摘要：Topical treatment for facial burns, Review question, We reviewed the evidence about the effects of topical (applied to the surface of the skin) treatments for healing burn wounds on the face or neck. We wanted to find out which treatments were most effective at healing these wounds and improving the appearance of scars, which is a particularly important issue in relation to facial burn injuries. We also wanted to find out how topical treatments affected the risk of complications such as infection and pain, and how they impacted on peoples' quality of life., Background, Burn injuries are an important health problem, and a major global cause of disability and disfigurement in both adults and children. Women and children in low‐income countries are at particular risk. Burns pose particular problems when they occur on the head or neck. The face is central to a person's identity and plays a vital role in communication. Other basic functions such as hearing, smell and breathing may become affected as a direct result of a facial burn. Topical treatments such as (non) antimicrobial creams and skin substitutes, are most commonly used to treat facial burns. We wanted to compare the effectiveness of these treatments to evaluate their benefits and harms., Study characteristics, In December 2019, we searched for randomised controlled trials (RCTs) investigating topical treatments for facial burns. RCTs are medical studies where the treatment or care people receive is chosen at random. This type of study design provides the most reliable health evidence about whether different approaches to treatment or care can make a difference. We found 12 studies that were suitable for inclusion in this review update, with 507 participants with mean ages ranging from 5.3 to 41.9 years. Three studies compared antimicrobials with non‐antimicrobials agents, two studies compared different antimicrobials, four studies compared skin substitutes with antimicrobials, while four studies compared a variety of topical treatments. One study contributed to two comparisons. Eight studies were small (fewer than 40 participants) and almost all studies were at high risk of bias due to lack of blinding (where participants and evaluators may have known which group the participants were allocated to and interpreted effects differently)., Key results, Overall, there is mainly low to very low‐certainty evidence on the effects of any topical intervention on wound healing or infection in people with facial burns. In addition, there is low to very low‐certainty evidence on the effects of the included interventions on need for surgery, pain, scar quality, patient satisfaction, length of hospital stay and side effects., All results were at high risk of bias and varied, which may have exaggerated the effects., Certainty of the evidence, Overall, the certainty of the evidence about the effectiveness of topical treatments for facial burns is low to very low. There is insufficient reliable evidence as to whether topical treatments improve outcomes for people with facial burns including improving wound healing, or rates of infection. Better trial design and reporting of these studies is required to contribute to evidence‐based burn care., How up to date is this review?, We searched for studies that had been published up to December 2019.

摘要：BACKGROUND: Thermal tissue injury is partly mediated by reactive oxygen metabolites. Oxygen free radicals are contributory to local tissue damage following thermal injury and accordingly an interventional therapy using antioxidants may be beneficial. Copper nicotinate complex can scavenge reactive oxygen species (i.e., has antioxidant activity). OBJECTIVES: To examine time-related morphological and biochemical changes following skin thermal injury and their modulation by copper nicotinate complex. MATERIALS AND METHODS: An animal model composed of 80 albino rats was established. Ten rats (nonburn group) served as a control group. Seventy rats (burn group) were anesthetized, given a 10% total body surface area, full-thickness burn. Ten rats (from the postburn group) were sacrificed after 24 h (without treatment, i.e., untreated-burn group). The remaining rats were divided into three subgroups (20 rats, each) and were treated topically either with soft paraffin, moist exposed burn ointment (MEBO, a standard therapeutic treatment for burns), or copper nicotinate complex. Five animals from each subgroup were sacrificed every week over a period of 4 weeks. The morphological and biochemical changes were evaluated and compared among the different groups. RESULTS: High levels of the plasma and skin nitiric oxide (marker of oxidative stress) were observed in the untreated-burn group. These levels were significantly low following the application of copper nicotinate complex. Low levels of plasma and skin superoxide dismutase (marker of oxidative stress) and plasma ceruloplasmin were observed in the untreated-burn group. These levels were significantly high following copper nicotinate complex treatment. The total and differential leukocyte counts were low following the onset of the thermal injury. They gradually returned to normal levels over a 4-week period following the application of MEBO or copper nicotinate complex. Compared to untreated-burn group, postburn-healing changes (resolution of the inflammatory reaction, reepithelization of the epidermis, angiogenesis, deposition of collagen fibers, and recovery of the subcellualr organelles) were significantly accelerated following the application of either MEBO or copper nicotinate complex. CONCLUSIONS: Application of copper nicotinate complex was associated with improved healing of the thermal burns of the skin. The underlying molecular changes underlying these effects await further investigations.

摘要：Background and Objective The purpose of this clinical paper is to explore the therapeutic effects, healing times, adverse effects, and maintenance periods of using a CO2 fractional laser in the treatment of photoaging in Asian skin. Study Design/Materials and Methods One fractional CO2 laser procedure was performed on the full face in 56 patients with photoaging. Based on the Dover scoring system, we evaluated the degree of skin aging before treatment and at one-month post laser and at five years post laser therapy in 30 of the patients. Statistical analysis was performed by the Wilcoxon's method. Results Thirty of the treated patients have had follow-up for 5 years at this time. The photoaging scores in these thirty patients were significantly changed (P < 0.01) at one month, one year, and five years after the fractional laser treatment, as compared with their baseline. Adverse events seen during this analysis were found to be minimal and not of clinical significance. Conclusions Fractional CO2 laser resurfacing in the treatment of photoaging in Asians is a useful modality with results, for the first time, being shown to have continued efficacy for up to 5 years. Lasers Surg. Med. 46:750–756, 2014. ? 2014 Wiley Periodicals, Inc.

摘要：Moist exposed burn ointment (MEBO) is an oil-based herbal paste, purported to be efficacious in managing burn wounds and more commonly used in Asia and the Middle East. A PRISMA-compliant systematic review was performed to analyse the evidence for the use of MEBO on burn wounds. Wound healing rate was the primary outcome of interest. PubMed-listed randomised controlled trials (RCTs) comparing the efficacy of MEBO with placebo, standard care or other therapies in the treatment of partial thickness burns in adults and children were eligible for inclusion (November 2019). Six RCTs were eligible. The majority of trials comparing wound healing between MEBO and SSD favoured MEBO (two of three). There may be improved healing in MEBO-treated wounds vs. those treated with povidone-iodine + bepanthenol cream. There was no difference between MEBO and Acquacel Ag, but Helix Aspersa had faster healing rates than MEBO. However, all evidence was from moderately to poorly reported trials with a high risk of bias, thereby limiting the strength of this evidence. In conclusion, the evidence for MEBO in English-language literature was poor and inconsistent with respect to wound healing rate and analgesis compared to 1% SSD, Acquacel Ag, Helix aspersa cream and povidone-iodine + bepanthenol cream. Blinded RCTs comparing MEBO to both placebo and other common topical treatments may further improve the confidence in concluding their analysis. There is some evidence that MEBO is as safe as its comparators as shown by the low complication rate.