烧伤和增生性瘢痕的护理进展:预防和皮肤再生的创新。

IF 1.6 4区 医学 Q3 SURGERY
Benjamin L Savitz, Vignesh Chennupati, Oliver Alexander, Erin N Abbott, Ronald M Cornely, Elizabeth L Dale Slater
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引用次数: 0

摘要

摘要:增生性瘢痕(HTS)仍然是烧伤护理的一个关键挑战,通常导致衰弱性挛缩,慢性疼痛和显著的社会心理负担。虽然目前的治疗强调结构修复,但最近的进展强调了解决纤维化生物学驱动因素的重要性。本文综述了烧伤疤痕预防的发展策略,重点介绍了组织工程基质、自体细胞疗法和预测性分子工具,这些工具将治疗从反应性转向再生性。生物和合成真皮基质(如Integra, BTM, Restrata)和自体皮肤细胞悬浮液(如ReCell)等创新已经证明可以改善真皮结构修复并降低供体部位的发病率。同时,包括转化生长因子β1、白细胞介素-6和维生素D受体多态性在内的新出现的遗传和蛋白质组学生物标志物提供了根据HTS风险对患者进行分层的潜力,从而实现个性化的治疗干预。生物制剂如rhPDGF和间充质干细胞是调节成纤维细胞活性和提高再生结果的额外途径。展望未来,将机器学习与实时生物标志物分析相结合,可能会实现动态的、针对患者的护理路径。由于烧伤管理的不断发展,预测诊断、生物调节和工程皮肤替代的融合不仅有望最大限度地减少纤维化,而且还有望恢复功能良好的天然皮肤,这标志着向精确烧伤重建的范式转变。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Advances in Care for Burn and Hypertrophic Scar: Innovations in Prevention and Dermal Regeneration.

Abstract: Hypertrophic scarring (HTS) remains a critical challenge in burn care, often resulting in debilitating contractures, chronic pain, and significant psychosocial burden. While current treatment emphasizes structural repair, recent advances underscore the importance of addressing the biological drivers of fibrosis. This review synthesizes evolving strategies in burn scar prevention, highlighting tissue-engineered matrices, autologous cell therapies, and predictive molecular tools that shift care from reactive to regenerative. Innovations such as biologic and synthetic dermal matrices (eg, Integra, BTM, Restrata) and autologous skin cell suspensions (eg, ReCell) have demonstrated improved dermal architecture restoration and reduced donor site morbidity. Concurrently, emerging genetic and proteomic biomarkers including transforming growth factor β1, interleukin-6, and vitamin D receptor polymorphisms offer the potential to stratify patients by HTS risk, enabling personalized therapeutic interventions. Biologic agents like rhPDGF and mesenchymal stem cells represent additional avenues for modulating fibroblast activity and enhancing regenerative outcomes. Looking forward, integration of machine learning with real-time biomarker profiling may enable dynamic, patient-specific care pathways. Because burn management continues to evolve, the convergence of predictive diagnostics, biologic modulation, and engineered skin replacements holds the promise of not only minimizing fibrosis but also restoring functional, native-like skin-marking a paradigm shift toward precision burn reconstruction.

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来源期刊
CiteScore
2.70
自引率
13.30%
发文量
584
审稿时长
6 months
期刊介绍: The only independent journal devoted to general plastic and reconstructive surgery, Annals of Plastic Surgery serves as a forum for current scientific and clinical advances in the field and a sounding board for ideas and perspectives on its future. The journal publishes peer-reviewed original articles, brief communications, case reports, and notes in all areas of interest to the practicing plastic surgeon. There are also historical and current reviews, descriptions of surgical technique, and lively editorials and letters to the editor.
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