In burn treatments,microorganisms on pressure garments during pressure therapy can prevent rehabilitation by causing functional,hygienic,and aesthetic difficulties. As bacterium is one of the most trouble-causing orga...In burn treatments,microorganisms on pressure garments during pressure therapy can prevent rehabilitation by causing functional,hygienic,and aesthetic difficulties. As bacterium is one of the most trouble-causing organisms,they can threaten patients causing infection during the long period of use of these garments.Novel burn pressure garments having durable antimicrobial property were developed using polyhexamethylene biguanide( PHMB)antimicrobial agent procedure on highly elastic nylon 66 /spandex fabrics in powernet,flat warp and weft knitted structures using paddry-cure method. Commercial wireless pressure sensors were used to control pressures at an acceptable medical range. Antimicrobial activity,wash durability,Fourier transform infrared spectroscopy(FTIR) and Scanning electron microscopy(SEM) analyses were conducted for the treated samples. Antimicrobial test results following AATCC 100 Test Method showed 99% reduction of bacteria for the fabric samples treated with PHMB. A small but significant decrease in antimicrobial activity was observed even after50 launderings. These treatments also yield good results to prevent odor,decrease infection by preventing and /or blocking microbial growth according to the antimicrobial mechanism and support reducing of scarring by providing a hygienic environment around the scar.展开更多
Marjolin's ulcer(MU) represents malignant degeneration that typically ensues over a period of time in the post-burned lesions and scars or any other chronic wound. This review highlights various facets of the pres...Marjolin's ulcer(MU) represents malignant degeneration that typically ensues over a period of time in the post-burned lesions and scars or any other chronic wound. This review highlights various facets of the presentation and management of MUs that originate from post-burned lesions. The incidence of MUs in such lesions is reported to be 0.77%-2%. This malignancy characteristically develops in the areas of full thickness skin burns that had been allowed for weeks to months to heal spontaneously by secondary intention, or burn wounds which never healed completely over years and the unstable post-burned scars. In the majority of cases, the MU is a squamous cell carcinoma(SCC). The MUs contribute to an overall 2% of all SCCs and 0.03% of all basal cell carcinomas of the skin. Clinically MUs present in two major morphologic forms. The commoner form is the flat, indurated, ulcerative variety while the less common form is the exophytic papillary variety. Lower limbs represent the most frequently affected body parts. Surgical resection of the primary tumor with 2-4 cm horizontal clearance margin, nodal clearance and radiotherapy constitute the cornerstones of effective oncologic management. Despite best efforts, the overall mortality is reported to be 21%.展开更多
Background:Problematic scarring remains a challenging aspect to address in the treatment of burns and can significantly affect the quality of life of the burn survivor.At present,there are few treatments available in ...Background:Problematic scarring remains a challenging aspect to address in the treatment of burns and can significantly affect the quality of life of the burn survivor.At present,there are few treatments available in the clinic to control adverse scarring,but experimental pharmacological anti-scarring strategies are now beginning to emerge.Their comparative success must be based on objective measurements of scarring,yet currently the clinical assessment of scars is not carried out systematically and is mostly based on subjective review of patients.However,several techniques and devices are being introduced that allow objective analysis of the burn scar.The aim of this article is to evaluate various objective measurement tools currently available and recommend a useful panel that is suitable for use in clinical trials of anti-scarring therapies.Methods:A systematic literature search was done using the Web of Science,PubMed and Cochrane databases.The identified devices were then classified and grouped according to the parameters they measured.The tools were then compared and assessed in terms of inter-and intra-rater reproducibility,ease of use and cost.Results:After duplicates were removed,5062 articles were obtained in the search.After further screening,157 articles which utilised objective burn scar measurement systems or tools were obtained.The scar measurement devices can be broadly classified into those measuring colour,metric variables,texture,biomechanical properties and pathophysiological disturbances.Conclusions:Objective scar measurement tools allow the accurate and reproducible evaluation of scars,which is important for both clinical and scientific use.However,studies to evaluate their relative performance and merits of these tools are scarce,and there remain factors,such as itch and pain,which cannot be measured objectively.On reviewing the available evidence,a panel of devices for objective scar measurement is recommended consisting of the 3D cameras(Eykona/Lifeviz/Vectra H1)for surface area and volume,DSM I colorimeter for colour,Dermascan high-frequency ultrasound for scar thickness and Cutometer for skin elasticity and pliability.展开更多
A nine-year-old girl sustained extreme postburn contractures of the face, neck, both axillae, elbows, wrists, and ankles, due to flame injury 5 years ago. No primary and plastic surgical burn treatment was available i...A nine-year-old girl sustained extreme postburn contractures of the face, neck, both axillae, elbows, wrists, and ankles, due to flame injury 5 years ago. No primary and plastic surgical burn treatment was available in a remote area of China. From October, 2005 to April, 2007, all adhesions were released in five operations and the huge defects covered with local musculo-cutaneous flaps, z-plasties, and with thick split skin gafts. This led to an optimal functional result and an aesthetic restoration of the face, giving her, back her self-esteem in daily life.展开更多
Abnormal wound healing is likely to induce scar formation, leading to dysfunction, deformity, and psychological trauma in burn patients. Despite the advancement of medical care treatment, scar contracture in burn pati...Abnormal wound healing is likely to induce scar formation, leading to dysfunction, deformity, and psychological trauma in burn patients. Despite the advancement of medical care treatment, scar contracture in burn patients remains a challenge. Myofibroblasts play a key role in scar contracture. It has been demonstrated that myofibroblasts, as well as inflammatory cells, fibroblasts, endothelial cells, and epithelial cells, secrete transforming growth factor-β1 (TGF-β1) and other cytokines, which can promote persistent myofibroblast activation via a positive regulation loop. In addition to the cellular contribution, the microenvironments, including the mechanical tension and integrin family, are also involved in scar contracture. Most recently, eukaryotic initiation factor 6 (eIF6), an upstream regulator of TGF-β1, has been demonstrated to be involved in myofibroblast differentiation and contraction in both in vitro fibroblast-populated collagen lattice (FPCL) and in vivo external mechanical stretch models. Moreover, the data showed that P311 could induce the transdifferentiation of epidermal stem cells to myofibroblasts by upregulating TGF-β1 expression, which mediated myofibroblast contraction. In this review, we briefly described the most current progress on the biological function of myofibroblasts in scar contracture and subsequently summarized the molecular events that initiated contracture. This would help us better understand the molecular basis of scar contracture as well as to find a comprehensive strategy for preventing/managing scar contracture.展开更多
Background:Vacuum massage is a non-invasive mechanical massage technique invented to treat burns and scars.To date,no effects of vacuum massage on thickness and density of human scar tissue have been reported.The proc...Background:Vacuum massage is a non-invasive mechanical massage technique invented to treat burns and scars.To date,no effects of vacuum massage on thickness and density of human scar tissue have been reported.The process in which external stimuli are converted into biochemical responses in the cell is known as mechanotransduction.In the skin endothelial cells,fibroblasts and myofibroblasts embedded in the extracellular matrix(ECM)sense mechanical stimuli(created by vacuum massage)and may promote intracellular processes leading to matrix remodelling.Since mechanotransduction could be a plausible working mechanism for vacuum massage as an anti-scarring therapy,this study aims to investigate the short-term effects of vacuum massage on thickness and density of epidermis and dermis in burn scars in order to find proof of ECM remodelling.Methods:A one group experimental study was performed.Patients with burn scars on upper extremities,lower extremities,and trunk were recruited for participation in this study.The DUB?cutis 22 MHz ultrasound scanner was used to assess thickness and density of the epidermal and dermal skin layers.After baseline measurements,vacuum massage was performed according to a pre-defined protocol.Measurements were carried out at 5 min,30 min,1 h,and 2 h post-intervention.Results:Thirteen scar sites from 9 different patients were investigated.In 8 out of the 13 scar sites,a disruption of the epidermis was noticed after the vacuum massage.Five minutes after the intervention,epidermal density decreased statistically significantly(p=.022)and dermal thickness increased(p=.018).Both changes lasted for more than 1 h,but after 2 h,the changes were no longer statistically significant.Dermal density decreased significantly(p=.048)immediately after the intervention,and this decrease was still present after 2 h(p=.011).Conclusions:Preliminary results show that the disruption of the epidermis may indicate that vacuum massage could be able to actually breach the skin barrier.The statistically significant changes in the dermal layers could suggest an increased ECM production after vacuum massage.展开更多
Introduction: The cicatricial acceleration method (MAC®) promotes photobiological effects of an anti-inflammatory and healing nature. Its therapeutic radiation is emitted, producing photobiostimulant effects that...Introduction: The cicatricial acceleration method (MAC®) promotes photobiological effects of an anti-inflammatory and healing nature. Its therapeutic radiation is emitted, producing photobiostimulant effects that result in rapid tissue repair and better tissue quality. The treatment of burns has always been a challenge, which involves both performing surgery and controlling and guiding scar regeneration, avoiding possible morbidities. Objective: To evaluate the effects of applying the MAC methodology with an AlGa (aluminum, gallium arsenide) laser on the time and quality of tissue repair in the skin of rats after induced chemical burns. Method: 22 adult male rats were subjected to a second-degree chemical burn on the back using 50% trichloroacetic acid. After the burns, the animals were randomly separated into 2 groups: control and experimental. The control group (G1) received placebo laser therapy and the laser group (G2) underwent laser irradiation with an energy density of 100 J/cm2. Histological analysis and macroscopic evaluation were carried out by means of the paper template method. Results: Group G1 showed (53%) of the necrosis area and group G2 showed (11%) necrosis area. Conclusion: The cicatricial acceleration method (MAC®) favored the repair of wounds caused by a 2nd-degree chemical burn, optimizing time and improving quality.展开更多
Scar tissue usually generates severe discomfort in the short and long term. Common symptoms include anesthetics sequelae, pruritus, joint malfunction, new wounds on the scar surface, and pain. There are several treatm...Scar tissue usually generates severe discomfort in the short and long term. Common symptoms include anesthetics sequelae, pruritus, joint malfunction, new wounds on the scar surface, and pain. There are several treatments for scars, like compression, topical or intralesional steroid infiltration, 5-fluorouracil, dermabrasion, and surgeries with new scar tissue. For adult patients, it is easier to choose the treatment. However, compression is commonly applied in children to prevent treatments that have adverse effects. This study reports the outcomes of 15 patients submitted to abdominoplasty, traumatic wounds and post-burn scar treatments, which showed significant changes after the continuous use of an ointment composed of petrolatum, cod liver oil, BHT, Chamomilla recutita (chamomile) oil, Helianthus annuus (sunflower) oil, and Prunus amygdalus dulcis (sweet almond) oil. As components of the stratum corneum, unsaturated fatty acids influence the cutaneous structural and immune status and permeability. They also interfere with the maturation and differentiation of the stratum corneum and inhibit the production of proinflammatory eicosanoids, reactive species (ROS and RNS), and cytokines, thereby influencing the inflammatory response and possibly wound healing. This article aims to share our experience with the regular use of an ointment in adult and pediatric patients for three months. The increase in proinflammatory cytokine production at wound sites, resulting in a noninvasive, therapeutical, and effective cutaneous wound healing and scarring modulation, may provide a physiopathological explanation for the fast improvement of scars.展开更多
Burn wound healing involves a complex sequence of processes. Recent studies have revealed that skin reinnervation may have an impact on physiological wound repair. Few studies have addressed the process of reinnervati...Burn wound healing involves a complex sequence of processes. Recent studies have revealed that skin reinnervation may have an impact on physiological wound repair. Few studies have addressed the process of reinnervation and morphological changes in regenerated nerve fibers. The regeneration of neurites during full-thickness burn wound healing was determined by immunofluorescent staining using an anti-neurofilament protein monoclonal antibody, and three-dimensional morphology was observed under a laser scanning confocal microscope. Morphology and the volume fraction of collagen and nerve fibers were measured. Skin reinnervation increased during wound healing, peaked during the proliferative scar stage, and then decreased to lower levels during the maturation period. The results from the skin nerve fibers correlated with those from collagen using semi-quantitative analysis. Disintegration and fragmentation were observed frequently in samples from the proliferative stage, and seldom occurred during the maturation stage. There was a remodeling process of regenerated nerve fibers during wound healing, which comprised changed innervation density and topical morphology. The mechanism of remodeling for nerve fibers requires further investigation.展开更多
The inflammatory and fibrous responses to injuries are painful and are inhibitory to the regeneration of specialized cells. The fibrous scarring of skin injuries can also be disfiguring. Cells obtain energy not only f...The inflammatory and fibrous responses to injuries are painful and are inhibitory to the regeneration of specialized cells. The fibrous scarring of skin injuries can also be disfiguring. Cells obtain energy not only from the metabolism of food, but also via the alternative cellular energy (ACE) pathway. The ACE pathway is reflected in a dynamic (kinetic) quality of the body’s fluids. It is postulated to result from the absorption of an environmental force called KELEA (kinetic energy limiting electrostatic attraction). The body’s ACE pathway can be enhanced by the parental administration and even the oral consumption of products comprising KELEA activated water. One of these products, termed Enercel, was originally considered a complex homeopathic remedy. Another product is water containing electrolysis-generated, copper-silver-citrate (CSC) complexes. This product was initially formulated to be bacteriocidal, especially for Gram positive bacteria. This article describes the independent successful use of each of these two products in achieving essentially painless, scar-free healing of skin injuries. The skin injuries were due to a variety of causes including: vascular insufficiency from diabetes;hot water burn;penetrating object;chronic infection;and surgical incision. It is proposed that the ACE pathway increases the resilience of cells of the innate immune system to the triggering of an inflammatory reaction by “danger signals” released from damaged tissues. KELEA activated water should be widely available for the urgent therapy of burns and other traumatic injuries to the skin. ACE pathway enhancing modalities also need to be evaluated in the repair of cellular damage occurring to the heart, brain and other internal organs of the body.展开更多
基金Financial support of this research was provided by NC State University College of Textilesthe Scientific and Technological Research Council of Turkey
文摘In burn treatments,microorganisms on pressure garments during pressure therapy can prevent rehabilitation by causing functional,hygienic,and aesthetic difficulties. As bacterium is one of the most trouble-causing organisms,they can threaten patients causing infection during the long period of use of these garments.Novel burn pressure garments having durable antimicrobial property were developed using polyhexamethylene biguanide( PHMB)antimicrobial agent procedure on highly elastic nylon 66 /spandex fabrics in powernet,flat warp and weft knitted structures using paddry-cure method. Commercial wireless pressure sensors were used to control pressures at an acceptable medical range. Antimicrobial activity,wash durability,Fourier transform infrared spectroscopy(FTIR) and Scanning electron microscopy(SEM) analyses were conducted for the treated samples. Antimicrobial test results following AATCC 100 Test Method showed 99% reduction of bacteria for the fabric samples treated with PHMB. A small but significant decrease in antimicrobial activity was observed even after50 launderings. These treatments also yield good results to prevent odor,decrease infection by preventing and /or blocking microbial growth according to the antimicrobial mechanism and support reducing of scarring by providing a hygienic environment around the scar.
文摘Marjolin's ulcer(MU) represents malignant degeneration that typically ensues over a period of time in the post-burned lesions and scars or any other chronic wound. This review highlights various facets of the presentation and management of MUs that originate from post-burned lesions. The incidence of MUs in such lesions is reported to be 0.77%-2%. This malignancy characteristically develops in the areas of full thickness skin burns that had been allowed for weeks to months to heal spontaneously by secondary intention, or burn wounds which never healed completely over years and the unstable post-burned scars. In the majority of cases, the MU is a squamous cell carcinoma(SCC). The MUs contribute to an overall 2% of all SCCs and 0.03% of all basal cell carcinomas of the skin. Clinically MUs present in two major morphologic forms. The commoner form is the flat, indurated, ulcerative variety while the less common form is the exophytic papillary variety. Lower limbs represent the most frequently affected body parts. Surgical resection of the primary tumor with 2-4 cm horizontal clearance margin, nodal clearance and radiotherapy constitute the cornerstones of effective oncologic management. Despite best efforts, the overall mortality is reported to be 21%.
文摘Background:Problematic scarring remains a challenging aspect to address in the treatment of burns and can significantly affect the quality of life of the burn survivor.At present,there are few treatments available in the clinic to control adverse scarring,but experimental pharmacological anti-scarring strategies are now beginning to emerge.Their comparative success must be based on objective measurements of scarring,yet currently the clinical assessment of scars is not carried out systematically and is mostly based on subjective review of patients.However,several techniques and devices are being introduced that allow objective analysis of the burn scar.The aim of this article is to evaluate various objective measurement tools currently available and recommend a useful panel that is suitable for use in clinical trials of anti-scarring therapies.Methods:A systematic literature search was done using the Web of Science,PubMed and Cochrane databases.The identified devices were then classified and grouped according to the parameters they measured.The tools were then compared and assessed in terms of inter-and intra-rater reproducibility,ease of use and cost.Results:After duplicates were removed,5062 articles were obtained in the search.After further screening,157 articles which utilised objective burn scar measurement systems or tools were obtained.The scar measurement devices can be broadly classified into those measuring colour,metric variables,texture,biomechanical properties and pathophysiological disturbances.Conclusions:Objective scar measurement tools allow the accurate and reproducible evaluation of scars,which is important for both clinical and scientific use.However,studies to evaluate their relative performance and merits of these tools are scarce,and there remain factors,such as itch and pain,which cannot be measured objectively.On reviewing the available evidence,a panel of devices for objective scar measurement is recommended consisting of the 3D cameras(Eykona/Lifeviz/Vectra H1)for surface area and volume,DSM I colorimeter for colour,Dermascan high-frequency ultrasound for scar thickness and Cutometer for skin elasticity and pliability.
文摘A nine-year-old girl sustained extreme postburn contractures of the face, neck, both axillae, elbows, wrists, and ankles, due to flame injury 5 years ago. No primary and plastic surgical burn treatment was available in a remote area of China. From October, 2005 to April, 2007, all adhesions were released in five operations and the huge defects covered with local musculo-cutaneous flaps, z-plasties, and with thick split skin gafts. This led to an optimal functional result and an aesthetic restoration of the face, giving her, back her self-esteem in daily life.
文摘Abnormal wound healing is likely to induce scar formation, leading to dysfunction, deformity, and psychological trauma in burn patients. Despite the advancement of medical care treatment, scar contracture in burn patients remains a challenge. Myofibroblasts play a key role in scar contracture. It has been demonstrated that myofibroblasts, as well as inflammatory cells, fibroblasts, endothelial cells, and epithelial cells, secrete transforming growth factor-β1 (TGF-β1) and other cytokines, which can promote persistent myofibroblast activation via a positive regulation loop. In addition to the cellular contribution, the microenvironments, including the mechanical tension and integrin family, are also involved in scar contracture. Most recently, eukaryotic initiation factor 6 (eIF6), an upstream regulator of TGF-β1, has been demonstrated to be involved in myofibroblast differentiation and contraction in both in vitro fibroblast-populated collagen lattice (FPCL) and in vivo external mechanical stretch models. Moreover, the data showed that P311 could induce the transdifferentiation of epidermal stem cells to myofibroblasts by upregulating TGF-β1 expression, which mediated myofibroblast contraction. In this review, we briefly described the most current progress on the biological function of myofibroblasts in scar contracture and subsequently summarized the molecular events that initiated contracture. This would help us better understand the molecular basis of scar contracture as well as to find a comprehensive strategy for preventing/managing scar contracture.
文摘Background:Vacuum massage is a non-invasive mechanical massage technique invented to treat burns and scars.To date,no effects of vacuum massage on thickness and density of human scar tissue have been reported.The process in which external stimuli are converted into biochemical responses in the cell is known as mechanotransduction.In the skin endothelial cells,fibroblasts and myofibroblasts embedded in the extracellular matrix(ECM)sense mechanical stimuli(created by vacuum massage)and may promote intracellular processes leading to matrix remodelling.Since mechanotransduction could be a plausible working mechanism for vacuum massage as an anti-scarring therapy,this study aims to investigate the short-term effects of vacuum massage on thickness and density of epidermis and dermis in burn scars in order to find proof of ECM remodelling.Methods:A one group experimental study was performed.Patients with burn scars on upper extremities,lower extremities,and trunk were recruited for participation in this study.The DUB?cutis 22 MHz ultrasound scanner was used to assess thickness and density of the epidermal and dermal skin layers.After baseline measurements,vacuum massage was performed according to a pre-defined protocol.Measurements were carried out at 5 min,30 min,1 h,and 2 h post-intervention.Results:Thirteen scar sites from 9 different patients were investigated.In 8 out of the 13 scar sites,a disruption of the epidermis was noticed after the vacuum massage.Five minutes after the intervention,epidermal density decreased statistically significantly(p=.022)and dermal thickness increased(p=.018).Both changes lasted for more than 1 h,but after 2 h,the changes were no longer statistically significant.Dermal density decreased significantly(p=.048)immediately after the intervention,and this decrease was still present after 2 h(p=.011).Conclusions:Preliminary results show that the disruption of the epidermis may indicate that vacuum massage could be able to actually breach the skin barrier.The statistically significant changes in the dermal layers could suggest an increased ECM production after vacuum massage.
文摘Introduction: The cicatricial acceleration method (MAC®) promotes photobiological effects of an anti-inflammatory and healing nature. Its therapeutic radiation is emitted, producing photobiostimulant effects that result in rapid tissue repair and better tissue quality. The treatment of burns has always been a challenge, which involves both performing surgery and controlling and guiding scar regeneration, avoiding possible morbidities. Objective: To evaluate the effects of applying the MAC methodology with an AlGa (aluminum, gallium arsenide) laser on the time and quality of tissue repair in the skin of rats after induced chemical burns. Method: 22 adult male rats were subjected to a second-degree chemical burn on the back using 50% trichloroacetic acid. After the burns, the animals were randomly separated into 2 groups: control and experimental. The control group (G1) received placebo laser therapy and the laser group (G2) underwent laser irradiation with an energy density of 100 J/cm2. Histological analysis and macroscopic evaluation were carried out by means of the paper template method. Results: Group G1 showed (53%) of the necrosis area and group G2 showed (11%) necrosis area. Conclusion: The cicatricial acceleration method (MAC®) favored the repair of wounds caused by a 2nd-degree chemical burn, optimizing time and improving quality.
文摘Scar tissue usually generates severe discomfort in the short and long term. Common symptoms include anesthetics sequelae, pruritus, joint malfunction, new wounds on the scar surface, and pain. There are several treatments for scars, like compression, topical or intralesional steroid infiltration, 5-fluorouracil, dermabrasion, and surgeries with new scar tissue. For adult patients, it is easier to choose the treatment. However, compression is commonly applied in children to prevent treatments that have adverse effects. This study reports the outcomes of 15 patients submitted to abdominoplasty, traumatic wounds and post-burn scar treatments, which showed significant changes after the continuous use of an ointment composed of petrolatum, cod liver oil, BHT, Chamomilla recutita (chamomile) oil, Helianthus annuus (sunflower) oil, and Prunus amygdalus dulcis (sweet almond) oil. As components of the stratum corneum, unsaturated fatty acids influence the cutaneous structural and immune status and permeability. They also interfere with the maturation and differentiation of the stratum corneum and inhibit the production of proinflammatory eicosanoids, reactive species (ROS and RNS), and cytokines, thereby influencing the inflammatory response and possibly wound healing. This article aims to share our experience with the regular use of an ointment in adult and pediatric patients for three months. The increase in proinflammatory cytokine production at wound sites, resulting in a noninvasive, therapeutical, and effective cutaneous wound healing and scarring modulation, may provide a physiopathological explanation for the fast improvement of scars.
基金the Natural Science Foundation of Shandong Province, No.Y2002C29
文摘Burn wound healing involves a complex sequence of processes. Recent studies have revealed that skin reinnervation may have an impact on physiological wound repair. Few studies have addressed the process of reinnervation and morphological changes in regenerated nerve fibers. The regeneration of neurites during full-thickness burn wound healing was determined by immunofluorescent staining using an anti-neurofilament protein monoclonal antibody, and three-dimensional morphology was observed under a laser scanning confocal microscope. Morphology and the volume fraction of collagen and nerve fibers were measured. Skin reinnervation increased during wound healing, peaked during the proliferative scar stage, and then decreased to lower levels during the maturation period. The results from the skin nerve fibers correlated with those from collagen using semi-quantitative analysis. Disintegration and fragmentation were observed frequently in samples from the proliferative stage, and seldom occurred during the maturation stage. There was a remodeling process of regenerated nerve fibers during wound healing, which comprised changed innervation density and topical morphology. The mechanism of remodeling for nerve fibers requires further investigation.
文摘The inflammatory and fibrous responses to injuries are painful and are inhibitory to the regeneration of specialized cells. The fibrous scarring of skin injuries can also be disfiguring. Cells obtain energy not only from the metabolism of food, but also via the alternative cellular energy (ACE) pathway. The ACE pathway is reflected in a dynamic (kinetic) quality of the body’s fluids. It is postulated to result from the absorption of an environmental force called KELEA (kinetic energy limiting electrostatic attraction). The body’s ACE pathway can be enhanced by the parental administration and even the oral consumption of products comprising KELEA activated water. One of these products, termed Enercel, was originally considered a complex homeopathic remedy. Another product is water containing electrolysis-generated, copper-silver-citrate (CSC) complexes. This product was initially formulated to be bacteriocidal, especially for Gram positive bacteria. This article describes the independent successful use of each of these two products in achieving essentially painless, scar-free healing of skin injuries. The skin injuries were due to a variety of causes including: vascular insufficiency from diabetes;hot water burn;penetrating object;chronic infection;and surgical incision. It is proposed that the ACE pathway increases the resilience of cells of the innate immune system to the triggering of an inflammatory reaction by “danger signals” released from damaged tissues. KELEA activated water should be widely available for the urgent therapy of burns and other traumatic injuries to the skin. ACE pathway enhancing modalities also need to be evaluated in the repair of cellular damage occurring to the heart, brain and other internal organs of the body.