Department of Surgery, University of Texas Medical Branch, Galveston, TX 77555, USA.
Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, A-8036 Graz, Austria.
Medicina (Kaunas). 2022 Jul 11;58(7):922. doi: 10.3390/medicina58070922.
Burn wound conversion refers to the phenomenon whereby superficial burns that appear to retain the ability to spontaneously heal, convert later into deeper wounds in need of excision. While no current treatment can definitively stop burn wound conversion, attempts to slow tissue damage remain unsatisfactory, justifying the need for new therapeutic interventions. To attenuate burn wound conversion, various studies have targeted at least one of the molecular mechanisms underlying burn wound conversion, including ischemia, inflammation, apoptosis, autophagy, generation of reactive oxygen species, hypothermia, and wound rehydration. However, therapeutic strategies that can target various mechanisms involved in burn wound conversion are still lacking. This review highlights the pathophysiology of burn wound conversion and focuses on recent studies that have turned to the novel use of biologics such as mesenchymal stem cells, biomaterials, and immune regulators to mitigate wound conversion. Future research should investigate mechanistic pathways, side effects, safety, and efficacy of these different treatments before translation into clinical studies.
烧伤创面转化是指原本看似能够自行愈合的浅度烧伤,后来转化为需要切除的深部创面的现象。目前尚无治疗方法能明确阻止烧伤创面转化,而试图减缓组织损伤的效果仍不理想,这也证明需要新的治疗干预。为了减轻烧伤创面转化,各种研究至少针对烧伤创面转化的一个分子机制,包括缺血、炎症、细胞凋亡、自噬、活性氧生成、低体温和创面再水化。然而,能够针对烧伤创面转化涉及的各种机制的治疗策略仍然缺乏。本文综述了烧伤创面转化的病理生理学,并重点介绍了最近利用间充质干细胞、生物材料和免疫调节剂等生物制剂来减轻创面转化的研究。未来的研究应在将这些不同的治疗方法转化为临床研究之前,调查这些不同治疗方法的作用机制、副作用、安全性和疗效。