Surgical treatment and management of the severely burn patient: Review and update

Gacto-Sánchez, Purificación

doi:10.1016/j.medin.2017.02.008

Cited by 69 publications

(50 citation statements)

References 76 publications

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“…Colloid-only resuscitation with albumin was used and average time to excision and grafting was 21 days ( 13 ). This is in stark contrast to crystalloid-based resuscitation ( 14 ) and early excision and grafting that is the practice of most burn institutions today ( 15 , 16 ).…”

Section: History Of Burn-induced Coagulopathy Researchmentioning

confidence: 98%

Burn-Induced Coagulopathies: a Comprehensive Review

Ball

Keyloun

Brummel‐Ziedins

et al. 2019

Shock

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Burn-induced coagulopathy is not well understood, and consensus on diagnosis, prevention, and treatments are lacking. In this review, literature on burn-induced (and associated) coagulopathy is presented along with the current understanding of the effects of burn injury on the interactions among coagulation, fibrinolysis, and inflammation in the acute resuscitative phase and reconstructive phase of care. The role of conventional tests of coagulopathy and functional assays like thromboelastography or thromboelastometry will also be discussed. Finally, reported methods for the prevention and treatment of complications related to burn-induced coagulopathy will be reviewed.

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Section: History Of Burn-induced Coagulopathy Researchmentioning

confidence: 98%

Burn-Induced Coagulopathies: a Comprehensive Review

Ball

Keyloun

Brummel‐Ziedins

et al. 2019

Shock

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“…Burn injuries typically destroy the skin integrity, and avascularity, protein rich environment and generalized immune suppression make burn wounds particularly susceptible to infections [ 17 – 20 ]. One of the most common bacterial species affecting burn patients is P. aeruginosa [ 17 – 20 ], and its presence may significantly worsen prognosis and survival rate. To overcome these limitations, different innovative approaches have been described, such as biomaterial functionalization with graphene oxide [ 32 ] or montmorillonite [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

“…In this regard, one of the main clinical challenges in patients affected by severe skin burns is preventing bacterial infection [ 17 – 19 ]. Specifically, Pseudomonas aeruginosa is one of the main pathogens that first colonizes burn wounds and can produce severe respiratory system and systemic complications that can compromise patient's life [ 17 , 18 , 20 ]. However, the treatment of these infections through conventional antibiotic therapies is often difficult due to the wide range of antimicrobial multidrug resistance of this pathogen and the low bioavailability of certain antibiotics [ 21 , 22 ].…”

Section: Introductionmentioning

confidence: 99%

Generation of a novel human dermal substitute functionalized with antibiotic-loaded nanostructured lipid carriers (NLCs) with antimicrobial properties for tissue engineering

et al. 2020

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Background Treatment of patients affected by severe burns is challenging, especially due to the high risk of Pseudomonas infection. In the present work, we have generated a novel model of bioartificial human dermis substitute by tissue engineering to treat infected wounds using fibrin-agarose biomaterials functionalized with nanostructured lipid carriers (NLCs) loaded with two anti-Pseudomonas antibiotics: sodium colistimethate (SCM) and amikacin (AMK). Results Results show that the novel tissue-like substitutes have strong antibacterial effect on Pseudomonas cultures, directly proportional to the NLC concentration. Free DNA quantification, WST-1 and Caspase 7 immunohistochemical assays in the functionalized dermis substitute demonstrated that neither cell viability nor cell proliferation were affected by functionalization in most study groups. Furthermore, immunohistochemistry for PCNA and KI67 and histochemistry for collagen and proteoglycans revealed that cells proliferated and were metabolically active in the functionalized tissue with no differences with controls. When functionalized tissues were biomechanically characterized, we found that NLCs were able to improve some of the major biomechanical properties of these artificial tissues, although this strongly depended on the type and concentration of NLCs. Conclusions These results suggest that functionalization of fibrin-agarose human dermal substitutes with antibiotic-loaded NLCs is able to improve the antibacterial and biomechanical properties of these substitutes with no detectable side effects. This opens the door to future clinical use of functionalized tissues.

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“…Burn injuries typically destroy the skin integrity, and avascularity, protein rich environment and generalized immune suppression make burn wounds particularly susceptible to infections (17)(18)(19)(20). One of the most common bacterial species affecting burn patients is P. aeruginosa (17)(18)(19)(20), and its presence may signi cantly worsen prognosis and survival rate. To overcome these limitations, different innovative approaches have been described, such as biomaterial functionalization with graphene oxide (32) or montmorillonite (33).…”

Section: Biomechanical Properties Of Fssmentioning

confidence: 99%

“…In this regard, one of the main clinical challenges in patients affected by severe skin burns is preventing bacterial infection (17)(18)(19). Speci cally, Pseudomonas aeruginosa is one of the main pathogens that rst colonizes burn wounds and can produce severe respiratory system and systemic complications that can compromise patient's life (17,18,20). However, the treatment of these infections through conventional antibiotic therapies is often di cult due to the wide range of antimicrobial multidrug resistance of this pathogen and the low bioavailability of certain antibiotics (21,22).…”

Section: Introductionmentioning

confidence: 99%

Generation of a novel human dermal substitute functionalized with antibiotic-loaded nanostructured lipid carriers (NLCs) with antimicrobial properties for tissue engineering

Chato‐Astrain

Chato-Astrain

Sánchez-Porras

et al. 2020

Preprint

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Background: Treatment of patients affected by severe burns is challenging, especially due to the high risk of Pseudomonas infection. In the present work, we have generated a novel model of bioartificial human dermis substitute by tissue engineering to treat infected wounds using fibrin-agarose biomaterials functionalized with nanostructured lipid carriers (NLCs) loaded with two anti-Pseudomonas antibiotics: sodium colistimethate (SCM) and amikacin (AMK). Results: Results show that the novel tissue-like substitutes have strong antibacterial effect on Pseudomonas cultures, directly proportional to the NLC concentration. Free DNA quantification, WST-1 and Caspase 7 immunohistochemical assays in the functionalized dermis substitute demonstrated that neither cell viability nor cell proliferation were affected by functionalization in most study groups. Furthermore, immunohistochemistry for PCNA and KI67 and histochemistry for collagen and proteoglycans revealed that cells proliferated and were metabolically active in the functionalized tissue with no differences with controls. When functionalized tissues were biomechanically characterized, we found that NLCs were able to improve some of the major biomechanical properties of these artificial tissues, although this strongly depended on the type and concentration of NLCs. Conclusions: These results suggest that functionalization of fibrin-agarose human dermal substitutes with antibiotic-loaded NLCs is able to improve the antibacterial and biomechanical properties of these substitutes with no detectable side effects. This opens the door to future clinical use of functionalized tissues.

show abstract

Surgical treatment and management of the severely burn patient: Review and update

Cited by 69 publications

References 76 publications

Burn-Induced Coagulopathies: a Comprehensive Review

Burn-Induced Coagulopathies: a Comprehensive Review

Generation of a novel human dermal substitute functionalized with antibiotic-loaded nanostructured lipid carriers (NLCs) with antimicrobial properties for tissue engineering

Generation of a novel human dermal substitute functionalized with antibiotic-loaded nanostructured lipid carriers (NLCs) with antimicrobial properties for tissue engineering

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