thermal burns

热烧伤
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    文章类型: Journal Article
    A platelet count of less than 150,000 per microliter of blood is called thrombocytopenia. Platelet count monitoring is essential in the care of burn patients. The aim of this study was to evaluate platelet count in groups of patients with different percentage of burns on the body surface and its relationship with the severity of burns and mortality. This retrospective descriptive cross-sectional study was performed on patients admitted to Shahid Motahari Hospital over a period of six months. The study was conducted on burn patients who were admitted to the hospital on the first day after injury. Patients were divided into two groups of with or without thrombocytopenia in the first week. Demographic information and treatment information about the patients were recorded. SPSS V.26 software was used for the statistical analysis of data. In this study, the prevalence of thrombocytopenia in the first week after burns was 36%. The variables of age, sex, duration of hospitalization, burn agent, percentage of burns and use of silver sulfadiazine ointment were significantly different in the two groups of patients. The group without thrombocytopenia had a mortality rate of 5.1%, while the group with thrombocytopenia had a rate of 32.2%. Based on the results of this study, thrombocytopenia is significantly associated with mortality in burn patients. Furthermore, the results of this study indicate that age, sex, burn agent, percentage of burns, and the use of silver sulfadiazine ointment have a clear impact on the thrombocytopenic status of patients.
    La thrombopénie est définie par un compte plaquettaire <150 000/mm3, et la surveillance de la numération plaquettaire (NP) fait partie de la biologie de routine chez les brûlés. Cette étude a pour but l’évaluation de la cinétique de la NP chez des brûlés sur des surfaces variables et sa relation avec la sévérité de la brûlure et la mortalité. Il s’agit d’une étude rétrospective auprès de patients admis dans les 24h suivant leur brûlure dans le CTB de l’hôpital Shahid Motahari durant une période de 6 mois. Nous avons comparé ceux ayant subi une thrombopénie dans la première semaine aux autres (démographie, traitement), les statistiques ayant été réalisées avec SSPS version 26. La prévalence de la thrombopénie précoce est de 36%. Âge, sexe, cause, surface brûlée, recours à la sulfadiazine argentique et durée d’hospitalisation étaient différents entre les deux groupes. La mortalité des patients thrombopénique était de 32,2% VS 5,1%. Elle est significativement associée à la mortalité. L’âge, le sexe, la cause, la surface et la sulfadiazine argentique sont associées à la survenue de thrombopénie.
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  • 文章类型: Journal Article
    这篇文献综述将提供关于所报道的角膜缘干细胞缺乏症(LSCD)动物模型的亮点和潜在陷阱的关键叙述概述,并将确定该研究领域被忽视的方面。在文献中存在关于用于创建模型的方法和当模型被认为完全适合用于评估和/或用于测试各种治疗干预时的损伤后的预定义持续时间的显著异质性。文献中也有许多实例,其中特定模型的实施在不同研究中显著不同。例如,化学物质的浓度,以及其在化学诱导的LSCD模型中的暴露时间和技术,不仅对模型的有效性有很大的影响,而且对并发症的严重程度也有很大的影响。此外,虽然一些模型诱发了全面的LSCD临床表现,有些是阻碍他们的能力只产生部分LSCD。要考虑的另一个方面是由特定方法引起的损坏的性质。由于热方法会导致更多的基质疤痕,它们可能更适合评估特定治疗的抗纤维化特性。另一方面,因为化学烧伤会导致更多的血管新生,它们提供了利用抗新生血管形成的潜在治疗方法的机会。动物物种(即,老鼠,老鼠,兔子,等。)也是模型有效性及其临床翻译潜力的关键因素,每种动物都有其独特的优点和缺点。这篇综述还将阐述其他被忽视的方面,例如实验期间使用的麻醉剂,动物的性别,LSCD诱导后的护理,和模型验证。审查将通过提供未来的观点和建议在这个相当重要的研究领域的进一步发展。
    This literature review will provide a critical narrative overview of the highlights and potential pitfalls of the reported animal models for limbal stem cell deficiency (LSCD) and will identify the neglected aspects of this research area. There exists significant heterogeneity in the literature regarding the methodology used to create the model and the predefined duration after the insult when the model is supposedly fully fit for evaluations and/or for testing various therapeutic interventions. The literature is also replete with examples wherein the implementation of a specific model varies significantly across different studies. For example, the concentration of the chemical, as well as its duration and technique of exposure in a chemically induced LSCD model, has a great impact not only on the validity of the model but also on the severity of the complications. Furthermore, while some models induce a full-blown clinical picture of total LSCD, some are hindered by their ability to yield only partial LSCD. Another aspect to consider is the nature of the damage induced by a specific method. As thermal methods cause more stromal scarring, they may be better suited for assessing the anti-fibrotic properties of a particular treatment. On the other hand, since chemical burns cause more neovascularisation, they provide the opportunity to tap into the potential treatments for anti-neovascularisation. The animal species (i.e., rats, mice, rabbits, etc.) is also a crucial factor in the validity of the model and its potential for clinical translation, with each animal having its unique set of advantages and disadvantages. This review will also elaborate on other overlooked aspects, such as the anaesthetic(s) used during experiments, the gender of the animals, care after LSCD induction, and model validation. The review will conclude by providing future perspectives and suggestions for further developments in this rather important area of research.
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  • 文章类型: Journal Article
    热烧伤会造成组织损伤,消除了组织的保护作用。由于严重烧伤造成的广泛组织损伤,发生过度活跃的免疫反应。此外,这增加了得败血症的可能性,细菌感染在整个身体中传播,而不仅仅是在受伤或局部感染的区域。为了确定Ajwa的化合物在感染性热烧伤中具有作为抗炎和抗菌剂的潜力。研究方法采用系统评价和荟萃分析指南的首选报告项目。从在线数据库GoogleScholar和PubMed中收集了各种参考文献,包括报告,期刊,所有参考文献大多发表不超过过去10年。这篇系统综述揭示了16篇相关研究文章。类黄酮等多酚类物质,糖苷,在ajwa枣中发现了酚酸。特定的多酚化学物质具有与一种或多种免疫细胞受体相互作用的能力,移动细胞内信息并影响宿主的免疫反应。Ajwadates\'多酚通过抑制病原体相关分子模式受体的表达,在严重烧伤中充当抗炎剂,控制转录因子,改变巨噬细胞的表型,在其他方式中。Ajwa枣的细菌活性和免疫应答调节,另一方面,也可以直接作为抗菌剂。Ajwa枣中的多酚化合物具有在受感染的热烧伤中作为抗炎和抗菌剂的潜力。
    Thermal burns produce tissue damage, which eliminates the protective role of tissue. Due to the extensive tissue damage from severe burns, an overactive immune response occurs. Furthermore, this raises the possibility of getting sepsis, a condition in which a bacterial infection spreads throughout the body rather than only in the area of the injury or localized infection. To determine the compounds of Ajwa dates have the potential as an anti-inflammatory and antibacterial agent in infectious thermal burns. The research method used the Preferred Reporting Items for Systematic Review and Meta-Analyses guideline. Various references were collected from the online database Google Scholar and PubMed including reports, journals, and all references mostly published no more than the past 10 years. This systematic review revealed 16 research articles that were pertinent. Polyphenolic substances such as flavonoids, glycosides, and phenolic acids were found in ajwa dates. Specified polyphenol chemicals have the ability to interact with one or more immune cell receptors, moving intracellular messages and influencing the host\'s immunological response. Ajwa dates\' polyphenol acts as an anti-inflammatory agent in severe burns by inhibiting the expression of pathogen-associated molecular pattern receptors, controlling transcription factors, and changing the phenotype of macrophage cells, among other ways. The bacterial activity and immune response regulation of Ajwa dates, on the other hand, also serve as an antibacterial agent directly. The polyphenol compounds in Ajwa dates have the potential to operate as an anti-inflammatory and antibacterial agent in infected thermal burns.
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  • 文章类型: Journal Article
    研究和比较儿童和成人急性眼烧伤(AOB)的人口统计学和临床特征。
    这个回顾性病例系列包括271名儿童(338只眼)和1300名成人(1809只眼),他们在维持AOB后的一个月内到两个三级眼部护理中心就诊。有关人口统计的数据,病原体,损伤的严重程度,视敏度(VA),收集和分析治疗方法。
    男性更常受到影响,尤其是在成年人中(81%对64%,P<0.00001)。在儿童中,79%的人遭受家庭伤害,而59%的成年人有工作场所伤害(P<0.0001)。大多数病例是由于碱(38%)和酸(22%)。食用石灰(chuna,32%),强力胶(14%),和儿童鞭炮(12%),和Chuna(7%),杀虫剂,碱液,强力胶(每个6%),成人的厕所清洁剂(4%)和电池酸(3%),是主要的病原体。儿童DuaIV-VI级病例的百分比更高(16%对9%;P=0.0001)。36%和14%的儿童和成人受影响的眼睛需要羊膜移植和/或tarsorraphhy,分别(P<0.00001)。儿童的VA中位数为logMAR0.5,成人为logMAR0.3(P=0.0001),两组均有明显改善(P<0.0001),但是儿童DuaIV-VI级烧伤的最终VA较差(logMAR1.3对logMAR0.8,P=0.04)。
    这些发现清楚地描述了风险群体,病原体,临床严重程度,以及AOB的治疗结果。需要提高意识和数据驱动的针对性预防策略,以减少AOB可避免的眼部发病率。
    UNASSIGNED: To study and compare the demographic and clinical profile of acute ocular burns (AOB) in children and adults.
    UNASSIGNED: This retrospective case series included 271 children (338 eyes) and 1300 adults (1809 eyes) who presented to two tertiary eye care centers within one month of sustaining AOB. Data regarding demographics, causative agents, severity of injury, visual acuity (VA), and treatment were collected and analyzed.
    UNASSIGNED: Males were more commonly affected particularly among adults (81% versus 64%, P < 0.00001). Among children, 79% sustained domestic injuries, whereas 59% of adults had work-place injuries (P < 0.0001). Most cases were due to alkali (38%) and acids (22%). Edible lime (chuna, 32%), superglue (14%), and firecrackers (12%) in children, and chuna (7%), insecticides, lye, superglue (6% each), toilet cleaner (4%) and battery acid (3%) in adults, were the main causative agents. The percentage of cases with Dua grade IV-VI was greater in children (16% versus 9%; P = 0.0001). Amniotic membrane grafting and/or tarsorrhaphy were needed in 36% and 14% of affected eyes in children and adults, respectively (P < 0.00001). The median presenting VA was logMAR 0.5 in children and logMAR 0.3 in adults (P = 0.0001), which improved significantly with treatment in both groups (P < 0.0001), but the final VA in eyes with Dua grade IV-VI burns was poorer in children (logMAR 1.3 versus logMAR 0.8, P = 0.04).
    UNASSIGNED: The findings clearly delineate the at-risk groups, causative agents, clinical severity, and treatment outcomes of AOB. Increased awareness and data-driven targeted preventive strategies are needed to reduce the avoidable ocular morbidity in AOB.
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  • 文章类型: Journal Article
    目的:眼部烧伤是眼科急症,可造成毁灭性损伤。本研究旨在分析流行病学,并发症,和眼周烧伤的处理。
    方法:2018年1月至2020年12月,我院收治眼周烧伤患者193例。患者的人口统计学特征,伤害变量,并发症,和治疗进行了评估。
    结果:男性142例(73.6%),女性51例(26.4%),平均年龄32.53±17.75岁。平均总表面积为12%(范围,1-80%)。受伤在工作(52.3%)和家庭(36.3%)中最常见。热烧伤是最常见的伤害(74.6%),其次是化学烧伤(14.5%)和电烧伤(10.9%)。碱性剂(75.0%),主要是氢氧化钠和石灰,在化学烧伤中很常见。热治疗组的眼睑浅部烧伤明显高于对照组(p<0.001),和III-IV级角膜烧伤在化学组明显更高(p<0.001)。50只(13%)眼出现各种并发症。仅在318只(82.4%)眼进行了药物治疗,对64只(17.6%)眼进行了额外的手术治疗;然而,54例(14.0%)接受了一次以上的手术。最常见的并发症是角膜疤痕(7.3%),角膜缘缺乏(4.1%),外翻(3.9%)。最常见的手术是羊膜移植(AMT)(11.9%)和tarsorraphhy(6.7%)。
    结论:化学烧伤,角膜缘和结膜缺血,全层眼睑缺损预后不良。发现角膜缘缺陷和眼内结构损伤的程度对其视力的结果有很大影响。
    OBJECTIVE: Ocular burns are ophthalmic emergencies that can cause devastating injuries. This study aimed to analyze the epidemiology, complications, and management of ocular-periocular burns.
    METHODS: A total of 193 patients with ocular-periocular burns were admitted to our tertiary hospital from January 2018 to December 2020. The demographic characteristics of the patients, injury variables, complications, and treatments were evaluated.
    RESULTS: There were 142 male (73.6%) and 51 female (26.4%) patients with a mean age of 32.53±17.75 years. The average total body surface area was 12% (range, 1-80%). Injuries were most common at work (52.3%) and home (36.3%). Thermal burns were the most common injuries (74.6%), followed by chemical (14.5%) and electrical burns (10.9%). Alkaline agents (75.0%), mainly sodium hydroxide and lime, were common in chemical burns. Superficial lid burns were significantly higher in the thermal group (p < 0.001), and grade III-IV corneal burns were significantly higher in the chemical group (p < 0.001). Various complications were developed in 50 (13%) eyes. Medical treatment only was performed in 318 (82.4%) eyes, and additional surgical treatment was performed in 64 (17.6%) eyes; however, 54 (14.0%) underwent more than one surgery. The most common complications were corneal scars (7.3%), limbal deficiency (4.1%), and ectropion (3.9%). The most frequent procedures performed were amniotic membrane transplantation (AMT) (11.9%) and tarsorrhaphy (6.7%).
    CONCLUSIONS: Chemical burns, limbal and conjunctival ischemia, and full-thickness eyelid defects had a poor prognosis. The degree of limbal deficiency and ınjury of intraocular structures were found to have a great influence on the outcome of their visual acuity.
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  • 文章类型: Journal Article
    已知间充质干细胞(MSC)通过增加组织再生而有助于伤口愈合。这项研究检查了MSC-冻干物(MSC-L)对热烧伤中停滞区恢复的影响。
    使用梳子在大鼠的背部诱发二度热烧伤(1×2cm)。烧伤后30分钟内,将源自脐带的MSC-L给予实验组,将1.5ml的0.9%等渗氯化钠给予假手术组。对照组不接受任何干预。在术后第7天收集组织样品。使用带有数码相机附件的显微镜进行组织病理学评估。使用IBM25的SPSS进行数据分析。
    在第7天在对照组和假手术组中观察到上皮损失和表皮下大疱。在实验组中,发现MSC-L给药增加真皮中的上皮组织形成和新生血管形成。实验组的表皮和真皮均未发现明显的病理结果。
    施用脐带衍生的MSC-L在伤口愈合中具有潜在的重要性。在我们的研究中,我们观察到含有150万个细胞的MSC-L显著有助于烧伤停滞区的恢复。
    Mesenchymal Stem Cells (MSCs) are known to contribute to wound healing by increasing tissue regeneration. This study examined the effect of MSC-Lyophilizate (MSC-L) on the recovery of the zone of stasis in thermal burns.
    A comb was used to induce second-degree thermal burns (1 × 2 cm) on the dorsum of the rats. Within 30 min after the burn, MSC-L derived from the umbilical cord was administered to the experimental group and 1.5 ml of 0.9% isotonic sodium chloride to the sham group. The control group did not receive any intervention. Tissue samples were collected on postoperative day 7. Histopathological assessments were made using a microscope with digital camera attachment. SPSS for IBM 25 was used for data analysis.
    Epithelial loss and subepidermal bullae were observed in the control and sham groups on day 7. In the experimental group, the MSC-L administration was found to increase epithelial tissue formation and neovascularization in the dermis. We found no significant pathological findings in the epidermis and dermis in the experimental group.
    Administration of umbilical cord-derived MSC-L is of potential importance in wound healing. In our study, we observed that MSC-L that contained 1.5 million cells contributed significantly to the recovery of the stasis zone of burn.
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  • 文章类型: Journal Article
    许多研究表明,烧伤有影响生活质量的生理和心理后遗症。Further,这些影响在某些地区和人群中可能更为普遍。我们试图获得有关热烧伤健康负担的不平衡分布和时间趋势。
    数据来自2017年全球疾病负担研究,残疾调整寿命年(DALY)1被用作健康负担的衡量标准。线性回归用于评估年龄标准化的DALY率与社会人口统计学指标之间的关系。2联合回归分析和比较线图均用于评估烧伤的时间趋势。
    全球热烧伤的年龄标准化DALY率下降了43.7%,从1990年的197(95%CI:152-228)/100,000到2017年的111(95%CI:93-129)/100,000。负担主要由1-4岁的儿童和80岁以上的人承担。社会人口统计学指数与年龄标准化的DALY率呈负相关。在中低和低社会人口指数地区,下降趋势比其他地区慢,年均百分比变化为-2.1%(95%CI:-2.2至-2.0)和-2.1%(95%CI:-2.1至-2.0),分别。在六个地理区域中,非洲的年龄标准化DALY率最高,1990年为每100,000人352(95%CI:275-410),2017年为每100,000人208(95%CI:175-236),并且平均下降趋势最慢。年平均百分比变化为-1.9%(95%CI:-2至-1.8)。
    从1990年到2017年,全球热烧伤负担呈下降趋势,社会人口指数较低的地区和非洲的负担更大,下降趋势更小。
    Many studies demonstrate that being burned has both physical and psychological sequelae that affect quality of life. Further, these effects may be more prevalent in some regions and populations. We sought to access the unbalanced distributions and temporal trends concerning the health burden of thermal burns.
    Data were collected from the Global Burden of Disease Study 2017, and the disability-adjusted life year (DALY)1 was used as a measure of health burden. Linear regression was used to evaluate the relationship between the age-standardized DALY rate and socio-demographic index.2 Joinpoint regression analysis and comparison line charts were all applied to assess the temporal trends of burns.
    The age-standardized DALY rate of global thermal burns decreased by 43.7%, from 197 (95% CI: 152-228) per 100,000 in 1990 to 111 (95% CI: 93-129) per 100,000 in 2017. The burden was borne mainly by children 1-4 years of age and people over 80 years. Socio-demographic index was negatively correlated with the age-standardized DALY rate. In low-middle and low socio-demographic index regions, the decreasing trends were slower than other regions with an average annual percentage change of -2.1% (95% CI: -2.2 to -2.0) and -2.1% (95% CI: -2.1 to -2.0), respectively. Among six geographical regions, Africa presented the highest age-standardized DALY rates of 352 (95% CI: 275-410) per 100,000 in 1990 and 208 (95% CI: 175-236) per 100,000 in 2017, and also the slowest average decreasing trend, with an average annual percentage change of -1.9% (95% CI: -2 to -1.8).
    The global burden of thermal burns shows a downward trend from 1990 to 2017, and regions with lower socio-demographic index and Africa show greater burdens and smaller downward trends.
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  • 文章类型: Journal Article
    The aim of the study was to evaluate the efficacy and safety of the Collost bioplastic material in the treatment of borderline and mosaic burns.
    UNASSIGNED: We conducted a prospective multicenter study, which included 94 patients aged 1 to 12 years with thermal skin burns (grade II-III by ICD-10). Patients were divided into four groups. In groups 1-3, various forms of the Collost bioplastic material were used (group 1 - 7% gel, group 2 - membranes, group 3 - powder) in combination with hydrocolloid dressings containing Ag+ ions. Patients of the control group (group 4) underwent the traditional local conservative treatment using hydrocolloid dressings alone. Concomitant therapy was similar in all of the participating centers. The total follow-up period was 4 weeks from the date of burn injury.
    UNASSIGNED: On day 14, there were 23 cases (92%) of complete epithelization in group 1, 13 cases (68.4%) - in group 2, 21 cases (78%) - in group 3, and 9 cases (39.1%) - in group 4. The data from groups 1 and 3 significantly differed from those in control (p<0.05). The epithelialization of the burned skin in the Collost groups (7% gel and powder) was on average one week faster compared to the control.
    UNASSIGNED: The Collost bioplastic material (in the form of gel or powder) in combination with hydrocolloid dressings can be a functional and inexpensive alternative to autografts in the treatment of borderline and mosaic burns.
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  • 文章类型: Journal Article
    实验性烧伤模型是模拟人体烧伤和探索烧伤后果或新治疗策略的重要工具。与临床研究不同,实验模型允许在受控条件下直接比较烧伤的不同方面,从而提供有关组织损伤和伤口愈合的分子机制的相关信息。以及潜在的治疗目标。虽然大多数比较烧伤研究是在动物模型中进行的,一些人类或人性化模型已成功用于研究受伤部位的局部事件.然而,关于全身炎症反应综合征(SIRS)的细胞和分子性质的动物和人类研究之间的共识,疤痕,新血管形成是有限的。许多种间差异阻止了动物模型研究的结果完全转化为人类系统。因此,更有针对性的发展,烧伤的个体化治疗仍是该领域的一大挑战.这篇综述集中于自2016年以来在实验性烧伤模型方面取得的最新进展,并总结了有关潜在方法学改进的结果。对损伤的分子反应评估,和治疗进展。
    Experimental burn models are essential tools for simulating human burn injuries and exploring the consequences of burns or new treatment strategies. Unlike clinical studies, experimental models allow a direct comparison of different aspects of burns under controlled conditions and thereby provide relevant information on the molecular mechanisms of tissue damage and wound healing, as well as potential therapeutic targets. While most comparative burn studies are performed in animal models, a few human or humanized models have been successfully employed to study local events at the injury site. However, the consensus between animal and human studies regarding the cellular and molecular nature of systemic inflammatory response syndrome (SIRS), scarring, and neovascularization is limited. The many interspecies differences prohibit the outcomes of animal model studies from being fully translated into the human system. Thus, the development of more targeted, individualized treatments for burn injuries remains a major challenge in this field. This review focuses on the latest progress in experimental burn models achieved since 2016, and summarizes the outcomes regarding potential methodological improvements, assessments of molecular responses to injury, and therapeutic advances.
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  • 文章类型: Case Reports
    Thermal burns of the oral cavity usually arise from ingestion of hot foods or beverages. A 38-year-old female patient presented with two painful ulcerative erythematous patches of the palate. The patient was consulted on the same day lesions appeared. Medical history was unremarkable. Clinically significant self-inflicted injuries may result in wide ulcers in the mouth and usually do not take less than 2 weeks to heal, whereas our patient, treated with low-level laser therapy, had a complete response in day 4, after 2 days of treatment. The fact that multiple lesions were present signaled against the World Health Organization exclusion diagnosis of erythroplakia for red patches. A traumatic ulcer, regardless of its cause of origin, usually heals within 2 weeks, after the source of injury is resolved. A thermal burn in the oral cavity usually takes longer than that to heal, but whenever this time frame is not respected, the suspicion of a potentially malignant disorder should always arise, and a biopsy should be performed. The present case showed two painful thermal burns with great results in terms of speeding up the relieve of symptoms and healing time with soft laser as opposed to the traditional treatment with oral topical corticosteroid.
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