Hydrogels in Burn Wound Management-A Review

Abstract

Inert hydrogels are of a great importance in burn first aid. Hydrogel dressings may be an alternative to cooling burn wounds with streaming water, especially in cases of mass casualty events, lack of clean water, hypothermia, or large extent of burns. Hydrogels that contain mostly water evacuate the heat cumulating in the skin by evaporation. They not only cool the burn wound, but also reduce pain and protect the wound area from contamination and further injuries. Hydrogels are ideally used during the first hours after injury, but as they do not have antimicrobial properties per se, they might not prevent wound infection. The hydrogel matrix enables incorporating active substances into the dressing. The active forms may contain ammonium salts, nanocrystal silver, zinc, growth factor, cytokines, or cells, as well as natural agents, such as honey or herbs. Active dressings may have antimicrobial activity or stimulate wound healing. Numerous experiments on animal models proved their safety and efficiency. Hydrogels are a new dressing type that are still in development.

Keywords: burns; dressing; hydrogels.

Figure 1

The depth of the burn wound evaluated at the admission to the burn unit. I—first degree/superficial; II—second degree, intermediate-depth; III—third degree/deep.

Figure 2

Analysis of the temperature of the burn wound (animal model). Thermal injury from heat at 150 °C for 15 s. (left) Change in the temperature of the burn wound without cooling, assessed 10 min after the burn; (right) decrease in the temperature of the injured tissues after 10 min of cooling commenced 5 min after burn.

Figure 3

Application of hydrogels sheets in pediatric burns.

Figure 4

A microporous structure of the inert hydrogel in which different active substances can be incorporated. Photo courtesy of KikGEL Poland, Lodz.

Figure 5

Chemical structures of the most commonly used synthetized hydrogels.

Figure 6

Types of hydrogels. On the left, an inert hydrogel in a sheet. On the right a semi-liquid, amorphic form.

Figure 7

Application of amorphic hydrogels containing polyhexanide (PHMB) after enzymatic debridement.