RESUMO
Autologous skin cell suspensions have been used for wound healing in patients with burns and against normal pigmentation in vitiligo. To separate cells and the extracellular matrix from skin tissue, most researchers use enzymatic digestion. Therefore, this process is difficult to perform during a routine surgical procedure. We aimed to prepare a suspension of noncultured autologous skin cells (NCSCs) using a tissue homogenizer as a new method instead of harsh biochemical reagents. The potential clinical applicability of NCSCs was analyzed using a nude-rat model of burn healing. After optimization of the homogenizer settings, cell viability ranged from 52 to 89%. Scanning electron microscopy showed evidence of keratinocyte-like cell morphology, and several growth factors, including epidermal growth factor and basic fibroblast growth factor, were present in the NCSCs. The rat model revealed that NCSCs accelerated skin regeneration. NCSCs could be generated using a tissue homogenizer for enhancement of wound healing in vivo. In the NCSC group of wounds, on day 7 of epithelialization, granulation was observed, whereas on day 14, there was a significant increase in skin adnexa regeneration as compared to the control group (PBS treatment; p < 0.05). This study suggests that the proposed process is rapid and does not require the use of biochemical agents. Thus, we recommend a combination of surgical treatment with the new therapy for a burn as an effective method.
Assuntos
Queimaduras/terapia , Separação Celular/métodos , Queratinócitos/citologia , Transplante de Pele/métodos , Pele/citologia , Cicatrização , Animais , Queimaduras/patologia , Sobrevivência Celular , Células Cultivadas , Peptídeos e Proteínas de Sinalização Intercelular/análise , Masculino , Ratos , Ratos Nus , Regeneração , Pele/patologia , Fenômenos Fisiológicos da PeleRESUMO
Human skin allografts are one of the best temporary biological coverings for severely burned patients. Cryopreserved (CPA) and glycerol-preserved (GPA) allografts are the most widely used types. This study compared the allograft efficiency of both preservation methods under the same conditions. To simulate actual clinical conditions, we used a porcine wound model. In addition, we evaluated the macroscopic and microscopic scoring of graft performance for each method. Porcine cadaver skin 1 mm thick was obtained from one pig. Cryopreserved skin cell viability was 20.8 %, glycerol-preserved skin was 9.08 %, and fresh skin was 58.6 %. We made ten partial-thickness wounds each in two pigs. The take rates on day 2 were 96.23 and 82.65 % in the GPA and CPA group (both n = 9), respectively. After 1 week, the take rates of both groups were nearly equal. The removal rate at week 5 was 98.87 and 94.41 % in the GPA and CPA group, respectively. On microscopic findings at week 2, inflammation was greater in the CPA group. Other findings such as fibroblast hyperplasia and neovascularization were not significantly different between both groups. At week 5, the score of collagen fiber synthesis was 2.67 ± 0.47 and 2.33 ± 0.47 in the GPA and CPA group, respectively. The epidermal-dermal junction was 2.22 ± 0.79 and 2.00 ± 0.47 in the GPA and CPA group, respectively. These findings suggest that wound healing takes longer in the CPA group. The preservation method of allografts is not a absolute factor in the wound healing process in this wound model.
Assuntos
Aloenxertos/efeitos dos fármacos , Criopreservação/métodos , Glicerol/farmacologia , Ferimentos e Lesões/patologia , Animais , Sobrevivência Celular/efeitos dos fármacos , Colágeno/metabolismo , Modelos Animais de Doenças , Inflamação/patologia , Sus scrofa , Suínos , Porco Miniatura , Sobrevivência de Tecidos/efeitos dos fármacos , Cicatrização/efeitos dos fármacosRESUMO
INTRODUCTION: Moxibustion, a traditional Chinese treatment that uses dried Artemisia argyi, is a common cause of burns treated in Korean hospitals. We aimed to examine the characteristics of moxibustion-induced burns. METHODS: This retrospective study examined the records of 59 patients who were treated for moxibustion-induced burns (April 2014-October 2015). All patients completed a questionnaire regarding their general characteristics and moxibustion use. RESULTS: The patients included 16 men and 43 women (average age: 49.1 years, 68 burn sites). Superficial second-degree burns were present at 21 sites, deep second- or third-degree burns at 44 sites, and unknown burns at 3 sites. The most common sites were the lower extremities, abdomen, and upper extremities. The most common practitioners were the patients (27/59, 45.7%) and Oriental medicine practitioners (23/59, 38.9%). The most common locations were the patient's home, Oriental medicine clinic, and moxibustion clinic. The most common reason for moxibustion was pain. Only the burn site was significantly associated with burn depth, and non-abdominal sites were 9.37-fold more likely to involve deep burns (vs. abdominal sites). CONCLUSION: Korean patients routinely undergo moxibustion, and care must be taken when using moxibustion at non-abdominal sites, due to the risk of deep burns.
Assuntos
Traumatismos Abdominais/epidemiologia , Traumatismos do Braço/epidemiologia , Queimaduras/epidemiologia , Traumatismos da Perna/epidemiologia , Moxibustão/efeitos adversos , Traumatismos Abdominais/etiologia , Adulto , Idoso , Traumatismos do Braço/etiologia , Queimaduras/etiologia , Criança , Feminino , Humanos , Traumatismos da Perna/etiologia , Masculino , Pessoa de Meia-Idade , Manejo da Dor , República da Coreia/epidemiologia , Estudos Retrospectivos , Inquéritos e Questionários , Índices de Gravidade do TraumaRESUMO
INTRODUCTION: Most cases of burns occurring in medical institutions are associated with activities involving heat. It is very difficult to detect these burns. To date, there are few reports on burns occurring in medical institutions. The purpose of this paper was to analyze the etiology of burns occurring in medical institutions and to elucidate the factors affecting burn depth. METHODS: We conducted a retrospective analysis of the medical records of patients who visited our center from April 2008 to February 2013. This study enrolled all patients with burns occurring in the medical institution during or related to treatment. We excluded burn patients whose burns were not related to treatment (for example, we excluded patients with scalding burns that occurred in the hospital cafeteria and pediatric patients with hot water burns from the water purifier). However, patients with burns that occurred in the recovery room after general anesthesia were included. RESULTS: A total of 115 patients were enrolled in this study. The average patient age was 41.5 years, with more women than men (M:F=31:84). There were 29 cases (25.3%) of superficial burns (first-degree and superficial second-degree) and 86 cases (74.7%) of deep burns (deep second-degree and third-degree). Hot packs were the most common cause of burns (27 cases, 23.5%), followed by laser therapy, heating pads, and grounding pads, accounting for 15 cases each. There were 89 cases (77.4%) of contact burns and 26 cases (22.6%) of non-contact burns. The most common site of burns was the lower extremities (41 cases, 35.7%). The burn site and contact burns were both factors affecting burn depth. The rate of deep burns was higher in patients with contact burns than in those with non-contact burns (odds ratio 4.26) and was associated with lower body burns (odds ratio 2.85). CONCLUSION: In burns occurring in medical institutions, there is a high probability of a deep burn if it is a contact burn or occurs in the lower body. Therefore, safety guidelines are needed for the use of hot packs, heating pads, and grounding pads to prevent such incidents.