title: Clostridial collagenase aggravates the systemic inflammatory response in rats with partial-thickness burns.
abstract: OBJECTIVE
  Clostridial collagenase A (CCA) has been shown effective in degrading collagen in eschar tissue and promoting healing in partial-thickness burns. As there are also reports of fever, leukocytosis, increased C-reactive protein (CRP) levels and septic complications during treatment with CCA, we aimed to determine in rats whether CCA aggravates the systemic inflammatory response.
  
  
  METHODS
  Rats with partial-thickness burns were randomly divided into groups with either no dressing (ND), povidone-iodine dressing (PID) or CCA dressing (CCAD). Body weights and temperatures, blood leukocyte counts, and serum levels of CRP, interleukin-1 beta (IL-1 beta), interleukin-6 (IL-6) and tumour necrosis factor-alpha (TNF-alpha), were measured at 0, 3, and 24h and days 3 and 7 from burn. Wounds were cultured on days 1, 3 and 7 and burn depth was evaluated on day 1.
  
  
  RESULTS
  Body weights for all groups were significantly lower after burn, with highest loss (25.5%) in the CCAD group. At 3h a significant drop in rectal temperature was noted in all groups. The CCAD group had higher rectal temperature levels than the PID group on days 3 and 7 (p<0.05). Changes in serum levels of CRP, IL-1 beta, IL-6 and TNF-alpha were not significant in the ND and PID groups; the CCAD group showed a significant rise in serum levels of CRP on day 1, of IL-6 on day 3 and of TNF-alpha on day 7. Wound infection was more common in CCAD group and increased on days 3 and 7, but this was insignificant.
  
  
  CONCLUSIONS
  CCA aggravated the systemic inflammatory response in rats with partial-thickness burns, which is accompanied by a higher risk of infection.
authors.affiliation: Department of Paediatric Surgery, Ege University Faculty of Medicine, Izmir, Turkey.
authors.forename: Zafer
authors.initials: Z
authors.lastname: Dokumcu
authors.forename: Orkan
authors.initials: O
authors.lastname: Ergun
authors.forename: Handan Ak
authors.initials: HA
authors.lastname: Celik
authors.forename: Sohret
authors.initials: S
authors.lastname: Aydemir
authors.forename: Murat
authors.initials: M
authors.lastname: Sezak
authors.forename: Geylani
authors.initials: G
authors.lastname: Ozok
authors.forename: Ahmet
authors.initials: A
authors.lastname: Celik
mesh_terms: D000818:Animals; D015415:Biomarkers / Q000032:analysis; D002056:Burns / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology; D002097:C-Reactive Protein / Q000032:analysis; D053583:Interleukin-1beta / Q000032:analysis; D015850:Interleukin-6 / Q000032:analysis; D007958:Leukocyte Count; D008297:Male; D003012:Microbial Collagenase / Q000009:adverse effects* / Q000627:therapeutic use; D009779:Occlusive Dressings; D009824:Ointments; D011206:Povidone-Iodine / Q000627:therapeutic use; D011897:Random Allocation; D051381:Rats; D017208:Rats, Wistar; D012867:Skin / Q000276:immunology* / Q000473:pathology; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis; D014945:Wound Healing / Q000276:immunology*
chemical_list: D015415:Biomarkers; D053583:Interleukin-1beta; D015850:Interleukin-6; D009824:Ointments; D014409:Tumor Necrosis Factor-alpha; D011206:Povidone-Iodine; D002097:C-Reactive Protein; D003012:Microbial Collagenase