Hydrogels in Burn Wound Management—A Review

Abstract

Inert hydrogels are of a great importance in burn first aid. Hydrogel dressings may be an alternative to cooling burn wounds with streaming water, especially in cases of mass casualty events, lack of clean water, hypothermia, or large extent of burns. Hydrogels that contain mostly water evacuate the heat cumulating in the skin by evaporation. They not only cool the burn wound, but also reduce pain and protect the wound area from contamination and further injuries. Hydrogels are ideally used during the first hours after injury, but as they do not have antimicrobial properties per se, they might not prevent wound infection. The hydrogel matrix enables incorporating active substances into the dressing. The active forms may contain ammonium salts, nanocrystal silver, zinc, growth factor, cytokines, or cells, as well as natural agents, such as honey or herbs. Active dressings may have antimicrobial activity or stimulate wound healing. Numerous experiments on animal models proved their safety and efficiency. Hydrogels are a new dressing type that are still in development.

Advancements in the Use of Hydrogels for Regenerative Medicine: Properties and Biomedical Applications

“…The intrinsic characteristics of hydrogels allow them to benefit from cutaneous healing essentially by supporting a moist environment. Hydrogel-based systems offer tremendous potential in skin regeneration for several reasons: they have long been recognized as the standard treatment for necrotic and sloughy wounds [ 156 ]; they offer sustained and/or stimuli-responsive delivery of antiseptics or antibiotics [ 157 ]; they can modulate the local inflammatory environment or incorporate antioxidants or anti-inflammatories [ 158 ]; and incorporating bioactive agents and different types of cells have been proposed as the future of advanced therapies [ 110 ]. Hydrogel dressings are more advantageous for chronic wound treatment because they can be conveniently designed to meet the specific needs of the treatment of chronic wounds.…”

Hydrogel-based dressings in the treatment of partial thickness experimentally induced burn wounds in rats

“…Hydrogel-based dressings may be used as first aid in burn wounds management as an alternative to quickly cooling the wound in cases of lack of clean water, hypothermia, or large extent burns. These dressings are important to protect the wound from contamination and reduce pain 19 . The maintenance of moist and humidity in the burn wound bed is essential to hydrate the wound, absorb the exudate and induce autolysis of the necrotic tissue 18,25 .…”

“…This property allows trauma-free removal, with little or no damage to the tissue, with less formation of necrosis in the wound bed. It also has sodium carboxymethyl cellulose, which stimulates angiogenesis and autolytic debridement and accelerates the tissue granulation process 19,[26][27][28] .…”

“…It is believed that this effect provided better granulation tissue than Debrigel™ and Solosite™ 13,16,24 . Some studies describe that, after adding hydrogel, silver sulfadiazine provided greater angiogenesis and re-epithelialization in comparison to silver sulfadiazine used alone 18,19,40,43 . In our study, in general, there was a benefit when using the hydrogel instead of silver sulfadiazine, improving the healing process.…”

“…Among the compounds that can be manipulated with the hydrogel are sodium and/or calcium alginate. Although hydrogels with alginate have shown benefits in terms of wound healing, their effects are not completely understood, regarding its microscopic and macroscopic effects on the healing process of burn wounds [17][18][19] . Regarding all the benefits described in a hydrogel-based dressing for burn wounds, we believe that this kind of wound would benefit and present better healing process with it.…”