Scars, burns & healing最新文献

Introduction: Experiences of seeing an altered appearance for the first time can have an important influence on an individual's psychological wellbeing, their body image and their adjustment. Existing research has explored this experience in individuals with breast cancer and facial burns, but limited research has been conducted in other appearance altering conditions. The aim of this study was to explore patient's initial experiences viewing themselves after acquiring an appearance altering condition, including distress, preparedness and social support.

Methods: Participants (n = 64) with a surgical scar, burn injury or amputation completed a mixed methods online survey. This survey included questions about practical elements of the experience, the support they received, their expectations, distress, and preparedness; as well as open questions regarding participant's feelings, fears, support and suggested improvements to the experience. Data analysis included statistical analysis and inductive content analysis.

Discussion: Participants reported a variety of initial experiences. Some felt adequately prepared and supported, whilst others felt this could have improved. A strong correlation was found between perceived support and distress (r_s = -.66, p = <.001) and preparedness and distress (r_s = -.66, p = <.001). No significant differences in preparedness, distress or support were found according to gender, age, or condition.

Conclusions: Whilst many participants reported satisfaction with viewing their appearance for the first time, some participants reported significant distress and a need for further support around this experience. This suggests an important role for healthcare providers in discussing expectations and providing appropriate patient support following injury or treatment.

[This corrects the article DOI: 10.1177/20595131241288298.].

Background: Mesenchymal stem cells (MSCs) have shown significant potential in a variety of clinical applications for repairing and regenerating damaged tissues. MSCs can stimulate cellular processes such as fibroblast proliferation, migration, and endothelial angiogenesis, as well as modulate the host's immune response to favor more optimal wound healing. Therefore, the application of mesenchymal stem cell (MSC) therapy to severe burn wounds holds promise as a potential avenue for improved outcomes, especially in cases where alternative therapies may be limited.

Case presentation: We present the results of a specific case excluded from our previously reported phase I Clinical Trial, examining the safety of allogeneic bone marrow-derived stem cell therapy for deep 2nd-degree burn wounds. This patient had been discontinued from the trial as a clinical decision was made that the patient would best be served by subsequent split-thickness skin grafting, an exclusion criterion for the trial.

Conclusion: We report the benefits of local allogenic MSC therapy followed by an early split-thickness skin graft. We observed a reduction in scar formation with improved sensation to touch using MSC therapy. No adverse events or evidence of rejection were seen. Our case report provides evidence supporting the notion that employing stem cell therapy preceding grafting represents a promising and synergistic therapeutic strategy for effectively treating burn injuries.

Lay summary: Hypertrophic scarring is a common issue in burn wounds, despite surgery or non-surgical treatments, and it often leads to tight, restrictive scars that can cause significant discomfort and complications for patients. This report explores the safety of using bone marrow-derived mesenchymal stem cells (BM-MSCs) as a potential treatment for burn wounds, applied either directly to the skin or beneath the surface.To date, no adverse side effects have been reported with these methods. The report details the case of a patient who first received stem cells under the skin, followed by a topical application, and later had a skin graft to treat a large, deep second-degree burn. The stem cells used were from a young healthy adult donor. The patient's progress was monitored for six months.The findings suggest that combining donor stem cells with skin grafting could be a helpful way to treat burn injuries, particularly in cases of deep second-degree burns. This approach appears to enhance wound healing, facilitate faster recovery, and reduce complications like infections, which could lead to shorter hospital stays.

Introduction: Scrotal burns resulting from wound care are a rare but preventable injury compared to the wide spectrum of post-circumcisions related complications documented. We report an inadvertent cetrimide-chlorhexidine antiseptic scrotal burns due to post-circumcision dressing and review the literature on genital chemical burns.

Case presentation: A 6-week-old baby presented with a 3-days history of worsening scrotal burns following smearing of undiluted cetrimide-chlorhexidine as dressing post-circumcision. Examination revealed a healthy baby with non-tender non-specific multiple ulcers and pan-erythematous scrotum. Wound swab isolated Klebsiella and Pseudomonas spp.

Discussions: Although there was no clinical complication during procedure, the wrongful post-operative care resulted in scrotal burns. The isolated uropathogens did not result in sepsis or Fournier's gangrene, we believe this preventable burn was eventually reported due to the worsening progression over the period, albeit with minor adverse effects.

Conclusion: Post-circumcision instruction for cetrimide-chlorhexidine use by caregiver must be understood to avoid scrotal burns.

Lay summary: Scrotal skin burns from chemical agent: Isolated scrotal skin burns are not common and even rarer when they are caused by prescribed medical solution. A neonate was brought in by the parents with complain of developing watery containing swellings on the scrotum that later bust and leads to peeling of the scrotal skin. The mother noticed this after applying dressing solution as part of the measures to prevent circumcision wound infection. Even though the child looked well, the large scrotal surface without skin cover could become a common point for bacteria entry into the body and its consequences. Even though our test isolated 2 different types of disease-causing bacteria from the scrotal wound, this child was managed well and the wounds healed without any further problem. The lessons: 1. circumcision is the commonest surgical procedure performed. 2. This incidence may only be the tip of the iceberg. 3. The parents brought him because it was getting worse. 4. It is a preventable injury by just using the agent in accordance with recommendations.

Purpose: The average life expectancy in Japan is 81.47 years for males and 87.57 years for females, which is expected to increase, and this has led to an increase in the number of patients aged ≥80 years with burns requiring hospitalization. Herein, we investigated the factors that affect the survival and length of hospital stay of patients aged ≥80 years with burns requiring hospitalization.

Major findings: The participants were patients admitted to our facility between 1 January 2008, and 31 December 2018. Deceased patients had significantly higher burn index, prognostic burn index, total body surface area, and revised Baux score, indicating the severity of burns; moreover, they had a lower Barthel index at admission and higher rates of inhalation injury and dementia. Regarding the length of hospital stay, patients with a higher burn index, prognostic body index, total body surface area, and rBaux scores took a longer period from admission to reach sitting and standing positions, and those who had buttock burns had significantly longer hospital stays.

Conclusions: In patients aged ≥80 years, higher mortality rates were associated with more severe burns, lower activities of daily living at admission, inhalation injury, and dementia. The length of hospital stay was longer in patients with severe burns, buttock burns, and inability to achieve early mobilization.

Lay summary: We investigated the factors influencing the survival rate and hospital stay duration among patients aged 80 years and older who required hospitalization for burns. We compared the records of surviving and deceased patients admitted to our hospital between 2008 and 2018. Our findings revealed that deceased patients experienced more severe burns, reduced activities of daily living at admission, and higher rates of inhalation injury and dementia. Furthermore, patients with severe burns had longer hospital stays, a longer period from admission to sitting and standing, and more frequently had buttock burns. These results indicate that burn severity, activities of daily living, inhalation injury, and dementia are critical factors in the treatment of burns in older patients.

Introduction: Maggot debridement therapy is an effective and widely used biodebridement method in chronic or non-healing wounds but is infrequently documented in burn injuries. Many burn patients wish to avoid surgical intervention, and in an ageing population with increasing comorbidities surgery may not always be preferable. Here we describe its successful use in an elderly and comorbid patient.

Methods: The larvae were applied to a 0.5% full thickness burn wound on the thigh using two treatments of BioMonde Biobags, and he achieved healing within eight weeks.

Discussion: Maggot debridement therapy has been documented to shorten healing time, increase the likelihood of healing, and reduce antibiotics use in other chronic wounds. Maggots may be more selective in debriding wounds than sharp surgical debridement, preserving more healthy tissue. There is evidence to suggest that maggots clear biofilms created by Staphylococcus aureus and Pseudomonas aeruginosa, which are common organisms cultured in burn wounds. The patient was enthusiastic about the therapy and would recommend it to other patients.

Conclusions: More formal evidence is required to compare outcomes between maggot debridement therapy and surgical intervention in such patient subgroups, as this may become a workhorse therapy for successful burns debridement and treatment.

Lay summary: Burn injuries are common and increasingly so in the elderly. Full-thickness injuries are those which involve all the layers of skin and are at risk of becoming long-term wounds if left to heal on their own. These types of wounds will often develop a hard covering layer, called eschar, which protects the regenerating skin underneath but can slow down how fast the wound heals. Often patients with full thickness injuries will need the eschar removed, the wound surgically cleaned (known as debriding) and a skin graft to reduce the healing time. However, in elderly patients with medical issues such as diabetes and heart problems (as in this case), surgery may not be advisable due to the risks of having anaesthetics, as well as the medical problems possibly impacting on how well the skin graft will work. Maggots are immature green-bottle fly larvae which feed on dead tissue and release enzymes to break it down to digest. They have been used in wound care for centuries but are less frequently considered an option for burns. In this case report, an elderly and comorbid patient sustained a deep burn injury to his thigh. He declined surgery and maggots were used instead, which were highly safe and effective. He did not require skin grafting. We suggest more studies are required to compare how effective this treatment is within the elderly population as means of avoiding surgery.

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.