Research in burns - Present and future

Abstract

There have been tremendous advances in burns care over the past 50 years. Much of this, but not all, can be attributed to basic science and clinically related research. Out of the best centres in the world, centres that are fully funded and richly resourced, best practice guidelines result in impressive outcomes not only in terms of survival but also in terms of a quality of survival. Indeed the remaining clinical challenges in these centres are the elderly, the inhalational burns, and the very extensive burns. There are however other challenges when looking at burns care in a global context and in particular is the provision of even minimal standards of acceptable care for burns patients in many parts of the world. Whilst the justification for research funding in the wealthy countries becomes increasingly esoteric, for example looking at the immunology of face transplantation, the global health challenges of burns care still remain. Perhaps, the greatest research challenge in burns care in the 21st century lies not in furthering our understanding of the phenomenon we observe but the global application of the knowledge we already possess.

Animal models of wound repair: Are they cutting it?

“…With respect to the holy grail of scar-free healing, several in vivo models, such as zebrafish or xenopus embryos, display regenerative healing (20,21). Mammalian embryos also heal regeneratively until relatively late in gestation, studied extensively in sheep (22) and mice (23). Indeed, regenerative healing of human embryos was first described over 30 years ago (24), where scar-free healing occurs up to 24 weeks of gestation (25).…”

More than just a filler – the role of hyaluronan for skin homeostasis

“…Hyaluronan preparations are used to improve non-healing wounds, for example chronic leg ulcers or burn wounds (178). The controversial effects of different HA preparations in earlier studies may be explained by differences in molecular organization, growth factor and cytokine presentation (179). Current research concentrates on the control of the ECM remodelling by manipulating the interaction of HA with other matrix molecules (49).…”