Epidemiology and Outcome Analysis of 470 Patients with Hand Burns: A Five-Year Retrospective Study in a Major Burn Center in Southwest China.

BACKGROUND This retrospective study aimed to investigate the epidemiology of burns to the hand, including the causes, demographic data, management, and outcome in a single center in Southwest China between 2012 and 2017. MATERIAL AND METHODS A retrospective study included 470 patients with hand burns who were treated at a single hospital in Southwest China between 2012 and 2017. Demographic, injury-related, and clinical data were obtained from the clinical electronic data collection system. RESULTS In 470 patients, men were more commonly admitted to hospital with hand burns (73.62%). Children under 10 years (29.57%) were the main patient group. Hospital admissions occurred in the coldest months, from December to March (55.11%). In 60.21% of cases, hand burns occurred outside the workplace. Fire (40.42%), electricity (30.85%), and hot liquids (20.21%) were the main causes of hand burns. Data from 428 patients showed that burns with a larger total body surface area and deeper burns were associated with surgery and amputation. Burn depth was a risk factor for skin grafting, and lack of burn cooling before hospital admission increased the risk of amputation. Data from 117 patients with localized burns showed that full-thickness burns and lack of cooling before admission were associated with an increased hospital stay. CONCLUSIONS The findings suggest that in Southwest China, prevention programs for children aged 0-9 years, injuries occurring in winter and non-workplace sites, and fire burns were imperative.

Surface-Adaptive and Initiator-Loaded Graphene as a Light-Induced Generator with Free Radicals for Drug-Resistant Bacteria Eradication.

Since generating toxic reactive oxygen species is largely dependent on oxygen, bacteria-infected wounds' hypoxia significantly inhibits photodynamic therapy's antibacterial efficiency. Therefore, a novel therapeutic method for eradicating multidrug-resistant bacteria is developed based on the light-activated alkyl free-radical generation (that is oxygen independent). According to the polydopamine-coated carboxyl graphene (PDA@CG), an initiator-loaded and pH-sensitive heat-producible hybrid of bactericides was synthesized. According to fluorescence/thermal imaging, under the low pH of the bacterial infection sites, this platform turned positively charged, which allows their accumulation in local infection site. The plasmonic heating effects of PDA@CG can make the initiator decomposed to generate alkyl radical (R•) under the followed near-infrared light irradiation. As a result, oxidative stress can be elevated, DNA damages in bacteria can be caused, and finally even multidrug-resistance death can be caused under different oxygen tensions. Moreover, our bactericidal could promote wound healing in vivo and negligible toxicity in vivo and in vitro and eliminate abscess. Accordingly, this study proves that combination of oxygen-independent free-radical-based therapy along with a stimulus-responsiveness moiety not only can be used as an effective treatment of multidrug-resistant bacteria infection, but also creates a use of a variety of free radicals for treatment of multidrug-resistant bacteria infection wounds.

Epidemiologic Investigation of Chemical Burns in Southwestern China from 2005 to 2016.

The epidemiological characteristics of chemical burns vary in different regions of the world. This study aims to survey the epidemiology, outcomes, and costs of chemical burns in southwest China, to determine associated risk factors and to obtain data for developing an effective approach to prevent and treat chemical burns. This retrospective study includes 410 cases with chemical burns admitted to the Institute of Burn Research of Southwest Hospital from 2005 to 2016. Data, including demographic, etiology, outcomes, and costs, were collected and analyzed. A total of 410 cases admitted to our burn center were included. The average age of the burn patients was 38.58 ± 14.66 years. The incidence of chemical burns peaked in autumn. The most common etiology were acids. Limbs were the most common burn sites (59.51%). Average total body surface area (TBSA) was 12.37 ± 18.67%. The percentage of patients who underwent procedures and the number of procedures were significantly greater for TBSA and full-thickness burns. The mortality of chemical burns was 1.22%. The median length of stay (LOS) and cost were 21 days and 65,852 CNY, respectively. The major risk factors for cost were the number of procedures, TBSA and full-thickness burns, the major risk factors for LOS were the number of procedures and outcome. Chemical burns mainly occurred in adult males with occupational exposures to chemical agents due to inappropriate operation. Emphasis on safety education for the public and professional pre-employment training for workers should become key preventive targets to reduce the incidence of chemical burns.

pH-triggered charge-reversible of glycol chitosan conjugated carboxyl graphene for enhancing photothermal ablation of focal infection.

Subcutaneous abscesses infected by multidrug-resistant bacteria are becoming an increasing challenge to human health. To address this challenge, a surface-adaptive and biocompatible glycol chitosan conjugated carboxyl graphene (GCS-CG) is developed, which exhibits unique self-adaptive target to the acidic microenvironment of abscess (∼pH 6.3) and no damage to the healthy tissue (pH 7.4) around the abscess. Originally, following conjugated with GCS, the absorbance of CG obviously increases in the near-infrared (NIR) region, enabling GCS-CG to generate an increment amount of heat. GCS-CG shows fast pH-responsive surface charge transition from negative to positive, which presents strong adherence to negatively charged bacteria surface in abscess, while exhibits poor affinity to host cells in healthy tissues. The local temperature of NIR-irradiated GCS-CG is estimated to be higher than their ambient temperature, ensuring targeted heating and eradicating the bacteria to reduce the damage to tissue; hence, wound healing is accelerated. Moreover, the in vitro and in vivo biosafety results demonstrate that GCS-CG presents greatly biocompatible even at a high concentration of 1 mg·mL-1. Given the above advantages as well as the simple preparation, graphene developed here may provide a new potential application as a useful antibacterial agent in the areas of healthcare. STATEMENT OF SIGNIFICANCE: A surface-adaptive nanomaterial, glycol chitosan conjugated carboxyl graphene (GCS-CG) is developed, which realizes the acidity-triggered bacteria targeting. GCS-CG can result in direct thermal ablation of bacteria and enhancement of the infected wound healing, but exhibit no damage to healthy tissues. The pH-responsive GCS-CG described here, containing no antibiotics, has great potentials in treating bacterial infection and even multidrug-resistant bacteria.

Recent advances of on-demand dissolution of hydrogel dressings.

Wound management is a major global challenge and a big financial burden to the healthcare system due to the rapid growth of chronic diseases including the diabetes, obesity, and aging population. Modern solutions to wound management include hydrogels that dissolve on demand, and the development of such hydrogels is of keen research interest. The formation and subsequent on-demand dissolution of hydrogels is of keen interest to scientists and clinicians. These hydrogels have excellent properties such as tissue adhesion, swelling, and water absorption. In addition, these hydrogels have a distinctive capacity to form in situ and dissolve on-demand via physical or chemical reactions. Some of these hydrogels have been successfully used as a dressing to reduce bleeding in hepatic and aortal models, and the hydrogels remove easily afterwards. However, there is an extremely wide array of different ways to synthesize these hydrogels. Therefore, we summarize here the recent advances of hydrogels that dissolve on demand, covering both chemical cross-linking cases and physical cross-linking cases. We believe that continuous exploration of dissolution strategies will uncover new mechanisms of dissolution and extend the range of applications for hydrogel dressings.

P311 Deficiency Leads to Attenuated Angiogenesis in Cutaneous Wound Healing.

P311 was identified to markedly promote cutaneous wound healing by our group. Angiogenesis plays a key role in wound healing. In this study, we sought to define the role of P311 in skin wound angiogenesis. It was noted that P311 was expressed in endothelial cells in the dermis of murine and human skin wounds. The expression of P311 was confirmed in cultured murine dermal microvascular endothelial cells (mDMECs). Moreover, it was found that knockout of P311 could attenuate the formation of tubes and motility of mDMECs significantly in vitro. In the subcutaneous Matrigel implant model, the angiogenesis was reduced significantly in P311 knockout mice. In addition, wound healing was delayed in P311 knockout mice compared with that in the wild type. Granulation tissue formation during the defective wound healing showed thinner and blood vessel numbers in wound areas in P311 knockout mice were decreased significantly. A reduction in VEGF and TGFß1 was also found in P311 KO mice wounds, which implied that P311 may modulate the exprssion of VEGF and TGFß1 in wound healing. Together, our findings suggest that P311 plays an important role in angiogenesis in wound healing.