Buz A, Görgülü T, Olgun A, Kargi E
Department of Plastic, Reconstructive and Aesthetic Surgery, Bulent Ecevit University Medical Faculty, A blok Kat:3, Kozlu, Zonguldak, Turkey.
Eur J Trauma Emerg Surg. 2016 Dec;42(6):775-783. doi: 10.1007/s00068-015-0607-8. Epub 2015 Nov 27.
Thermal burns are the leading cause of trauma worldwide. Currently, no consensus on optimal treatment of deep partial-thickness (second-degree) burns has emerged, as reflected by the wide variability in available wound-care materials. The relative efficacies of products used for treatment of partial-thickness thermal burns remain unclear. Mesotherapy features intradermal administration of various agents, depending on burn location. In the present experimental study, we explored the efficacy of mesotherapy used to treat partial-thickness thermal burns in 50 male Wistar rats divided into five groups of equal number. No procedure was performed after infliction of thermal burns in control group (Group 1). Mesotherapy was applied with physiological saline in sham group (Group 2), glutathione, taurine, and L-carnitine were separately applied in Group 3, Group 4, and Group 5, respectively.
Mesotherapeutic agents were injected intradermally into the reticular layer of the dermis using the point technique. The first course of mesotherapy was given within the first 2 h after infliction of thermal burns, and therapy was continued to day 10. On day 22, unhealed thermal burn areas were measured prior to sacrifice, and biopsies covering the total areas of burns were performed to allow of pathological evaluation.
Group 3 (the glutathione group) showed the best extent of healing, followed by Group 4 (the taurine group) and Group 5 (the L-carnitine group). The healed thermal burn areas in these groups were significantly greater than those in the control and sham groups (P = 0.001). All of healing, acute and chronic inflammation, the amount of granulation tissue, the level of fibroblast maturation, the amount of collagen, the extent of re-epithelization and neovascularization, and ulcer depth were scored upon pathological examination of tissue cross-sections. The best outcomes were evident in the glutathione group, with statistical significance. Although wound healing in the L-carnitine and taurine groups was better than in the control and sham groups, the differences were not statistically significant.
Thus, glutathione mesotherapy was effective when used to treat partial-thickness thermal burns and may be a useful treatment option for various human burns.
热烧伤是全球创伤的主要原因。目前，对于深度部分厚度（二度）烧伤的最佳治疗方法尚未达成共识，这从现有的伤口护理材料的广泛差异中可见一斑。用于治疗部分厚度热烧伤的产品的相对疗效仍不明确。中胚层疗法的特点是根据烧伤部位皮内注射各种药物。在本实验研究中，我们探讨了中胚层疗法对50只雄性Wistar大鼠部分厚度热烧伤的治疗效果，这些大鼠被平均分为五组。对照组（第1组）在造成热烧伤后不进行任何处理。假手术组（第2组）用生理盐水进行中胚层疗法，第3组、第4组和第5组分别单独应用谷胱甘肽、牛磺酸和左旋肉碱。
采用点刺技术将中胚层治疗药物皮内注射到真皮网状层。中胚层疗法的第一个疗程在热烧伤后的头2小时内进行，并持续治疗至第10天。在第22天，处死大鼠前测量未愈合的热烧伤面积，并对覆盖烧伤总面积的组织进行活检以进行病理评估。
第3组（谷胱甘肽组）愈合程度最佳，其次是第4组（牛磺酸组）和第5组（左旋肉碱组）。这些组中愈合的热烧伤面积明显大于对照组和假手术组（P = 0.001）。在对组织横截面进行病理检查时，对所有愈合情况、急性和慢性炎症、肉芽组织量、成纤维细胞成熟水平、胶原量、再上皮化和新血管形成程度以及溃疡深度进行评分。谷胱甘肽组的效果最佳，具有统计学意义。虽然左旋肉碱组和牛磺酸组的伤口愈合情况优于对照组和假手术组，但差异无统计学意义。
因此，谷胱甘肽中胚层疗法用于治疗部分厚度热烧伤是有效的，可能是治疗各种人类烧伤的一种有用的治疗选择。
