Tsolakidis Savas, Alharbi Ziyad, Rennekampff Hans Oliver, Schmidhammer Markus Robert, Schmidhammer Robert, Rosenauer Rudolf
Austrian Cluster of Tissue Regeneration, Research Centre for Traumatology of the Austrian Workers Compensation Board (AUVA), Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Donaueschingenstraße 13, 1200 Vienna, Austria.
Millesi Center for Surgery of Peripheral Nerves, Vienna Private Clinic, Pelikangasse 15, 1090 Vienna, Austria.
Eur Burn J. 2022 Jun 14;3(2):370-376. doi: 10.3390/ebj3020032.
Full-thickness burn injuries (FTBI) not only lead to a significant burden in multiple ways, including social life and self-esteem, but have also a tremendous impact on environmental interaction by reducing sensibility in manifold ways. On these grounds, possible ways and solutions to recover sensibility in burn wounds are essentials and should not be overlooked.
A review of experimental, clinical studies and the related literature was performed with the aim to highlight post-burn nerve regeneration and discover ways for sensory re-integration to complement the therapeutic concept.
In human burn injuries, it has been hypothesized that grafted cells, partly multipotent stem cells, could be additionally responsible for nerve regeneration in burn wound areas. In addition, burn eschar excision, performed within a short post-burn time frame, can reduce or even avoid long-term nerve damage by reducing post-burn toxic mediator release. Various animal studies could demonstrate sensory reinnervation of different qualities in burn wounds. Post-burn scar tissue prevents, or at least decelerates, nerve reinnervation, but could be reduced by targeted mediators.
Sensory loss is present in skin grafted areas following full-thickness burn-wound excision, thereby leading to a reduction in quality of life. In addition, various mediators might reduce or avoid nerve damage and should be considered at an early stage as part of a holistic burn-patient therapeutic approach. In addition, supportive multifaceted physical therapy strategies are essential.
全层烧伤不仅在多方面造成重大负担，包括社交生活和自尊，还通过多种方式降低感觉功能，对与环境的互动产生巨大影响。基于这些原因，恢复烧伤创面感觉功能的可能方法和解决方案至关重要，不容忽视。
对实验、临床研究及相关文献进行综述，旨在突出烧伤后神经再生情况，并探寻感觉重新整合的方法以完善治疗理念。
在人类烧伤中，据推测移植的细胞，部分为多能干细胞，可能额外负责烧伤创面区域的神经再生。此外，在烧伤后短时间内进行烧伤焦痂切除，可通过减少烧伤后毒性介质释放来减轻甚至避免长期神经损伤。各种动物研究能够证明烧伤创面存在不同性质的感觉神经再支配。烧伤后瘢痕组织会阻碍或至少减缓神经再支配，但可通过靶向介质予以减轻。
全层烧伤创面切除后，植皮区域存在感觉丧失，从而导致生活质量下降。此外，多种介质可能减轻或避免神经损伤，应在早期作为整体烧伤患者治疗方法的一部分加以考虑。此外，支持性的多方面物理治疗策略必不可少。
