Burn injuries are a significant global health concern, with more than 11 million people requiring medical intervention each year and approximately 180,000 deaths annually. Despite progress in health and social care, burn injuries continue to result in socioeconomic burdens for victims and their families. The management of severe burn injuries involves preventing and treating burn shock and promoting skin repair through a two-step procedure of covering and closing the wound. Currently, split-thickness/full-thickness skin autografts are the gold standard for permanent skin substitution. However, deep burns treated with split-thickness skin autografts may contract, leading to functional and appearance issues. Conversely, defects treated with full-thickness skin autografts often result in more satisfactory function and appearance. The development of tissue-engineered dermal templates has further expanded the scope of wound repair, providing scar reductive and regenerative properties that have extended their use to reconstructive surgical interventions. Although their interactions with the wound microenvironment are not fully understood, these templates have shown potential in local infection control. This narrative review discusses the current state of wound repair in burn injuries, focusing on the progress made from wound cover to wound closure and local infection control. Advancements in technology and therapies hold promise for improving the outcomes for burn injury patients. Understanding the underlying mechanisms of wound repair and tissue regeneration may provide new insights for developing more effective treatments in the future.
- MeSH
- hojení ran MeSH
- jizva etiologie prevence a kontrola chirurgie MeSH
- kůže patologie MeSH
- lidé MeSH
- popálení * chirurgie patologie MeSH
- transplantace kůže metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
Porušením hojení rány vznikají hyperplastické jizvy. Článek poskytuje pohled na patogene-zi tvorby jizvy a na různé typy jizev. Rozdíly mezi keloidními a hypertrofickými jizvami zahrnují odlišný klinický vzhled a histologickou morfologii. V článku jsou popsány léčebné možnosti hyperplastických jizev a preventivní opatření před jejich vznikem.
Aberrant wound healing results in hypertroplastic scarring. The article presents an overview on the pathogenesis of a scar and of the different types of scars. Differences between keloids, hypertro-phic scars include distinct scar appearance, histologic morphology. This article also describes the strate-gies available for hyperplastic scar treatment ad their prevention.
- Klíčová slova
- jizva hyperplastická,
- MeSH
- diferenciální diagnóza MeSH
- gely terapeutické užití MeSH
- hormony kůry nadledvin aplikace a dávkování MeSH
- jizva * diagnóza farmakoterapie klasifikace prevence a kontrola terapie MeSH
- kryochirurgie MeSH
- lidé MeSH
- tretinoin analogy a deriváty MeSH
- triamcinolon aplikace a dávkování MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
The study aimed to determine the effects of protease-activated receptor-2 (PAR-2) on glial scar formation after spinal cord injury (SCI) in Sprague-Dawley (SD) rats and the underlying mechanisms. Rivlin and Tator's acute extradural clip compression injury (CCI) model of severe SCI was established in this study. Animals were divided into four groups: 1) sham group (laminectomy only); 2) model group, treated with normal saline; 3) PAR-2 inhibitor group; 4) PAR-2 activator group. Enhanced GFAP and vimentin expression were the markers of glial scar formation. To determine whether JNK was involved in the effects of PAR-2 on GFAP and vimentin expression, we administered anisomycin (a JNK activator) in the presence of PAR-2 inhibitor and SP600125 (a JNK inhibitor) in the presence of PAR-2 activator. At 1, 7, 14 and 28 day after SCI, Basso, Beattie, and Bresnahan (BBB) locomotor score test was used to assess the locomotor functional recovery; immunofluorescence and western blot analysis were used to assess the expression level of GFAP, vimentin and p-JNK. Double immunofluorescence staining with GFAP and tubulin beta was used to assess the glial scar formation and the remaining neurons. Results suggested that PAR-2 is involved in glial scar formation and reduces neurons residues which can cause a further worsening in the functional outcomes after SCI via JNK signaling. Therefore, it may be effective to target PAR-2 in the treatment of SCI.
- MeSH
- anisomycin farmakologie MeSH
- anthraceny farmakologie MeSH
- jizva metabolismus patologie prevence a kontrola MeSH
- krysa rodu rattus MeSH
- MAP kinasový signální systém účinky léků fyziologie MeSH
- poranění míchy metabolismus patologie MeSH
- potkani Sprague-Dawley MeSH
- receptor PAR-2 antagonisté a inhibitory biosyntéza MeSH
- zvířata MeSH
- Check Tag
- krysa rodu rattus MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
Jizva je výsledným stavem po traumatu či operačním zásahu. Některé typy jizev mohou vznikat i spontánně, bez zřejmého vyvolávajícího faktoru. Hojení rány je komplexní proces, který zahrnuje vysoce regulované kaskády dějů, které vyžadují koordinované interakce mezi buňkami, chemotaktickými faktory a složkami extracelulární matrix. Porušením těchto dějů dojde k vzniku patologické jizvy. Patologické jizvy se dělí na jizvy hyperplastické a jizvy atrofické. Hyperplastické jizvy pak mají dvě podskupiny – jizvy hypertrofické a jizvy keloidní. Terapeutickými možnostmi léčby jizev jsou chirurgická excize, intralézionální aplikace kortikosteroidů a dalších látek, kryoterapie, aplikace silikonových gelů, ošetření lasery a další. Neméně důležitá je také prevence vzniku patologických jizev.
The scar is a condition resulting from trauma or operational intervention. Some types of scars can also occur spontaneously, without causing obvious factor. Wound repair is a complex process involving a highly regulated cascade of events requiring coordinated interactions between cells, soluble factors, and extracellular matrix components. Pathological scars are caused by the wrong mechanism of healing. Pathological scars are divided into hyperplastic scars and atrophic scars. Hyperplastic scars have two subgroups - hypertrophic scars and keloid scars. Therapeutic options for scar treatment include surgical excision, intralasional application of corticosteroids and other substances, cryotherapy, application of topical silicone gels, laser treatment and others. Prevention of pathological scarring is also very important.
- MeSH
- dítě MeSH
- herpes simplex radioterapie MeSH
- hojení ran účinky záření MeSH
- jizva prevence a kontrola radioterapie MeSH
- kožní nemoci radioterapie MeSH
- laserová terapie s nízkou intenzitou světla * ekonomika metody přístrojové vybavení MeSH
- lidé MeSH
- předškolní dítě MeSH
- primární zdravotní péče MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
The aim of this study was to examine whether nanofiber scaffolds seeded with rabbit bone marrow mesenchymal stem cells (MSCs nanofibers) transferred onto the damaged corneal surface and covered with cyclosporine A (CsA)-loaded nanofiber scaffolds (CsA nanofibers) enable healing of the rabbit cornea injured with 1N NaOH. The healing of damaged corneas was examined morphologically, immunohistochemically and biochemically on day 24 after the injury. Compared to untreated injured corneas, where corneal ulceration or large corneal thinning or even perforation were developed, injured corneas treated with drug free nanofibers healed without profound disturbances in a majority of cases, although with fibrosis and scar formation. In injured corneas treated with CsA nanofibers or MSCs nanofibers, the development of scar formation was reduced. Best healing results were obtained with a combination of MSCs and CsA nanofibers (MSCs-CsA nanofibers). Corneas healed with highly restored transparency. Neovascularization highly expressed in untreated injured corneas and reduced in corneas treated with CsA nanofibers or MSCs nanofibers, was suppressed in corneas treated with MSCs-CsA nanofibers. The levels of matrix metalloproteinase 9, inducible nitric oxide synthase, interleukin 6, α-smooth muscle actin, tumor growth factor β and vascular endothelial growth factor were significantly decreased in these corneas as compared to untreated corneas, where the levels of the above mentioned markers were high. In conclusion, MSCs-CsA nanofibers were effective in the treatment of severe alkali-induced corneal injury.
- MeSH
- cyklosporin aplikace a dávkování MeSH
- hojení ran účinky léků MeSH
- hydroxid sodný toxicita MeSH
- imunosupresiva aplikace a dávkování MeSH
- jizva prevence a kontrola MeSH
- kaustika toxicita MeSH
- králíci MeSH
- modely nemocí na zvířatech MeSH
- nanovlákna MeSH
- neovaskularizace rohovky prevence a kontrola MeSH
- nosiče léků MeSH
- poranění rohovky terapie MeSH
- systémy cílené aplikace léků metody MeSH
- tkáňové podpůrné struktury MeSH
- transplantace mezenchymálních kmenových buněk metody MeSH
- zvířata MeSH
- Check Tag
- králíci MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
Hojení rány je proces vedoucí k tvorbě jizvy, která se od nepoškozené kůže odlišuje jak morfologicky, tak i funkčně. V závislosti na genetické dispozici, věku, pigmentaci kůže, lokalizaci a vlastnostech rány může být výsledná jizva hladká, asymptomatická, téměř nerozeznatelná, ale také problematická, charakterizovaná jizvou hypertrofickou nebo keloidní. Oproti tomu strie (pajizévky) vznikají úbytkem elastinových a kolagenních vláken v dermis vlivem hormonálních a vnitřních fyzikálních faktorů. Obě poruchy pojivové tkáně bývají příčinou nežádoucích kosmetických změn, jizvy mohou navíc působit i symptomatické potíže. V léčbě je rozhodující včasný zásah, v samém začátku lze ovlivnit proces hojení rány a výsledný vzhled jizev i strií.
During the process of the healing of the wound,a scar is formed, which differs from the undamadged skin in morphology as well as in the function. Depending on the genetic disposition, age, pigmentation of the skin, localisation and characteristics of the wound the final scar can be smooth, barely visible, asymptomatic, and yet also problematic, such as scar hyperthrophic or keloid. Striae arise due to the lack of elastin and collagen fibres in dermis as a result of hormonal and physical factors. Both disorders are of the reason for the undesirable cosmetic changes, moreover the scars can be symptomatic. However, the early treatment determines the final appearance of the scar or striae.
- MeSH
- hojení ran MeSH
- hormony kůry nadledvin terapeutické užití MeSH
- jizva hypertrofická prevence a kontrola terapie MeSH
- jizva * prevence a kontrola terapie MeSH
- keloid prevence a kontrola terapie MeSH
- kompresní obvazy MeSH
- kryoterapie MeSH
- laserová terapie MeSH
- léky bez předpisu MeSH
- lidé MeSH
- silikony terapeutické užití MeSH
- striae distensae * terapie MeSH
- Check Tag
- lidé MeSH
BACKROUND: Deep skin burn injuries, especially those on the face, hands, feet, genitalia and perineum represent significant therapeutic challenges. Autologous dermo-epidermal skin grafts (DESG) have become standard of care for treating deep burns. Additionally, human autologous thrombin activated autologous platelet concentrate (APC) has gained acceptance in the setting of wounds. While each of these interventions has been independently shown to accelerate healing, the combination of the two has never been evaluated. We hypothesized that the addition of platelets (source of growth factors and inhibitors necessary for tissue repair) to the DESG (source of progenitor cells and of tissue proteases necessary for spatial and temporal control of growth regulators released from platelets) would create the optimal environment for the reciprocal interaction of cells within the healing tissues. METHODS: We used clinical examination (digital photography), standardised scales for evaluating pain and scarring, in combination with blood perfusion (laser Doppler imaging), as well as molecular and laboratory analyses. RESULTS: We show for the first time that the combination of APC and DESG leads to earlier relief of pain, and decreased use of analgesics, antipruritics and orthotic devices. Most importantly, this treatment is associated with earlier discharges from hospital and significant cost savings. CONCLUSIONS: Our findings indicate that DESG engraftment is facilitated by the local addition of platelets and by systemic thrombocytosis. This local interaction leads to the physiological revascularization at 1-3 months. We observed significant elevation of circulating platelets in early stages of engraftment (1-7 days), which normalized over the subsequent 7 and 90 days.
- MeSH
- bolest farmakoterapie etiologie MeSH
- hojení ran MeSH
- jizva prevence a kontrola chirurgie MeSH
- laser doppler flowmetrie MeSH
- lidé středního věku MeSH
- lidé MeSH
- měření bolesti MeSH
- plazma bohatá na destičky * MeSH
- popálení chirurgie terapie ultrasonografie MeSH
- pruritus farmakoterapie etiologie MeSH
- reoperace MeSH
- transplantace kůže škodlivé účinky metody MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- klinické zkoušky MeSH
- práce podpořená grantem MeSH
- Research Support, N.I.H., Extramural MeSH
- Research Support, U.S. Gov't, Non-P.H.S. MeSH
[X]
- MeSH
- dermatochirurgické výkony * škodlivé účinky MeSH
- hormony kůry nadledvin aplikace a dávkování MeSH
- jizva hypertrofická prevence a kontrola MeSH
- jizva prevence a kontrola MeSH
- kosmetické techniky MeSH
- krvácení při operaci prevence a kontrola MeSH
- kryoterapie metody využití MeSH
- laserová terapie MeSH
- lidé MeSH
- pooperační komplikace * prevence a kontrola MeSH
- radioterapie MeSH
- silikonové gely MeSH
- Check Tag
- lidé MeSH
