A burn is a type of injury to skin caused by heat, electricity, chemicals, friction, or radiation (7). The depth of burn is important in determining the management of the burn. Superficial epidermal burns are where the epidermis is damaged. The skin will be red, slightly swollen and painful but not blistered (sun burn). Superficial dermal burns are where the epidermis and part of the dermis are damaged.
The skin will be pale pink, painful and there may be small blisters (first-degree burns). Deep dermal or partial thickness burns are where the epidermis and the dermis are damaged.
This type of burn makes the skin turn red and blotchy. The skin may also be dry or moist, become swollen and blistered, and it may be very painful or painless (second-degree burn). Full thickness burns are where all three layers of skin (the epidermis, dermis and subcutis) are damaged. In this type of burn, the skin is often burnt away, and the tissue underneath may appear pale or blackened. The remaining skin will be dry and white, brown or black with no blisters. The texture of the skin may also be leathery or waxy (third-degree burn). A fourth degree burn additionally involves injury to deeper tissues, such as muscle or bone.
Current treatment for burns depends on the severity of the burn. Superficial burns may be managed with little more than simple pain relievers, while major burns may require prolonged treatment in specialized burn centers. Cooling with tap water may help relieve pain and decrease damage; however, prolonged exposure may result in low body temperature. Partial-thickness burns may require cleaning with soap and water, followed by dressings. It is not clear how to manage blisters, but it is probably reasonable to leave them intact. Full-thickness burns usually require surgical treatments, such as skin grafting. Extensive burns often require large amounts of intravenous fluids because the subsequent inflammatory response will result in significant capillary fluid leakage and edema. The most common complications of burns are related to infection.
While large burns can be fatal, modern treatments developed since 1960 have significantly improved the outcomes, especially in children and young adults (8). Every year, around 13,000 people are admitted to hospital for burns and scalds in UK. Many thousands more go to hospital accident and emergency (A&E) departments. Globally, about 11 million people seek medical treatment, and 300,000 die from burns each year (9). In the United States, approximately 4% of those admitted to a burn center die from their injuries (10). The long-term outcome is primarily related to the size of burn and the age of the person affected.
The combination of Carocell Bio ’s peptide anti-inflammatories and nanoparticle delivery technology will have a synergistic effect on acute burn wound healing. The peptide will significantly reduce the intense inflammation associated with an acute burn. The Nanocin has also been shown to accelerate wound healing by stimulating keratinocyte and epithelial cell growth (11). This effect has been shown to vary depending on the duration of exposure and concentration of polyhexanide applied. A dose of 0.5ug/ml has been identified as an optimal stimulation (12).
Carocell Bio has just been awarded an Innovate UK grant of £400,000 (US$ 500,000) to examine the efficacy of JEL2603 at ameliorating the severe inflammation seen after a 2nd and 3rd degree burns. If we can demonstrate this in human burn tissue biopsies projection could indicate that the reduction in inflammation will lead to a reduction of pain and possibly a reduction in collagen deposition after a burn and so reduce burn scarring. This program will begin July 1st, 2020 and run for 16 months. During this program we will be working closely with Lucideon for formulation, Professor Mamta Shah from Wythenshawe NHS Hospital Trust burns unit for burns tissue samples and Immundnz immunological services for tissue analysis.
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