Managing severe burn injuries: challenges and solutions in complex and chronic wound care

Abstract

Encountered regularly by health care providers across both medical and surgical fields and an increasing socioeconomic burden globally, wound care is severely neglected. Practice is heavily influenced by anecdote rather than evidence-based protocols and industry-biased literature rather than robust randomized controlled trials. Burn units are well placed to address this considerable need, as a result of their infrastructure, their multispecialty staffing, and their need to evolve in light of the declining incidence of major burn injury in developed countries. The aim of this review is to evaluate some of the ideological and practical challenges facing wound practitioners and burn surgeons while managing chronic and complex wounds. It also includes an approach to wound assessment and how to conceptualize and implement dressing strategies and new and existing multimodal therapies.

Development of a Novel Covalently Bonded Conjugate of Caprylic Acid Tripeptide (Isoleucine–Leucine–Aspartic Acid) for Wound-Compatible and Injectable Hydrogel to Accelerate Healing

“…Third-degree burn injuries involve the destruction of full-thickness skin, posing a significant health threat [1][2][3]. The typical treatment for burn wounds involves debridement, followed by the application of topical and antimicrobial agents to support skin rebuilding and vascular network formation [4].…”

Accelerating healing of infected wounds with G. glabra extract and curcumin Co-loaded electrospun nanofibrous dressing

“…Wound healing, as a spatiotemporally dynamic progress to restore cutaneous integrity destroyed by lesions/damages/infections, involves sequential but overlapping phases mediated by various cells, growth factors, cytokines, and chemokines. 1 These processes are generally divided into four stages; hemostasis, inflammation, proliferation, and tissue remodeling, so acute wounds are usually healed within 8 to 12 weeks, whereas in chronic wounds, the arranged healing process is impaired and could last more than 12 weeks. 2 Nearly 1-2 % of the global population is affected by chronic wounds during their lifetime.…”

3D-printed hydrogels dressings with bioactive borate glass for continuous hydration and treatment of second-degree burns

“…Although the existing advanced wound dressings cover a broad range of moderate to high exuding wounds, a small number of wound care products are specifically designed for low exuding wounds, e.g ., second-degree burns. Despite good clinical outcomes for wet wounds, the majority of these products end up with inadequate healing and poor hydration in second-degree burn wounds [ 10 , 11 ] . Topical agents, such as silver sulfadiazine, are typically associated with pain and prolonged healing due to wound dehydration, poor re-epithelialization, traumatic removal, and non-transparent appearance [ 10 – 22 ] .…”

“…Despite good clinical outcomes for wet wounds, the majority of these products end up with inadequate healing and poor hydration in second-degree burn wounds [ 10 , 11 ] . Topical agents, such as silver sulfadiazine, are typically associated with pain and prolonged healing due to wound dehydration, poor re-epithelialization, traumatic removal, and non-transparent appearance [ 10 – 22 ] . Hydrogel dressings provide a moist environment for the second-degree wound and help with pain relief.…”