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Burns ; 34(4): 474-86, 2008 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-17980970

RESUMO

In the management of partial thickness burns, it is difficult to balance between conservative management and surgical intervention. Our hypothesis was that a triangular relationship exists between protease/anti-protease profile at the burn wound surface, angiogenesis and re-epithelialisation. By manipulation of the biochemical profile at the wound level, we determined to affect the nature and extent of angiogenesis and resulting re-epithelialisation. We performed a randomised longitudinal observational study on partial thickness burns in adult patients presenting to two regional burns units. Our results demonstrated that a high-protease wound environment is associated with lower levels of the angiogenic factor VEGF, a lower more uniform change in wound bloodflow and a uniform well healed wound with an architecturally normal epidermis. In addition, we found that a low protease wound environment is associated with higher levels of the angiogenic factor VEGF, a higher wound bloodflow throughout the wound healing period and a more chaotic, hypercellular, overkeratinised, and chaotic thickened epidermis.


Assuntos
Queimaduras/enzimologia , Neovascularização Fisiológica/fisiologia , Peptídeo Hidrolases/metabolismo , Pele/irrigação sanguínea , Cicatrização/fisiologia , Adolescente , Adulto , Idoso , Curativos Hidrocoloides , Queimaduras/terapia , Contagem de Células , Células Epiteliais/fisiologia , Humanos , Imuno-Histoquímica , Fluxometria por Laser-Doppler , Pessoa de Meia-Idade , Tratamento de Ferimentos com Pressão Negativa , Adulto Jovem
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