[Sequential management of residual wounds in burn patients].
OBJECTIVE
To seek a sequential method for the management of residual wounds in burn patients.


METHODS
Three chronic residual wounds on each of 25 burn patients were either covered with vaseline gauze (A group), human tissue-engineered active skin (Active Skin, B group) or Active Skin after rinsing with fluid containing oxygen and vacuum assisted drainage ( C group) on wounds. The contents of (TNF)a in granulation tissue were assayed by enzyme linked immunosorbent assay (ELISA). Expression of metalloproteinase-13 (MMP-13) mRNA in granulation tissue was determined with reverse transcription polymerase chain reaction (RT-PCR). Moreover, quantity of wound bacteria in the wounds and wound healing rate were determined with usual method.


RESULTS
The quantities of wound bacteria in C group on 3,6,9, 12 post-treatment day( PTD) were (5.30 +/- 1.60), (1.30 +/-0.80) , (1.70 +/- 0. 60)and (0.60 +/-0. 10)clone formation unit/ml( CFU/ml) , respectively, which were obviously lower than those in A and B groups. The contents of TNFa and expression of metalloproteinase-13 (MMP-13) mRNA in granulation tissue in C group on 6 PTD were [ (0. 650 +/- 0. 040) ng/mg and 0. 210 +/- 0. 010,] ,respectively, and they were evidently lower than those in A group [(1.550 +/-0. 370)ng/mg,1. 040 +/- 0. 050, P <0.01] and B group (0. 810 +/- 0.080) ng/mg, 0.640 +/- 0.030, P <0.01]. Meanwhile, the contents of (TNF)a and expression of MMP-13 mRNA in B group were also obviously lower than those in A group. The wound healing ratio in C group on 15 and 30 PTD were markedly higher than those in A or B group ( P <0.01).


CONCLUSIONS
Covering the residual burn wounds with Active Skin after rinsing with fluid containing oxygen followed by vacuum assisted drainage can improve repairing of residual burn wounds.
Wang
Jia-han
JH
Department of Burns , Nanfang Hospital, Southern Medical University , Guangzhou 510515 , PR China.
Li
Zhi-qing
ZQ
Chen
Jing
J
Ren
Jia-liang
JL
Qiu
Xue-wen
XW
D000293:Adolescent; D000328:Adult; D002056:Burns / Q000382:microbiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D053509:Matrix Metalloproteinase 13 / Q000378:metabolism; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy; D012333:RNA, Messenger / Q000378:metabolism; D017768:Skin, Artificial; D007507:Therapeutic Irrigation; D023822:Tissue Engineering; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism; D014945:Wound Healing; D055815:Young Adult
D012333:RNA, Messenger; D014409:Tumor Necrosis Factor-alpha; C507079:MMP13 protein, human; D053509:Matrix Metalloproteinase 13