Cook Katherine A, Martinez-Lozano Edith, Sheridan Robert, Rodriguez Edward K, Nazarian Ara, Grinstaff Mark W
Department of Chemistry, Biomedical Engineering, and Medicine, Boston University, Boston, MA, 02215, USA.
Musculoskeletal Translational Innovation Initiative, Carl J. Shapiro, Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, 02215, USA.
Burns Trauma. 2022 Dec 8;10:tkac047. doi: 10.1093/burnst/tkac047. eCollection 2022.
Burn wounds result from exposure to hot liquids, chemicals, fire, electric discharge or radiation. Wound severity ranges from first-degree injury, which is superficial, to fourth-degree injury, which exposes bone, tendons and muscles. Rapid assessment of burn depth and accurate wound management in the outpatient setting is critical to prevent injury progression into deeper layers of the dermis. Injury progression is of particular pertinence to second-degree burns, which are the most common form of thermal burn. As our understanding of wound healing advances, treatment options and technologies for second-degree burn management also evolve. Polymeric hydrogels are a class of burn wound dressings that adhere to tissue, absorb wound exudate, protect from the environment, can be transparent facilitating serial wound evaluation and, in some cases, enable facile removal for dressing changes. This review briefly describes the burn level classification and common, commercially available dressings used to treat second-degree burns, and then focuses on new polymeric hydrogel burn dressings under preclinical development analyzing their design, structure and performance. The review presents the follow key learning points: (1) introduction to the integument system and the wound-healing process; (2) classification of burns according to severity and clinical appearance; (3) available dressings currently used for second-degree burns; (4) introduction to hydrogels and their preparation and characterization techniques; and (5) pre-clinical hydrogel burn wound dressings currently being developed.
烧伤创面是由接触热液体、化学物质、火焰、放电或辐射引起的。伤口严重程度从浅表的一度损伤到暴露骨骼、肌腱和肌肉的四度损伤不等。在门诊环境中快速评估烧伤深度并进行准确的伤口处理对于防止损伤进展到真皮深层至关重要。损伤进展对于二度烧伤尤为相关,二度烧伤是最常见的热烧伤形式。随着我们对伤口愈合的理解不断进步,二度烧伤处理的治疗选择和技术也在不断发展。聚合物水凝胶是一类烧伤创面敷料,它能粘附于组织、吸收伤口渗出液、保护伤口免受外界环境影响、可以是透明的便于连续评估伤口,并且在某些情况下便于更换敷料时移除。本文综述简要描述了烧伤程度分类以及用于治疗二度烧伤的常见市售敷料,然后重点介绍了处于临床前开发阶段的新型聚合物水凝胶烧伤敷料,分析了它们的设计、结构和性能。本文综述呈现了以下关键要点:(1)皮肤系统和伤口愈合过程介绍;(2)根据严重程度和临床表现对烧伤进行分类;(3)目前用于二度烧伤的现有敷料;(4)水凝胶及其制备和表征技术介绍;以及(5)目前正在开发的临床前水凝胶烧伤创面敷料。