Superficial Degree Research Articles

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

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

Glosa do wyroku Trybunału Konstytucyjnego z 16 grudnia 2020 r., SK 26/16 (wyłączenie zatarcia skazania w przypadku przestępstw seksualnych na szkodę małoletnich)

The commented judgment of the Constitutional Tribunal recognises that the complete and lifelong exclusion of expungement of a criminal convicted for so-called paedophilia crimes is consistent with the principle of humanitarianism, the right to privacy, the right to personal freedom and the freedom to choose an occupation. In the author’s opinion, the judgment of the Constitutional Tribunal deserves criticism. The Tribunal refers only to the superficial degree to the constitutional problem presented to it, which in fact has been reduced to a simple conflict between “the rights of a criminal” and the abstractly understood “best interest of a child”. The reasonings lack any considerations as to whether the examined solution is effective in practice, i.e. whether it actually contributes to the protection of children against sexual offenders. The judgment of the Constitutional Tribunal illustrates the loosening of the standard for assessing the admissibility of restrictions on civil rights and freedoms, in which the overriding goal (in this case, “the child’s best interest”) plays a central role, while the fact whether a given solution is at least useful or necessary or proportionate is less significant.

Burn Hypertrophic Scar Profile Based on POSAS Score at Prof. Dr. R. D. Kandou Hospital Manado

Burn injury is skin damage due to extreme temperature resulting in hypertrophic scar if impaired of wound healing occurs that can impact on the quality of life. Evaluation of hypertrophic scar objectively and subjectively including scar quality and quality of life patient could performed with POSAS score. This study aimed to evaluate burn hypertrophic scar profile based on POSAS core at Prof. Dr. R. D. Kandou Hospital Manado. This was a retrospective study using medical records of burn patients from 2018 to 2020 at Prof. Dr. R. D. Kandou Hospital. The results obtained 64 samples. Most of the patients were male (75.0%). The most dominant age of patients was over the age of 21 years (79.7%). The most frequent cause of burns was exposure to hot water (71.9%) followed by fire (21.9%). The undergraduate education level was the most affected by burns (79.7%). The type of work most affected was the professional group (62.5%) followed by housewives (18.8%). Most of the wounds were superficial-middermal degree (71%) followed by superficial degree (15,6%) and deep dermal full thickness (12,5%). Assessment of hypertrophic scars using the POSAS score showed almost the same results between observers and patients. In conclusion, hypertrophic scar evaluation with POSAS score is very useful because it can evaluate the scar quality and the quality of life. POSAS score evaluation is depended on wound treatment, duration of wound healing, grading and wound burn area, and length of stay. Keywords: hypertrophic scar; POSAS score; quality of life

Epidemiology of Burn Injury in the Southern Border Provinces of Thailand

Objective: This study aimed to investigate burns, from any situation, and the treatment in the Burn Center of Yala Hospital. Material and Methods: This research was a retrospective study in the Burn Center of Yala Hospital; from April 1, 2019 to May 31, 2021. Results: Enrollment consisted of 161 burn patients (male 65.8%, female 34.2%). Most burns in children were scalds (67.3%); whereas, in adults and the elderly they were flame burns (51.0% in adults and 66.7% in the elderly) (p-value<0.001), which were usually <20% of total body surface area (p-value<0.001). Most burns were superficial second degree burns. Patients in all age groups required surgical intervention (p-value=0.003). The median length of hospital stay was approximately seven days (IQR4-17); however, the elderly required intensive care more often than other age groups (p-value=0.003). All enrolled cases survived. Conclusion: The most common cause of burns in adults and the elderly was burning from flames, while burns from scalds occurred most in children. Burns in the elderly were more severe, and required admission to the intensive care unit more than any other age group.

92 Burn Injury Assessment Study: How Good Are We at Assessing Burn Injury?

92 Burn Injury Assessment Study: How Good Are We at Assessing Burn Injury?

Gauge Symmetries and Renormalization

We study the perturbative renormalization of quantum gauge theories in the Hopf algebra setup of Connes and Kreimer. It was shown by van Suijlekom (Commun Math Phys 276:773–798, 2007) that the quantum counterparts of gauge symmetries—the so-called Ward–Takahashi and Slavnov–Taylor identities—correspond to Hopf ideals in the respective renormalization Hopf algebra. We generalize this correspondence to super- and non-renormalizable Quantum Field Theories, extend it to theories with multiple coupling constants and add a discussion on transversality. In particular, this allows us to apply our results to (effective) Quantum General Relativity, possibly coupled to matter from the Standard Model, as was suggested by Kreimer (Ann Phys 323:49–60, 2008). To this end, we introduce different gradings on the renormalization Hopf algebra and study combinatorial properties of the superficial degree of divergence. Then we generalize known coproduct and antipode identities to the super- and non-renormalizable cases and to theories with multiple vertex residues. Building upon our main result, we provide criteria for the compatibility of these Hopf ideals with the corresponding renormalized Feynman rules. A direct consequence of our findings is the well-definedness of the Corolla polynomial for Quantum Yang–Mills theory without reference to a particular renormalization scheme.

Adverse Events of Electronic Moxibustion Treatment for Knee Osteoarthritis: Case Reports and a Literature Review

Background: Electronic moxibustion has the advantage of temperature control and maintenance, and overcomes the limitations of the existing moxibustion process without the use of the combustion process. However, as the application of electronic moxibustion in clinical practice has increased, safety issues are emerging.Methods: Clinical cases of electronic moxibustion treatment for knee osteoarthritis where burns occurred were collected. In addition, adverse events reported in clinical studies using electronic moxibustion for patients with knee osteoarthritis were collected from studies retrieved from Korean and international databases.Results: There were 3 cases of superficial 2nd degree burns retrospectively collected through chart reviews. Among the selected 5 studies for literature review, 2 studies reported adverse events which were burns milder than those reported in these 3 cases in this retrospective case review.Conclusion: Since the risk of superficial 2nd degree burn was discovered in the cases reviewed, further research on safe electronic moxibustion treatment is required without compromising the effectiveness of moxibustion.

Effectiveness of green tea cream in comparison with silver sulfadiazine cream in the treatment of second degree burn in human subjects

BackgroundThe objective of the present clinical study was to compare the efficacy of green tea (GT) extract cream with 1% silver sulfadiazine (SSD) cream in the treatment of superficial second degree burns in human subjects. MethodsTwo-step hot water procedure was used for extraction. The antibacterial potency of the GT extract was compared with standard antibiotics against three common burn wounds bacteria. In addition, GT cream was subjected to a preservative challenge test. Using the 13 scoring items proposed by the Bates-Jensen wound assessment tool, the effectiveness of the cream was compared with SSD cream on 50 patients with second degree burns with a 14-day follow up. ResultsGT extract showed a wide range of in vitro antibacterial activity which was comparable with imipenem, gentamicin and more potent than vancomycin. In addition, it successfully passed the challenge test. Both treatment groups showed no significant differences, either in the rate of healing, or in other allocated healing parameters. However, epithelialisation, granulation tissue, oedema and exudate types showed a non-significant better profile of healing. In conclusion, these results suggest that GT extract is a promising novel agent in the treatment of 2nd degree superficial burns in human subjects. Further studies on its effectiveness in the treatment of deep second degree burn wounds are recommended.

Comparison of the outcome of amnion versus conventional (Vaseline-impregnated gauze) dressing in superficial partial thickness burn patients in terms of healing time and mean pain.

Objectives: To compare the healing time and mean pain score of Amnion versus Conventional (Vaseline-impregnated gauze) dressing in superficial partial thickness burn patients. Study Design: Randomized controlled study. Settings: Plastic & Reconstructive Surgery Department, Jinnah Hospital & Burn Center, Lahore. Period: January 2018 to January 2019. Material & Methods: A total of 60 patients with superficial second degree burns full filling the inclusion criteria were recruited for the study. Subjects were divided into two groups randomly. All patients were followed up regularly and dressing was changed on alternate days in Group B (Vaseline-impregnated gauze) and only secondary dressing was changed in Group A (amnion) until the auto sloughage (self-removal) of amnion. Outcome variables i.e. pain during first dressing change and healing time were noted. Statistical analysis of data was done using SPSS version 22. Quantitative variables i.e. age, duration of burn, total body surface area, pain during dressing and healing time were presented as mean and standard deviation. Frequency and percentage was calculated for qualitative variables like gender. The pain during dressing change and healing time of both groups were compared for difference. Student’t’ test was applied to compare the outcome and p-value ≤0.05 was considered as significant. Results: Out of sixty cases, 18 (30.0%) were females and 42 (70.0%) were males, with female to male ratio of 1:2.3. Mean age of patients in group A was 33.0 ± 10.19 years and in group B was 33.73 ± 9.55 years. The mean pain score in group A (amnion group) was 1.93 ± 0.91 and in group B (Vaseline-impregnated gauze) was 3.33 ± 1.56 with p-value of 0.0001. The mean healing time in group A (amnion group) was 15.73 ± 2.79 days and in group B (Vaseline-impregnated gauze) was 22.80 ± 4.44 days with p-value of 0.0001. Conclusion: Amnion dressing in superficial partial thickness burn patients is more effective in terms of mean pain score and healing time as compared to conventional (Vaseline-impregnated gauze) dressing.

Use of 816 Consecutive Burn Wound Biopsies to Inform a Histologic Algorithm for Burn Depth Categorization

Burn experts are only 77% accurate when subjectively assessing burn depth, leaving almost a quarter of patients to undergo unnecessary surgery or conversely suffer a delay in treatment. To aid clinicians in burn depth assessment (BDA), new technologies are being studied with machine learning algorithms calibrated to histologic standards. Our group has iteratively created a theoretical burn biopsy algorithm (BBA) based on histologic analysis, and subsequently informed it with the largest burn wound biopsy repository in the literature. Here, we sought to report that process. This was an IRB-approved, prospective, multicenter study. A BBA was created a priori and refined in an iterative manner. Patients with burn wounds assessed by burn experts as requiring excision and autograft underwent 4 mm biopsies procured every 25 cm2. Serial still photos were obtained at enrollment and at excision intraoperatively. Burn biopsies were histologically assessed for presence/absence of epidermis, papillary dermis, reticular dermis, and proportion of necrotic adnexal structures by a dermatopathologist using H&E with whole slide scanning. First degree and superficial second degree were considered to be burn wounds likely to have healed without surgery, while deep second- and third-degree burns were considered unlikely to heal by 21 days. Biopsy pathology results were correlated with still photos by five burn experts for consensus of final burn depth diagnosis. Sixty-six subjects were enrolled with 117 wounds and 816 biopsies. The BBA was used to categorize subjects' wounds into four categories: 7% of burns were categorized as first degree, 13% as superficial second degree, 43% as deep second degree, and 37% as third degree. Therefore, 20% of burn wounds were incorrectly judged as needing excision and grafting by the clinical team as per the BBA. As H&E is unable to assess the viability of papillary and reticular dermis, with time our team came to appreciate the greater importance of adnexal structure necrosis over dermal appearance in assessing healing potential. Our study demonstrates that a BBA with objective histologic criteria can be used to categorize BDA with clinical misclassification rates consistent with past literature. This study serves as the largest analysis of burn biopsies by modern day burn experts and the first to define histologic parameters for BDA.

136 Use of 816 Consecutive Burn Wound Biopsies to Inform a Histologic Algorithm for Burn Depth Diagnosis

Abstract Introduction Burn experts are only 77% accurate when subjectively assessing burn depth, leaving almost a quarter of patients to undergo unnecessary surgery or conversely suffer a delay in treatment. To aid clinicians in burn depth assessment (BDA), new technologies are being studied with machine learning algorithms calibrated to histologic standards. Our group has iteratively created a theoretical burn biopsy algorithm (BBA) based on histologic analysis, and subsequently informed it with the largest burn wound biopsy repository in the literature. Here, we sought to report that process. Methods This was an IRB-approved, prospective, multicenter study. A BBA was created a priori and refined in an iterative manner, resulting in the current state of the algorithm seen in Figure 1. Patients with burn wounds assessed by burn experts as requiring excision and autograft underwent 4mm biopsies procured every 25cm2. Serial still photos were obtained at enrollment and at excision intraoperatively. Burn biopsies were histologically assessed for presence/absence of epidermis, papillary dermis, reticular dermis, and proportion of necrotic adnexal structures by a dermatopathologist using H&E with whole slide scanning. First degree and superficial 2nd degree were considered to be burn wounds likely to have healed without surgery, while deep 2nd and 3rd degree burns were considered unlikely to heal by 21 days. Biopsy histopathology results were correlated with still photos by 3 burn experts for consensus of final burn depth diagnosis. Results Sixty-six subjects were enrolled with 117 wounds and 816 biopsies. The BBA was used to categorize 100% of subjects into 4 categories: 7% of burns were categorized as 1st degree, 13% as superficial 2nd degree, 43% as deep 2nd degree, and 37% as 3rd degree. Therefore 20% of burn wounds were incorrectly judged as needing excision and grafting by the clinical team. As H&E is unable to assess the viability of papillary and reticular dermis, with time our team came to appreciate the greater importance of adnexal structure necrosis over dermal appearance in assessing healing potential. Conclusions Our study demonstrates that a BBA with objective histologic criteria can be used to categorize BDA with clinical misclassification rates consistent with past literature. This study serves as the largest analysis of burn biopsies by modern day burn experts and the first to define histologic parameters for BDA.

Managing blisters in minor burns: Should they be deroofed?

Introduction: Management of burn blister has always been controversial. The options available are deroofing the blister, aspiration of fluid or leaving the blister intact. There is no set dressing protocol for managing blisters.Aims and objectives: To compare two treatment modalities i.e. deroofing and keeping the burn blister intact for the optimal management of minor superficial 2nd degree burns.Material and Methods: This prospective study was done on 27 patients who presented with minor superficial 2nd degree burns of upper limbs. Total of 50 blister wounds were randomly split into two categories of 25 each. One subset of blisters (Category 1) was deroofed and dressed every alternate day with silver alginate dressing. The other subset of blisters was left intact (Category 2) and dressed every alternate day. The parameters assessed and compared were pain at burn site, soakage of dressing and time to complete healingStatistical Analysis: Student t –test and Chi square (χ2) test . SPSS 21 softwareResults: The mean age of patients was 36 years. Category 1 wound patients had more pain (as assessed by Visual Analogue Scale) in comparison to Category 2 wounds. The time to wound healing was less by mean of 1.7days in Category 1 wounds compared to Category 2 wounds. Wound soakage was comparable in both subsets.Conclusion: De roofing a burn blister results in statistically significant decrease in time to wound healing and is recommended for management of minor superficial 2nd degree burns.

The renormalization structure of [formula omitted] supersymmetric higher-derivative gauge theory

We consider the harmonic superspace formulation of higher-derivative 6D,N=(1,0) supersymmetric gauge theory and its minimal coupling to a hypermultiplet. In components, the kinetic term for the gauge field in such a theory involves four space-time derivatives. The theory is quantized in the framework of the superfield background method ensuring manifest 6D,N=(1,0) supersymmetry and the classical gauge invariance of the quantum effective action. We evaluate the superficial degree of divergence and prove it to be independent of the number of loops. Using the regularization by dimensional reduction, we find possible counterterms and show that they can be removed by the coupling constant renormalization for any number of loops, while the divergences in the hypermultiplet sector are absent at all. Assuming that the deviation of the gauge-fixing term from that in the Feynman gauge is small, we explicitly calculate the divergent part of the one-loop effective action in the lowest order in this deviation. In the approximation considered, the result is independent of the gauge-fixing parameter and agrees with the earlier calculation for the theory without a hypermultiplet.

A bio-degradable synthetic membrane to treat superficial and deep second degree burn wounds in adults and children – 4 year experience

IntroductionA new bio-degradable synthetic membrane was recently introduced to treat second degree burns in adults and pediatric patients. ObjectiveTo assess complications and outcomes using this absorbable synthetic membrane to treat second degree burns. Methods229 burn patients, 138 pediatric, with superficial and deep second -degree wounds, treated with the absorbable synthetic membrane (Suprathel®, Polymedics, Denkendorf, Germany) were included in this study. Patients were treated under anesthesia or moderate sedation. The wound bed was prepared by using either rough debridement or dermabrasion excision. After hemostasis, the membrane was applied to the wound with an outer layer dressing of fatty gauze, bridal veil, absorptive gauze and an ACE® wrap. The outer dressing was removed every one to four days, depending on exudate, in order to closely follow the wound through the translucent membrane and fatty gauze layers. After complete epithelialization, the dressing separated and could be removed. The study focused on the need for subsequent grafting, healing time, patient pain level, hypertrophic scarring and rate of infection. ResultsAll wounds in this study that were treated with Suprathel® healed without grafting. The average TBSA (Total Body Surface Area) was 8.9% (1%-60%). Average time to healing was 13.7 days for ≥ 90% epithelialization with 11.9 days for pediatric patients versus 14.7 days for adults. Throughout the treatment period, the average pain level was 1.9 on a 10-point scale. 27 patients developed hypertrophic scarring in some areas (11.7%). Average Length of stay (LOS) was 6.9 days. The rate of infection was 3.8% (8/229). Failure or progression to full thickness in part of the wounds was 5.2% (12/229). ConclusionIn treating second degree burn wounds, this membrane provides a simple, effective solution alternative with good outcomes and less pain than conventional and previously studied treatment options in the same institution. Fewer dressing changes and easier overall management of the wounds contribute to its favorable profile.

Real-time Burn Classification using Ultrasound Imaging

This article presents a real-time approach for classification of burn depth based on B-mode ultrasound imaging. A grey-level co-occurrence matrix (GLCM) computed from the ultrasound images of the tissue is employed to construct the textural feature set and the classification is performed using nonlinear support vector machine and kernel Fisher discriminant analysis. A leave-one-out cross-validation is used for the independent assessment of the classifiers. The model is tested for pair-wise binary classification of four burn conditions in ex vivo porcine skin tissue: (i) 200 °F for 10 s, (ii) 200 °F for 30 s, (iii) 450 °F for 10 s, and (iv) 450 °F for 30 s. The average classification accuracy for pairwise separation is 99% with just over 30 samples in each burn group and the average multiclass classification accuracy is 93%. The results highlight that the ultrasound imaging-based burn classification approach in conjunction with the GLCM texture features provide an accurate assessment of altered tissue characteristics with relatively moderate sample sizes, which is often the case with experimental and clinical datasets. The proposed method is shown to have the potential to assist with the real-time clinical assessment of burn degrees, particularly for discriminating between superficial and deep second degree burns, which is challenging in clinical practice.

650 Exploring the Mechanism of Wound Healing in Rats of Different Ages Using a Burn Model

Abstract Introduction This study attempted to explore the mechanism of wound healing in rats of different ages using an reliable and reproducible burn model. Methods A self-made metal column, heated in a boiling water bath, was applied for different time periods to the lower back of rats of different ages in burn creation. Wounds were observed visibly at different time points post burning. Biopsies were obtained and examined at 72 h post burn to determine the depth of burns. In exploring the mechanism of wound healing in rats of different ages, we used primary antibodies including Anti-EGFR [EP38Y] (ab52894) and p75NTR (D4B3) for immunofluorescence of the skin paraffin sections (5μm) obtained from normal rats and on day 3 post burn creation. And we measured the expression of CD271 and EGFR. Results The contact durations producing the desired depth of injury in the rat model under constant temperature and pressure were: 3 seconds (deep second degree) and 5 seconds (third degree) in 1-month-old rats; 3 seconds (superficial second degree), 5 seconds (deep second degree), and 7–9 seconds (third degree) in 2-month-old rats; 3–5 seconds (superficial second degree), 7–9 seconds (deep second degree), and 11–13 seconds (third degree) in 12- and 18-month-old rats. The distribution of CD271 and epidermal stem cells showed no age-related changes (P＞0.05), and the expression of EGFR decreased with age in normal rats (P＜0.001). Compared with normal rats, the content of CD271 and epidermal stem cells and the expression of EGFR increased in burned rats. Conclusions The reliable and reproducible experimental model produces consistent burn injuries in rats of different ages. The number of CD271 and epidermal cells and the expression of EGFR increase during wound healing in rats, suggesting that CD271, epidermal cells and EGFR in epidermal stem cell membranes are associated with burn wound healing. Applicability of Research to Practice This research may be used in clinical practice in the future for better wound care.

735 Advantages of Biocellulose for Burn Injures

Abstract Introduction Facial burns are extremely important biological dressings have been developed as temporary substitutes for human skin to avoid infection and accelerate tissue repair, with comfort to the patient. The biocellulose film is produced by the bacterium Acetobacter xylinium. After dehydration process, the obtained product turns into a film. We also use the celluloses film hydrated. Aim: To show the experience of the use of a biocellulose membrane in our hospital, for facial superficial second degree burns.x’x’ Methods This study took place from January 2009 till December 2017. We selected forty five patients with facial superficial second degree burns treated with a biocellulose film since day one post burn. It remained on the face until the complete epithelialization and spontaneous detachment. We studied 45 patients (25 children and 20 adults). We evaluated the final healing time, the pain, the dressing changes and the facility of application (notes from 0 to 10). Results The evaluation note for the ease of application varied from 7 and 8 (40%) and 9 to 10 (60%). We saw spontaneous detachment of the dressing in all cases till day 10. The grade of pain varied from 0 to 2. After day 4 no one referred pain. The full epithelization occurred in 8 days in 90% of children and in 10 days in the other 10% of the children. The restoration in the adults followed t the same pattern. Conclusions The biocellulose dressing seems to be a good option for superficial facial burns. It is painless, easy to apply and has a good cost benefit relation. The authors suggest longer randomized studies. Applicability of Research to Practice New technologies that are cheape, less painfull and efective can be of a great value not only for us but for everyone who work with burn patients.

49 Indocyanine Green Angiography in the Surgical Evaluation of Partial Thickness Burn Wounds

Abstract Introduction While treatment of 1st and 3rd degree burns is fairly well understood, second-degree burns pose a challenge. This can lead to delayed treatment, or unnecessary operations, either of which can lead to scarring, contractures, infections, and poor cosmetic outcomes. While Laser Doppler Imaging has been used to differentiate second degree burns it is not reliable in studying uneven surfaces, requires long scan times, and has limited penetration. ICG angiography, which has gained wide use in breast reconstruction, can circumvent many of these issues. In this study, we used ICG angiography to investigate 2nd degree burns in an effort to develop an objective measure to differentiate deep from superficial 2nd degree burns. Methods All patients with 2nd degree burns covering greater than 1% total body surface and consented to the study were enrolled. Exclusion criteria included iodide allergy and the inability to follow up. All burns presented within 48 hours of injury. Patients were evaluated with ICG imaging on presentation and re-imaged at 24-hour intervals up to 72 hours after the initial injury and at the time of excision. The patients were managed by a blinded Burn Surgeon, with follow up pictures performed at 2 weeks, 1 month, 6 months, and 1 year. All images were analyzed using software to determine if areas with different scores ended up receiving operative or conservative treatment. Results Thus far 6 patients have enrolled in the study. All patients presented following flash burns, with BSA ranging from 10–30%. Of the 6 patients, only one required operative treatment. For the five patients treated conservatively areas of burn presented with SPY Q readings ranging from 70–110. These readings improved universally with each subsequent image, often by 10–20 each image, although one burn was found to double its perfusion by 72 hours post-injury. In contrast, the patient requiring operative intervention presented with a SPY-Q reading of 20–30. While there was a minor improvement, the maximum reading the area of resection reached was only 40–50. The patient was eventually taken to the OR for debridement and STSG. Conclusions While these preliminary results are limited due to the small sample size of our population, we feel that this study demonstrates the utility of ICG angiography in the diagnosis of second-degree burns. Our previous work on a porcine model verified that SPY can be used to measure both vertical and horizontal burn progression, and our early results in this study show a sharp difference between the patients treated conservatively, and the one patient requiring operative intervention. Applicability of Research to Practice Using these results, we plan to develop an objective cut off that will serve as a benchmark for when operative intervention is required. And with a secondary objective to evaluate the level excision.

Investigation of acute effects of topical Alpinia officinarum (galangal) treatment in experimental contact type burns and comparison with topical silver sulfadiazine treatment.

It was aimed to determine whether Alpinia officinarum (AO) (galangal), which has been regarded to be effective on wound healing, is healing on experimental contact type burns and compare its effects with silver sulfadiazine (SSD). Thirty-five rats were divided into five groups of seven rats each group. Superficial second degree burns were formed by contacting a 1×1 cm copper tip which was kept at 100°C constant temperature to the three shaved areas on the back of rats without applying any pressure for 10 s. All groups were irrigated with a 100 cc saline solution for 2 min. Any procedure or treatment was not applied to Group I (Control). Group II (Burn Control) was only irrigated, Group III (SSD) was applied topical SSD 4 times, with 6-h intervals (at h 0, 6, 12 and 18), Group IV (Galangal) was applied topical AO 4 times, and Group V (Gel) was applied placebo topical material, used for the preparation of topical AO, 4 times. Wound healing findings were evaluated histopathologically. In the galangal group, it was found that collagen discoloration didn't penetrate into deep dermis compared to other groups; epidermis, hair follicles, and sebaceous glands remained protected compared to the burn control group, and there was a thicker layer of epidermis. It was found that the galangal group was the closest group to the control group histologically. In the galangal group, it was determined that the number of vessels and total hair follicles were significantly higher in the 8th h and 4th h respectively (p<0.05), while epidermal thickness and number of degenerated hair follicles were significantly higher in all hours compared to other three groups (p<0.05). It was determined that galangal group had the lowest scores in the evaluation of edema, polymorphonuclear leukocytes infiltration, collagen discoloration, injury of vessels, hair follicles and sebaceous glands in comparisons between groups and within groups' own processes. Administrating AO containing gel 4 times a day within the first 24 h is effective in the experimental contact type second degree burn model. It is significantly superior to SSD treatment, especially in the first 8 h of administration.

Non-Propellant Foams of Green Nano-Silver and Sulfadiazine: Development and In Vivo Evaluation for Burn Wounds.

A non-propellant based foam (NPF) system was developed incorporating the antibiotics, pectin capped green nano-silver and sulfadiazine (SD) for the topical treatment of burn wounds as a convenient alternative to the existing therapies. NPF were prepared using various surfactants and oils forming a nanoemulsion. Anti-microbial studies by resazurin microtitre assay, ex vivo diffusion, in vivo skin permeation and deposition studies, and acute irritation studies were carried out. NPF was applied onto secondary thermal wounds manifested on mice models followed by macroscopic and histological examinations. NPF had an average globule size of <75nm. The viscosity was ~10cP indicating the feasibility of expulsion from the container upon actuation. With no skin irritation, the foams showed a higher skin deposition of SD. A high contraction and an evident regeneration of the skin tissue upon treatment with NPF indicated a good recovery from the thermal injury was apparent from the histology studies. NPF represents an alternative topical formulation that can be employed as a safe and effective treatment modality for superficial second degree (partial thickness) burn wounds. With a minimal requirement of mechanical force, the no-touch application of NPF makes it suitable for sensitive and irritant skin surfaces.