Saving the zone of stasis in burns with activated protein C: An experimental study in rats

Nişancı, Mustafa; Eski, Muhitdin; Şahin, İsmail; Ilgan, Seyfettin; Işık, Selçuk

doi:10.1016/j.burns.2009.06.208

Cited by 42 publications

(36 citation statements)

References 24 publications

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“…3(a)) and are typically not differentiated clinically until several days after the burn injury [2][3][4]. Because earlier intervention has been shown to shorten hospital stays [7][8][9] and improve the healing response for patients [6], we examined these burn wounds with LSI and SFDI shortly after the initial burn and for three days post-burn to determine when these imaging techniques could reliably categorize burn severity.…”

Section: Discussionmentioning

confidence: 99%

“…This is largely due to the dynamic nature of burn wounds during the first 48 hours. This is also the reason that clinical assessments are typically made several days after the initial burn [2] even though earlier intervention has been shown to improve healing [6], reduce complication rates (infection, scarring) and shorten hospital stays for patients [7][8][9]. This highlights the rationale for developing new objective techniques that will enable more timely decision making related to burn wound severity and management.…”

Section: Introductionmentioning

confidence: 99%

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Quantitative assessment of graded burn wounds in a porcine model using spatial frequency domain imaging (SFDI) and laser speckle imaging (LSI)

Ponticorvo¹,

Burmeister²,

Yang³

et al. 2014

Biomed. Opt. Express

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Accurate and timely assessment of burn wound severity is a critical component of wound management and has implications related to course of treatment. While most superficial burns and full thickness burns are easily diagnosed through visual inspection, burns that fall between these extremes are challenging to classify based on clinical appearance. Because of this, appropriate burn management may be delayed, increasing the risk of scarring and infection. Here we present an investigation that employs spatial frequency domain imaging (SFDI) and laser speckle imaging (LSI) as non-invasive technologies to characterize in-vivo burn severity. We used SFDI and LSI to investigate controlled burn wounds of graded severity in a Yorkshire pig model. Burn wounds were imaged starting at one hour after the initial injury and daily at approximately 24, 48 and 72 hours post burn. Biopsies were taken on each day in order to correlate the imaging data to the extent of burn damage as indicated via histological analysis. Changes in reduced scattering coefficient and blood flow could be used to categorize burn severity as soon as one hour after the burn injury. The results of this study suggest that SFDI and LSI information have the potential to provide useful metrics for quantifying the extent and severity of burn injuries. Durkin, "Spatial frequency domain imaging of burn wounds in a preclinical model of graded burn severity," J. ©2014 Optical Society of America

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Quantitative assessment of graded burn wounds in a porcine model using spatial frequency domain imaging (SFDI) and laser speckle imaging (LSI)

Ponticorvo¹,

Burmeister²,

Yang³

et al. 2014

Biomed. Opt. Express

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“…Biopsy punches of 6 mm diameter were taken from the following areas: three from the wound center (>5 mm from edge of wound), three from wound edges (although entirely within the burn wound), and three from healthy skin outside of the wound (>5 mm from wound) at selected time points. At minor time points (4,6,8,12, and 36 h postburn) at least three animals, and at major time points (24,48, and 72 h postburn), at least eight animals were killed to harvest the tissues. Tissues were ground in liquid nitrogen and further processed to obtain supernatants of tissue homogenates.…”

Section: Methodsmentioning

confidence: 99%

“…Burn wounds are characterized by three distinct "zones" of coagulation, stasis, and hyperemia. The zone of coagulation represents tissue that was instantly destroyed at the time of injury, which is surrounded by a zone of stasis where there is exuberant inflammation and poor perfusion (5,6). Surrounding the zone of stasis is a zone of hyperemia where microvascular perfusion is not impaired.…”

mentioning

confidence: 99%

Alternative erythropoietin-mediated signaling prevents secondary microvascular thrombosis and inflammation within cutaneous burns

Bohr

Patel

Shen

et al. 2013

Proc. Natl. Acad. Sci. U.S.A.

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Alternate erythropoietin (EPO)–mediated signaling via the heteromeric receptor composed of the EPO receptor and the β-common receptor (CD131) exerts the tissue-protective actions of EPO in various types of injuries. Herein we investigated the effects of the EPO derivative helix beta surface peptide (synonym: ARA290), which specifically triggers alternate EPO-mediated signaling, but does not bind the erythropoietic EPO receptor homodimer, on the progression of secondary tissue damage following cutaneous burns. For this purpose, a deep partial thickness cutaneous burn injury was applied on the back of mice, followed by systemic administration of vehicle or ARA290 at 1, 12, and 24 h postburn. With vehicle-only treatment, wounds exhibited secondary microvascular thrombosis within 24 h postburn, and subsequent necrosis of the surrounding tissue, thus converting to a full-thickness injury within 48 h. On the other hand, when ARA290 was systemically administered, patency of the microvasculature was maintained. Furthermore, ARA290 mitigated the innate inflammatory response, most notably tumor necrosis factor-alpha–mediated signaling. These findings correlated with long-term recovery of initially injured yet viable tissue components. In conclusion, ARA290 may be a promising therapeutic approach to prevent the conversion of partial- to full-thickness burn injuries. In a clinical setting, the decrease in burn depth and area would likely reduce the necessity for extensive surgical debridement as well as secondary wound closure by means of skin grafting. This use of ARA290 is consistent with its tissue-protective properties previously reported in other models of injury, such as myocardial infarction and hemorrhagic shock.

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“…[4] The outermost layer is the zone of hyperemia with increased blood flow, representing an inflammatory response to the tissue injury. It always stays viable.…”

mentioning

confidence: 99%

Saving the zone of stasis in burns with melatonin: An experimental study in rats

Kayapınar

Seyhan

Avunduk

et al. 2015

Ulus Travma Acil Cerrahi Derg

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Saving the zone of stasis in burns with activated protein C: An experimental study in rats

Cited by 42 publications

References 24 publications

Quantitative assessment of graded burn wounds in a porcine model using spatial frequency domain imaging (SFDI) and laser speckle imaging (LSI)

Quantitative assessment of graded burn wounds in a porcine model using spatial frequency domain imaging (SFDI) and laser speckle imaging (LSI)

Alternative erythropoietin-mediated signaling prevents secondary microvascular thrombosis and inflammation within cutaneous burns

Saving the zone of stasis in burns with melatonin: An experimental study in rats

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