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Maxillofacial Burn Trauma preclinical model to study scar management

Mohamed El Masry, MD, Nandini Ghosh, PhD, Amitava Das, PhD, Sashwati Roy, PhD, Chandan K. Sen, PhD Indiana Center for Regenerative Medicine & Engineering, Indiana University School of Medicine, Indianapolis, IN
Indiana University ,School of medicine,ICRME
2020-02-14

Presenter: Mohamed El Masry MD

Affidavit:
Mohamed El Masry

Director Name: Chandan K.Sen

Author Category: Fellow Plastic Surgery
Presentation Category: Basic Science Research
Abstract Category: Craniomaxillofacial

Background Face thermal injury is a challenge for plastic surgeons particularly managing its complications such as skin contracture, ectorpion and macro or microstomia with excessive scar formation. The consequential facial deformity burdens the subject socially, emotionally, and psychologically. The primary objective of this work was to study the scarring outcomes in a preclinical porcine model of maxillofacial burn trauma using traditional dressings compared to split-thickness skin grafting (STSG).
Methods. Burn wounds were made using a standardized electrical burner that created burn affected up to 50% of the facial surface. Wounds were treated with either placebo dressing (Acticoat) or Elasto-Gel dressing once weekly or skin grafted at d7 post burn. Progression of burn wound healing were followed using non-invasive imaging until d84. Histopathological examination of the burn wound was performed using standard histopathology/immunohistochemistry.
Results & Conclusion. Thermal injury resulted in a fourth degree burn and excessive Contracture and scarring (n=7, p<0.05) that were evident at d84 post burn. STSG significantly improved face deformity with diminished (n=5, p<0.05) inflammatory response concomitant with improved angiogenesis. Elasto-Gel dressing application significantly (p<0.05; n = 3) enhanced the wound closure during the acute phase and less scarring (p<0.05; n = 3) with near normal ratio of collagenⅠ:Ⅲ (p<0.05; n=3) as compared to acticoat treatment. In summary, this pre-clinical model recapitulates features characteristic of human facial burns with severe contracture involving the muco-cutaneous junctions. STGS significantly improved the scar outcomes. Application of Elasto-Gel dressing improved early phase healing responses with less scar formation.

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