-thickness burn injury: the advantages of combining zinc-hyaluronan gel with silver foam dressing

BackgroundThere are several options available for conservative treatment of partial-thickness burns, however, reliable, affordable, and easily obtainable animal testing models are hard to find for the comparison of the different treatment methods. We aimed at developing a preclinical testing model and at comparing four treatment methods for superficial partial-thickness burns. MethodsBurn injury was induced in 90 adult male Wistar rats by placing the 130°C hot tip of a commercially obtainable soldering device for 30 s on the clipped skin of the interscapular region at a steady pressure. Skin histology was studied on days 5, 10, and 22 after the induction of the burn injury, on which days, respectively, the ratio of the not epithelialized wound (%), the extent of re-epithelialization (score), and the scar thickness (µm) were assessed. We compared 4 groups: silver-sulfadiazine cream, zinc-hyaluronan gel, silver foam dressing, and the combination of zinc-hyaluronan gel with a silver foam dressing. ResultsOn day 5, the induction of superficial partial-thickness burn injury was confirmed histologically in the rats. The zinc-hyaluronan gel and the combination treatment resulted in a markedly smaller ratio of the non-epithelialized area (29 ± 10% and 28 ± 13%, respectively) than silver-sulfadiazine cream (69 ± 4%; p < 0.01). On day 10, the extent of re-epithelialization was the lowest (∼0.2) in the silver-sulfadiazine cream group, while the other 3 treatments performed significantly better. The combination treatment lead to the maximal score of 2 in all rats, which was higher than in the other 3 treatment groups. On day 22, the scar thickness was the smallest in the combination treatment group (560 ± 42 µm), which was significantly less than in the silver-sulfadiazine cream group (712 ± 38 µm; p < 0.05). ConclusionsWe designed and histologically confirmed a reproducible method for induction of superficial partial-thickness burns in rats for preclinical testing. In our model, the combination of zinc-hyaluronan gel with silver foam dressing was more effective than either of its components alone or than silver-sulfadiazine cream.

Establishment of a Bama miniature pig burn model with different burn depths.

The skin morphological characteristics of the Bama miniature pig are very similar to those of humans; thus, the Bama miniature pig is an ideal choice for establishing a skin burn model. In this study, 6 ordinary, male, Bama miniature pigs (weight: 23-28 kg and length: 71-75 cm) were used to establish burn models. A mixture of 1 mg of Ketamine and Sumianxin II was used for Bama miniature pigs anesthetizing, and 1 mg of Pentobarbital sodium was added as necessary. The different burn depths were made using a continuous pressure of 1 kg and contact times of 0 s, 10 s, 15 s, 20 s, 25 s, 30 s, 35 s, 40 s, and 45 s by the newly invented electronic burn instrument. The burned tissues were collected and examined with hematoxylin and eosin (H&E) and Masson staining. Burning for 10-15 s caused a first-degree burn; the blood vessels in the superficial dermis were dilated and congested, and necrosis occurred above the basal layer of the epidermis. Burning for 20-25 s caused a superficial partial-thickness burn; the whole epidermal layer was necrotic, and the collagen fibers were slightly deformed. Burning for 30-35 s caused a deep partial-thickness burn; the whole epidermal layer and dermal layers were necrotic with leukocyte infiltration zones, and the collagen fibers were disordered, degenerated, and necrotized. Burning for 40-45 s caused a third-degree burn; the skin layers and adipose tissues were necrotic, and the thick blood vessels in the skin adipose tissues were full of disintegrated and agglutinated red blood cells. Stable burn depth models of Bama miniature pigs were constructed using a new and innovative electronic burn instrument. Our findings provide a basis for further research on the burn mechanism and evaluations of therapeutic drugs.