BACKGROUND Aplasia cutis congenita (ACC) in newborns is a condition in which congenital defects or hypoplasia is present in part of the epidermis,dermis and even subcutaneous tissue (including muscle and bones).First ...BACKGROUND Aplasia cutis congenita (ACC) in newborns is a condition in which congenital defects or hypoplasia is present in part of the epidermis,dermis and even subcutaneous tissue (including muscle and bones).First reported by Cordon in 1767,ACC is a rare disease with a low incidence of 1/100000 to 3/10000.Currently,there are 500 cases reported worldwide.ACC can be accompanied by other malformations.The onset mechanism of the disease remains unknown but is thought to be correlated to factors such as genetics,narrow uterus,foetal skin and amniotic membrane adhesion,use of teratogenic drugs in early pregnancy and viral infection.CASE SUMMARY In August 2018,we treated a newborn with ACC on the left lower limbs using a combination of ionic silver dressing and moist exposed burn ointment (MEBO) and achieved a satisfactory treatment outcome.The skin defects were observed on the external genitals and on areas from the left foot to 3/4 of the upper left side.Subcutaneous tissue and blood vessels were observed in the regions with skin defects.The following treatments were provided.First,the wound was rinsed with 0.9% sodium chloride solution followed by disinfection with povidone-iodine twice.And then MEBO was applied to the wound at a thickness of approximately 1 mm.After applying ionic silver dressing,the wound was covered with sterile gauze.The wound dressing was replaced every 2-3 d.At the 4-mo follow-up,the treatment outcome was satisfactory.There was minimal scar tissue formation,and limb function was not impaired.CONCLUSION The combination of ionic silver dressing and MEBO to ACC is helpful.展开更多
Background: The pubic region is often involved in accidental hot water or soup-spill burns. Most of these wounds are superficial partial thickness burns. Due to their proximity to the urinary system, as well as vagina...Background: The pubic region is often involved in accidental hot water or soup-spill burns. Most of these wounds are superficial partial thickness burns. Due to their proximity to the urinary system, as well as vaginal and anal openings,these burns are easily contaminated. Daily dressings are routinely prescribed as the sole treatment. The cumbersome dressing process is uncomfortable and embarrassing for patients. Biobrane^(TM) is a bilayered biosynthetic dressing. Its coverage of superficial partial thickness burns promotes wound healing and allows one-time application.Case presentations: We report two patients who suffered superficial dermal burns over their pubic region. One patient had 23% total body surface area(TBSA) burns over her lower abdomen, both thighs and pubic region. The second patient had 10% TBSA burns that involved her perineum and the medial sides of both thighs and buttocks.Both were managed with the standard resuscitation protocol in the initial phase. Their burn injuries were managed by shaving, Foley catheterization and Biobrane^(TM) coverage. Their wounds healed uneventfully without complications.Full epithelization was achieved by post-operative day seven. Both patients consented to medical photography and academic publication.Conclusions: Shaving and catheterization improved the hygiene of the burns of the pubic area. The Biobrane^(TM)method circumvents the need of regular dressing changes, eliminating the pain due to dressing changes and preserving patient dignity.展开更多
Burn wounds are destructive skin traumas typically of irregular shape and large area. Prone to infection, they require frequent dressing replacement, and painless removal of dressings from burn wounds remains a major ...Burn wounds are destructive skin traumas typically of irregular shape and large area. Prone to infection, they require frequent dressing replacement, and painless removal of dressings from burn wounds remains a major challenge. This study focuses on the dynamic characteristics and treatment difficulty of burn wounds. Hydrogel dressings based on glycol chitosan and propionaldehyde-or benzaldehyde-terminated 4-arm poly(ethylene glycol) were designed on the basis of Schiff base cross-linking networks. The hydrogels exhibited shape-adaptability, self-healing and fast-degradation properties, which makes these hydrogels suitable for burn wounds. Salvianolic acid B(SaB)-loaded hydrogel exhibited good antioxidant properties in vitro. In a rat model of deep second-degree burn wounds, the SaB-loaded hydrogel could quickly reduce wound temperature, regulate wound oxidant microenvironment, promote angiogenesis, and accelerate wound healing. Thus, the drug-loaded hydrogel shows significant potential as a first-aid dressing for treatment of burn wounds.展开更多
Burn injury is a serious public health problem and scientists are continuously aiming to develop promising biomimetic dressings for effective burn wound management.In this study,a greater efficacy in burn wound healin...Burn injury is a serious public health problem and scientists are continuously aiming to develop promising biomimetic dressings for effective burn wound management.In this study,a greater efficacy in burn wound healing and the associated mechanisms ofα-lactalbumin(ALA)based electrospun nanofibrous scaffolds(ENs)as compared to other regenerative protein scaffolds were established.Bovine serum albumin(BSA),collagen type I(COL),lysozyme(LZM)and ALA were separately blended with poly(ε-caprolactone)(PCL)to fabricate four different composite ENs(LZM/PCL,BSA/PCL,COL/PCL and ALA/PCL ENs).The hydrophilic composite scaffolds exhibited an enhancedwettability and variablemechanical properties.The ALA/PCL ENs demonstrated higher levels of fibroblast proliferation and adhesion than the other composite ENs.As compared to PCL ENs and other composite scaffolds,the ALA/PCL ENs also promoted a better maturity of the regenerative skin tissues and showed a comparable wound healing effect to Collagen sponge^(■)on third-degree burn model.The enhanced wound healing activity of ALA/PCL ENs compared to other ENs could be attributed to their ability to promote serotonin production at wound sites.Collectively,this investigation demonstrated that ALA is a unique protein with a greater potential for burn wound healing as compared to other regenerative proteins when loaded in the nanofibrous scaffolds.展开更多
Burn injuries have been and remain a very significant source of mortality and morbidity in low- and middle-income countries. As a country in this category, Ghana, is not exempted. Ghana has a population of 31 Million ...Burn injuries have been and remain a very significant source of mortality and morbidity in low- and middle-income countries. As a country in this category, Ghana, is not exempted. Ghana has a population of 31 Million with only 21 Plastic Reconstructive and Burn surgeons. Moreover, the country can boast of only 3 major Burn centres. This notwithstanding the country in particular and Africa, in general, carries an extraordinary burden of Burn injuries with devastating consequences. Burn data from the 37 Military Hospital were analyzed from March 2018 to September 2019—a period of 18 months. In all, 217 burn cases were seen representing about 2.1% of all trauma and surgical cases. Our burn data analyzed the peculiarities of epidemiology, types of burn, the pattern of injuries, and the outcome of burn care at the 37 Military Hospital. Flame is emerging as the predominant cause of burns, most frequently occurring from the use of Liquid Petroleum Gas. In the pediatric population, however, the most frequent cause of burns is hot water burns. The mortality rate among the burn population was 1.8% (4 mortalities). This paper aims to point out management methods adopted by our unit which helped to improve burn outcomes and to reduce mortality.展开更多
Background Wound dressings are divided into traditional and new types. The new dressings are thought to accelerate wound healing. The purpose of this study was to supplement the scanty data on the absorbency of the ne...Background Wound dressings are divided into traditional and new types. The new dressings are thought to accelerate wound healing. The purpose of this study was to supplement the scanty data on the absorbency of the new dressings and their effects on evaporation from the burn surface.Methods The water absorption rate of four dressings （carbon fiber dressing, hydrogel dressing, silver nanoparticle dressing, and vaseline gauze） were measured by the immersion-weight gain method. A total of 120 inpatients with 10% superficial partial-thickness burn wounds were randomly assigned to four groups, each with 30 participants. Carbon fiber dressing, hydrogel dressing, and silver nanoparticle dressing were used in groups A, B, and C as the primary dressing, and traditional vaseline gauze was used in group D as the control. Multi-spot evaporation from normal skin and naked wound, and from wounds covered with each of the four dressings was measured post-burn on days 1, 3, 5, and 7 by an EP-I evaporimeter under conditions of 21℃ -22℃ ambient temperature and 74%-78% humidity.Results The absorption rates of the four dressings were 988% with carbon fiber dressing, 96% with silver nanoparticle, 41% with vaseline gauze, and 6% with hydrogel. Evaporation from the naked burn wounds was about 1/3 higher than from normal skin （P〈0.01）. Compared with wounds without applied dressing, evaporation from dressed wounds decreased and was time-dependent （P〈0.01）. The evaporation of wounds with carbon fiber dressing was the lowest （（13.40 ± 2.82） ml·h^-1·m^-2, P〈0.01） on day 1 post-burn, compared with the other groups. Conclusion All four dressings have water retention capacity while carbon fiber dressing has the highest absorption rate and shows the best containment and evaporation from the burn wound.展开更多
Wound closure represents a primary goal in the treatment of very deep and/or large wounds,for which the mortality rate is particularly high.However,the spontaneous healing of adult skin eventually results in the forma...Wound closure represents a primary goal in the treatment of very deep and/or large wounds,for which the mortality rate is particularly high.However,the spontaneous healing of adult skin eventually results in the formation of epithelialized scar and scar contracture(repair),which might distort the tissues and cause lifelong deformities and disabilities.This clinical evidence suggests that wound closure attained by means of skin regeneration,instead of repair,should be the true goal of burn wound management.The traditional concept of temporary wound dressings,able to stimulate skin healing by repair,is thus being increasingly replaced by the idea of temporary scaff olds,or regenerative templates,able to promote healing by regeneration.As wound dressings,polymeric hydrogels provide an ideal moisture environment for healing while protecting the wound,with the additional advantage of being comfortable to the patient,due to their cooling eff ect and non-adhesiveness to the wound tissue.More importantly,recent advances in regenerative medicine demonstrate that bioactive hydrogels can be properly designed to induce at least partial skin regeneration in vivo.The aim of this review is to provide a concise insight on the key properties of hydrogels for skin healing and regeneration,particularly highlighting the emerging role of hydrogels as next generation skin substitutes for the treatment of fullthickness burns.展开更多
Wounds may remain open for a few weeks in severe burns,which provide an entry point for pathogens and microorganisms invading.Thus,wound dressings with long-term antimicrobial activity are crucial for severe burn woun...Wounds may remain open for a few weeks in severe burns,which provide an entry point for pathogens and microorganisms invading.Thus,wound dressings with long-term antimicrobial activity are crucial for severe burn wound healing.Here,a sandwich structure composite wound dressing anchored with silver nanoparticles(AgNPs)was developed for severe burn wound healing.AgNPs were in situ synthesized on the fibers of chitosan nonwoven fabric(CSNWF)as the interlayer of wound dressing for sustained release of silver ion.The firmly anchored AgNPs could prevent its entry into the body,thereby eliminating the toxicity of nanomaterials.The outer layer was a polyurethane membrane,which has a nanoporous structure that could maintain free transmission of water vapor.Chitosan/collagen sponge was selected as the inner layer because of its excellent biocompatibility and biodegradability.The presence of AgNPs in the CSNWF was fully characterized,and the high antibacterial activity of CSNWF/AgNPs was confirmed by against Escherichia coli,Pseudomonas aeruginosa and Staphylococcus aureus.The superior wound healing effect on deep dermal burns of presented composite wound dressing was demonstrated in a porcine model.Our finding suggested that the prepared AgNPs doped sandwich structure composite wound dressing has great potential application in severe wound care.展开更多
The deep burn skin injures usually severely damage the dermis with the loss of hair follicle loss,which are difficult to regenerate.Furthermore,severe burns often accompanied with large amount of wound exudates making...The deep burn skin injures usually severely damage the dermis with the loss of hair follicle loss,which are difficult to regenerate.Furthermore,severe burns often accompanied with large amount of wound exudates making the wound moist,easily infected,and difficult to heal.Therefore,it is of great clinical significance to develop wound dressings to remove wound exudates and promote hair follicle regeneration.In this study,a sandwich-structured wound dressing(SWD)with Janus membrane property was fabricated by hot compression molding using hydrophilic zinc silicate bioceramics(Hardystonite,ZnCS)and hydrophobic polylactic acid(PLA).This unique organic/inorganic Janus membrane structure revealed excellent exudate absorption property and effectively created a dry wound environment.Meanwhile,the incorporation of ZnCS bioceramic particles endowed the dressing with the bioactivity to promote hair follicle regeneration and wound healing through the release of Zn^(2+)and SiO^(2-)_(3)ions,and this bioactivity of the wound dressing is mainly attributed to the synergistic effect of Zn^(2+)and SiO^(2-)_(3)to promote the recruitment,viability,and differentiation of hair follicle cells.Our study demonstrates that the utilization of the Janus membrane and synergistic effect of different type bioactive ions are effective approaches for the design of wound dressings for burn wound healing.展开更多
文摘BACKGROUND Aplasia cutis congenita (ACC) in newborns is a condition in which congenital defects or hypoplasia is present in part of the epidermis,dermis and even subcutaneous tissue (including muscle and bones).First reported by Cordon in 1767,ACC is a rare disease with a low incidence of 1/100000 to 3/10000.Currently,there are 500 cases reported worldwide.ACC can be accompanied by other malformations.The onset mechanism of the disease remains unknown but is thought to be correlated to factors such as genetics,narrow uterus,foetal skin and amniotic membrane adhesion,use of teratogenic drugs in early pregnancy and viral infection.CASE SUMMARY In August 2018,we treated a newborn with ACC on the left lower limbs using a combination of ionic silver dressing and moist exposed burn ointment (MEBO) and achieved a satisfactory treatment outcome.The skin defects were observed on the external genitals and on areas from the left foot to 3/4 of the upper left side.Subcutaneous tissue and blood vessels were observed in the regions with skin defects.The following treatments were provided.First,the wound was rinsed with 0.9% sodium chloride solution followed by disinfection with povidone-iodine twice.And then MEBO was applied to the wound at a thickness of approximately 1 mm.After applying ionic silver dressing,the wound was covered with sterile gauze.The wound dressing was replaced every 2-3 d.At the 4-mo follow-up,the treatment outcome was satisfactory.There was minimal scar tissue formation,and limb function was not impaired.CONCLUSION The combination of ionic silver dressing and MEBO to ACC is helpful.
文摘Background: The pubic region is often involved in accidental hot water or soup-spill burns. Most of these wounds are superficial partial thickness burns. Due to their proximity to the urinary system, as well as vaginal and anal openings,these burns are easily contaminated. Daily dressings are routinely prescribed as the sole treatment. The cumbersome dressing process is uncomfortable and embarrassing for patients. Biobrane^(TM) is a bilayered biosynthetic dressing. Its coverage of superficial partial thickness burns promotes wound healing and allows one-time application.Case presentations: We report two patients who suffered superficial dermal burns over their pubic region. One patient had 23% total body surface area(TBSA) burns over her lower abdomen, both thighs and pubic region. The second patient had 10% TBSA burns that involved her perineum and the medial sides of both thighs and buttocks.Both were managed with the standard resuscitation protocol in the initial phase. Their burn injuries were managed by shaving, Foley catheterization and Biobrane^(TM) coverage. Their wounds healed uneventfully without complications.Full epithelization was achieved by post-operative day seven. Both patients consented to medical photography and academic publication.Conclusions: Shaving and catheterization improved the hygiene of the burns of the pubic area. The Biobrane^(TM)method circumvents the need of regular dressing changes, eliminating the pain due to dressing changes and preserving patient dignity.
基金supported by the National Natural Science Foundation of China(Grant Nos. 52173147, 22105198, 51973218, 51833010)the Scientific and Technological Development Projects of Jilin Province(Grant No. 20210204136YY)。
文摘Burn wounds are destructive skin traumas typically of irregular shape and large area. Prone to infection, they require frequent dressing replacement, and painless removal of dressings from burn wounds remains a major challenge. This study focuses on the dynamic characteristics and treatment difficulty of burn wounds. Hydrogel dressings based on glycol chitosan and propionaldehyde-or benzaldehyde-terminated 4-arm poly(ethylene glycol) were designed on the basis of Schiff base cross-linking networks. The hydrogels exhibited shape-adaptability, self-healing and fast-degradation properties, which makes these hydrogels suitable for burn wounds. Salvianolic acid B(SaB)-loaded hydrogel exhibited good antioxidant properties in vitro. In a rat model of deep second-degree burn wounds, the SaB-loaded hydrogel could quickly reduce wound temperature, regulate wound oxidant microenvironment, promote angiogenesis, and accelerate wound healing. Thus, the drug-loaded hydrogel shows significant potential as a first-aid dressing for treatment of burn wounds.
基金supported by the Liaoning Pan Deng Xue Zhe Scholar(No.XLYC2002061)the Overseas Expertise Introduction Project for Discipline Innovation(“111 Project”)(No.D20029)+5 种基金X.G.acknowledges the Educational Department of Liaoning Province(grant No.LJKZ0925),(Youth Project,grant No.LJKQZ2021035)the international postdoctoral exchange fellowship program(grant No.PC2021047)H.B.thanks the financial support from National Natural Science Foundation of China(grant No.82050410448)Fellowship of China Postdoctoral Science Foundation(grant No.2021MD703857)D.Cun acknowledges financial support from Ministry of Education Chunhui Program(2020)VF acknowledges VILLUM FONDEN for supporting the project via the Villum Young Investigator Grant(grant No.19175).
文摘Burn injury is a serious public health problem and scientists are continuously aiming to develop promising biomimetic dressings for effective burn wound management.In this study,a greater efficacy in burn wound healing and the associated mechanisms ofα-lactalbumin(ALA)based electrospun nanofibrous scaffolds(ENs)as compared to other regenerative protein scaffolds were established.Bovine serum albumin(BSA),collagen type I(COL),lysozyme(LZM)and ALA were separately blended with poly(ε-caprolactone)(PCL)to fabricate four different composite ENs(LZM/PCL,BSA/PCL,COL/PCL and ALA/PCL ENs).The hydrophilic composite scaffolds exhibited an enhancedwettability and variablemechanical properties.The ALA/PCL ENs demonstrated higher levels of fibroblast proliferation and adhesion than the other composite ENs.As compared to PCL ENs and other composite scaffolds,the ALA/PCL ENs also promoted a better maturity of the regenerative skin tissues and showed a comparable wound healing effect to Collagen sponge^(■)on third-degree burn model.The enhanced wound healing activity of ALA/PCL ENs compared to other ENs could be attributed to their ability to promote serotonin production at wound sites.Collectively,this investigation demonstrated that ALA is a unique protein with a greater potential for burn wound healing as compared to other regenerative proteins when loaded in the nanofibrous scaffolds.
文摘Burn injuries have been and remain a very significant source of mortality and morbidity in low- and middle-income countries. As a country in this category, Ghana, is not exempted. Ghana has a population of 31 Million with only 21 Plastic Reconstructive and Burn surgeons. Moreover, the country can boast of only 3 major Burn centres. This notwithstanding the country in particular and Africa, in general, carries an extraordinary burden of Burn injuries with devastating consequences. Burn data from the 37 Military Hospital were analyzed from March 2018 to September 2019—a period of 18 months. In all, 217 burn cases were seen representing about 2.1% of all trauma and surgical cases. Our burn data analyzed the peculiarities of epidemiology, types of burn, the pattern of injuries, and the outcome of burn care at the 37 Military Hospital. Flame is emerging as the predominant cause of burns, most frequently occurring from the use of Liquid Petroleum Gas. In the pediatric population, however, the most frequent cause of burns is hot water burns. The mortality rate among the burn population was 1.8% (4 mortalities). This paper aims to point out management methods adopted by our unit which helped to improve burn outcomes and to reduce mortality.
文摘Background Wound dressings are divided into traditional and new types. The new dressings are thought to accelerate wound healing. The purpose of this study was to supplement the scanty data on the absorbency of the new dressings and their effects on evaporation from the burn surface.Methods The water absorption rate of four dressings （carbon fiber dressing, hydrogel dressing, silver nanoparticle dressing, and vaseline gauze） were measured by the immersion-weight gain method. A total of 120 inpatients with 10% superficial partial-thickness burn wounds were randomly assigned to four groups, each with 30 participants. Carbon fiber dressing, hydrogel dressing, and silver nanoparticle dressing were used in groups A, B, and C as the primary dressing, and traditional vaseline gauze was used in group D as the control. Multi-spot evaporation from normal skin and naked wound, and from wounds covered with each of the four dressings was measured post-burn on days 1, 3, 5, and 7 by an EP-I evaporimeter under conditions of 21℃ -22℃ ambient temperature and 74%-78% humidity.Results The absorption rates of the four dressings were 988% with carbon fiber dressing, 96% with silver nanoparticle, 41% with vaseline gauze, and 6% with hydrogel. Evaporation from the naked burn wounds was about 1/3 higher than from normal skin （P〈0.01）. Compared with wounds without applied dressing, evaporation from dressed wounds decreased and was time-dependent （P〈0.01）. The evaporation of wounds with carbon fiber dressing was the lowest （（13.40 ± 2.82） ml·h^-1·m^-2, P〈0.01） on day 1 post-burn, compared with the other groups. Conclusion All four dressings have water retention capacity while carbon fiber dressing has the highest absorption rate and shows the best containment and evaporation from the burn wound.
文摘Wound closure represents a primary goal in the treatment of very deep and/or large wounds,for which the mortality rate is particularly high.However,the spontaneous healing of adult skin eventually results in the formation of epithelialized scar and scar contracture(repair),which might distort the tissues and cause lifelong deformities and disabilities.This clinical evidence suggests that wound closure attained by means of skin regeneration,instead of repair,should be the true goal of burn wound management.The traditional concept of temporary wound dressings,able to stimulate skin healing by repair,is thus being increasingly replaced by the idea of temporary scaff olds,or regenerative templates,able to promote healing by regeneration.As wound dressings,polymeric hydrogels provide an ideal moisture environment for healing while protecting the wound,with the additional advantage of being comfortable to the patient,due to their cooling eff ect and non-adhesiveness to the wound tissue.More importantly,recent advances in regenerative medicine demonstrate that bioactive hydrogels can be properly designed to induce at least partial skin regeneration in vivo.The aim of this review is to provide a concise insight on the key properties of hydrogels for skin healing and regeneration,particularly highlighting the emerging role of hydrogels as next generation skin substitutes for the treatment of fullthickness burns.
基金supported by the National Natural Science Foundation of China(31800796)the Nature Sciences Funding of Fujian Province(2019J01238)the Fuzhou University Testing Fund of Precious Apparatus(2021T018).
文摘Wounds may remain open for a few weeks in severe burns,which provide an entry point for pathogens and microorganisms invading.Thus,wound dressings with long-term antimicrobial activity are crucial for severe burn wound healing.Here,a sandwich structure composite wound dressing anchored with silver nanoparticles(AgNPs)was developed for severe burn wound healing.AgNPs were in situ synthesized on the fibers of chitosan nonwoven fabric(CSNWF)as the interlayer of wound dressing for sustained release of silver ion.The firmly anchored AgNPs could prevent its entry into the body,thereby eliminating the toxicity of nanomaterials.The outer layer was a polyurethane membrane,which has a nanoporous structure that could maintain free transmission of water vapor.Chitosan/collagen sponge was selected as the inner layer because of its excellent biocompatibility and biodegradability.The presence of AgNPs in the CSNWF was fully characterized,and the high antibacterial activity of CSNWF/AgNPs was confirmed by against Escherichia coli,Pseudomonas aeruginosa and Staphylococcus aureus.The superior wound healing effect on deep dermal burns of presented composite wound dressing was demonstrated in a porcine model.Our finding suggested that the prepared AgNPs doped sandwich structure composite wound dressing has great potential application in severe wound care.
基金This work was supported by the National Key Research and Development Program of China(No.2016YFC1100201)the National Natural Science Foundation of China(No.81772078)+1 种基金the National Natural Science Foundation of China(No.81671830)the Science and Technology Commission of Shanghai Municipality(No.19441902300).
文摘The deep burn skin injures usually severely damage the dermis with the loss of hair follicle loss,which are difficult to regenerate.Furthermore,severe burns often accompanied with large amount of wound exudates making the wound moist,easily infected,and difficult to heal.Therefore,it is of great clinical significance to develop wound dressings to remove wound exudates and promote hair follicle regeneration.In this study,a sandwich-structured wound dressing(SWD)with Janus membrane property was fabricated by hot compression molding using hydrophilic zinc silicate bioceramics(Hardystonite,ZnCS)and hydrophobic polylactic acid(PLA).This unique organic/inorganic Janus membrane structure revealed excellent exudate absorption property and effectively created a dry wound environment.Meanwhile,the incorporation of ZnCS bioceramic particles endowed the dressing with the bioactivity to promote hair follicle regeneration and wound healing through the release of Zn^(2+)and SiO^(2-)_(3)ions,and this bioactivity of the wound dressing is mainly attributed to the synergistic effect of Zn^(2+)and SiO^(2-)_(3)to promote the recruitment,viability,and differentiation of hair follicle cells.Our study demonstrates that the utilization of the Janus membrane and synergistic effect of different type bioactive ions are effective approaches for the design of wound dressings for burn wound healing.
