Pathophysiologic Mechanisms and Current Treatments for Cutaneous Sequelae of Burn Wounds

Abstract

Burn injuries are a pervasive clinical problem. Extensive thermal trauma can be life-threatening or result in long-lasting complications, generating a significant impact on quality of life for patients as well as a cost burden to the healthcare system. The importance of addressing global or systemic issues such as resuscitation and management of inhalation injuries is not disputed but is beyond the scope of this review, which focuses on cutaneous pathophysiologic mechanisms for current treatments, both in the acute and long-term settings. Pathophysiological mechanisms of burn progression and wound healing are mediated by highly complex cascades of cellular and biochemical events, which become dysregulated in slow-healing wounds such as burns. Burns can result in fibroproliferative scarring, skin contractures, or chronic wounds that take weeks or months to heal. Burn injuries are highly individualized owing to wound-specific differences such as burn depth and surface area, in addition to patient-specific factors including genetics, immune competency, and age. Other extrinsic complications such as microbial infection can complicate wound healing, resulting in prolonged inflammation and delayed re-epithelialization. Although mortality is decreasing with advancements in burn care, morbidity from postburn deformities continues to be a challenge. Optimizing specialized acute care and late burn outcome intervention on a patient-by-patient basis is critical for successful management of burn wounds and the associated pathological scar outcome. Understanding the fundamentals of integument physiology and the cellular processes involved in wound healing is essential for designing effective treatment strategies for burn wound care as well as development of future therapies. Published 2018. Compr Physiol 8:371-405, 2018.

Potential effect of non-thermal plasma for the inhibition of scar formation: a preliminary report

“…Intact skin is essential for the survival of an organism, and thus wound healing is a vital process 15 . Wound healing is a complicated process in which skin, and the underlying tissues are repaired after injury 16 . This process consists of four stages: hemostasis, inflammation, proliferation, and tissue remodeling 17 .…”

Place and role of topical antiseptic agents in the treatment of skin burns from the standpoint of adermatologist

“…Среди терапевтических модальностей, наиболее часто используемых в амбулаторной хирургической практике для лечения термических ожогов 1 и 2 степени (топические глюкокортикостероиды, топические антибактериальные препараты, ферментативные лекарственные средства, адгезивные повязки и пр. ), особое место занимают антисептические препараты [5]. Избыточная колонизация ожоговой поверхности микроорганизмами комменсалами и ее последующая импетигинизация может негативно отразиться на скорости и характере эпителизации дефекта кожи.…”

Role of H2S Supplementation on Burn Wound Healing and Molecular Chaperones

“…The burn wound healing is delayed owing to many critical factors viz. dysregulated inflammation, neuropathy, vascular system impairment, excessive proteolysis, oxidative stress and septicemia [1][2] . Therefore, the innumerable complexities concomitant with the treatment of intractable burn wounds impose a profound burden on the medical healthcare system.…”