Histological evaluation of five different wound closure materials in the treatment of second degree burn wounds of children

Özet (En): Objective Physical and biological defense mechanisms which are very important for the human body, disappears by burn injury. In the treatment of burn wounds the aim is to regain those defense mechanisms by various wound dressings which can mimick the skin physically and biologically, while providing adequate epithelization and scar tissue formation without infecting the whole process. Various materials are being used in wound dressings to create the main physical barrier. Various wound dressing materials are being developed for this purpose, which maintains adequate wound moisture without maseration, necessitates less dressing changes, are preventing infection without toxic residue.Material and Method In this prospective randomised reserch, healing effects of five different wound dressing materials were studied histologically on the burn wounds. In control group, sterile gauses saturated with Furacin® pomade were used. In research groups AquacellAg®, Textus®, Curasorb® Ca and Curasorb® Ca+Zn were used. In every five patients dressing materials were repeated randomly. Ten patients were selected for each group and in a total of fifty patients were studied. Punch bipsies were taken from all patients at the end of 21 st. day of each treatment. Histologically, the number and the length of papillae, thethickness of stratum corneum and the epithelial layer were measured. The amount of fibroblast, collagen, mononuclear and polymorphonuclear cells were also scored. Since Nuclear Organizing Regions (NOR) are indicators of the activation of the epithelial cell nucleus and reflects the epithelial cell regeneration, NOR painting were done for each specimen and the number of AgNOR (Argyrophylic NOR) corpuscules were counted.Results Only stratum corneum thickness was found to be statistically important (p<0.05) between the study groups. The thickest stratum corneum layer was found in the Aquacel®Ag group and it is followed by Textus® bioactiv, Curasorb®Ca, Curasorb® Ca + Zn and control groups. Although there were no stastistically important difference of fibroblast, collagen and AgNOR corpuscules scores between the groups their high amounts were shown histologically in Aquacel®Ag group. According to the whole histological healing parameters, wound healing duration was found as; Aquacel® Ag < Curasorb® Ca < Textus® bioactiv < Curasorb® Ca+Zn < control group.Conclusion Depending of the datas of this prospective randomized clinical study, either its easy and atraumatic application or longevity of dressing intervals, faster healing time and higher absorbtion capability, as well as its potential to accelerate the healing process that is demonstrated histopathologically, Aquacel® Ag is considered as a highly effective wound closure material in second degree burn wounds.