Enzymatic Debridement of Porcine Burn Wounds via a Novel Protease, SN514.

Autor:	Stone R; Department of Burn and Soft Tissue Research, US Army Institute of Surgical Research, JBSA Fort Sam Houston, Texas., Jockheck-Clark AR; Department of Burn and Soft Tissue Research, US Army Institute of Surgical Research, JBSA Fort Sam Houston, Texas., Natesan S; Department of Burn and Soft Tissue Research, US Army Institute of Surgical Research, JBSA Fort Sam Houston, Texas., Rizzo JA; US Army Burn Center, US Army Institute of Surgical Research, JBSA Fort Sam Houston, Texas., Wienandt NA; Comparative Pathology, US Army Institute of Surgical Research, JBSA Fort Sam Houston, Texas., Scott LL; Epidemiology and Biostatistics, US Army Institute of Surgical Research, JBSA Fort Sam Houston, Texas., Larson DA; Department of Burn and Soft Tissue Research, US Army Institute of Surgical Research, JBSA Fort Sam Houston, Texas., Wall JT; Department of Burn and Soft Tissue Research, US Army Institute of Surgical Research, JBSA Fort Sam Houston, Texas., Holik MA; Department of Burn and Soft Tissue Research, US Army Institute of Surgical Research, JBSA Fort Sam Houston, Texas., Shaffer LJ; Department of Burn and Soft Tissue Research, US Army Institute of Surgical Research, JBSA Fort Sam Houston, Texas., Park N; Department of Burn and Soft Tissue Research, US Army Institute of Surgical Research, JBSA Fort Sam Houston, Texas., Jovanovic A; US Army Burn Center, US Army Institute of Surgical Research, JBSA Fort Sam Houston, Texas., Tetens S; Department of Biologics and Regenerative Medicine, Sam Houston, Texas., Roche ED; Department of Biologics and Regenerative Medicine, Sam Houston, Texas., Shi L; Department of Biologics and Regenerative Medicine, Sam Houston, Texas., Christy RJ; Department of Burn and Soft Tissue Research, US Army Institute of Surgical Research, JBSA Fort Sam Houston, Texas.
Jazyk:	angličtina
Zdroj:	Journal of burn care & research : official publication of the American Burn Association [J Burn Care Res] 2020 Sep 23; Vol. 41 (5), pp. 1015-1028.
DOI:	10.1093/jbcr/iraa111
Abstrakt:	Necrotic tissue generated by a thermal injury is typically removed via surgical debridement. However, this procedure is commonly associated with blood loss and the removal of viable healthy tissue. For some patients and contexts such as extended care on the battlefield, it would be preferable to remove devitalized tissue with a nonsurgical debridement agent. In this paper, a proprietary debridement gel (SN514) was evaluated for the ability to debride both deep-partial thickness (DPT) and full-thickness burn wounds using an established porcine thermal injury model. Burn wounds were treated daily for 4 days and visualized with both digital imaging and laser speckle imaging. Strip biopsies were taken at the end of the procedure. Histological analyses confirmed a greater debridement of the porcine burn wounds by SN514 than the vehicle-treated controls. Laser speckle imaging detected significant increases in the perfusion status after 4 days of SN514 treatment on DPT wounds. Importantly, histological analyses and clinical observations suggest that SN514 gel treatment did not damage uninjured tissue as no edema, erythema, or inflammation was observed on intact skin surrounding the treated wounds. A blinded evaluation of the digital images by a burn surgeon indicated that SN514 debrided more necrotic tissue than the control groups after 1, 2, and 3 days of treatment. Additionally, SN514 gel was evaluated using an in vitro burn model that used human discarded skin. Treatment of human burned tissue with SN514 gel resulted in greater than 80% weight reduction compared with untreated samples. Together, these data demonstrate that SN514 gel is capable of debriding necrotic tissue and suggest that SN514 gel could be a useful option for austere conditions, such as military multi-domain operations and prolonged field care scenarios. (Published by Oxford University Press on behalf of the American Burn Association 2020.)
Databáze:	MEDLINE
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