scholarly journals Systematic Review of Stem-Cell-Based Therapy of Burn Wounds: Lessons Learned from Animal and Clinical Studies

Cells ◽  
2020 ◽  
Vol 9 (12) ◽  
pp. 2545
Author(s):  
Josefine Lin Henriksen ◽  
Nana Brandborg Sørensen ◽  
Trine Fink ◽  
Vladimir Zachar ◽  
Simone Riis Porsborg
Keyword(s):  
Wound Healing ◽  
Systematic Reviews ◽  
Clinical Studies ◽  
Meta Analysis ◽  
Lessons Learned ◽  
Burn Patients ◽  
Thermal Burn ◽  
Burn Wounds ◽  
Cell Based Therapy ◽  
Healing Phase

Treatment of severe burn wounds presents a daunting medical challenge, and novel approaches promoting healing and reducing scarring are highly desirable. The application of mesenchymal stem/stromal cells (MSCs) has been suggested as a novel treatment. In this paper, we present systematic reviews of pre-clinical and clinical studies of MSC therapy for second- or third-degree thermal burn wounds. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, the PubMed and Embase databases were searched, and interventional studies of MSC therapy using rodent models (21 studies) or human burn patients (three studies) were included in the pre-clinical and clinical reviews, respectively, where both overall outcome and wound-healing-phase-specific methodologies and effects were assessed. The pre-clinical studies demonstrated a promising effect of the application of MSCs on several wound healing phases. The clinical studies also suggested that the MSC treatment was beneficial, particularly in the remodeling phase. However, the limited number of studies, their lack of homogeneity in study design, relatively high risk of bias, lack of reporting on mode of action (MOA), and discontinuity of evidence restrict the strength of these findings. This comprehensive review presents an overview of available methodologies to assess the MOA of MSC treatment for distinct wound healing phases. Furthermore, it includes a set of recommendations for the design of high-quality clinical studies that can determine the efficacy of MSCs as a therapy for burn wounds.

scholarly journals A 3D In Vitro Model for Burn Wounds: Monitoring of Regeneration on the Epidermal Level

Biomedicines ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1153
Author(s):  
Verena Schneider ◽  
Daniel Kruse ◽  
Ives Bernardelli de Mattos ◽  
Saskia Zöphel ◽  
Kendra-Kathrin Tiltmann ◽  
...  
Keyword(s):  
Wound Healing ◽  
Inflammatory Response ◽  
Healing Process ◽  
Three Dimensional ◽  
Source Model ◽  
Burn Wound ◽  
Thermal Burn ◽  
Burn Wounds

Burns affect millions every year and a model to mimic the pathophysiology of such injuries in detail is required to better understand regeneration. The current gold standard for studying burn wounds are animal models, which are under criticism due to ethical considerations and a limited predictiveness. Here, we present a three-dimensional burn model, based on an open-source model, to monitor wound healing on the epidermal level. Skin equivalents were burned, using a preheated metal cylinder. The healing process was monitored regarding histomorphology, metabolic changes, inflammatory response and reepithelialization for 14 days. During this time, the wound size decreased from 25% to 5% of the model area and the inflammatory response (IL-1β, IL-6 and IL-8) showed a comparable course to wounding and healing in vivo. Additionally, the topical application of 5% dexpanthenol enhanced tissue morphology and the number of proliferative keratinocytes in the newly formed epidermis, but did not influence the overall reepithelialization rate. In summary, the model showed a comparable healing process to in vivo, and thus, offers the opportunity to better understand the physiology of thermal burn wound healing on the keratinocyte level.

scholarly journals The Effects of a Fixed Combination of Berberis aristata and Silybum marianum on Dyslipidaemia – A Meta-analysis and Systematic Review

Planta Medica ◽  
2019 ◽  
Vol 86 (02) ◽  
pp. 132-143
Author(s):  
Barbara Tóth ◽  
Dávid Németh ◽  
Alexandra Soós ◽  
Péter Hegyi ◽  
Gréta Pham-Dobor ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Clinical Studies ◽  
Fixed Combination ◽  
Meta Analysis ◽  
Density Lipoprotein ◽  
Optimum Dose ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Silybum Marianum ◽  
Lipoprotein Level

AbstractA fixed combination of Berberis aristata and Silybum marianum (Berberol) has been used by patients with dyslipidaemia. The aim of the present meta-analysis was to systematically evaluate the efficacy and safety of a fixed combination of B. aristata and S. marianum (Berberol) on serum lipid levels compared to placebo in a meta-analysis based on randomised, controlled trials. The meta-analysis was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, using the PICO (patients, intervention, comparison, outcome) format, and it was registered in the International Prospective Register of Systematic Reviews. The Cochrane Central Register of Controlled Trials, PubMed, Embase, and Web of Science databases were searched for relevant studies. Placebo-controlled clinical studies involving adult patients with a condition of dyslipidaemia and receiving a fixed combination of B. aristata and S. marianum were included. Four randomised trials, including a total of 491 patients, were pooled in statistical analysis. According to the present meta-analysis, Berberol significantly lowered the low-density lipoprotein level, total cholesterol, fasting plasma glucose levels, and the Homeostatic Model Assessment index compared to placebo; however, its effects on the high-density lipoprotein level, triglyceride level, and body mass index were not statistically significant by the end of a 3-month treatment period. Berberol appeared to be safe, and it did not increase the levels of alanine transaminase, aspartate transaminase, and creatine kinase enzymes. Berberol is an effective and presumably safe complementary therapy for the treatment of dyslipidaemia; however, the evidence supporting its use is very limited. The optimum dose and duration of treatment are unclear. A comprehensive evaluation of efficacy and safety is required in further high-quality clinical studies involving larger patient populations.

High-Frequency Ventilation Modalities as Salvage Therapy for Smoke Inhalation–Associated Acute Lung Injury: A Systematic Review

2017 ◽  
Vol 33 (6) ◽  
pp. 335-345 ◽  
Author(s):  
Andrew C. Miller ◽  
Paula A. Ferrada ◽  
Sameer S. Kadri ◽  
Krupa Nataraj-Bhandari ◽  
Amir Vahedian-Azimi ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Acute Lung Injury ◽  
Lung Injury ◽  
Systematic Reviews ◽  
Clinical Studies ◽  
High Frequency ◽  
Meta Analysis ◽  
Systematic Search ◽  
Smoke Inhalation ◽  
Quality Evidence

Background: Smoke inhalation–associated acute lung injury (SI-ALI) is a major cause of morbidity and mortality in victims of fire tragedies. To date, there are no evidence-based guidelines on ventilation strategies in acute respiratory distress syndrome (ARDS) after smoke inhalation. We reviewed the existing literature for clinical studies of salvage mechanical ventilation (MV) strategies in patients with SI-ALI, focusing on mortality and pneumonia as outcomes. Methods: A systematic search was designed in accordance with preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Risk of bias assessment was performed using the Newcastle-Ottawa Quality Assessment Scale (NOS; 0 to 9 stars), with a score ≥7 being the threshold for inclusion in the meta-analysis. A systematic search strategy was used to search 10 databases. Clinical studies were included in which patients: (1) experienced smoke inhalation, (2) treated with MV, and (3) described a concurrent or historical control group. Results: A total of 226 potentially relevant studies were identified, of which 7 studies on high-frequency percussive ventilation (HFPV) met inclusion criteria. No studies met inclusion for meta-analysis (NOS ≥ 7). In studies comparing HFPV to conventional mechanical ventilation (CMV), mortality and pneumonia incidence improved in 3 studies and remained unchanged in 3 others. No change in ventilator days or ICU length of stay was observed; however, oxygenation and work of breathing improved with HFPV. Conclusions: Mechanical ventilation in patients with SI-ALI has not been well studied. High-frequency percussive ventilation may decrease in-hospital mortality and pneumonia incidence when compared to CMV. The absence of “good” quality evidence precluded meta-analysis. Based upon low-quality evidence, there was a very weak recommendation that HFPV use may be associated with lower mortality and pneumonia rates in patients with SI-ALI. Given SI-ALI’s unique underlying pathophysiology, and its potential implications on therapy, randomized controlled studies are required to ensure that patients receive the safest and most effective care. Trial Registration: The study was registered with PROSPERO International prospective register of systematic reviews (#47015).

Effects and Safety of Different Silver Preparation in Burns Treatment: A Bayesian Network Meta-analysis

2021 ◽  
pp. 153473462110040
Author(s):  
Dilixiati Kuerban ◽  
Maisiwuti Maimaiti ◽  
Zhao Chen
Keyword(s):  
Wound Healing ◽  
Treatment Group ◽  
Statistical Difference ◽  
Meta Analysis ◽  
Healing Time ◽  
Cochrane Library ◽  
Burn Wounds ◽  
Randomized Controlled ◽  
The Cochrane Library ◽  
Wound Healing Time

Silver formulation has been used for external use of burn wounds for several decades, mainly including silver sulfadiazine (SSD), nanosilver dressing (NSD), and silver ion dressing (SID). At present, there is no simultaneous comparison of the effects of silver formulation on burn wounds. The databases were retrieved in an orderly manner from the dates of their establishment to May 2020, including PubMed, the Cochrane Library, Web of Science, and Clinical Trials. Then a network meta-analysis was conducted using R and RevMan 5.1 software. A total of 13 randomized controlled trials (RCTs) involving 945 patients with burns were included. A pairwise meta-analysis of the results was presented: the wound healing time in the SID or NSD treatment group was less than that in the SSD group; and in relieving the pain there was a statistical difference between the SSD, SID, or NSD groups. Network meta-analysis of the results was presented: the wound healing time and relieving the pain in the SID or NSD treatment group were less than that in the SSD group, but there was no statistical difference between the SID and NSD groups. The possibility of NSD in the wound healing time being the best treatment was 75.2%, followed by SID (36.6%), and finally SSD (1.1%); and the possibility of NSD being the best relieving the pain was 83.5%; followed by SID (60.0%), and finally SSD (16.3%). According to the evidence, treatment for burns with NSD can improve the wound healing time and relieve the pain of wounds.

scholarly journals Effects of topical insulin on wound healing: a meta-analysis of animal and clinical studies

2021 ◽  
Author(s):  
Honghong Liu ◽  
Jiao Wang ◽  
Yuanyuan Deng ◽  
Guilin Zou ◽  
Jixiong Xu
Keyword(s):  
Wound Healing ◽  
Clinical Studies ◽  
Meta Analysis

A clinical trial with a novel collagen dermal substitute for wound healing in burn patients

2020 ◽  
Vol 8 (3) ◽  
pp. 823-829 ◽  
Author(s):  
Dogeon Yoon ◽  
Yoon Soo Cho ◽  
So Young Joo ◽  
Cheong Hoon Seo ◽  
Yong Suk Cho
Keyword(s):  
Clinical Trial ◽  
Wound Healing ◽  
Biomechanical Properties ◽  
Skin Regeneration ◽  
Dermal Substitute ◽  
Burn Patients ◽  
Medical Field ◽  
Commercial Products ◽  
Burn Wounds

Biomechanical properties of new dermal replacement were very similar than commercial products. Also this replacement can be used for skin regeneration for burn wounds. Therefore, we suggest that new dermal replacement can be used in the medical field.

Meta-Analysis of the Therapeutic Effect of Nanosilver on Burned Skin

2020 ◽  
Vol 20 (12) ◽  
pp. 7730-7734
Author(s):  
Yixuan Li ◽  
Li Wang ◽  
Xuewen He ◽  
Aihua Hou
Keyword(s):  
Wound Healing ◽  
Treatment Group ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Small Sample ◽  
Controlled Study ◽  
Controlled Trials ◽  
Nano Silver ◽  
Burn Wounds ◽  
Randomized Controlled

Nano silver is widely used in the treatment of burn wounds globally, but most clinical studies on the efficacy of the treatment are small-sample randomized controlled studies. Hence, we aimed to systematically evaluate the efficacy of nano silver and sulfadiazine silver for the treatment of burn wounds through meta-analysis of multiple small studies. Randomized controlled trials were collected from the published literature to compare the effects of nano silver application and sulfadiazine silver application on burns. After evaluating the quality of the methodology and extracting the data from each study, we used RevMan 5.1 software to conduct meta-analysis on eight randomized controlled trials which encompassed 513 patients with second degree burns. The results of the meta-analysis showed that the wound healing time of the nano silver treatment group was less than that of sulfadiazine silver group (P < 0.001) but the wound healing rate of nano silver treatment group was not significantly different from that of control group on the 15th day (MD = 7.10; 95% P = 0.14). Compared with the sulfadiazine silver treatment group, the difference between the nano silver treatment group and sulfadiazine silver treatment group was significant in reducing the pain of burn wounds (P < 0.001). This suggests that the application of nano silver can promote the healing of burn wounds compared with sulfadiazine silver and has considerable advantages in relieving the pain intensity of burn wounds. However, these conclusions need to be further confirmed by a large sample in a high-quality randomized controlled study.

scholarly journals Effectiveness of acupuncture for cancer pain: protocol for an umbrella review and meta-analyses of controlled trials

BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e018494 ◽  
Author(s):  
Yihan He ◽  
Yihong Liu ◽  
Brian H May ◽  
Anthony Lin Zhang ◽  
Haibo Zhang ◽  
...  
Keyword(s):  
Cancer Pain ◽  
Systematic Reviews ◽  
Clinical Studies ◽  
Meta Analysis ◽  
Grey Literature ◽  
Sensitivity Analyses ◽  
Controlled Trials ◽  
Statistical Heterogeneity ◽  
Meta Analyses

IntroductionThe National Comprehensive Cancer Network guidelines for adult cancer pain indicate that acupuncture and related therapies may be valuable additions to pharmacological interventions for pain management. Of the systematic reviews related to this topic, some concluded that acupuncture was promising for alleviating cancer pain, while others argued that the evidence was insufficient to support its effectiveness.Methods and analysisThis review will consist of three components: (1) synthesis of findings from existing systematic reviews; (2) updated meta-analyses of randomised clinical trials and (3) analyses of results of other types of clinical studies. We will search six English and four Chinese biomedical databases, dissertations and grey literature to identify systematic reviews and primary clinical studies. Two reviewers will screen results of the literature searches independently to identify included reviews and studies. Data from included articles will be abstracted for assessment, analysis and summary. Two assessors will appraise the quality of systematic reviews using Assessment of Multiple Systematic Reviews; assess the randomised controlled trials using the Cochrane Collaboration’s risk of bias tool and other types of studies according to the Newcastle-Ottawa Scale. We will use ‘summary of evidence’ tables to present evidence from existing systematic reviews and meta-analyses. Using the primary clinical studies, we will conduct meta-analysis for each outcome, by grouping studies based on the type of acupuncture, the comparator and the specific type of pain. Sensitivity analyses are planned according to clinical factors, acupuncture method, methodological characteristics and presence of statistical heterogeneity as applicable. For the non-randomised studies, we will tabulate the characteristics, outcome measures and the reported results of each study. Consistencies and inconsistencies in evidence will be investigated and discussed. Finally, we will use the Grading of Recommendations Assessment, Development and Evaluation approach to evaluate the quality of the overall evidence.Ethics and disseminationThere are no ethical considerations associated with this review. The findings will be disseminated in peer-reviewed journals or conference presentations.PROSPERO registration numberCRD42017064113.

Introduction to Cumulative Meta-analysis in Dentistry: Lessons Learned from Undertaking a Cumulative Meta-analysis in Periodontology

2005 ◽  
Vol 84 (4) ◽  
pp. 345-349 ◽  
Author(s):  
D.R. Moles ◽  
I.G. Needleman ◽  
R. Niederman ◽  
J. Lau
Keyword(s):  
Systematic Reviews ◽  
Meta Analysis ◽  
Well Being ◽  
Lessons Learned ◽  
Data Synthesis ◽  
Potential Source ◽  
Sufficient Detail ◽  
Using Data ◽  
Health And Well Being

Improving health and well-being from the consideration of isolated studies is problematic. Systematic reviews have been developed to address this problem and may include a quantitative data synthesis in the form of a meta-analysis, or a cumulative meta-analysis. The value of systematic reviews depends greatly on the availability and quality of the results of primary research. The objective of the current project was to demonstrate the technique of cumulative meta-analysis in dentistry using data from a previously published systematic review. The process highlights an issue that some trials could not be synthesized due to the lack of reporting of measures of variation. This represents a potential source of bias. Investigators are encouraged to consider their trials as part of an information continuum and to report sufficient detail to permit the trials’ incorporation into subsequent syntheses.

Efficacy of Levodropropizine in Pediatric and Adult Population: 2 Systematic Reviews and Meta-analysis of Published Clinical Studies

CHEST Journal ◽  
2014 ◽  
Vol 146 (4) ◽  
pp. 526A
Author(s):  
Francesco De Blasio ◽  
Luigi Lanata ◽  
Giovanni Fontana ◽  
Federico Saibene ◽  
Alessandro Zanasi
Keyword(s):  
Systematic Reviews ◽  
Clinical Studies ◽  
Meta Analysis ◽  
Adult Population
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