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Effect of necrotic tissue on progressive injury in deep partial thickness burn wounds
Shuliang Lu1, Jun Xiang, Chun Qing
1Burn Institute of Shanghai & Burn Center, Rui Jin Hospital, Shanghai Second Medical University, Shanghai 200025, China. sllu@public8.sta.net.cn
Objective:
To evaluate the influence of necrotic tissue on progressive injury in deep partial thickness burn wounds.
Methods:
Tissue specimens were cultured both for estimation of IL-8, EGF, bFGF, PDGF-AB and histopathological examination, from the pre-operation, post-operation, and non-operation wounds from seven patients with deep partial thickness burn.
Results:
In seven specimens from the non-operation group, IL-8 release increased compared with those in the post-operation group (P < 0.001), while the levels of EGF, bFGF, PDGF-AB release were lower than those in the post-operation group. Histopathological examination revealed that in the non-operation group, the degree of neutrophil infiltration was enhanced, the extent of tissue necrosis enlarged, and residual skin appendages disappeared. In contrast, in the post-operation group, the degree of inflammatory response was decreased, with the formation of fresh granulation tissue and epithelialization.
Conclusion:
This study suggests that the presence of necrotic tissue could be the inhibitory factor in the wound healing process, as it might cause tissue progressive injury leading to the delay of wound healing. To promote wound healing, active tangential excision is recommended to remove necrotic tissue.