摘要:OBJECTIVE: Wound healing in burn wounds presents a challenge in healthcare, and there is still a lack of alternatives in topical burn wound treatments. - The purpose of this study was to evaluate the efficacy of a new therapeutic ointment (MEBO) in the treatment of partial thickness burns. METHODS: 40 patients received either topical treatment with Moist Exposed Burn Ointment (MEBO) or standard Flammazine treatment. All patients suffered from partial-thickness burn injuries (< 20% TBSA). Wounds were evaluated for 60 up to days regarding wound healing, water loss, inflammation, and pain alleviation. RESULTS: For transepidermal water loss, there was a difference of 2.3 gr/m2/h between MEBO, and Flammazine, favoring MEBO. However, this difference was not statistically significant (p=0.78). For all secondary efficacy parameter results were similar. - CONCLUSIONS: This study showed that MEBO ointment for topical treatment of burn injuries presents an attractive alternative for the topical treatment of limited partial thickness thermal burns.
摘要:The myofibroblast, a major component of granulation tissue, is a key cell during wound healing, tissue repair and connective tissue remodelling. Persistence of myofibroblasts within a fibrotic lesion leads to excessive scarring impairing function and aesthetics. Various wound-healing cytokines can be modulated by topical application of active agents to promote optimal wound healing and improve scar quality. Thus, the myofibroblast may represent an important target for wound-healing modulation to improve the evolution of conditions such as hypertrophic scars. The purpose of this work is to study the modulation of myofibroblasts and integrin αvβ3 in a full thickness wound performed on rabbits treated with different topical agents using: (1) saline, (2) Tegaderm occlusive dressing (3) silver sulfadiazine and (4) moist exposed burn ointment (MEBO). The reepithelialisation was 4 days faster in the MEBO group compared with the other therapies with less oedema formation, delayed contraction, less inflammatory cells and the lowest transepidermal water loss (TEWL) resulting in a soft scar. Although α-smooth muscle actin (α-SMA) was the highest around day 12 in the MEBO group, wound contraction and myofibroblast's activity were the least for the same period probably because of a downregulation of the integrin αvβ3. It seems that the effect of MEBO could be more pronounced on force transmission rather then on force generation. Greater insight into the pathology of scars may translate into non surgical treatments in the future and further work in myofibroblast biology will eventually result in efficient pharmacological tools, improving the evolution of healing and scar formation.
摘要:Introduction:? After partial-thickness skin graft (PTSG) harvesting, a dermal surface is exposed and an iatrogenic wound is created. Application of various agents has been studied for enhancement of healing process in PTSG donor area. The ideal agent should accelerate healing, provide comfort to the patient, not allow infection, and be easily applicable and cheap. Materials and Methods:? The Cochrane Central Register of Controlled Trials, PubMed, Scopus. and EMBASE databases were screened for words (“skin graft” + “donor”), by using time limits between 1989 and 2018. This study involved a total of 5 systematic reviews and 43 original articles which met the inclusion criteria. Articles were reviewed and parameters such as healing time, pain, infection rate, cosmetic result, and cost were extracted. Results:? Systematic reviews favor moist dressing materials over dry ones considering healing time and patient comfort. Hydrocolloids provide rapid wound healing, and dressing changes do not cause any disruption to the newly regenerated epithelium. Alginates seem to have a longer healing time than hydrocolloid materials. Polyurethane films are characterized by rapid epithelialization and painless monitoring as well as low costs. The epithelialization time of MEBO?, a cosmeceutical product, is reported to be faster than polyurethane films. Local and systemic drug applications warrant further research before routine clinical usage. Conclusion:? Dressing materials are the most commonly used and appropriate group according to the studies performed to date. It is seen that moist dressing materials are more favorable. Although there is not a subgroup with a clear superiority, it can be seen that the hydrofiber and polyurethane film groups are one step ahead in terms of ease of use, patient comfort, epithelialization speed, and scar quality. Polyurethane films have a cost advantage to the hydrofiber group.
摘要:目的:通过对细胞外基质(extracellular matrix,ECM)中Ⅰ型胶原蛋白(Collagen Ⅰ)和Ⅲ型胶原蛋白(Collagen Ⅲ)的表达水平研究,来探究湿润暴露疗法/湿润烧伤膏(moist exposed burn therapy/moist exposed burn ointment,MEBT/MEBO)能否通过影响CollagenⅠ和CollagenⅢ的表达水平,加快治疗慢性难愈合性创面修复进程,探讨MEBT/MEBO的部分作用机制,为其临床推广应用于慢性难愈合创面的治疗提供参考数据。方法:(1)健康成年SPF级Wistar雄性大鼠60只,用随机数字表法分为:空白组(KB组)12只、急性组(JX组)12只、模型组(MX组)12只、MEBO组(MB组)12只和贝复新组(BFX组)12只。KB组只剃毛,JX组只切除皮肤,后三组建立大鼠慢性难愈合创面模型。每日换药2次。(2)分别在造模后第3、7、14天,每组处死4只大鼠后,再取标本,观察各组大鼠的创面情况,并计算其愈合率,通过HE染色及Masson染色来观察创面组织形态学变化。(3)采用Western Blot、Real-time qPCR检测各组CollagenⅠ和CollagenⅢ的蛋白表达变化及CollagenⅠ和CollagenⅢ的mRNA转录水平的差异。结果:(1)疗效观察:MB组和BFX组创面修复效果好,创面修复情况与JX组无显著性差异(P>0.05)。HE染色及Masson染色:与MX组相比,JX组、MB组和BFX组的毛细血管、胶原纤维、皮肤及皮肤附属器新生较快。(2)各组大鼠创面组织中Collagen Ⅰ和Collagen Ⅲ蛋白表达:造模后第14天,JX组的CollagenⅠ和Collagen Ⅲ蛋白表达水平与KB组无统计学差异(P>0.05),JX组接近愈合状态。造模后第3天,JX组的两种蛋白表达水平最低(P<0.05);造模后第7天,MX组、MB组和BFX组三组的Collagen Ⅰ蛋白表达水平上升,JX组表达仍最低(P<0.05);造模后第14天,JX组的Collagen Ⅰ蛋白表达水平继续保持上升,而MX组、MB组呈下降趋势(P<0.05)。造模后第14天,MX组的CollagenⅢ蛋白表达水平下降,另外三组呈现上升趋势(P<0.05)。到愈合后期,计算Collagen Ⅰ:Collagen Ⅲ的比值,MX组高于MB组...