Scald injuries,which describe burns to living tissue from hot liquids,are a very common injury that occur across geographical,social,economic,and national boundaries.Despite their ubiquitous nature,a complete understa...Scald injuries,which describe burns to living tissue from hot liquids,are a very common injury that occur across geographical,social,economic,and national boundaries.Despite their ubiquitous nature,a complete understanding of the conditions which are required to cause scald burns is not yet available.In addition,clear guidance to medical practitioners is available through various guidelines however in actual situations,the extent of the burn is not fully known and this lack of knowledge complicates care.Here,a comprehensive review is made of the available knowledge of temperatures and scald durations which lead to skin-burn injuries.The range of volumes and liquid temperatures are typical of those found in heated consumer beverages.This review can help medical practitioners design initial treatment protocols and can be used by manufacturers of hot-liquid products to avoid the most severe burns.Next,within the context of this ability to quantify burn depths,a review of current burn treatment guidelines is given.Included in this review is a visual recognition of the extent of burns into the dermal layer as well as decision guidelines for selection of patients which would benefit from referral to a dedicated burn center.It is hoped that by bringing together both the quantified burn-depth information and current treatment guidelines,this review can be used as a resource for persons in the medical,manufacturing,beverage service,and other industries to reduce the human impact of scald injuries.展开更多
Background:Delayed wound healing remains a common but challenging problem in patients with acute or chronic wound following accidental scald burn injury.However,the systematic and detailed evaluation of the scald burn...Background:Delayed wound healing remains a common but challenging problem in patients with acute or chronic wound following accidental scald burn injury.However,the systematic and detailed evaluation of the scald burn injury,including second-degree deep scald(SDDS)and thirddegree scald(TDS),is still unclear.The present study aims to analyze the wound-healing speed,the formation of granulation tissue,and the healing quality after cutaneous damage.Methods:In order to assess SDDS and TDS,the models of SDDS and TDS were established using a scald instrument in C57BL/6 mice.Furthermore,an excisional wound was administered on the dorsal surface in mice(Cut group).The wound-healing rate was first analyzed at days 0,3,5,7,15 and 27,with the Cut group as a control.Then,on the full-thickness wounds,hematoxylin and eosin(H&E)staining,Masson staining,Sirius red staining,Victoria blue staining and immunohistochemistry were performed to examine re-epithelialization,the formation of granulation tissue,vascularization,inflammatory infiltration and the healing quality at different time points in the Cut,SDDS and TDS groups.Results:The presented data revealed that the wound-healing rate was higher in the Cut group,when compared with the SDDS and TDS groups.H&E staining showed that re-epithelialization,formation of granulation tissue and inflammatory infiltration were greater in the Cut group,when compared with the SDDS and TDS groups.Immunohistochemistry revealed that the number of CD31,vascular endothelial growth factor A,transforming growth factor-βandα-smooth muscle actin reached preferential peak in the Cut group,when compared with other groups.In addition,Masson staining,Sirius red staining,Victoria blue staining,Gordon-Sweets staining and stress analysis indicated that the ratio of collagen I to III,reticular fibers,failure stress,Young’s modulus and failure length in the SDDS group were similar to those in the normal group,suggesting that healing quality was better in the SDDS group,when compared with the Cut and TDS groups.Conclusion:Overall,the investigators first administered a comprehensive analysis in the Cut,SDDS and TDS groups through in vivo experiments,which further proved that the obstacle of the formation of granulation tissue leads to delayed wound healing after scald burn injury in mice.展开更多
Background:The present study was designed to evaluate the potential of isoquercetin-based cream formulation on scald burn wound injury in rats.Methods:Four isoquercetin-based cream formulations viz.0.01,0.02,0.04,and ...Background:The present study was designed to evaluate the potential of isoquercetin-based cream formulation on scald burn wound injury in rats.Methods:Four isoquercetin-based cream formulations viz.0.01,0.02,0.04,and 0.06%w/w were prepared.Cream base and standard anti-burn cream containing silver sulfadiazine were also used for comparison.Scald burn was given to rats by pouring water at 90℃on a shaved dorsal area of 20 mm2.Deep second-degree burn injury was produced which was evaluated for the next 21 days for the percentage of wound contraction and period of epithelialization.On day 21,the rats were sacrificed and histopathological slides were prepared using hematoxylin-eosin staining.Burned tissue was also screened for levels of oxidative stress using thiobarbituric acid reactive species(TBARS)and reduced glutathione(GSH)estimation.Results:There was a significant increase in the percentage of wound contraction and a significant decrease in the period of epithelialization in isoquercetin-based cream-treated groups as compared with the control group.However,most significant results were obtained with isoquercetin 0.06%w/w cream.Histological y,isoquercetin 0.06%w/w cream treatment resulted in almost complete re-epithelialization and re-structuring of the wound tissue.There was a significant rise in TBARS and a decrease in GSH levels in the burn injury group which was reversed to a major extent by the application of isoquercetin-based cream.Conclusions:The results indicate the wound healing potential of isoquercetin-based cream.Tissue biochemical studies indicate towards a possible role of free radical scavenging in the observed effects of isoquercetin in wound healing.展开更多
Background:The molecular pattern of severe burn-induced acute lung injury, characterized by cell structure damage and leukocyte infiltration, remains unknown. This study aimed to determine whether calpain, a protease ...Background:The molecular pattern of severe burn-induced acute lung injury, characterized by cell structure damage and leukocyte infiltration, remains unknown. This study aimed to determine whether calpain, a protease involved in both processes, mediates severe burn-induced acute lung injury. Methods:Rats received ful-thickness scald burns covering 30%of the total body surface area, fol owed by instant fluid resuscitation. MDL28170 (Tocris Bioscience), an inhibitor of calpain, was given intravenously 1 h before or after the scald burn. The histological score, wet/dry weight ratio, and caspase-3 activity were examined to evaluate the degree of lung damage. Calpain activity and its source were detected by an assay kit and immunofluorescence staining. The proteolysis of membrane skeleton proteinsα-fodrin and ankyrin-B, which are substrates of calpain, was measured by Western blot. Results:Time-course studies showed that tissue damage reached a peak between 1 and 6 h post-scald burn and gradually diminished at 24 h. More importantly, calpain activity reached peak levels at 1 h and was maintained until 24 h, paralleled by lung damage to some extent. Western blot showed that the levels of the proteolyzed forms ofα-fodrin and ankyrin-B correlated well with the degree of damage. MDL28170 at a dose of 3 mg/kg b. w. given 1 h before burn injury not only antagonized the increase in calpain activity but also ameliorated scald burn-induced lung injury, including the degradation ofα-fodrin and ankyrin-B. Immunofluorescence images revealed calpain 1 and CD45 double-positive cel s in the lung tissue of rats exposed to scald burn injury, suggesting that leukocytes were a dominant source of calpain. Furthermore, this change was blocked by MDL28170. Final y, MDL28170 given at 1 h post-scald burn injury significantly ameliorated the wet/dry weight ratio compared with burn injury alone. Conclusions:Calpain, a product of infiltrating leukocytes, is a mediator of scald burn-induced acute lung injury that involves enhancement of inflammation and proteolysis of membrane skeleton proteins. Its late effects warrant further study.展开更多
Objectives: A retrospective analysis of scald burns in children in a region with a significant prevalence of Roma ethnicity living in poor socioeconomic situation. Patients: During 3 year period 273 children were admi...Objectives: A retrospective analysis of scald burns in children in a region with a significant prevalence of Roma ethnicity living in poor socioeconomic situation. Patients: During 3 year period 273 children were admitted to the Clinic of Burns and Reconstructive Surgery of our hospital;201 of them were with scald burns accounting for 73.6% of all pediatric burn admissions. More than half (58.7%) of the 201 children with scald burns were of Roma ethnicity. Results: The average BSAB of the children with scald burns was 10.8%;mean length of hospital stay 11.5 days. 58.7% of the children with scald burns was of Roma ethnicity. The non-scald admissions of children had a similar pattern but these children were older and with an even higher prevalence of Roma patients (75%), a slightly lower average BSAB (9.8%) and a significantly longer need of hospital treatment (average 15.7 days). Conclusion: The frequency of scald burn injuries in very young Roma children in our region is very high. Prevention of scald burns is possible only through targeted and well-organized education of this vulnerable population.展开更多
Perineal reconstruction is an essential component of the overall treatment plan of perineal electric burn, but it is a very difficult and complex job. The modified thoraco-umbilical flap may be a perfect way of repair...Perineal reconstruction is an essential component of the overall treatment plan of perineal electric burn, but it is a very difficult and complex job. The modified thoraco-umbilical flap may be a perfect way of repairing perineal area. It is based on the deep inferior epigastric artery and vein and the superior epigastric artery and vein, which look like the “reverse TRAM flap”. The large flap could be fashioned into a perfect perineal area without the need for free flap. It left a satisfactory donor scar, and it avoided the need to change the patient’s position during the operation. Four cases were reconstructed by modified thoraco-umbilical flap after perineal electric burn, and all of them were satisfied with the results. The modified thoraco-umbilical flap has been emerged as a very useful reconstructive tool and is particularly valuable in reconstruction of the perineal electric burn.展开更多
Objective: To determine the trends in burn admissions, and aetiology, severity and mortality of patients admitted to the Burns Intensive Care Unit of the Komfo Anokye Teaching Hospital from May 2009 to April 2016 (7 y...Objective: To determine the trends in burn admissions, and aetiology, severity and mortality of patients admitted to the Burns Intensive Care Unit of the Komfo Anokye Teaching Hospital from May 2009 to April 2016 (7 years). Methods: Patients' data used in this longitudinal and retrospective study were accessed from the records of the Reconstructive Plastic Surgery and Burns Unit. Processed data were depicted in tables and figures as appropriate. Univariate and multivariate analysis and Pearson's rank correlation were used in comparing relevant groups. Data analysis was conducted using Excel version 2013 and SPSS version 17.0. Results: A total of 681 patients, with a male to female ratio of 1.1:1.0, were analysed. The average annual incidence was 97.28 with a progressive decline in incidence. Mortality rate was 24.2%. Majority of the patients were children less than 10 years (43.5%) with scalds as the main aetiology in this group. Open flame was the major aetiology of burns (49.9%). Majority of the patients spent less than 10 days on admission (67.1%). Mean total body surface area was 30.54%. There was correlation between TBSA and disposition, total body surface area and aetiology and number of days in the Burns Intensive Care Unit, total body surface area and aetiology, and aetiology and number of days in the Burns Intensive Care Unit. Conclusions: Children below 10 years were the main victims. There was a shift from scald to open flame burns in this current study. Mean total body surface area and mortality rate have increased. There is urgent need for prevention campaign of flame burn and first aid education on intensive burns.展开更多
目的 以网络药理学为主要研究手段,结合分子对接技术,分析烧伤酊治疗烧烫伤的分子机制。方法 利用中药整合药理学研究平台(integrative pharmacology-based research platform of traditional Chinese medicine, TCMIP)及中药系统药理...目的 以网络药理学为主要研究手段,结合分子对接技术,分析烧伤酊治疗烧烫伤的分子机制。方法 利用中药整合药理学研究平台(integrative pharmacology-based research platform of traditional Chinese medicine, TCMIP)及中药系统药理学数据库(traditional Chinese medicine systems pharmacology database and analysis platform, TCMSP)筛选烧伤酊(榆树皮、黄柏或关黄柏)的相关靶点及其活性成分,采用UniProt数据库标准化靶点,并利用Cytoscape可视化软件构建活性成分-靶点网络,在数据库Gene Cards中检索与烧烫伤有关的基因,利用数据库STRING构建蛋白质的相互作用网络,并同时进行基因本体论(gene ontology, GO)功能富集分析和京都基因与基因组百科全书(kyoto encyclopedia of genes and genomes, KEGG)通路富集分析,最后采用分子对接技术对接核心的活性成分和靶位置。结果 通过类药性(drug likeness, DL)参数筛选得出烧伤酊组分榆树皮、黄柏和关黄柏中的主要活性化合物118个、核心靶点248个;检索疾病数据库得到烧烫伤疾病相关靶点2 147个;通过可视化数据分析得到38个潜在核心靶点及与其对应的51个中药潜在活性单体成分;结合GO功能与KEGG通路分析,烧伤酊中的活性成分槲皮素、沃戈宁黄酮、黄芩素主要通过调节蛋白激酶B1(protein kinase B1,AKT1)、白细胞介素-6(interleukin-6,IL-6)、上皮生长因子受体(epidermal growth factor receptor, EGFR)、上皮生长因子(epidermal growth factor, EGF)、血管内皮生长因子(vascular endothelial growth factor, VEGF)、肿瘤坏死因子(tumor necrosis factor, TNF)等蛋白以及肿瘤坏死因子、癌症中的蛋白多糖和细胞因子之间的受体作用等信号通路来发挥炎症应答、免疫应答、信号转导以及细胞增殖的正调控等作用,从而达到治疗烧烫伤的效果。结论 初步揭示了烧伤酊多层次、多环节治疗烧烫伤的作用机制。展开更多
文摘Scald injuries,which describe burns to living tissue from hot liquids,are a very common injury that occur across geographical,social,economic,and national boundaries.Despite their ubiquitous nature,a complete understanding of the conditions which are required to cause scald burns is not yet available.In addition,clear guidance to medical practitioners is available through various guidelines however in actual situations,the extent of the burn is not fully known and this lack of knowledge complicates care.Here,a comprehensive review is made of the available knowledge of temperatures and scald durations which lead to skin-burn injuries.The range of volumes and liquid temperatures are typical of those found in heated consumer beverages.This review can help medical practitioners design initial treatment protocols and can be used by manufacturers of hot-liquid products to avoid the most severe burns.Next,within the context of this ability to quantify burn depths,a review of current burn treatment guidelines is given.Included in this review is a visual recognition of the extent of burns into the dermal layer as well as decision guidelines for selection of patients which would benefit from referral to a dedicated burn center.It is hoped that by bringing together both the quantified burn-depth information and current treatment guidelines,this review can be used as a resource for persons in the medical,manufacturing,beverage service,and other industries to reduce the human impact of scald injuries.
文摘Background:Delayed wound healing remains a common but challenging problem in patients with acute or chronic wound following accidental scald burn injury.However,the systematic and detailed evaluation of the scald burn injury,including second-degree deep scald(SDDS)and thirddegree scald(TDS),is still unclear.The present study aims to analyze the wound-healing speed,the formation of granulation tissue,and the healing quality after cutaneous damage.Methods:In order to assess SDDS and TDS,the models of SDDS and TDS were established using a scald instrument in C57BL/6 mice.Furthermore,an excisional wound was administered on the dorsal surface in mice(Cut group).The wound-healing rate was first analyzed at days 0,3,5,7,15 and 27,with the Cut group as a control.Then,on the full-thickness wounds,hematoxylin and eosin(H&E)staining,Masson staining,Sirius red staining,Victoria blue staining and immunohistochemistry were performed to examine re-epithelialization,the formation of granulation tissue,vascularization,inflammatory infiltration and the healing quality at different time points in the Cut,SDDS and TDS groups.Results:The presented data revealed that the wound-healing rate was higher in the Cut group,when compared with the SDDS and TDS groups.H&E staining showed that re-epithelialization,formation of granulation tissue and inflammatory infiltration were greater in the Cut group,when compared with the SDDS and TDS groups.Immunohistochemistry revealed that the number of CD31,vascular endothelial growth factor A,transforming growth factor-βandα-smooth muscle actin reached preferential peak in the Cut group,when compared with other groups.In addition,Masson staining,Sirius red staining,Victoria blue staining,Gordon-Sweets staining and stress analysis indicated that the ratio of collagen I to III,reticular fibers,failure stress,Young’s modulus and failure length in the SDDS group were similar to those in the normal group,suggesting that healing quality was better in the SDDS group,when compared with the Cut and TDS groups.Conclusion:Overall,the investigators first administered a comprehensive analysis in the Cut,SDDS and TDS groups through in vivo experiments,which further proved that the obstacle of the formation of granulation tissue leads to delayed wound healing after scald burn injury in mice.
文摘Background:The present study was designed to evaluate the potential of isoquercetin-based cream formulation on scald burn wound injury in rats.Methods:Four isoquercetin-based cream formulations viz.0.01,0.02,0.04,and 0.06%w/w were prepared.Cream base and standard anti-burn cream containing silver sulfadiazine were also used for comparison.Scald burn was given to rats by pouring water at 90℃on a shaved dorsal area of 20 mm2.Deep second-degree burn injury was produced which was evaluated for the next 21 days for the percentage of wound contraction and period of epithelialization.On day 21,the rats were sacrificed and histopathological slides were prepared using hematoxylin-eosin staining.Burned tissue was also screened for levels of oxidative stress using thiobarbituric acid reactive species(TBARS)and reduced glutathione(GSH)estimation.Results:There was a significant increase in the percentage of wound contraction and a significant decrease in the period of epithelialization in isoquercetin-based cream-treated groups as compared with the control group.However,most significant results were obtained with isoquercetin 0.06%w/w cream.Histological y,isoquercetin 0.06%w/w cream treatment resulted in almost complete re-epithelialization and re-structuring of the wound tissue.There was a significant rise in TBARS and a decrease in GSH levels in the burn injury group which was reversed to a major extent by the application of isoquercetin-based cream.Conclusions:The results indicate the wound healing potential of isoquercetin-based cream.Tissue biochemical studies indicate towards a possible role of free radical scavenging in the observed effects of isoquercetin in wound healing.
基金The study was supported by grants from the National Natural Science Foundation of China(no:81772070 and 31371181).The funding body had no role in the design of the study and col ection,analysis,and interpretation of the data and in the writing of the manuscript.
文摘Background:The molecular pattern of severe burn-induced acute lung injury, characterized by cell structure damage and leukocyte infiltration, remains unknown. This study aimed to determine whether calpain, a protease involved in both processes, mediates severe burn-induced acute lung injury. Methods:Rats received ful-thickness scald burns covering 30%of the total body surface area, fol owed by instant fluid resuscitation. MDL28170 (Tocris Bioscience), an inhibitor of calpain, was given intravenously 1 h before or after the scald burn. The histological score, wet/dry weight ratio, and caspase-3 activity were examined to evaluate the degree of lung damage. Calpain activity and its source were detected by an assay kit and immunofluorescence staining. The proteolysis of membrane skeleton proteinsα-fodrin and ankyrin-B, which are substrates of calpain, was measured by Western blot. Results:Time-course studies showed that tissue damage reached a peak between 1 and 6 h post-scald burn and gradually diminished at 24 h. More importantly, calpain activity reached peak levels at 1 h and was maintained until 24 h, paralleled by lung damage to some extent. Western blot showed that the levels of the proteolyzed forms ofα-fodrin and ankyrin-B correlated well with the degree of damage. MDL28170 at a dose of 3 mg/kg b. w. given 1 h before burn injury not only antagonized the increase in calpain activity but also ameliorated scald burn-induced lung injury, including the degradation ofα-fodrin and ankyrin-B. Immunofluorescence images revealed calpain 1 and CD45 double-positive cel s in the lung tissue of rats exposed to scald burn injury, suggesting that leukocytes were a dominant source of calpain. Furthermore, this change was blocked by MDL28170. Final y, MDL28170 given at 1 h post-scald burn injury significantly ameliorated the wet/dry weight ratio compared with burn injury alone. Conclusions:Calpain, a product of infiltrating leukocytes, is a mediator of scald burn-induced acute lung injury that involves enhancement of inflammation and proteolysis of membrane skeleton proteins. Its late effects warrant further study.
文摘Objectives: A retrospective analysis of scald burns in children in a region with a significant prevalence of Roma ethnicity living in poor socioeconomic situation. Patients: During 3 year period 273 children were admitted to the Clinic of Burns and Reconstructive Surgery of our hospital;201 of them were with scald burns accounting for 73.6% of all pediatric burn admissions. More than half (58.7%) of the 201 children with scald burns were of Roma ethnicity. Results: The average BSAB of the children with scald burns was 10.8%;mean length of hospital stay 11.5 days. 58.7% of the children with scald burns was of Roma ethnicity. The non-scald admissions of children had a similar pattern but these children were older and with an even higher prevalence of Roma patients (75%), a slightly lower average BSAB (9.8%) and a significantly longer need of hospital treatment (average 15.7 days). Conclusion: The frequency of scald burn injuries in very young Roma children in our region is very high. Prevention of scald burns is possible only through targeted and well-organized education of this vulnerable population.
文摘Perineal reconstruction is an essential component of the overall treatment plan of perineal electric burn, but it is a very difficult and complex job. The modified thoraco-umbilical flap may be a perfect way of repairing perineal area. It is based on the deep inferior epigastric artery and vein and the superior epigastric artery and vein, which look like the “reverse TRAM flap”. The large flap could be fashioned into a perfect perineal area without the need for free flap. It left a satisfactory donor scar, and it avoided the need to change the patient’s position during the operation. Four cases were reconstructed by modified thoraco-umbilical flap after perineal electric burn, and all of them were satisfied with the results. The modified thoraco-umbilical flap has been emerged as a very useful reconstructive tool and is particularly valuable in reconstruction of the perineal electric burn.
文摘Objective: To determine the trends in burn admissions, and aetiology, severity and mortality of patients admitted to the Burns Intensive Care Unit of the Komfo Anokye Teaching Hospital from May 2009 to April 2016 (7 years). Methods: Patients' data used in this longitudinal and retrospective study were accessed from the records of the Reconstructive Plastic Surgery and Burns Unit. Processed data were depicted in tables and figures as appropriate. Univariate and multivariate analysis and Pearson's rank correlation were used in comparing relevant groups. Data analysis was conducted using Excel version 2013 and SPSS version 17.0. Results: A total of 681 patients, with a male to female ratio of 1.1:1.0, were analysed. The average annual incidence was 97.28 with a progressive decline in incidence. Mortality rate was 24.2%. Majority of the patients were children less than 10 years (43.5%) with scalds as the main aetiology in this group. Open flame was the major aetiology of burns (49.9%). Majority of the patients spent less than 10 days on admission (67.1%). Mean total body surface area was 30.54%. There was correlation between TBSA and disposition, total body surface area and aetiology and number of days in the Burns Intensive Care Unit, total body surface area and aetiology, and aetiology and number of days in the Burns Intensive Care Unit. Conclusions: Children below 10 years were the main victims. There was a shift from scald to open flame burns in this current study. Mean total body surface area and mortality rate have increased. There is urgent need for prevention campaign of flame burn and first aid education on intensive burns.
文摘目的 以网络药理学为主要研究手段,结合分子对接技术,分析烧伤酊治疗烧烫伤的分子机制。方法 利用中药整合药理学研究平台(integrative pharmacology-based research platform of traditional Chinese medicine, TCMIP)及中药系统药理学数据库(traditional Chinese medicine systems pharmacology database and analysis platform, TCMSP)筛选烧伤酊(榆树皮、黄柏或关黄柏)的相关靶点及其活性成分,采用UniProt数据库标准化靶点,并利用Cytoscape可视化软件构建活性成分-靶点网络,在数据库Gene Cards中检索与烧烫伤有关的基因,利用数据库STRING构建蛋白质的相互作用网络,并同时进行基因本体论(gene ontology, GO)功能富集分析和京都基因与基因组百科全书(kyoto encyclopedia of genes and genomes, KEGG)通路富集分析,最后采用分子对接技术对接核心的活性成分和靶位置。结果 通过类药性(drug likeness, DL)参数筛选得出烧伤酊组分榆树皮、黄柏和关黄柏中的主要活性化合物118个、核心靶点248个;检索疾病数据库得到烧烫伤疾病相关靶点2 147个;通过可视化数据分析得到38个潜在核心靶点及与其对应的51个中药潜在活性单体成分;结合GO功能与KEGG通路分析,烧伤酊中的活性成分槲皮素、沃戈宁黄酮、黄芩素主要通过调节蛋白激酶B1(protein kinase B1,AKT1)、白细胞介素-6(interleukin-6,IL-6)、上皮生长因子受体(epidermal growth factor receptor, EGFR)、上皮生长因子(epidermal growth factor, EGF)、血管内皮生长因子(vascular endothelial growth factor, VEGF)、肿瘤坏死因子(tumor necrosis factor, TNF)等蛋白以及肿瘤坏死因子、癌症中的蛋白多糖和细胞因子之间的受体作用等信号通路来发挥炎症应答、免疫应答、信号转导以及细胞增殖的正调控等作用,从而达到治疗烧烫伤的效果。结论 初步揭示了烧伤酊多层次、多环节治疗烧烫伤的作用机制。
