A Glycerin-based Wound Dressing Improves Healing Outcomes In Preclinical Porcine Model Of Maxillofacial Burn Trauma
AMITAVA Das1, Mohamed El-Masry1, Nandini Ghosh2, Anurag Nalluri1, Douglas Guzior2, Valerie Bergdall2, Edward Stout3, Sashwati Roy1, Chandan K. Sen1.
1Indiana University School of Medicine, Indianapolis, IN, USA, 2The Ohio State University, Columbus, OH, USA, 3Southwest technologies Inc, Kansas City, MO, USA.
Background: Thermal injury of the face results in ectropion (epithelial-ocular junction), eversion of the lip (epithelial-oral junction), skin contracture, and excessive scar formation. The resultant facial disfiguration along with features such as oral incompetence burdens the subject socially, emotionally, and psychologically. The goal of this work was to test the healing outcomes of a glycerin-based wound dressing Elasto-Gel on a preclinical porcine model of maxillofacial burn trauma. Methods: Fourth degree burn wounds involving 50% of the face were made on female domestic Yorkshire pigs using a gauged, electrically powered burner which continually measures the temperature of the instrument and increases the power to the heated stylus to maintain the desired temperature. Wounds were treated with placebo dressing (Acticoat) or Elasto-Gel once a week for 84 days. The burn affected 50% of the face and caused injury to the mandibular bone. Progression of burn wound healing was followed using noninvasive imaging such as (1) laser speckle microperfusion imaging, (2) harmonic ultrasound Doppler imaging, and (3) computed tomography with angiography for 3D reconstruction of face and vasculature. Results: The application of heat resulted in a fourth degree burn with bone involvement showing severe deficits including ectropion, eversion of the oral mucosa, overt contracture and excessive scarring. Affected pigs suffered from drooling during eating. Contracture and scarring were dramatically evident at d84 post burn. Elasto-Gel significantly accelerated the rate of wound closure during the acute phase (p<0.05; n=3). The later phase of healing was characterized by increased regression of blood vessels upon Elasto-Gel treatment (p<0.05; n=3). Interestingly Elasto-Gel treated wounds showed significantly less scar area at all time-points (d21, d42, d63 and d84; p<0.05; n=3). Conclusion: This work constitutes maiden report on a porcine model of severe facial burn contracture. Application of Elasto-Gel dressing minimized scar outcomes.
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