Deep second-degree burns induce the complete destruction of epidermis but preserve hair follicles in the deep dermis from which epidermal healing can be initiated, and they promote hypertrophic scar formation. Superficial second-degree burns also in part affect the dermis while preserving some epidermal rete ridges, enabling spontaneous scarless healing. A first-degree burn is a superficial one that affects only the epidermis. The duration and intensity of exposure to these different factors, as well as location and depth of the trauma, determine the gravity of burn injuries. Most of them were caused by fire/flames, scald, electricity, and chemical products. recorded by the American Burn Association. There are approximately 15,000–20,000 hospitalizations per year for acute burn injuries in the U.S.
Then arises the challenge of covering these deep and extensive burns as fast as possible to protect the patients from septicemia and achieve the best functional and aesthetic healing possible. Major improvements in resuscitation techniques in the last 50 years enable the survival of patients with more than 90% of total body surface area burned. In addition, burn is the most traumatic injury that the human body can bear and induces a complete disruption of the body's homeostasis, including immunodepression, massive hypermetabolism, and vascular hyperpermeability, which enhances edema formation. Indeed, the rupture of the skin's barrier function induces massive water loss that will rapidly cause a deadly hypovolemic shock. However, a destruction of only 15% of the skin's total body surface area is sufficient to be life-threatening.
#Fourth degree burn treatment skin#
In this concise review, we provide a description of the characteristics of and current treatments for extensive burns, including tissue-engineered skin approaches to improve cutaneous nerve regeneration, and describe prospective uses for autologous skin-derived adult stem cells to enhance recovery of the skin's sense of touch.Īlthough skin is the largest organ of the body, it is rarely seen as a vital one like the brain or the heart. Although the nerve regeneration process was studied largely in the context of nerve transections, very few studies have been aimed at developing strategies to improve it in the context of cutaneous wound healing.
In addition, the cutaneous nerve network has been recently highlighted to play an important role in epidermal homeostasis and may be essential at least in the early phase of wound healing through the induction of neurogenic inflammation. Restoration of pain, temperature, and touch perceptions should now be a major challenge to solve in order to improve patients' quality of life. Cutaneous nerve regeneration can occur from the nerve endings of the wound bed, but it is often compromised by scar formation or anarchic wound healing. However, patients often complain about a loss of skin sensation and even cutaneous chronic pain. Different strategies have been developed over the years to cover deep and extensive burns with the ultimate goal of regenerating the barrier function of the epidermis while recovering an acceptable aesthetic aspect. Burns not only destroy the barrier function of the skin but also alter the perceptions of pain, temperature, and touch.
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