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      Carboxymethyl chitosan hydrogel formulations enhance the healing process in experimental partial-thickness (second-degree) burn wound healing

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          ABSTRACT

          Purpose

          This study aimed to elaborate a hydrogel constituted by carboxymethyl chitosan (CMC), hyaluronic acid (HA) and silver (Ag) and to evaluate its healing effect on partial-thickness burn wounds experimentally induced in rats.

          Methods

          CMC was obtained by chitosan reacting with monochloroacetic acid. The carboxymethylation was confirmed by Fourier-transform infrared spectroscopy and hydrogen nuclear magnetic resonance (NMR). Scanning electron microscopy was used to determine the morphologicalcharacteristics of chitosan and CMC. After the experimental burn wound induction, the animals (n = 126) were treated with different CMC formulations, had their occlusive dressings changed daily and were followed through 7, 14 and 30 days. Morphometric, macroscopic and microscopic aspects and collagen quantification were evaluated.

          Results

          Significative wound contraction, granulation tissue formation, inflammatory infiltration and collagen fibers deposit throughout different phases of the healing process were observed in the CMC hydrogels treated groups.

          Conclusions

          The results showed that, in the initial phase of the healing process, the most adequate product was the CMC/HA/Ag association, while in the other phases the CMC/HA association was the best one to promote the healing of burn wounds.

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          Most cited references74

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          Wound dressings – a review

          Wound healing is a dynamic and complex process which requires suitable environment to promote healing process. With the advancement in technology, more than 3000 products have been developed to treat different types of wounds by targeting various aspects of healing process. The present review traces the history of dressings from its earliest inception to the current status and also discusses the advantage and limitations of the dressing materials.
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            Burn injury

            Burn injuries are under-appreciated injuries that are associated with substantial morbidity and mortality. Burn injuries, particularly severe burns, are accompanied by an immune and inflammatory response, metabolic changes and distributive shock that can be challenging to manage and can lead to multiple organ failure. Of great importance is that the injury affects not only the physical health, but also the mental health and quality of life of the patient. Accordingly, patients with burn injury cannot be considered recovered when the wounds have healed; instead, burn injury leads to long-term profound alterations that must be addressed to optimize quality of life. Burn care providers are, therefore, faced with a plethora of challenges including acute and critical care management, long-term care and rehabilitation. The aim of this Primer is not only to give an overview and update about burn care, but also to raise awareness of the ongoing challenges and stigmata associated with burn injuries.
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              • Article: not found

              Chitosan preparations for wounds and burns: antimicrobial and wound-healing effects.

              Since its discovery approximately 200 years ago, chitosan, as a cationic natural polymer, has been widely used as a topical dressing in wound management owing to its hemostatic, stimulation of healing, antimicrobial, nontoxic, biocompatible and biodegradable properties. This article covers the antimicrobial and wound-healing effects of chitosan, as well as its derivatives and complexes, and its use as a vehicle to deliver biopharmaceuticals, antimicrobials and growth factors into tissue. Studies covering applications of chitosan in wounds and burns can be classified into in vitro, animal and clinical studies. Chitosan preparations are classified into native chitosan, chitosan formulations, complexes and derivatives with other substances. Chitosan can be used to prevent or treat wound and burn infections not only because of its intrinsic antimicrobial properties, but also by virtue of its ability to deliver extrinsic antimicrobial agents to wounds and burns. It can also be used as a slow-release drug-delivery vehicle for growth factors to improve wound healing. The large number of publications in this area suggests that chitosan will continue to be an important agent in the management of wounds and burns.
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                Author and article information

                Journal
                Acta Cir Bras
                Acta Cir Bras
                acb
                Acta Cirúrgica Brasileira
                Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia
                0102-8650
                1678-2674
                05 April 2021
                2021
                : 36
                : 3
                : e360303
                Affiliations
                [1 ]PhD. Universidade Federal de Goiás – Instituto de Patologia Tropical e Saúde Pública – Programa de Pós-Graduação em Medicina Tropical e Saúde Pública – Goiânia (GO), Brazil.
                [2 ]PhD. Universidade Estadual de Goiás – Campus de Ciências Exatas e Tecnológicas – Anápolis (GO), Brazil.
                [3 ]Graduate student. Universidade Federal de Goiás – Faculdade de Medicina – Goiânia (GO), Brazil.
                [4 ]PhD. Universidade Federal de Goiás – Instituto de Patologia Tropical e Saúde Pública – Departamento de Biociências e Tecnologia – Goiânia (GO), Brazil.
                Author notes
                [* ]Corresponding author: ruy@ 123456ufg.br | (55 62)3209-6163

                Conflict of interest: Nothing to declare

                Authors’ contribution: Substantive scientific and intellectual contributions to the study : Gonçalves RC and Lino Junior RS; Conception and design : Signini R and Lino Junior RS; Acquisition of data: Rosa LM and Dias YSP; Acquisition, analysis and interpretation of data : Gonçalves RC and Signini R; Technical procedures: Gonçalves RC, Rosa LM and Dias YSP; Histopathological examinations: Gonçalves RC, Rosa LM and Dias YSP; Statistics analysis: Gonçalves RC; Manuscript preparation : Gonçalves RC and Vinaud MC; Manuscript writing : Vinaud MC; Critical revision: Vinaud MC; Final approval: Lino Junior RS.

                Author information
                http://orcid.org/0000-0003-3675-9628
                http://orcid.org/0000-0002-0946-8414
                http://orcid.org/0000-0003-2780-1185
                http://orcid.org/0000-0002-6630-7975
                http://orcid.org/0000-0002-6746-9191
                http://orcid.org/0000-0002-0572-5102
                Article
                00202
                10.1590/ACB360303
                8026200
                33825787
                9a5798f5-0b30-49b6-9db7-951b828b4c1e

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 16 November 2020
                : 19 January 2021
                : 15 February 2021
                Page count
                Figures: 9, Tables: 2, Equations: 5, References: 64
                Categories
                Original Article

                hydrogels,carboxymethyl chitosan,experimental burn wound,rats,general pathologic processes

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