Scars, burns & healing最新文献

Possible benefits of food supplementation or diet in scar management: A scoping review. 食物补充或饮食在疤痕管理中可能带来的益处：范围综述。

Scars, burns & healing

Pub Date : 2024-09-13 eCollection Date: 2024-01-01 DOI: 10.1177/20595131241282105

Thibau Demarbaix, Ulrike Van Daele, Jill Meirte, Mieke Anthonissen, Koen Maertens, Peter Moortgat

Aim: 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.Method: 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.Results: 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.Conclusion: 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.Lay summary: Aim: 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.Method: 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.Results: 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":"https://doi.org/10.1177/20595131241282105","url":null,"abstract":"Aim: 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.Method: 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.Results: 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.Conclusion: 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.Lay summary: Aim: 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.Method: 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.Results: 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":null,"pages":null},"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}

引用次数: 0

Use of 'stacked' dermal template: Biodegradable temporising matrix to close a large myelomeningocele defect in a newborn. 使用 "堆叠 "真皮模板：生物可降解临时基质用于缝合新生儿大面积髓母细胞瘤缺损。

Scars, burns & healing

Pub Date : 2024-09-02 eCollection Date: 2024-01-01 DOI: 10.1177/20595131241270220

Saiidy Hasham, Ciaran O'Boyle, Skaria Alexander

Background: 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.Objectives: 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.Discussion: 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.Lay summary: Background: 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.Objectives: 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

背景：脊髓膜膨出症是一种严重而复杂的中枢神经系统先天性畸形。神经管在妊娠四周左右闭合失败，导致神经胎盘与外界环境之间的交流开放，并伴有不同程度的功能障碍。通常需要进行手术治疗：手术治疗的主要目的是保护神经功能和减少感染。重建取决于缺损的部位、大小以及周围软组织的质量。外科医生可能会采用一系列重建技术来实现闭合。皮肤替代物，也称为真皮再生模板，也已得到应用：在我们科室，我们使用 NovoSorb 生物可降解临时基质来重建全厚皮肤和软组织缺损。这是一种人工合成、可生物降解的真皮再生模板，由聚氨酯泡沫和透明密封膜粘合而成，通常需要两个阶段的重建。整合和血管化大约需要三周时间。三周后，受体伤口床就可以进行分层植皮了。真皮再生模板的另一个优点是可以 "堆叠 "层，这样可以增加最终结构的厚度，最大限度地减少整体轮廓缺陷。作者介绍了一例出生一天的足月新生儿腰骶部巨大髓母细胞瘤病例，该病例采用分阶段、堆叠式 NovoSorb 生物可降解临时基质和分层厚度皮肤移植术成功治愈。作者认为这是第一例使用 "堆叠式 "真皮再生模板实现原发性脊髓膜缺损愈合的病例：NovoSorb生物可降解临时基质（BTM）是一种真皮再生模板（DRT），用于重建因烧伤、创伤、感染或手术造成的全厚皮肤和软组织缺损的伤口。它由 2 毫米厚的可生物降解合成聚氨酯泡沫和透明（不可生物降解）密封膜组成。与所有 DRT 一样，它是细胞整合和血管化的支架，最终形成 "新皮肤"。这种情况通常在三周左右开始显现。然后可以进行第二阶段手术，去除外层密封膜，在血管层上进行分层植皮：脊髓膜膨出症是一种严重而复杂的中枢神经系统先天性畸形，是通常被称为神经管缺陷（NTD）的一类畸形。神经管闭合通常发生在妊娠四周左右，闭合失败会导致神经胎盘与外部环境之间的交流开放。功能障碍的程度各不相同，但可能包括：下肢瘫痪、感觉缺失、膀胱和肠道功能障碍。为了保护神经功能并将感染风险降至最低，通常需要进行手术来关闭缺损。重建方法多种多样，取决于缺损的部位和大小以及周围软组织的质量。使用局部皮瓣可能会出现皮肤坏死的并发症。以肌肉为基础的皮瓣可能会使人衰弱，限制未来的功能，并使姿势发育恶化。我们接诊了一名患有巨大腰骶部髓膜膨出的一天大新生儿。我们选择了 DRT（NovoSorb BTM）作为主要的重建方法。首先，选择这种方法风险相对较低，发病率极低，并保留了完整的皮瓣重建方案，以备后期需要器械治疗时使用。其次，NovoSorb BTM 可为硬脑膜修复提供稳固的密封，且无明显的脑脊液渗漏。第三，NovoSorb BTM 可以分层（"堆叠"）添加，一旦前一层完成整合和血管化，就可以重建更深的轮廓缺损：讨论：我们展示了将 NovoSorb BTM 作为 DRT 成功用于大面积腰骶部脊髓膜膨出症的闭合，且无并发症，并具有长期稳定性。我们相信，这项技术为重建团队提供了另一种有效、安全、可重复的选择，并在需要时为未来的选择性重建手术保留了局部组织。

{"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":"Background: 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.Objectives: 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.Discussion: 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.Lay summary: Background: 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.Objectives: 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":null,"pages":null},"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}

引用次数: 0

Principles and clinical applications of transcutaneous laser-assisted drug delivery: A narrative review. 经皮激光辅助给药的原理和临床应用：综述。

Scars, burns & healing

Pub Date : 2024-03-18 eCollection Date: 2024-01-01 DOI: 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.

导言：经皮激光辅助给药（LADD）被认为是一种治疗皮肤疾病的新兴疗法：讨论：据报道，该疗法目前已有 12 项临床应用：结论：激光辅助给药具有广泛应用于皮肤疾病治疗的潜力。这项技术正在对从皮肤癌到脱发等各种疾病进行临床评估。

引用次数: 0

Risk factors for burn contractures in a lower income country: Four illustrative cases. 低收入国家烧伤挛缩的风险因素：四个说明性案例。

Scars, burns & healing

Pub Date : 2024-03-12 eCollection Date: 2024-01-01 DOI: 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.

导言：烧伤在中低收入国家最为常见，但人们对这些国家烧伤挛缩的风险因素却知之甚少。来自低收入和中等收入国家的一些研究证据表明，在烧伤后挛缩的发展过程中，社会经济和卫生系统问题等非医疗因素可能与生物医学因素一样重要，甚至可能更重要：方法：本文介绍了四个病例，以说明在低收入环境下非医疗因素对挛缩结果的影响。这些病例来自一项横断面研究的参与者，该研究调查了孟加拉国挛缩的风险因素：两个病例的烧伤情况相似，但由于社会经济原因，护理标准不同，导致挛缩结果大相径庭。两个病例均可获得专科护理，但由于非医疗原因，挛缩结果大相径庭。本文记录并比较了每个病例的风险因素和挛缩结果：总结：烧伤在中低收入国家（LMICs）很常见，但这些国家烧伤挛缩的风险因素却鲜为人知。烧伤挛缩是指烧伤后在关节附近或关节上形成的瘢痕导致活动受限。低收入与中等收入国家的一些研究表明，在烧伤后挛缩的形成过程中，社会经济（如家庭收入、教育水平）和卫生系统问题（如能否获得专业烧伤护理）等非医疗因素可能与非医疗因素（如烧伤类型、深度和所接受的治疗）一样重要，甚至可能更重要。这些病例来自一项大型研究的参与者，该研究调查了孟加拉国挛缩的风险因素。两个病例的烧伤情况相似，但护理标准不同，结果也不同。两个病例获得专科护理的机会相似，但由于非医疗原因，结果却大相径庭。本研究对每个病例中存在的风险因素和挛缩结果进行了记录和比较，强调并讨论了非医疗因素在低收入国家烧伤后挛缩发展中的重要性。

{"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":"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.","PeriodicalId":94205,"journal":{"name":"Scars, burns & healing","volume":null,"pages":null},"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}

引用次数: 0

Histological evaluation of tissue destruction in mouse tongues caused by cryosurgery. 冷冻手术对小鼠舌头组织破坏的组织学评估

Scars, burns & healing

Pub Date : 2024-02-20 eCollection Date: 2024-01-01 DOI: 10.1177/20595131241230398

Tadashi Kawai, Atsushi Ogawa, Isao Hoshi, Hiroyuki Yamada, Akira Fujimura

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.

简介冷冻手术被认为是治疗各种口腔病变的一种方法。虽然冷冻手术比手术治疗创伤更小、更容易操作，但如果冷冻过度，可能会出现口腔炎和疤痕等不良反应。有关冷冻手术对周围软组织影响的研究很少。因此，本研究调查了接受冷冻手术的小鼠舌头的组织破坏程度和愈合进度：方法：使用八周大的雄性 BALB/c 小鼠。方法：使用 8 周大的雄性 BALB/c 小鼠，用液氮冷却的仪器轻触舌头右侧 5 秒钟，10 秒钟后进行第二次测试。冷冻术后 3 天、7 天和 14 天进行组织学评估。冷冻术后 1、3、7、14 和 21 天，用印度墨水对血管进行评估：结果：软组织的破坏在 3 天后扩散到舌头左侧。7 天后，证实肌肉组织正在修复过程中，14 天后完全修复。虽然 3 天时未确认有血管，但 7 天后可见血管，21 天时确认血管遍布整个舌头：讨论和结论：这些结果表明，冷冻手术造成的组织破坏是广泛的，建议临床使用时应尽量减少冷冻的时间和频率。冷冻病灶会导致组织塌陷，从而使病灶消失。虽然冷冻手术比手术治疗创伤小、操作简单，但如果冷冻过度，也会出现口腔炎和疤痕等不良反应。本研究调查了接受冷冻手术的小鼠舌头的组织破坏程度和愈合进度。用液氮冷却仪器冷冻小鼠右侧舌头 5 秒钟，10 秒钟后进行第二次测试。在冷冻后 3 天、7 天和 14 天对组织破坏情况进行评估。在冷冻后 1、3、7、14 和 21 天，用印度墨水对血管进行评估。组织破坏在 3 天后扩散到舌头左侧。7 天后，证实肌肉组织正在修复过程中，14 天后完全修复。21 天时，整个舌头的血管修复得到确认。这些结果表明，冷冻手术造成的组织破坏很大，建议临床使用时应尽量缩短冷冻时间和减少冷冻次数。

{"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":"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.","PeriodicalId":94205,"journal":{"name":"Scars, burns & healing","volume":null,"pages":null},"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}

引用次数: 0

Clinical evaluation of post-surgical scar hyperaesthesia: a longitudinal observational pilot study. 手术后疤痕过度麻醉的临床评估：一项纵向观察试验研究。

Scars, burns & healing

Pub Date : 2024-02-20 eCollection Date: 2024-01-01 DOI: 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

导言：持续性疤痕疼痛的机制尚未完全阐明，疤痕疼痛的临床评估证据也很有限。这项试验性观察研究调查了参与数据，并试图为未来的试验确定客观的临床疤痕评估方法：在获得伦理批准和同意的情况下，一家英国国家医疗服务系统医院招募了接受手部手术计划的成年人。在手术后 1 个月和 4 个月，通过定量感觉测试评估疤痕热阈值和机械痛阈值；通过红外测温仪评估疤痕周围炎症；通过硬度计评估疤痕柔韧性。对参与数据进行了描述性统计分析；分析了临床指标与患者报告的疤痕疼痛之间的关联：由于 COVID-19 大流行，21 名参与者（22% 符合条件的患者）在研究结束前注册；13 人完成了随访。临床疤痕评估未出现不良事件或退出。70%的参与者表示已独立进行非处方性局部疤痕治疗。神经病理性疼痛症状量表（NPSI）的评分在整个评分范围内较为分散，反映了参与者报告的疤痕症状的差异性。疤痕形态、柔韧性和炎症与疤痕疼痛无关。疤痕与对侧皮肤在热痛和机械痛敏感性方面存在差异：结论：急性手部疤痕患者可参与临床研究，并独立启动疤痕治疗。手术后急性手部疤痕的临床测试具有良好的耐受性。NPSI显示了探究疤痕疼痛症状的实用性，并有助于阐明持续性疤痕疼痛的机制。热敏性、机械性和敏感性临床测试是未来试验中很有希望的候选疤痕疼痛临床测量指标。我们不知道疤痕的柔韧性、炎症或对温度或压力的敏感性是否与疤痕疼痛有关。我们调查了患者是否愿意参加疤痕研究、是否能够耐受疤痕测试以及临床测试是否对未来的疤痕研究有用。研究过程：在获得伦理批准和同意后，一家英国国家医疗服务系统医院招募了成年手外科患者。在手术后 1 个月和 4 个月对疤痕疼痛、炎症以及对热、尖锐和压力测试的反应进行评估。我们从统计学角度分析了研究参与度、对临床疤痕测试的耐受性以及疤痕测试是否与疤痕疼痛有关。研究结果：由于 COVID-19 大流行，21 名参与者（22% 的合格患者）在研究结束前加入了研究；13 人完成了随访。没有参与者因疤痕测试而受伤。70%的参与者表示可独立治疗疤痕。神经病理性疼痛症状量表（NPSI）允许参与者就其疤痕症状给出广泛的答案。疤痕柔韧性和炎症的临床测试得分与参与者报告的疤痕疼痛无关。与未受影响的皮肤相比，疤痕对针刺和寒冷测试更敏感。我们的收获：手部有新疤痕的人参与研究并独立发起疤痕治疗。手术后手部疤痕的临床测试具有良好的耐受性。NPSI 对于探索疤痕疼痛症状很有用，可以帮助我们了解持续性疤痕疼痛。针刺和冷冻临床测试可能是未来疤痕研究中有用的客观疼痛测试。

{"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":"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","PeriodicalId":94205,"journal":{"name":"Scars, burns & healing","volume":null,"pages":null},"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}

引用次数: 0

Autologous nanofat harvested from donor site of full-thickness skin or skin flap grafting for the treatment of early postburn scarring: a case series. 从全层皮肤或皮瓣移植供体部位获取自体纳米脂肪用于治疗烧伤后早期瘢痕：病例系列。

Scars, burns & healing

Pub Date : 2024-02-20 eCollection Date: 2024-01-01 DOI: 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

导言：烧伤后瘢痕往往从功能和美容角度提出了特殊的整形挑战。本研究旨在探讨从供体部位的全层皮肤或皮瓣中获取的自体纳米脂肪是否可重复用于治疗早期烧伤后瘢痕：2018年7月至2022年4月，烧伤后早期瘢痕患者因轮廓畸形和/或瘢痕挛缩接受全层皮肤或皮瓣瘢痕重建手术，并在同一手术中进行自体纳米脂肪移植。在手术前、手术后 2-3 周和 3 个月对温哥华疤痕评分（VSS）、瘙痒和疼痛评分进行评估。对同一患者在不同时间点的情况进行了比较：共有 17 名年龄在 18 个月至 62 岁之间的患者参与了此次分析。术后 2-3 周的 VSS 从 10.00 ± 2.12 降至 7.41 ± 1.277，术后 3 个月的 VSS 降至 5.53 ± 1.37。疼痛和瘙痒评分分别从 4.65 ± 1.37 和 6.35 ± 1.27 降至术后 2-3 周时的 3.70 ± 1.10 和 4.94 ± 1.30，以及术后 3 个月时的 3.00 ± 1.28 和 3.94 ± 0.97。VSS、疼痛和瘙痒评分在统计学上有显著降低（P 结论：自体纳米脂肪移植的疗效更佳：从全厚皮肤或皮瓣的供体部位进行自体纳米脂肪移植可能是治疗烧伤后早期疤痕的一种有前途的方法，因为它能促进疤痕软化，改善疤痕内的瘙痒和疼痛。然而，这只是一个小规模的病例系列，只有 17 名患者。总结：肥厚性瘢痕是部分厚度烧伤后最常见的并发症，其发病机制复杂，动态过程漫长，治疗效果不佳。在过去的几十年中，随着吸脂和脂肪移植技术的进步，纳米脂肪移植已被用于伤口愈合、硬皮病、面部年轻化和神经痛等多个外科领域。然而，纳米脂肪移植在预防和治疗烧伤后早期瘢痕方面的作用还没有很好的记录。迄今为止，全厚皮肤移植或皮瓣移植是重建增生性疤痕最常用的方法。在本研究中，我们在准备全厚皮肤或皮瓣时采集了皮下脂肪，制备了纳米脂肪，并将其注射到非手术部位的疤痕中。对比手术前后的疤痕颜色、疤痕厚度、疤痕僵硬度和疤痕规则度评分，结果显示手术后评分明显降低，治疗后疤痕色素沉着、疤痕厚度和美学效果均有显著改善。最重要的是，疼痛和瘙痒评分的降低可以得到客观评估。由此看来，纳米脂肪移植是一种预防和治疗烧伤后早期疤痕的潜在方法。

{"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":"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","PeriodicalId":94205,"journal":{"name":"Scars, burns & healing","volume":null,"pages":null},"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}

引用次数: 0

The effect of adult coloring (mandala pattern) on pain and anxiety associated with dressing changes in burn patients: A randomized controlled trial. 成人涂色（曼陀罗图案）对烧伤患者换药时的疼痛和焦虑的影响：随机对照试验。

Scars, burns & healing

Pub Date : 2024-02-08 eCollection Date: 2024-01-01 DOI: 10.1177/20595131231218062

Hamidreza Sadeqi, Kobra Rahzani, Davood Hekmatpou, Siamak Rakei Isfahani

Introduction: The study investigated the effect of mandala coloring on pain and anxiety associated with dressing changes in burn patients.

Method: This clinical trial was conducted on 60 patients in two groups. At the beginning of the study [baseline (T1)], anxiety and pain were assessed using the BSPAS and VAS. A mandala pattern with colored pencils was provided to the patients in the intervention group. Each patient was given 30 min to color. Anxiety was measured at the 35th minute (T2). A dressing change was performed and 15 min later, the variables were measured again (T3). The control group received no intervention.

Results: The mean anxiety at the baseline (T1), 35th minute (T2), and 15 min after dressing changes (T3) in the intervention and control groups were 38.73 ± 5.55, 26.20 ± 6.08 and 28 ± 8.53, and 39.17 ± 4.17, 41.27 ± 3.68 and 41.63 ± 2.97, respectively. Anxiety at T1 was at the same for both groups. The anxiety in the intervention group decreased (P < 0.001) at T2 and T3 and increased in the control group. The mean pain intensity at the baseline (T1) and 15 min after dressing changes (T2) in the intervention group was 8.47 ± 1.432 and 5.9 ± 1.9, respectively, and in the control group was 8.33 ± 0.802 and 8.77 ± 0.626. Pain intensity at T1 was at the same level for both groups. The pain in the intervention group decreased at T2 (P < 0.001), whilst it increased in the control group.

Conclusion: Mandala coloring can reduce pain and anxiety during dressing changes in burn patients. It can be used as adjuvant treatment.

Lay summary: Wound dressing in burn patients is accompanied by pain. This painful experience can lead to wound dressing anxiety in these patients. For this purpose, a study was conducted to check whether coloring before wound dressing can reduce the pain and anxiety of dressing in adults. Two groups of patients were included in the study; before the dressing, one group received a pre-prepared image of mandela designs along with colored pencils and colored the design to their taste. The other group did not receive any intervention. The intensity of pain and the level of anxiety of the two groups were measured before and after the dressing. The results showed that the coloring of the mandela design before dressing reduced the pain and anxiety related to the proceedure.

简介：本研究探讨了曼陀罗涂色对烧伤患者换药时疼痛和焦虑的影响：本研究探讨了曼陀罗涂色对烧伤患者换药时的疼痛和焦虑的影响：本临床试验针对 60 名患者，分为两组。研究开始时（基线（T1）），使用 BSPAS 和 VAS 评估焦虑和疼痛。为干预组患者提供了一个用彩色铅笔绘制的曼陀罗图案。每位患者有 30 分钟的涂色时间。第 35 分钟（T2）时测量焦虑程度。换药后 15 分钟再次测量变量（T3）。对照组未接受任何干预：干预组和对照组在基线（T1）、第 35 分钟（T2）和换药后 15 分钟（T3）的平均焦虑分别为 38.73 ± 5.55、26.20 ± 6.08 和 28 ± 8.53，以及 39.17 ± 4.17、41.27 ± 3.68 和 41.63 ± 2.97。两组在 T1 阶段的焦虑程度相同。干预组的焦虑程度有所减轻（P 结论：曼陀罗涂色可以减轻疼痛和焦虑：曼陀罗涂色可以减轻烧伤患者换药时的疼痛和焦虑。总结：烧伤患者在伤口换药时会感到疼痛。这种痛苦体验会导致这些患者产生伤口包扎焦虑。为此，我们进行了一项研究，以检验在伤口包扎前涂抹颜色是否能减轻成人的疼痛和包扎焦虑。研究包括两组患者；在包扎前，一组患者会收到事先准备好的曼德拉设计图片和彩色铅笔，并根据自己的喜好为设计上色。另一组没有接受任何干预。在包扎前后测量了两组患者的疼痛强度和焦虑程度。结果表明，在包扎前为曼德拉图案上色可减轻与手术有关的疼痛和焦虑。

{"title":"The effect of adult coloring (mandala pattern) on pain and anxiety associated with dressing changes in burn patients: A randomized controlled trial.","authors":"Hamidreza Sadeqi, Kobra Rahzani, Davood Hekmatpou, Siamak Rakei Isfahani","doi":"10.1177/20595131231218062","DOIUrl":"https://doi.org/10.1177/20595131231218062","url":null,"abstract":"Introduction: The study investigated the effect of mandala coloring on pain and anxiety associated with dressing changes in burn patients.Method: This clinical trial was conducted on 60 patients in two groups. At the beginning of the study [baseline (T1)], anxiety and pain were assessed using the BSPAS and VAS. A mandala pattern with colored pencils was provided to the patients in the intervention group. Each patient was given 30 min to color. Anxiety was measured at the 35th minute (T2). A dressing change was performed and 15 min later, the variables were measured again (T3). The control group received no intervention.Results: The mean anxiety at the baseline (T1), 35th minute (T2), and 15 min after dressing changes (T3) in the intervention and control groups were 38.73 ± 5.55, 26.20 ± 6.08 and 28 ± 8.53, and 39.17 ± 4.17, 41.27 ± 3.68 and 41.63 ± 2.97, respectively. Anxiety at T1 was at the same for both groups. The anxiety in the intervention group decreased (P < 0.001) at T2 and T3 and increased in the control group. The mean pain intensity at the baseline (T1) and 15 min after dressing changes (T2) in the intervention group was 8.47 ± 1.432 and 5.9 ± 1.9, respectively, and in the control group was 8.33 ± 0.802 and 8.77 ± 0.626. Pain intensity at T1 was at the same level for both groups. The pain in the intervention group decreased at T2 (P < 0.001), whilst it increased in the control group.Conclusion: Mandala coloring can reduce pain and anxiety during dressing changes in burn patients. It can be used as adjuvant treatment.Lay summary: Wound dressing in burn patients is accompanied by pain. This painful experience can lead to wound dressing anxiety in these patients. For this purpose, a study was conducted to check whether coloring before wound dressing can reduce the pain and anxiety of dressing in adults. Two groups of patients were included in the study; before the dressing, one group received a pre-prepared image of mandela designs along with colored pencils and colored the design to their taste. The other group did not receive any intervention. The intensity of pain and the level of anxiety of the two groups were measured before and after the dressing. The results showed that the coloring of the mandela design before dressing reduced the pain and anxiety related to the proceedure.","PeriodicalId":94205,"journal":{"name":"Scars, burns & healing","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10854211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139725554","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}

引用次数: 0

'Scars: How Our Wounds Make Us Who We Are': Improving appearance-based stigma, conceptualisation of beauty and body esteem through a documentary. “伤疤:我们的伤口如何塑造我们”:通过一部纪录片改善基于外表的耻辱，对美的概念化和对身体的尊重。

Scars, burns & healing

Pub Date : 2023-11-16 eCollection Date: 2023-01-01 DOI: 10.1177/20595131231205398

Abigail Mathews, Bruna Costa, Aida Mikkola, Diana Harcourt

Introduction: Those with an altered appearance as a result of injury, health condition or treatment can face stigma, which may contribute to adverse psychosocial outcomes. However, current research tends to focus on supporting individuals themselves to cope, rather than targeting societal stigma. This study aimed to reduce societal stigma towards this group, through the use of a documentary about people with scars.

Methods: 146 adults completed questionnaires before and after viewing the documentary.

Results: After viewing, participants had reduced self-reported intentions to behave in a stigmatising way towards those with visible differences, broader conceptualisation of beauty, and more positive body-esteem. Qualitative data also suggested further positive impacts.

Conclusion: Those with visible differences (for example scars) are subject to societal stigmatisation which perpetuates psychological and social problems. Therefore, alleviating social stigma through the media, as demonstrated through the documentary in this study, may improve the lives of those living with visible differences.

Lay summary: People with an altered appearance or scars as a result of injury, health condition or treatment can face stigma, which may contribute to harmful psychological and social outcomes. However, current research tends to focus on supporting affected individuals themselves to cope, rather than targeting societal stigma. This study aimed to find out whether a documentary about people with scars was successful at reducing viewers' stigma towards this group. A group of 146 adults completed questionnaires before and after viewing the documentary. After viewing, questionnaires indicated that participants had reduced intentions to behave in a stigmatising way towards those with visible differences. Furthermore, they also viewed a broader range of appearances as beautiful and felt more positive about their own bodies. Comments and feedback from participants also suggested further positive impacts. Those with visible differences (for example scars) are subject to societal stigmatisation which can cause and worsen mental health problems. Therefore, alleviating social stigma through the media, as demonstrated through the documentary in this study, may improve the lives of those living with visible differences.

导言:那些因受伤、健康状况或治疗而外貌改变的人可能面临耻辱，这可能导致不良的社会心理后果。然而，目前的研究往往侧重于支持个人自己应对，而不是针对社会耻辱。这项研究旨在通过使用一部关于伤疤人的纪录片来减少社会对这个群体的污名。方法:146名成人在观看纪录片前后分别填写问卷。结果:观看后，参与者减少了自我报告的对那些明显不同的人进行侮辱的意图，更广泛的美的概念，更积极的身体自尊。定性数据也显示出进一步的积极影响。结论:那些有明显差异(例如伤疤)的人容易受到社会的污名化，从而使心理和社会问题长期存在。因此，正如本研究的纪录片所展示的那样，通过媒体来缓解社会污名可能会改善那些生活在明显差异中的人的生活。概要:由于受伤、健康状况或治疗而导致外表改变或留下疤痕的人可能面临耻辱，这可能导致有害的心理和社会后果。然而，目前的研究往往侧重于支持受影响的个人自己应对，而不是针对社会耻辱。这项研究的目的是找出一部关于有伤疤的人的纪录片是否能成功地减少观众对这个群体的污名。146名成年人在观看纪录片之前和之后分别完成了问卷调查。观看后，调查问卷显示，参与者对那些有明显差异的人进行侮辱的意愿降低了。此外，她们还认为更广泛的外表都是美丽的，对自己的身体也更有信心。与会者的意见和反馈也表明了进一步的积极影响。那些有明显差异(例如伤疤)的人会受到社会歧视，这可能导致和恶化心理健康问题。因此，正如本研究的纪录片所展示的那样，通过媒体来缓解社会污名可能会改善那些生活在明显差异中的人的生活。

{"title":"'Scars: How Our Wounds Make Us Who We Are': Improving appearance-based stigma, conceptualisation of beauty and body esteem through a documentary.","authors":"Abigail Mathews, Bruna Costa, Aida Mikkola, Diana Harcourt","doi":"10.1177/20595131231205398","DOIUrl":"https://doi.org/10.1177/20595131231205398","url":null,"abstract":"Introduction: Those with an altered appearance as a result of injury, health condition or treatment can face stigma, which may contribute to adverse psychosocial outcomes. However, current research tends to focus on supporting individuals themselves to cope, rather than targeting societal stigma. This study aimed to reduce societal stigma towards this group, through the use of a documentary about people with scars.Methods: 146 adults completed questionnaires before and after viewing the documentary.Results: After viewing, participants had reduced self-reported intentions to behave in a stigmatising way towards those with visible differences, broader conceptualisation of beauty, and more positive body-esteem. Qualitative data also suggested further positive impacts.Conclusion: Those with visible differences (for example scars) are subject to societal stigmatisation which perpetuates psychological and social problems. Therefore, alleviating social stigma through the media, as demonstrated through the documentary in this study, may improve the lives of those living with visible differences.Lay summary: People with an altered appearance or scars as a result of injury, health condition or treatment can face stigma, which may contribute to harmful psychological and social outcomes. However, current research tends to focus on supporting affected individuals themselves to cope, rather than targeting societal stigma. This study aimed to find out whether a documentary about people with scars was successful at reducing viewers' stigma towards this group. A group of 146 adults completed questionnaires before and after viewing the documentary. After viewing, questionnaires indicated that participants had reduced intentions to behave in a stigmatising way towards those with visible differences. Furthermore, they also viewed a broader range of appearances as beautiful and felt more positive about their own bodies. Comments and feedback from participants also suggested further positive impacts. Those with visible differences (for example scars) are subject to societal stigmatisation which can cause and worsen mental health problems. Therefore, alleviating social stigma through the media, as demonstrated through the documentary in this study, may improve the lives of those living with visible differences.","PeriodicalId":94205,"journal":{"name":"Scars, burns & healing","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10656807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138465290","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}

引用次数: 0

Functional and cosmetic reconstruction of palmar heat press injury following wound bed preparation combined with artificial highly concentrated carbon dioxide bathing: A case report. 创面预备联合高浓度二氧化碳人工洗浴后掌热压损伤功能及美容重建1例。

Scars, burns & healing

Pub Date : 2023-11-16 eCollection Date: 2023-01-01 DOI: 10.1177/20595131231213705

Masakatsu Hihara, Kota Takeji, Toshihito Mitsui, Atsuyuki Kuro, Natsuko Kakudo

Background: The effect of artificial highly concentrated carbon dioxide bathing on heat-press-injured wounds has been clinically observed.

Case presentation: A 46-year-old male patient with a heat press injury of the right palmar region achieved complete necrotic tissue removal and sufficient granulation of the skin graft by continuous hand bathing in a solution containing highly concentrated carbon dioxide for four weeks. The patient successfully underwent a full-thickness skin graft from the plantar to the palmar region, and his right hand function improved to the extent that it did not interfere with daily life.

Conclusions: Heat press injuries are often refractory to treatment owing to the synergistic effects of heat and crush injuries. Highly concentrated carbon dioxide bathing has long been known to increase skin and muscle blood flow, and its clinical applications in ischemic limbs, skin ulcers, and osteomyelitis have already been reported. In this case, the results suggest an effect of improved blood flow leading to maturation of the graft bed at the heat-press injury site.

Lay summary: Highly concentrated carbon dioxide bathing is not only clinically applicable to ischemic extremities, skin ulcers, and osteomyelitis, due to increased cutaneous and muscular blood flow, but also to the reliable debridement of heat press injury wounds and the granulation of graft beds. We successfully used this novel combination of procedures to establish a graft bed with a good blood flow despite the deep heat press injury occurring in the palmar region, leading to an excellent functional recovery. The cost per procedure is low, at about $1(USD), making it a wound care option that should be considered from a healthcare economic perspective.

背景:临床观察了高浓度二氧化碳人工洗浴治疗热压伤创面的效果。病例介绍:一名46岁男性患者右掌区热压损伤，通过在含有高浓度二氧化碳的溶液中连续手浴四周，实现了完全的坏死组织去除和移植皮肤的充分肉芽化。患者成功地接受了从足底到掌区的全层皮肤移植，其右手功能得到改善，不影响日常生活。结论:由于热压伤与挤压伤的协同作用，热压伤往往难以治疗。高浓度二氧化碳浴长期以来被认为可以增加皮肤和肌肉的血流量，其在缺血性肢体、皮肤溃疡和骨髓炎的临床应用已经有报道。在这种情况下，结果表明血液流动的改善导致了热压损伤部位移植物床的成熟。摘要:高浓度二氧化碳浴在临床上不仅适用于四肢缺血、皮肤溃疡、骨髓炎等，因为皮肤和肌肉的血流量增加，而且对热压伤创面和移植物床的肉芽肿也有可靠的清创作用。我们成功地使用这种新颖的手术组合建立了移植物床，尽管掌区发生了深度热压损伤，但移植物床的血流良好，导致了良好的功能恢复。每次手术的费用很低，约为1美元，从医疗保健经济的角度来看，这是一种伤口护理选择。

{"title":"Functional and cosmetic reconstruction of palmar heat press injury following wound bed preparation combined with artificial highly concentrated carbon dioxide bathing: A case report.","authors":"Masakatsu Hihara, Kota Takeji, Toshihito Mitsui, Atsuyuki Kuro, Natsuko Kakudo","doi":"10.1177/20595131231213705","DOIUrl":"https://doi.org/10.1177/20595131231213705","url":null,"abstract":"Background: The effect of artificial highly concentrated carbon dioxide bathing on heat-press-injured wounds has been clinically observed.Case presentation: A 46-year-old male patient with a heat press injury of the right palmar region achieved complete necrotic tissue removal and sufficient granulation of the skin graft by continuous hand bathing in a solution containing highly concentrated carbon dioxide for four weeks. The patient successfully underwent a full-thickness skin graft from the plantar to the palmar region, and his right hand function improved to the extent that it did not interfere with daily life.Conclusions: Heat press injuries are often refractory to treatment owing to the synergistic effects of heat and crush injuries. Highly concentrated carbon dioxide bathing has long been known to increase skin and muscle blood flow, and its clinical applications in ischemic limbs, skin ulcers, and osteomyelitis have already been reported. In this case, the results suggest an effect of improved blood flow leading to maturation of the graft bed at the heat-press injury site.Lay summary: Highly concentrated carbon dioxide bathing is not only clinically applicable to ischemic extremities, skin ulcers, and osteomyelitis, due to increased cutaneous and muscular blood flow, but also to the reliable debridement of heat press injury wounds and the granulation of graft beds. We successfully used this novel combination of procedures to establish a graft bed with a good blood flow despite the deep heat press injury occurring in the palmar region, leading to an excellent functional recovery. The cost per procedure is low, at about $1(USD), making it a wound care option that should be considered from a healthcare economic perspective.","PeriodicalId":94205,"journal":{"name":"Scars, burns & healing","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10656804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138465291","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}

引用次数: 0