Background: In Ethiopian traditional medicine, Rumex nervosus Vahl leaves are used to treat wounds. However, despite traditional claims and supportive in vitro findings, no scientific study has been conducted to evaluate the in vivo wound healing activity of R. nervosus Vahl leaves.
Aim of the study: To evaluate the wound healing activity of crude extract of the leaves of R. nervosus Vahl and its solvent fractions in mice.
Methods: R. nervosus Vahl leaves were extracted with 80% methanol, and then the crude extract was fractionated using ethyl acetate, chloroform, and water. Ointments at 5% and 10% strengths were formulated from the crude extract and its fractions. The healing activity of the crude extract was evaluated using linear incision, circular excision, and burn wound models in mice. Additionally, the activity of solvent fractions was assessed using circular excision wounds in mice.
Results: Treatment of wounds with ointments containing 5% and 10% crude extract showed significantly increased wound contraction rate, shorter epithelialization period, and higher skin-breaking strength (P < 0.05) compared with the negative control. Both 5% and 10% formulations of the aqueous and ethyl acetate fractions significantly increased wound contraction and decreased the period of epithelialization in the excision wound model (p < 0.05), however, the chloroform fraction showed no significant wound healing effect compared with the negative control.
Conclusion: The 80% methanol crude extract as well as the aqueous and ethyl acetate fractions of R. nervosus Vahl leaves possess wound healing activity as evidenced by improved wound contraction rate and tensile strength and decreased epithelialization period.
{"title":"Evaluation of wound healing activity of the crude extract and solvent fractions of <i>Rumex nervosus</i> Vahl (Polygonaceae) leaves in mice.","authors":"Abel Andualem, Kefyalew Ayalew Getahun, Bahiru Tenaw Goshu, Yaschilal Muche Belayneh","doi":"10.1177/20595131251316791","DOIUrl":"10.1177/20595131251316791","url":null,"abstract":"<p><strong>Background: </strong>In Ethiopian traditional medicine, <i>Rumex nervosus</i> Vahl leaves are used to treat wounds. However, despite traditional claims and supportive in vitro findings, no scientific study has been conducted to evaluate the in vivo wound healing activity of <i>R. nervosus</i> Vahl leaves.</p><p><strong>Aim of the study: </strong>To evaluate the wound healing activity of crude extract of the leaves of <i>R. nervosus</i> Vahl and its solvent fractions in mice.</p><p><strong>Methods: </strong><i>R. nervosus</i> Vahl leaves were extracted with 80% methanol, and then the crude extract was fractionated using ethyl acetate, chloroform, and water. Ointments at 5% and 10% strengths were formulated from the crude extract and its fractions. The healing activity of the crude extract was evaluated using linear incision, circular excision, and burn wound models in mice. Additionally, the activity of solvent fractions was assessed using circular excision wounds in mice.</p><p><strong>Results: </strong>Treatment of wounds with ointments containing 5% and 10% crude extract showed significantly increased wound contraction rate, shorter epithelialization period, and higher skin-breaking strength (P < 0.05) compared with the negative control. Both 5% and 10% formulations of the aqueous and ethyl acetate fractions significantly increased wound contraction and decreased the period of epithelialization in the excision wound model (p < 0.05), however, the chloroform fraction showed no significant wound healing effect compared with the negative control.</p><p><strong>Conclusion: </strong>The 80% methanol crude extract as well as the aqueous and ethyl acetate fractions of <i>R. nervosus</i> Vahl leaves possess wound healing activity as evidenced by improved wound contraction rate and tensile strength and decreased epithelialization period.</p>","PeriodicalId":94205,"journal":{"name":"Scars, burns & healing","volume":"11 ","pages":"20595131251316791"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-11eCollection Date: 2024-01-01DOI: 10.1177/20595131241302942
Andrew P Bain, Isabel Garcia, Matthew Leveno, Chiaka Akarichi
<p><strong>Introduction: </strong>Extracorporeal membranous oxygenation (ECMO) as a salvage therapy for patients with severe acute respiratory distress syndrome (ARDS) has been described but experience is limited in burn cases. Few case reports detail the use of ECMO the setting of burn excision.</p><p><strong>Case: </strong>Here, we describe a 40-year-old female found down in a house fire who presented with 30% total body surface area burns and severe inhalation injury resulting in ARDS. Veno-venous ECMO was initiated 12 h after injury, with a total ECMO run of 523 h. In that time, she underwent three tangential excisions with significant intraoperative and postoperative bleeding complications requiring in total 37 units of packed red blood cells, 8 pools of platelets, 24 units of fresh frozen plasma, and 1 unit of cryoprecipitate. The patient was successfully weaned from veno-venous ECMO. She required six subsequent excisions after her ECMO decannulation for both infection control and complete excision of her full-thickness burns. She was ultimately discharged to an inpatient rehabilitation facility.</p><p><strong>Discussion: </strong>This report serves as the first detailed description of perioperative resuscitation on ECMO during burn excision and adds to the body of literature regarding ECMO support in the burned patient. This case specifically highlights the multidisciplinary care and resource demands of performing burn excision during ECMO as well as the associated bleeding complications of doing so. Further study is needed to define optimal timing, patient selection, and strategy for coagulopathy management and surgical care of the burn patient with ARDS treated with ECMO.</p><p><strong>Lay summary: </strong>Patients with severe burn injuries can have associated injuries to their lungs from both smoke and as a response to the stress a severe burn puts on the body. The injuries can be so severe that supportive machines can be needed that do the work of the lungs by adding oxygen to the blood, called extracorporeal membranous oxygenation (ECMO). These extreme measures are critical to supporting severe respiratory problems and have been incorporated into caring for burn patients with severely injured lungs. ECMO requires significant resources and has risks, including bleeding and clotting issues. Severely burned patients also need surgery to remove burned skin and decrease the stress placed on the body. Only a handful of cases have been described where burn surgery has been performed while a patient was on ECMO support. In our experience caring for a severely burned patient and performing multiple surgeries on ECMO, we encountered multiple bleeding complications secondary to the use of ECMO, resulting in large amounts of transfusion products needed. After one month, the patient's lungs recovered and ECMO was not needed. The patient survived to discharge from the hospital after completion of additional necessary burn surgeries. This report is
{"title":"Early extracorporeal membranous oxygenation and burn excision in severe burn and inhalation injury.","authors":"Andrew P Bain, Isabel Garcia, Matthew Leveno, Chiaka Akarichi","doi":"10.1177/20595131241302942","DOIUrl":"10.1177/20595131241302942","url":null,"abstract":"<p><strong>Introduction: </strong>Extracorporeal membranous oxygenation (ECMO) as a salvage therapy for patients with severe acute respiratory distress syndrome (ARDS) has been described but experience is limited in burn cases. Few case reports detail the use of ECMO the setting of burn excision.</p><p><strong>Case: </strong>Here, we describe a 40-year-old female found down in a house fire who presented with 30% total body surface area burns and severe inhalation injury resulting in ARDS. Veno-venous ECMO was initiated 12 h after injury, with a total ECMO run of 523 h. In that time, she underwent three tangential excisions with significant intraoperative and postoperative bleeding complications requiring in total 37 units of packed red blood cells, 8 pools of platelets, 24 units of fresh frozen plasma, and 1 unit of cryoprecipitate. The patient was successfully weaned from veno-venous ECMO. She required six subsequent excisions after her ECMO decannulation for both infection control and complete excision of her full-thickness burns. She was ultimately discharged to an inpatient rehabilitation facility.</p><p><strong>Discussion: </strong>This report serves as the first detailed description of perioperative resuscitation on ECMO during burn excision and adds to the body of literature regarding ECMO support in the burned patient. This case specifically highlights the multidisciplinary care and resource demands of performing burn excision during ECMO as well as the associated bleeding complications of doing so. Further study is needed to define optimal timing, patient selection, and strategy for coagulopathy management and surgical care of the burn patient with ARDS treated with ECMO.</p><p><strong>Lay summary: </strong>Patients with severe burn injuries can have associated injuries to their lungs from both smoke and as a response to the stress a severe burn puts on the body. The injuries can be so severe that supportive machines can be needed that do the work of the lungs by adding oxygen to the blood, called extracorporeal membranous oxygenation (ECMO). These extreme measures are critical to supporting severe respiratory problems and have been incorporated into caring for burn patients with severely injured lungs. ECMO requires significant resources and has risks, including bleeding and clotting issues. Severely burned patients also need surgery to remove burned skin and decrease the stress placed on the body. Only a handful of cases have been described where burn surgery has been performed while a patient was on ECMO support. In our experience caring for a severely burned patient and performing multiple surgeries on ECMO, we encountered multiple bleeding complications secondary to the use of ECMO, resulting in large amounts of transfusion products needed. After one month, the patient's lungs recovered and ECMO was not needed. The patient survived to discharge from the hospital after completion of additional necessary burn surgeries. This report is","PeriodicalId":94205,"journal":{"name":"Scars, burns & healing","volume":"10 ","pages":"20595131241302942"},"PeriodicalIF":0.0,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-11eCollection Date: 2024-01-01DOI: 10.1177/20595131241288298
Joshua Lewis, Lornee C Pride, Shawn Lee, Ogechukwu Anwaegbu, Nangah N Tabukumm, Manav M Patel, Wei-Chen Lee
<p><strong>Introduction: </strong>Burns are associated with a high risk of developing comorbidities, including psychiatric disorders such as Post-Traumatic Stress Disorder (PTSD). This study aimed to evaluate the association between PTSD and opioid use, chronic pain syndrome, and other outcomes following burn injuries.</p><p><strong>Methods: </strong>A retrospective case-control analysis was conducted using the TriNetX database, a federated, de-identified national health research network with 92 healthcare organizations across the United States. Burn patients with and without PTSD were identified and matched based on demographics and injury severity. The likelihood of opioid use and other outcomes, including chronic pain, depression, anxiety, and emergency department visits, were compared between cohorts. Our study examined eight cohorts based on the percentage of total body surface area burned (TBSA%) and the presence or absence of PTSD. These cohorts were stratified as follows: patients with or without PTSD with TBSA, 1-19%, 20-39%, 40-59%, and 60+%. This stratification enabled a detailed comparison of outcomes across different levels of burn severity and the presence of PTSD, providing a comprehensive context for the results.</p><p><strong>Results: </strong>The mean age of patients with PTSD was slightly higher (46 ± 16 years) than that of those without PTSD (43 ± 23 years). Incidence of PTSD ranged from 4.96 to 12.26%, differing by percentage of total body surface area burned (TBSA%). Significant differences in various complications and comorbidities were observed between patients with and without PTSD within each burn severity cohort. Compared to the patients without PTSD, patients with PTSD had a significantly higher risk of opioid use in all cohorts: TBSA 1-19%, 20-39%, 40-59%, and 60+%.</p><p><strong>Conclusion: </strong>PTSD is associated with a significant increased likelihood of adverse outcomes following severe burns, particularly opioid use, chronic pain, psychological disorders, and higher healthcare utilization. These findings underscore the importance of identifying PTSD in burn patient management and highlight the need for further research into postoperative pain management strategies for this vulnerable population. Psychological assessments and cognitive behavioral therapy may be particularly useful.</p><p><strong>Lay summary: </strong>Burn injuries can cause serious problems like infections and organ failure, and they sometimes lead to death. Severe burns affect about 4.4% of all burn cases and can be deadly in nearly 18% of those cases. They cause inflammation that can lead to long-term heart, metabolism, and thinking problems. These injuries can also cause mental health issues like PTSD (Post-Traumatic Stress Disorder).PTSD means people might relive their trauma through bad memories or nightmares, avoid thinking about it, and feel different emotions for at least a month after it happens. People who survive burns often get PTS
{"title":"Examining the role of post-traumatic stress disorder, chronic pain and opioid use in burn patients: A multi-cohort analysis.","authors":"Joshua Lewis, Lornee C Pride, Shawn Lee, Ogechukwu Anwaegbu, Nangah N Tabukumm, Manav M Patel, Wei-Chen Lee","doi":"10.1177/20595131241288298","DOIUrl":"10.1177/20595131241288298","url":null,"abstract":"<p><strong>Introduction: </strong>Burns are associated with a high risk of developing comorbidities, including psychiatric disorders such as Post-Traumatic Stress Disorder (PTSD). This study aimed to evaluate the association between PTSD and opioid use, chronic pain syndrome, and other outcomes following burn injuries.</p><p><strong>Methods: </strong>A retrospective case-control analysis was conducted using the TriNetX database, a federated, de-identified national health research network with 92 healthcare organizations across the United States. Burn patients with and without PTSD were identified and matched based on demographics and injury severity. The likelihood of opioid use and other outcomes, including chronic pain, depression, anxiety, and emergency department visits, were compared between cohorts. Our study examined eight cohorts based on the percentage of total body surface area burned (TBSA%) and the presence or absence of PTSD. These cohorts were stratified as follows: patients with or without PTSD with TBSA, 1-19%, 20-39%, 40-59%, and 60+%. This stratification enabled a detailed comparison of outcomes across different levels of burn severity and the presence of PTSD, providing a comprehensive context for the results.</p><p><strong>Results: </strong>The mean age of patients with PTSD was slightly higher (46 ± 16 years) than that of those without PTSD (43 ± 23 years). Incidence of PTSD ranged from 4.96 to 12.26%, differing by percentage of total body surface area burned (TBSA%). Significant differences in various complications and comorbidities were observed between patients with and without PTSD within each burn severity cohort. Compared to the patients without PTSD, patients with PTSD had a significantly higher risk of opioid use in all cohorts: TBSA 1-19%, 20-39%, 40-59%, and 60+%.</p><p><strong>Conclusion: </strong>PTSD is associated with a significant increased likelihood of adverse outcomes following severe burns, particularly opioid use, chronic pain, psychological disorders, and higher healthcare utilization. These findings underscore the importance of identifying PTSD in burn patient management and highlight the need for further research into postoperative pain management strategies for this vulnerable population. Psychological assessments and cognitive behavioral therapy may be particularly useful.</p><p><strong>Lay summary: </strong>Burn injuries can cause serious problems like infections and organ failure, and they sometimes lead to death. Severe burns affect about 4.4% of all burn cases and can be deadly in nearly 18% of those cases. They cause inflammation that can lead to long-term heart, metabolism, and thinking problems. These injuries can also cause mental health issues like PTSD (Post-Traumatic Stress Disorder).PTSD means people might relive their trauma through bad memories or nightmares, avoid thinking about it, and feel different emotions for at least a month after it happens. People who survive burns often get PTS","PeriodicalId":94205,"journal":{"name":"Scars, burns & healing","volume":"10 ","pages":"20595131241288298"},"PeriodicalIF":0.0,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-13eCollection Date: 2024-01-01DOI: 10.1177/20595131241282105
Thibau Demarbaix, Ulrike Van Daele, Jill Meirte, Mieke Anthonissen, Koen Maertens, Peter Moortgat
<p><strong>Aim: </strong>The evidence regarding a potential role of food supplementation as an adjunct therapy in scar aftercare is limited. In this scoping review we aim to provide an overview of the possible beneficial role of supplementations in aftercare settings.</p><p><strong>Method: </strong>After formulating the research question and accompanying key words, a comprehensive search for relevant publications was performed using PubMed and Web of Science. Two authors independently identified and checked each study against the inclusion criteria. All data was collected and summarized for further discussion.</p><p><strong>Results: </strong>After screening, 11 studies were included in the qualitative synthesis. Four studies including human subjects showed a promising connection between scar improvement and supplementation of vitamin D, omega-3 fatty-acids or a Solanaceae-free diet and lower omega-6 fatty-acid intake. Most of the studies were performed on in-vitro models. Preliminary evidence confirmed the beneficial role of vitamin D. Curcumin- and quercetin-supplementation were linked to decreased fibroblast proliferation. Vitamin C enhanced collagen production in healthy as well as keloidal dermal fibroblasts. Chitin stimulated cell-proliferation in human fibroblasts and keratinocytes.</p><p><strong>Conclusion: </strong>The findings suggest early potential benefits of additional food supplementation in scar management for scars but provide no clear evidence. To establish guidelines or gather more evidence on food supplementation, studies involving human subjects (in vivo) are essential. The intricacies associated with nutritional studies in vivo present multifaceted challenges. It should be emphasized that substantial additional evidence is required before aspects such as timing and dosage of supplementation could be addressed for clinical application.</p><p><strong>Lay summary: </strong><b>Aim:</b> This scoping review looks at whether taking food supplements might help with scar care alongside standard scar management following burn injury. Little information is thought to be available on this subject. An up-to-date review of the literature was undertaken to assimilate the body of evidence and determine if a consensus could be drawn.<b>Method:</b> A specific research question was designed and search conducted in scientific databases like PubMed and Web of Science. Two of our team members carefully selected and reviewed each study to determine which studies met the inclusion or exclusion criteria. All studies that met the inclusion criteria were then reviewed and the information collated to enable conclusions to be drawn.<b>Results:</b> Eleven studies met the inclusion criteria and were used to formulate the conclusions drawn. Four studies showed that taking vitamin D, omega-3 fatty acids, a diet without certain vegetables (Solanaceae), and eating less omega-6 fatty acids might help improve scars. It is important to note that most studies (sev
目的：有关食物补充剂在疤痕术后护理中作为辅助疗法的潜在作用的证据有限。在这篇范围综述中，我们旨在概述补充剂在术后护理中可能发挥的有益作用：在提出研究问题和相关关键词后，我们使用 PubMed 和 Web of Science 对相关出版物进行了全面搜索。两位作者根据纳入标准对每项研究进行了独立鉴定和检查。收集并汇总了所有数据，以供进一步讨论：经过筛选，有 11 项研究被纳入定性综述。四项包含人类受试者的研究表明，疤痕的改善与补充维生素 D、ω-3 脂肪酸或不含茄科植物的饮食以及降低ω-6 脂肪酸的摄入量之间存在良好的联系。大多数研究都是在体外模型上进行的。补充姜黄素和槲皮素与成纤维细胞增殖减少有关。维生素 C 能促进健康和瘢痕疙瘩真皮成纤维细胞中胶原蛋白的生成。甲壳素可刺激人体成纤维细胞和角质细胞的细胞增殖：结论：研究结果表明，在疤痕治疗中补充额外的食物对疤痕有早期潜在的益处，但没有提供明确的证据。要制定有关食物补充的指导原则或收集更多证据，必须开展以人为对象（体内）的研究。与体内营养研究相关的复杂性带来了多方面的挑战。需要强调的是，在将补充剂的时间和剂量等方面应用于临床之前，还需要大量的补充证据。摘要：目的：本范围综述探讨了在烧伤后进行标准疤痕处理的同时，服用食物补充剂是否有助于疤痕护理。目前有关这方面的信息很少。我们对文献进行了最新综述，以吸收大量证据并确定能否达成共识：设计了一个具体的研究问题，并在 PubMed 和 Web of Science 等科学数据库中进行了搜索。我们团队的两名成员仔细挑选并审查了每项研究，以确定哪些研究符合纳入或排除标准。然后对所有符合纳入标准的研究进行审查，并对信息进行整理，以便得出结论：结果：有 11 项研究符合纳入标准，并据此得出结论。四项研究表明，服用维生素 D、ω-3 脂肪酸、不食用某些蔬菜（茄科）和少吃ω-6 脂肪酸可能有助于改善疤痕。值得注意的是，大多数研究（11 项中的 7 项）都是在实验室中进行的，而不是在真人身上进行的。这些实验室研究表明，维生素 D 可能会有所帮助。姜黄素和槲皮素等补充剂似乎能减缓成纤维细胞和角质细胞等皮肤细胞的生长。维生素 C 有助于胶原蛋白的合成，而胶原蛋白对正常和瘢痕疙瘩疤痕细胞的皮肤健康都很重要。另一种物质甲壳素也有助于皮肤细胞和角质形成细胞更好地生长：我们的研究结果表明，在早期服用额外的营养补充剂对控制疤痕可能有一些好处，但并没有提供明确的证据。需要进行更多的研究，以便制定补充剂建议和指南。未来的研究应侧重于人体试验，但要记住，对人体进行补充剂研究是比较复杂的。本次范围界定审查提供的证据不足以建议为控制疤痕摄入任何补充剂或实施饮食限制。
{"title":"Possible benefits of food supplementation or diet in scar management: A scoping review.","authors":"Thibau Demarbaix, Ulrike Van Daele, Jill Meirte, Mieke Anthonissen, Koen Maertens, Peter Moortgat","doi":"10.1177/20595131241282105","DOIUrl":"10.1177/20595131241282105","url":null,"abstract":"<p><strong>Aim: </strong>The evidence regarding a potential role of food supplementation as an adjunct therapy in scar aftercare is limited. In this scoping review we aim to provide an overview of the possible beneficial role of supplementations in aftercare settings.</p><p><strong>Method: </strong>After formulating the research question and accompanying key words, a comprehensive search for relevant publications was performed using PubMed and Web of Science. Two authors independently identified and checked each study against the inclusion criteria. All data was collected and summarized for further discussion.</p><p><strong>Results: </strong>After screening, 11 studies were included in the qualitative synthesis. Four studies including human subjects showed a promising connection between scar improvement and supplementation of vitamin D, omega-3 fatty-acids or a Solanaceae-free diet and lower omega-6 fatty-acid intake. Most of the studies were performed on in-vitro models. Preliminary evidence confirmed the beneficial role of vitamin D. Curcumin- and quercetin-supplementation were linked to decreased fibroblast proliferation. Vitamin C enhanced collagen production in healthy as well as keloidal dermal fibroblasts. Chitin stimulated cell-proliferation in human fibroblasts and keratinocytes.</p><p><strong>Conclusion: </strong>The findings suggest early potential benefits of additional food supplementation in scar management for scars but provide no clear evidence. To establish guidelines or gather more evidence on food supplementation, studies involving human subjects (in vivo) are essential. The intricacies associated with nutritional studies in vivo present multifaceted challenges. It should be emphasized that substantial additional evidence is required before aspects such as timing and dosage of supplementation could be addressed for clinical application.</p><p><strong>Lay summary: </strong><b>Aim:</b> This scoping review looks at whether taking food supplements might help with scar care alongside standard scar management following burn injury. Little information is thought to be available on this subject. An up-to-date review of the literature was undertaken to assimilate the body of evidence and determine if a consensus could be drawn.<b>Method:</b> A specific research question was designed and search conducted in scientific databases like PubMed and Web of Science. Two of our team members carefully selected and reviewed each study to determine which studies met the inclusion or exclusion criteria. All studies that met the inclusion criteria were then reviewed and the information collated to enable conclusions to be drawn.<b>Results:</b> Eleven studies met the inclusion criteria and were used to formulate the conclusions drawn. Four studies showed that taking vitamin D, omega-3 fatty acids, a diet without certain vegetables (Solanaceae), and eating less omega-6 fatty acids might help improve scars. It is important to note that most studies (sev","PeriodicalId":94205,"journal":{"name":"Scars, burns & healing","volume":"10 ","pages":"20595131241282105"},"PeriodicalIF":0.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11402062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-02eCollection Date: 2024-01-01DOI: 10.1177/20595131241270220
Saiidy Hasham, Ciaran O'Boyle, Skaria Alexander
<p><strong>Background: </strong>Myelomeningocele is a severe and complex congenital malformation of the central nervous system. Failure of neural tube closure at around four weeks of gestation results in an open communication between the neural placode and the external environment with varied functional impairment. Surgery is usually required.</p><p><strong>Objectives: </strong>The primary goals of surgical management are to preserve neural function and minimise infection. Reconstruction is dependent upon the site and size of the defect as well as the quality of the surrounding soft tissues. Surgeons may employ a range of reconstructive techniques in order to achieve closure. Skin substitutes, also known as dermal regeneration templates, have also been utilised.</p><p><strong>Discussion: </strong>In our unit, we use NovoSorb Biodegradable Temporising Matrix to reconstruct full-thickness skin and soft tissue defects. It is a synthetic, biodegradable, dermal regeneration template, composed of polyurethane foam bonded to a transparent sealing membrane and typically requires a two stage reconstruction. Integration and vascularisation take approximately three weeks. After this time, the recipient wound bed is suitable for split thickness skin grafting. A further benefit of dermal regeneration templates is the possibility of 'stacking' layers, which serves to increase the thickness of the final construct and to minimise overall contour defects. The authors present the case of a one-day-old full-term neonate with a large lumbosacral myelomeningocele that was successfully managed with staged, stacked NovoSorb Biodegradable Temporising Matrix and split thickness skin grafting. The authors believe this is the first case in which a 'stacked' dermal regeneration templates has been used to achieve healing of a primary myelomeningocele defect.</p><p><strong>Lay summary: </strong><b>Background:</b> NovoSorb Biodegradable Temporising Matrix (BTM) is a dermal regeneration template (DRT) and is used to reconstruct wounds following full-thickness skin and soft tissue loss resulting from burn injury, trauma, infection or surgery. It is composed of 2-millimetre thick, synthetic, biodegradable polyurethane foam bonded to a transparent (non-biodegradable) sealing membrane. Like all DRTs, it acts as a scaffold for cellular integration and vascularisation to eventually form a 'neo-dermis'. This is usually apparent from around three weeks. A second stage procedure can then be performed, with removal of the outer sealing membrane and split thickness skin grafting of the vascularised layer.<b>Objectives:</b> Myelomeningocele is a severe and complex congenital malformation of the central nervous system and forms the group of anomalies commonly referred to as neural tube defects (NTDs). Neural tube closure usually occurs at around four weeks of gestation and failure to do so, results in an open communication between the neural placode and the external environment. The degree
{"title":"Use of 'stacked' dermal template: Biodegradable temporising matrix to close a large myelomeningocele defect in a newborn.","authors":"Saiidy Hasham, Ciaran O'Boyle, Skaria Alexander","doi":"10.1177/20595131241270220","DOIUrl":"10.1177/20595131241270220","url":null,"abstract":"<p><strong>Background: </strong>Myelomeningocele is a severe and complex congenital malformation of the central nervous system. Failure of neural tube closure at around four weeks of gestation results in an open communication between the neural placode and the external environment with varied functional impairment. Surgery is usually required.</p><p><strong>Objectives: </strong>The primary goals of surgical management are to preserve neural function and minimise infection. Reconstruction is dependent upon the site and size of the defect as well as the quality of the surrounding soft tissues. Surgeons may employ a range of reconstructive techniques in order to achieve closure. Skin substitutes, also known as dermal regeneration templates, have also been utilised.</p><p><strong>Discussion: </strong>In our unit, we use NovoSorb Biodegradable Temporising Matrix to reconstruct full-thickness skin and soft tissue defects. It is a synthetic, biodegradable, dermal regeneration template, composed of polyurethane foam bonded to a transparent sealing membrane and typically requires a two stage reconstruction. Integration and vascularisation take approximately three weeks. After this time, the recipient wound bed is suitable for split thickness skin grafting. A further benefit of dermal regeneration templates is the possibility of 'stacking' layers, which serves to increase the thickness of the final construct and to minimise overall contour defects. The authors present the case of a one-day-old full-term neonate with a large lumbosacral myelomeningocele that was successfully managed with staged, stacked NovoSorb Biodegradable Temporising Matrix and split thickness skin grafting. The authors believe this is the first case in which a 'stacked' dermal regeneration templates has been used to achieve healing of a primary myelomeningocele defect.</p><p><strong>Lay summary: </strong><b>Background:</b> NovoSorb Biodegradable Temporising Matrix (BTM) is a dermal regeneration template (DRT) and is used to reconstruct wounds following full-thickness skin and soft tissue loss resulting from burn injury, trauma, infection or surgery. It is composed of 2-millimetre thick, synthetic, biodegradable polyurethane foam bonded to a transparent (non-biodegradable) sealing membrane. Like all DRTs, it acts as a scaffold for cellular integration and vascularisation to eventually form a 'neo-dermis'. This is usually apparent from around three weeks. A second stage procedure can then be performed, with removal of the outer sealing membrane and split thickness skin grafting of the vascularised layer.<b>Objectives:</b> Myelomeningocele is a severe and complex congenital malformation of the central nervous system and forms the group of anomalies commonly referred to as neural tube defects (NTDs). Neural tube closure usually occurs at around four weeks of gestation and failure to do so, results in an open communication between the neural placode and the external environment. The degree ","PeriodicalId":94205,"journal":{"name":"Scars, burns & healing","volume":"10 ","pages":"20595131241270220"},"PeriodicalIF":0.0,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-18eCollection Date: 2024-01-01DOI: 10.1177/20595131241234715
Baoyi Liu, Rajiv Sood, Fuyang Wang, Feng Zhang, Lu Sun, Xing Qiu, Dewei Zhao, William Charles Lineaweaver
Introduction: Transcutaneous laser-assisted drug delivery (LADD) is recognized as a developing therapy for skin disorders.
Method: Current literature was reviewed to summarize current applications for LADD.
Discussion: 12 clinical applications for this therapy are currently reported.
Conclusion: LADD has potential for wide application in skin disorder treatment.
Lay summary: Laser assisted drug delivery improves drug bioavailability for treatment of skin disorders. This technique is being assessed clinically in disorders ranging from skin cancers to alopecia.
{"title":"Principles and clinical applications of transcutaneous laser-assisted drug delivery: A narrative review.","authors":"Baoyi Liu, Rajiv Sood, Fuyang Wang, Feng Zhang, Lu Sun, Xing Qiu, Dewei Zhao, William Charles Lineaweaver","doi":"10.1177/20595131241234715","DOIUrl":"https://doi.org/10.1177/20595131241234715","url":null,"abstract":"<p><strong>Introduction: </strong>Transcutaneous laser-assisted drug delivery (LADD) is recognized as a developing therapy for skin disorders.</p><p><strong>Method: </strong>Current literature was reviewed to summarize current applications for LADD.</p><p><strong>Discussion: </strong>12 clinical applications for this therapy are currently reported.</p><p><strong>Conclusion: </strong>LADD has potential for wide application in skin disorder treatment.</p><p><strong>Lay summary: </strong>Laser assisted drug delivery improves drug bioavailability for treatment of skin disorders. This technique is being assessed clinically in disorders ranging from skin cancers to alopecia.</p>","PeriodicalId":94205,"journal":{"name":"Scars, burns & healing","volume":"10 ","pages":"20595131241234715"},"PeriodicalIF":0.0,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10949547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140178546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-12eCollection Date: 2024-01-01DOI: 10.1177/20595131241236190
RuthAnn Fanstone, Mohammad Rabiul Karim Khan
Introduction: Burns are most prevalent in low- and middle-income countries but the risk factors for burn contractures in these settings are poorly understood. There is some evidence from low- and middle-income country studies to suggest that non-medical factors such as socio-economic and health system issues may be as, or possibly more, important than biomedical factors in the development of post-burn contractures.
Methods: Four cases are presented to illustrate the impact of non-biomedical factors on contracture outcomes in a low-income setting. The cases were drawn from participants in a cross-sectional study which examined risk factors for contracture in Bangladesh.
Discussion: The two cases had similar burns but different standards of care for socio-economic reasons, leading to very different contracture outcomes The two cases both had access to specialist care but had very different contracture outcomes for non-medical reasons. The risk factors and contracture outcomes in each case are documented and compared.
Conclusion: The impact of non-biomedical factors in contracture development after burns in low- and middle-income countries is highlighted and discussed.
Lay summary: Burns are common in low- and middle-income countries (LMICs) but the risk factors for burn contractures in these settings are poorly understood. Burn contractures are formed when scarring from a burn injury is near or over a joint and results in limited movement. There is some evidence from LMIC studies which suggests that non-medical factors such as socio-economic (e.g., household income, level of education) and health system issues (e.g., whether specialist burn care could be accessed) may be as, or possibly more, important than non-medical factors (such as the type and depth of burn and the treatments received) in the development of contractures following burn injuries.Four cases are presented to illustrate the impact of non-biomedical factors on contracture outcomes in a low-income setting. The cases were drawn from participants in a larger study which examined risk factors for contracture in Bangladesh. Two cases had similar burns but different standards of care and different outcomes. Two cases had similar access to specialist care but very different outcomes for non-medical reasons. The risk factors present and contractures outcomes in each case are documented and compared.The importance of non-biomedical factors in contracture development after burns in LMICs is highlighted and discussed.
{"title":"Risk factors for burn contractures in a lower income country: Four illustrative cases.","authors":"RuthAnn Fanstone, Mohammad Rabiul Karim Khan","doi":"10.1177/20595131241236190","DOIUrl":"10.1177/20595131241236190","url":null,"abstract":"<p><strong>Introduction: </strong>Burns are most prevalent in low- and middle-income countries but the risk factors for burn contractures in these settings are poorly understood. There is some evidence from low- and middle-income country studies to suggest that non-medical factors such as socio-economic and health system issues may be as, or possibly more, important than biomedical factors in the development of post-burn contractures.</p><p><strong>Methods: </strong>Four cases are presented to illustrate the impact of non-biomedical factors on contracture outcomes in a low-income setting. The cases were drawn from participants in a cross-sectional study which examined risk factors for contracture in Bangladesh.</p><p><strong>Discussion: </strong>The two cases had similar burns but different standards of care for socio-economic reasons, leading to very different contracture outcomes The two cases both had access to specialist care but had very different contracture outcomes for non-medical reasons. The risk factors and contracture outcomes in each case are documented and compared.</p><p><strong>Conclusion: </strong>The impact of non-biomedical factors in contracture development after burns in low- and middle-income countries is highlighted and discussed.</p><p><strong>Lay summary: </strong>Burns are common in low- and middle-income countries (LMICs) but the risk factors for burn contractures in these settings are poorly understood. Burn contractures are formed when scarring from a burn injury is near or over a joint and results in limited movement. There is some evidence from LMIC studies which suggests that non-medical factors such as socio-economic (e.g., household income, level of education) and health system issues (e.g., whether specialist burn care could be accessed) may be as, or possibly more, important than non-medical factors (such as the type and depth of burn and the treatments received) in the development of contractures following burn injuries.Four cases are presented to illustrate the impact of non-biomedical factors on contracture outcomes in a low-income setting. The cases were drawn from participants in a larger study which examined risk factors for contracture in Bangladesh. Two cases had similar burns but different standards of care and different outcomes. Two cases had similar access to specialist care but very different outcomes for non-medical reasons. The risk factors present and contractures outcomes in each case are documented and compared.The importance of non-biomedical factors in contracture development after burns in LMICs is highlighted and discussed.</p>","PeriodicalId":94205,"journal":{"name":"Scars, burns & healing","volume":"10 ","pages":"20595131241236190"},"PeriodicalIF":0.0,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10935743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140121719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Cryosurgery is recognized as a treatment option for various types of oral lesions. Although cryosurgery is less invasive and easier to perform than surgical treatments, adverse events, such as stomatitis and scarring can occur if the freezing is excessive. There are few studies regarding the effects of cryosurgery on the surrounding soft tissues. Thus, this study investigated the extent of tissue destruction and healing progress in tongues of mice who underwent cryosurgery.
Methods: Eight-week-old male BALB/c mice were used. An instrument cooled with liquid nitrogen was lightly touched on the right side of the tongue for 5 s, and a second test was performed 10 s later. Histological evaluation was performed 3, 7, and 14 days after cryosurgery. Blood vessels were evaluated with India ink at 1, 3, 7, 14, and 21 days after cryosurgery.
Results: Destruction of the soft tissue spread to the left side of the tongue after 3 days. At 7 days, it was confirmed that the muscle tissue was in the process of repair and was completely repaired at 14 days. Although blood vessels were not confirmed at 3 days, they were visible after seven days and were confirmed at 21 days all over the tongue.
Discussion and conclusion: These results indicated that the tissue destruction caused by cryosurgery was extensive and suggest that the duration and frequency of freezing should be minimized for clinical use.
Lay summary: Cryosurgery is a treatment method for various types of oral lesions. Freezing the lesion causes the tissue to collapse, resulting in its disappearance. Although cryosurgery is less invasive and easier to perform than surgical treatments, adverse events, such as stomatitis and scarring can occur if the freezing is excessive. This study investigated the extent of tissue destruction and healing progress in tongues of mice who underwent cryosurgery.The right side of mice tongues were frozen by an instrument cooled with liquid nitrogen for 5 s, and a second test was performed 10 s later. The tissue destruction was evaluated at 3, 7, and 14 days after freezing. Blood vessels were evaluated with India ink at 1, 3, 7, 14, and 21 days after freezing. Tissue destruction spread to the left side of the tongue after 3 days. At 7 days, it was confirmed that the muscle tissue was in the process of repair and was completely repaired at 14 days. Blood vessel repair was confirmed at 21 days in the throughout tongue. These results indicated that the tissue destruction caused by cryosurgery was large and suggest that the duration and frequency of freezing should be minimized for clinical use.
{"title":"Histological evaluation of tissue destruction in mouse tongues caused by cryosurgery.","authors":"Tadashi Kawai, Atsushi Ogawa, Isao Hoshi, Hiroyuki Yamada, Akira Fujimura","doi":"10.1177/20595131241230398","DOIUrl":"10.1177/20595131241230398","url":null,"abstract":"<p><strong>Introduction: </strong>Cryosurgery is recognized as a treatment option for various types of oral lesions. Although cryosurgery is less invasive and easier to perform than surgical treatments, adverse events, such as stomatitis and scarring can occur if the freezing is excessive. There are few studies regarding the effects of cryosurgery on the surrounding soft tissues. Thus, this study investigated the extent of tissue destruction and healing progress in tongues of mice who underwent cryosurgery.</p><p><strong>Methods: </strong>Eight-week-old male BALB/c mice were used. An instrument cooled with liquid nitrogen was lightly touched on the right side of the tongue for 5 s, and a second test was performed 10 s later. Histological evaluation was performed 3, 7, and 14 days after cryosurgery. Blood vessels were evaluated with India ink at 1, 3, 7, 14, and 21 days after cryosurgery.</p><p><strong>Results: </strong>Destruction of the soft tissue spread to the left side of the tongue after 3 days. At 7 days, it was confirmed that the muscle tissue was in the process of repair and was completely repaired at 14 days. Although blood vessels were not confirmed at 3 days, they were visible after seven days and were confirmed at 21 days all over the tongue.</p><p><strong>Discussion and conclusion: </strong>These results indicated that the tissue destruction caused by cryosurgery was extensive and suggest that the duration and frequency of freezing should be minimized for clinical use.</p><p><strong>Lay summary: </strong>Cryosurgery is a treatment method for various types of oral lesions. Freezing the lesion causes the tissue to collapse, resulting in its disappearance. Although cryosurgery is less invasive and easier to perform than surgical treatments, adverse events, such as stomatitis and scarring can occur if the freezing is excessive. This study investigated the extent of tissue destruction and healing progress in tongues of mice who underwent cryosurgery.The right side of mice tongues were frozen by an instrument cooled with liquid nitrogen for 5 s, and a second test was performed 10 s later. The tissue destruction was evaluated at 3, 7, and 14 days after freezing. Blood vessels were evaluated with India ink at 1, 3, 7, 14, and 21 days after freezing. Tissue destruction spread to the left side of the tongue after 3 days. At 7 days, it was confirmed that the muscle tissue was in the process of repair and was completely repaired at 14 days. Blood vessel repair was confirmed at 21 days in the throughout tongue. These results indicated that the tissue destruction caused by cryosurgery was large and suggest that the duration and frequency of freezing should be minimized for clinical use.</p>","PeriodicalId":94205,"journal":{"name":"Scars, burns & healing","volume":"10 ","pages":"20595131241230398"},"PeriodicalIF":0.0,"publicationDate":"2024-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10880518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139934894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-20eCollection Date: 2024-01-01DOI: 10.1177/20595131241230742
Donna L Kennedy, Shehan Hettiaratchy, Caroline M Alexander
Introduction: The mechanisms underlying persistent scar pain are not fully elucidated and evidence for the clinical evaluation of scar pain is limited. This pilot observational study investigated participation data and sought to identify objective clinical scar evaluation measures for future trials.
Methods: With ethical approval and consent, adults undergoing planned hand surgery were enrolled from one NHS hospital. At 1- and 4-months post-surgery scar thermal and mechanical pain thresholds were evaluated with quantitative sensory testing; peri-scar inflammation with infrared thermometry and pliability with durometry. Participation data were analysed with descriptive statistics; the association of clinical measures with patient reported scar pain was analysed.
Results: Twenty-one participants (22% eligible patients) enrolled before study closure due to the COVID-19 pandemic; 13 completed follow up. No adverse events or dropouts resulted from clinical scar evaluation. Seventy percent of participants reported undertaking topical, nonprescription scar treatment independently. Neuropathic Pain Symptom Inventory (NPSI) scores were dispersed across the score range, capturing variability in participant-reported scar symptoms. Scar morphology, pliability and inflammation were not associated with scar pain. Differences between scar and contralateral skin in thermal and mechanical pain sensitivity were identified.
Conclusion: People with acute hand scars participate in clinical research and independently initiate scar treatment. Clinical testing of acute post-surgical hand scars is well tolerated. The NPSI demonstrates utility for exploring scar pain symptoms and may support the elucidation of mechanisms of persistent scar pain. Clinical tests of thermal and mechanical and sensitivity are promising candidate clinical measures of scar pain for future trials.
Lay summary: Background: it is unknown why some scars remain painful long-term. We do not know if scar flexibility, inflammation or sensitivity to temperature or pressure relate to scar pain. We investigated if patients would enrol in scar research, if scar testing was tolerated and if clinical tests are useful for future scar studies. Study conduct: with ethical approval and consent, adult hand surgery patients were enrolled from one NHS hospital. Scar pain, inflammation and response to thermal, sharp and pressure tests were assessed at 1- and 4-months after surgery. Statistically, we analysed study participation, tolerance for clinical scar tests and if the scar tests related to scar pain. Findings: 21 participants (22% eligible patients) enrolled before study closure due to the COVID-19 pandemic; 13 completed follow up. No participants were injured due to scar testing. 70% of participants reported treating their scar independently. Neuropathic Pain Symptom Inventory (N
{"title":"Clinical evaluation of post-surgical scar hyperaesthesia: a longitudinal observational pilot study.","authors":"Donna L Kennedy, Shehan Hettiaratchy, Caroline M Alexander","doi":"10.1177/20595131241230742","DOIUrl":"10.1177/20595131241230742","url":null,"abstract":"<p><strong>Introduction: </strong>The mechanisms underlying persistent scar pain are not fully elucidated and evidence for the clinical evaluation of scar pain is limited. This pilot observational study investigated participation data and sought to identify objective clinical scar evaluation measures for future trials.</p><p><strong>Methods: </strong>With ethical approval and consent, adults undergoing planned hand surgery were enrolled from one NHS hospital. At 1- and 4-months post-surgery scar thermal and mechanical pain thresholds were evaluated with quantitative sensory testing; peri-scar inflammation with infrared thermometry and pliability with durometry. Participation data were analysed with descriptive statistics; the association of clinical measures with patient reported scar pain was analysed.</p><p><strong>Results: </strong>Twenty-one participants (22% eligible patients) enrolled before study closure due to the COVID-19 pandemic; 13 completed follow up. No adverse events or dropouts resulted from clinical scar evaluation. Seventy percent of participants reported undertaking topical, nonprescription scar treatment independently. Neuropathic Pain Symptom Inventory (NPSI) scores were dispersed across the score range, capturing variability in participant-reported scar symptoms. Scar morphology, pliability and inflammation were not associated with scar pain. Differences between scar and contralateral skin in thermal and mechanical pain sensitivity were identified.</p><p><strong>Conclusion: </strong>People with acute hand scars participate in clinical research and independently initiate scar treatment. Clinical testing of acute post-surgical hand scars is well tolerated. The NPSI demonstrates utility for exploring scar pain symptoms and may support the elucidation of mechanisms of persistent scar pain. Clinical tests of thermal and mechanical and sensitivity are promising candidate clinical measures of scar pain for future trials.</p><p><strong>Lay summary: </strong><b>Background:</b> it is unknown why some scars remain painful long-term. We do not know if scar flexibility, inflammation or sensitivity to temperature or pressure relate to scar pain. We investigated if patients would enrol in scar research, if scar testing was tolerated and if clinical tests are useful for future scar studies. <b>Study conduct:</b> with ethical approval and consent, adult hand surgery patients were enrolled from one NHS hospital. Scar pain, inflammation and response to thermal, sharp and pressure tests were assessed at 1- and 4-months after surgery. Statistically, we analysed study participation, tolerance for clinical scar tests and if the scar tests related to scar pain. <b>Findings:</b> 21 participants (22% eligible patients) enrolled before study closure due to the COVID-19 pandemic; 13 completed follow up. No participants were injured due to scar testing. 70% of participants reported treating their scar independently. Neuropathic Pain Symptom Inventory (N","PeriodicalId":94205,"journal":{"name":"Scars, burns & healing","volume":"10 ","pages":"20595131241230742"},"PeriodicalIF":0.0,"publicationDate":"2024-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10916468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140051412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-20eCollection Date: 2024-01-01DOI: 10.1177/20595131241230739
Hongtao Wang, Yang Liu, Yan Li, Fu Han, Qiaohua Chen, Juntao Han, Dahai Hu
Introduction: Postburn scarring often presents a specific reconstructive challenge from both functional and cosmetic perspectives. The purpose of this study was to investigate whether autologous nanofat harvested from the donor site of full skin or a skin flap can be reused for the treatment of early postburn scaring.
Methods: From July 2018 to April 2022, patients with early postburn scarring underwent scar reconstruction surgery with full-thickness skin or a skin flap for a contour deformity and/or scar contracture, and autologous nanofat grafting was performed during the same operation. The Vancouver Scar Score (VSS) and the itch and pain scores were evaluated at the preoperation time point as well as at 2-3 weeks and 3-months postoperation. A comparison was made among the same patients at different time points.
Results: A total of 17 patients, aged from 18 months to 62 years old were included in this analysis. The VSS was reduced from 10.00 ± 2.12 to 7.41 ± 1.277 at the 2-3-week postoperation time point, and to 5.53 ± 1.37 at the 3-month postoperation time point. The pain and itch score were reduced from 4.65 ± 1.37 and 6.35 ± 1.27, to 3.70 ± 1.10 and 4.94 ± 1.30 at the 2-3-week postoperation time point, and to 3.00 ± 1.28 and 3.94 ± 0.97 at the 3-month postoperation time point respectively. The VSS and pain and itch scores showed a statistically significant reduction (P < 0.05) at the 2-3-week and 3-month postoperative follow-ups compared with the preoperation time point.
Conclusion: Autologous nanofat grafting from donor sites of full thickness skin or skin flap may be a promising treatment for an early postburn scaring as it promotes scar softening, improves itching and pain within the scar. However, this is a small case series with only 17 patients. Further conclusions need to be drawn through expanded samples for randomized controlled clinical trials.
Lay summary: Hypertrophic scarring is the most common complication after partial thickness burn injury, and the complex pathogenesis and prolonged dynamic process render treatments only marginally effective. In the past few decades, with the technological advances of liposuction and fat grafting, nanofat grafting has been used in a variety of surgical fields, including wound healing, scleroderma, facial rejuvenation, and neuralgia. However, the role of nanofat grafting is not well documented in the prevention and treatment of early postburn scarring. Full-thickness skin grafting or skin flap transplantation is the most common method for the reconstruction of a hypertrophic scaring until now. In the current study, we harvested subcutaneous fat during the preparation of the full-thickness skin or skin flap, prepared nanofat and injected it in the scar located at a nonsurgical site. Comparison of the pre- and postoperation scores for scar color, scar thickness, scar stiffness, and sc
{"title":"Autologous nanofat harvested from donor site of full-thickness skin or skin flap grafting for the treatment of early postburn scarring: a case series.","authors":"Hongtao Wang, Yang Liu, Yan Li, Fu Han, Qiaohua Chen, Juntao Han, Dahai Hu","doi":"10.1177/20595131241230739","DOIUrl":"10.1177/20595131241230739","url":null,"abstract":"<p><strong>Introduction: </strong>Postburn scarring often presents a specific reconstructive challenge from both functional and cosmetic perspectives. The purpose of this study was to investigate whether autologous nanofat harvested from the donor site of full skin or a skin flap can be reused for the treatment of early postburn scaring.</p><p><strong>Methods: </strong>From July 2018 to April 2022, patients with early postburn scarring underwent scar reconstruction surgery with full-thickness skin or a skin flap for a contour deformity and/or scar contracture, and autologous nanofat grafting was performed during the same operation. The Vancouver Scar Score (VSS) and the itch and pain scores were evaluated at the preoperation time point as well as at 2-3 weeks and 3-months postoperation. A comparison was made among the same patients at different time points.</p><p><strong>Results: </strong>A total of 17 patients, aged from 18 months to 62 years old were included in this analysis. The VSS was reduced from 10.00 ± 2.12 to 7.41 ± 1.277 at the 2-3-week postoperation time point, and to 5.53 ± 1.37 at the 3-month postoperation time point. The pain and itch score were reduced from 4.65 ± 1.37 and 6.35 ± 1.27, to 3.70 ± 1.10 and 4.94 ± 1.30 at the 2-3-week postoperation time point, and to 3.00 ± 1.28 and 3.94 ± 0.97 at the 3-month postoperation time point respectively. The VSS and pain and itch scores showed a statistically significant reduction (P < 0.05) at the 2-3-week and 3-month postoperative follow-ups compared with the preoperation time point.</p><p><strong>Conclusion: </strong>Autologous nanofat grafting from donor sites of full thickness skin or skin flap may be a promising treatment for an early postburn scaring as it promotes scar softening, improves itching and pain within the scar. However, this is a small case series with only 17 patients. Further conclusions need to be drawn through expanded samples for randomized controlled clinical trials.</p><p><strong>Lay summary: </strong>Hypertrophic scarring is the most common complication after partial thickness burn injury, and the complex pathogenesis and prolonged dynamic process render treatments only marginally effective. In the past few decades, with the technological advances of liposuction and fat grafting, nanofat grafting has been used in a variety of surgical fields, including wound healing, scleroderma, facial rejuvenation, and neuralgia. However, the role of nanofat grafting is not well documented in the prevention and treatment of early postburn scarring. Full-thickness skin grafting or skin flap transplantation is the most common method for the reconstruction of a hypertrophic scaring until now. In the current study, we harvested subcutaneous fat during the preparation of the full-thickness skin or skin flap, prepared nanofat and injected it in the scar located at a nonsurgical site. Comparison of the pre- and postoperation scores for scar color, scar thickness, scar stiffness, and sc","PeriodicalId":94205,"journal":{"name":"Scars, burns & healing","volume":"10 ","pages":"20595131241230739"},"PeriodicalIF":0.0,"publicationDate":"2024-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10880530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139934956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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