Burns最新文献

Background: Pediatric burn injuries pose significant health concerns and rank fifth globally in non-fatal injuries. Current evidence associates lower socioeconomic status (SES) with higher incidence of burn injury, greater TBSA, higher need for admission, and greater involvement of child protective services. There is a paucity of Canadian data on the topic, and effects of indices of deprivation on outcomes have not been investigated extensively.

Methods: A retrospective single-centre study was carried out to examine effects of SES and Ontario Marginalization Index (OMI) on pediatric burn patient outcomes. One-way ANOVA with post hock Bonferroni correction was used for continuous dependent variables (i.e. TBSA, length of stay), and Pearson chi-square analysis was done for categorical variables (i.e. CAS involvement, need for OR, need for admission). P-value of 0.05 was set a priori to determine statistical significance.

Results: No differences in outcomes were found between the four quartiles of SES categories. Analysis of the OMI for Material Resources, Racialized and Newcomer Populations, Age and Labour Force, and Household and Dwellings produced statistically significant findings. Patients with a higher degree of marginalization for most indices tended to have greater TBSA, time to surgery, and length of stay. An unexpected finding was that patients with the lowest Age and Labour Force deprivation indices were likely to have greater TBSA.

Conclusion: Identifying the effects of various social determinants of health on pediatric burn patients remains a challenging problem. While this study found no differences in patient outcomes based on income alone, examination of the granularity in deprivation provided notable differences. These effects could be further clarified with a cross-provincial or national study.

Chronic wounds in patients with type 2 diabetes mellitus reflect persistent wound stress and its interaction with systemic metabolic and inflammatory disorders. Building on this concept, this review summarises therapeutic strategies aimed at relieving local wound stress while protecting organ function. We first outline conventional regimens for wound management in type 2 diabetes mellitus, including glycaemic optimisation, anti-infective therapy, microcirculatory support, antioxidant and anti-inflammatory interventions, promotion of angiogenesis and neural repair, and comprehensive local care (debridement, dressings, negative-pressure therapy and multidisciplinary management). We then discuss tissue-engineering approaches that combine cells, bioactive factors, and advanced biomaterials or three-dimensional printing to reconstruct a pro-healing microenvironment, enhance neovascularisation and re-epithelialisation, and reduce systemic stress responses. Finally, we propose coordinated local wound repair and systemic stress regulation as a potential strategy to interrupt the cycle of persistent wound stress and multi-organ injury in type 2 diabetes mellitus.

Diabetic foot ulcers (DFUs) represent a severe, non-healing complication of diabetes, primarily driven by chronic inflammation and impaired tissue regeneration. This study investigated the therapeutic efficacy and underlying immunological mechanisms of a novel topical formulation: a water-soluble β-glucan/cross-linked sodium hyaluronate hydrogel, on wound healing in db/db diabetic mice. Wound closure analysis demonstrated that daily application of the β-glucan hydrogel significantly accelerated healing, achieving an average closure rate of 90.95 %±3.15 % by postoperative day (POD) 14, markedly surpassing the 65.67 %±3.64 % observed in the control group. Histological examination revealed enhanced epithelialization, collagen deposition, and microvessel density (MVD), alongside a substantial reduction in total inflammatory cell and mast cell infiltration. Immunofluorescence and qRT-PCR analyses showed that β-glucan significantly promoted macrophage polarization toward the pro-reparative M2 phenotype (marked by increased CD206⁺ cells), downregulating pro-inflammatory factors (IL-1β, TNF-α) while simultaneously upregulating IL-10 and TGF-β. In conclusion, the β-glucan smearable hydrogel exhibits potent therapeutic capacity for diabetic wounds by resolving chronic inflammation and promoting tissue repair via the M2 macrophage polarization pathway. This finding offers a promising and non-invasive immunomodulatory strategy for DFU management.

Background: Scar formation following significant tissue injury remains a major clinical challenge, with metabolic processes and inflammation critically influencing tissue remodeling and fibrotic outcomes.

Objective: This study aims to elucidate the causal relationships between plasma metabolites and scar pathogenesis using Mendelian randomization (MR).

Methods: By employing a two-sample MR approach, we analyzed genetic variants from GWAS as instrumental variables (IVs) to assess the impact of plasma metabolites on scar formation. Data on metabolite levels were sourced from a GWAS database of 8299 individuals, and scar outcome data involved 463,010 European skin tissue samples. Five MR methods were utilized to ensure robust causal inference, including inverse variance weighting, MR-Egger regression, and weighted median, complemented by sensitivity analyses to address potential confounding factors and pleiotropy.

Results: The analysis of MR identified a total of four metabolites significantly associated with scar risk. Among them, (S)-α-amino-ω-caprolactam, N-acetylalanine and glycochenodeoxycholate 3-sulfate were linked to increased scar formation, while alliin demonstrated protective effects. Consistency across different MR methods underscored the robustness of these findings. Sensitivity analyses confirmed the absence of pleiotropy and the stability of causal estimates.

Conclusion: The identified causal relationships between specific plasma metabolites and scar formation suggest that metabolic modulation may offer new therapeutic avenues for managing scar development.