Hydrogels for the management of second-degree burns: currently available options and future promise

Abstract

Burn wounds result from exposure to hot liquids, chemicals, fire, electric discharge or radiation. Wound severity ranges from first-degree injury, which is superficial, to fourth-degree injury, which exposes bone, tendons and muscles. Rapid assessment of burn depth and accurate wound management in the outpatient setting is critical to prevent injury progression into deeper layers of the dermis. Injury progression is of particular pertinence to second-degree burns, which are the most common form of thermal burn. As our understanding of wound healing advances, treatment options and technologies for second-degree burn management also evolve. Polymeric hydrogels are a class of burn wound dressings that adhere to tissue, absorb wound exudate, protect from the environment, can be transparent facilitating serial wound evaluation and, in some cases, enable facile removal for dressing changes. This review briefly describes the burn level classification and common, commercially available dressings used to treat second-degree burns, and then focuses on new polymeric hydrogel burn dressings under preclinical development analyzing their design, structure and performance. The review presents the follow key learning points: (1) introduction to the integument system and the wound-healing process; (2) classification of burns according to severity and clinical appearance; (3) available dressings currently used for second-degree burns; (4) introduction to hydrogels and their preparation and characterization techniques; and (5) pre-clinical hydrogel burn wound dressings currently being developed.

Advances in the Research and Application of Smart-Responsive Hydrogels in Disease Treatment

“…Hydrogels offer unique advantages in wound repair due to their excellent hydrophilicity, biocompatibility, and three-dimensional porous structures, resembling the extracellular matrix [ 111 ]. Smart-responsive hydrogels, through flexible structural modifications, the integration of different functional components, and the loading of bioactive substances, have been widely applied in wound repair research and clinical practice, as they can promptly respond to changes in the wound microenvironment [ 112 ]. Temperature and pH are important physicochemical factors in the human body, and stimulus-responsive hydrogels, designed based on variations in surface pH and temperature, can effectively accelerate wound healing.…”

Facile synthesis of hydroxypropyl chitosan-egg white hydrogel dressing with antibacterial and antioxidative activities for accelerating the healing of burn wounds

“…Hydrogel dressings have excellent potential in the management of irregular burn wounds. [18][19][20][21] In particular, protein-based natural-polymer hydrogels promote proliferation, which is attributed to their inherent bioactive elements.…”

“…Hydrogel dressings have excellent potential in the management of irregular burn wounds. 18–21 In particular, protein-based natural-polymer hydrogels promote proliferation, which is attributed to their inherent bioactive elements. Nevertheless, many protein-based natural-polymers are subject to expensive sources and extraction along with purification procedures, which may not be affordable for most patients.…”

An enhanced fractal self-pumping dressing with continuous drainage for accelerated burn wound healing

“…Burn injury is a typical trauma that is threatening people’s health due to its high incidence of complications, multiple organ failure ( Jeschke et al, 2011 ; Jeschke et al, 2020 ; Peck and Toppi, 2020 ) and mortality ( Chauhan and Mir, 2018 ). Excessive exudates secreted from the burn wounds can probably cause tissue maceration ( Cutting and White, 2002 ), which increases the risk of infection ( Glik et al, 2018 ) and leads to prolonged wound healing ( Cook et al, 2022 ). Lots of absorbent dressings have been developed for absorbing wound exudates to promote healing, such as polyacrylate fibers ( Tyan et al, 2003 ; Desroche et al, 2016 ), chitosan foam ( Loke et al, 2000 ), and bio-ceramic powder ( Zhang Z. W. B. et al, 2021 ).…”