Article
Evaluation of oxidative stress and consequences in burns
Search Medline for
Authors
-
Mehmet Demircan
- Pediatric Intensive Burn Care Unit, Department of Pediatric Surgery, Faculty of Medicine, Inönu University, Malatya, Turkey
-
Kubilay Gürünoglu
- Pediatric Intensive Burn Care Unit, Department of Pediatric Surgery, Faculty of Medicine, Inönu University, Malatya, Turkey
-
Herbert Haller
- Pediatric Intensive Burn Care Unit, Department of Pediatric Surgery, Faculty of Medicine, Inönu University, Malatya, Turkey
| Published: | January 13, 2020 |
|---|
Outline
Text
Introduction: In a more extensive burn, the local inflammatory process is going on, causing a systemic inflammatory reaction. Increased xanthine-oxidase and neutrophil activation are the sources for the systemic oxidative stress reaction. The excess generation of reactive oxygen/nitrogen species is a critical event in the pathogenesis of thermal injury. By fragmenting hyaluronan chains ROS can influence vascular permeability, causing burn edema and damage to organs like heart, lung, liver kidneys, and muscles as well as hypermetabolism.
Material and methods: To evaluate the oxidative stress response in burns and the effect of dressings, blood samples were collected on days 0, 3, 7, 14, and 21 in 60 children with partial thickness burns. MDA, GSH, Total Oxidant Capacity, and Total Antioxidant Capacity were tested and compared between groups treated with HFAg and PLM. MDA content, Glutathione levels were determined spectrophotometrically, TOC, as well as TAC using the technique of Erel.
Oxidative stress reduces the expression of telomerase, controlling the length of telomeres. Conditions such as Oxidative Stress and absence of telomerase in the nucleus cause telomere shorting. Apoptosis occurs when a critical measure of telomeres is falling short. To evaluate the effect of oxidative stress on skin quality and the influence of burn dressings, 20 children each were tested on the impact of Hydrofiber with silver, polylactic membranes, or silver-sulfadiazine, in a prospective study, containing a control group and three groups with 20 children each. Skin biopsies were treated with TERT(A6) antibodies. TERT stained nucleus ratio and the number of cell nuclei were analyzed as well as the total cell count.
In another study the inflammatory response was measured by IL-6, TNF-α, and TGF-β under HF Ag or PLM dressing.
Results: Levels of IL-6 and TNF-α were significantly lower in the PLM group, and TGF-β was significantly higher within the first two weeks returning to a normal level in the third week, indicating a significantly lower inflammatory response under Suprathel. The backing of PLM to a normal level after two weeks avoided the predisposition for hypertrophic scarring.
Total Oxidant Capacity was significantly lower; Total antioxidant capacity significantly higher in the PLM group having a significantly shorter healing time under PLM. These parameters show a lesser systemic response resulting in shorter healing time and promise less complications.
The inhibition of the effect of telomere shortening by oxidative influence by PLM could also be demonstrated when comparing to HFAg and SSD, resulting in a higher cell count indicating a better quality of the skin.
Conclusion: Different dressings can influence Oxidative Stress response in burns. PLM showed an excellent performance in reducing oxidative stress and the consequences.
Products used: HFAg =Aquacell® AG, Convatec, Princeton, NJ:
PLM: Suprathel®, Polymedics Innovations GmbH, Denkendorf, Germany
