Enzymatic debridement of hands with deep burns: a single center experience in the treatment of 52 hands.

Background: Bromelain-based enzymatic debridement has been introduced as an alternative to surgical excision in deep partial thickness and full thickness burns. We aimed to analyze effectiveness and predictors of spontaneous epithelialization after enzymatic debridement of deep hand burns.Methods: All patients who received enzymatic debridement for deep partial thickness or full thickness burns of the hands at our institution in the last 5 years were identified. Demographic, clinical and outcome data were collected and analyzed. For patients with deep partial thickness burns, Kaplan-Meier log-rank and subsequent multivariate Cox-regression analysis were performed to identify predictors of spontaneous epithelialization.Results: 44 patients and 52 hands were treated in the observation period. Among these, 14 had full thickness burns and received split thickness skin grafts. In the 38 hands with deep partial thickness burns, predictors of 28-day epithelialization were total burn extent and mechanism of burn injury. During the first 3 years, 8 out of 13 treated deep partial thickness burns received split thickness skin grafts after a median of 3 days. The following 3 years, 5 out of 25 deep partial thickness burns received surgery after a median of 14 days.Conclusions: Enzymatic debridement is a useful tool in the treatment of burned hands but the decision-making and correct timing of operative intervention in deep partial thickness burns after debridement requires experience. In our cohort, spontaneous healing of deep partial thickness burns was best in patients with contact burns and less than 15% burn TBSA.

Resveratrol induces apoptosis and alters gene expression in human fibrosarcoma cells.

BACKGROUND/AIM: Metastatic fibrosarcomas still represent a therapeutic dilemma. Commonly used chemotherapeutic agents such as doxorubicin have been proven effective in fewer than 30% of all cases disseminated of fibrosarcoma. Elderly patients with cardiac disease are not suitable for systemic chemotherapy with doxorubicin. We therefore tested the apoptotic effects of the natural and well-tolerated compound resveratrol on human fibrosarcoma cells (HT1080). MATERIALS AND METHODS: Vital, apoptotic and necrotic cells were quantified using flow cytometric analysis. Gene expression was analyzed by RNA microarrays. RESULTS: Application of resveratrol induced apoptotic cell death and significantly reduced proliferation of HT1080 cells. Correspondingly, expression of apoptosis-associated genes was altered in microarray analysis. CONCLUSION: This in vitro study demonstrates the anticancer activity of resveratrol against human fibrosarcoma cells. These results provide experimental support for in vivo trials assessing the effect of the natural polyphenol resveratrol.

Pro­apoptotic effects of pycnogenol on HT1080 human fibrosarcoma cells.

Complete surgical resection with clear margins remains the mainstay of therapy for localised fibrosarcomas. Nevertheless, metastatic fibrosarcomas still represent a therapeutic dilemma. Commonly used chemotherapeutic agents like doxorubicin have proven to be effective in <30% of all cases of disseminated fibrosarcoma. Especially elderly patients with cardiac subdisease are not suitable for systemic chemotherapy with doxorubicin. Therefore we tested the apoptotic effects of the well-tolerated pine bark extract pycnogenol and its constituents on human fibrosarcoma cells (HT1080). Ten healthy subjects (six females, four males, mean age 24.8 ± 6 years) received a single dose of 300 mg pycnogenol orally. Blood plasma samples were obtained before and 6 h after intake of pycnogenol. HT1080 cells were treated with these plasma samples. Additionally, HT1080 were incubated separately with catechin, epicatechin and taxifolin that are known as the main constituents of pycnogenol. Vital, apoptotic and necrotic cells were quantified using flow cytometric analysis. Gene expression was analyzed by RNA microarray. The results showed that single application of taxifolin, catechin and epicatechin reduced cell viability of HT1080 cells only moderately. A single dose of 300 mg pycnogenol given to 10 healthy adults produced plasma samples that led to significant apoptotic cell death ex vivo whereas pycnogenol-negative serum displayed no apoptotic activity. Microarray analysis revealed remarkable expression changes induced by pycnogenol in a variety of genes, which are involved in different apoptotic pathways of cancer cells [Janus kinase 1 (JAK1), DUSP1, RHOA, laminin γ1 (LAMC1), fibronectin 1 (FN1), catenin α1 (CTNNA1), ITGB1]. In conclusion, metabolised pycnogenol induces apoptosis in human fibrosarcoma cells. Pycnogenol exhibits its pro-apoptotic activity as a mixture and is more effective than its main constituents catechin, epicatechin and taxifolin indicating that the metabolised components interact synergistically. These results provide experimental support for in vivo trials assessing the effect of the pine bark extract pycnogenol.