Improved Wound Healing of Cutaneous Sulfur Mustard Injuries in a Weanling Pig Model

摘要

OBJECTIVE: The objective was to examine the efficacy of several treatment regimens in improving wound healing of cutaneous sulfur mustard (HD) injuries. METHODS: Wound healing studies were conducted in weanling pigs. Superficial dermal HD injuries were debrided at 48 hours post-exposure using an erbium-doped yttrium aluminum garnet (Er:YAG) laser, followed by application of a treatment adjunct. A variety of noninvasive bioengineering methods were conducted during the post-surgical observation period to examine the various cosmetic and functional aspects of the skin. Histopathology was performed at the end of each study (14 or 21 days post-surgery). RESULTS: As noted clinically, re-epithelialization was nearly complete by 7 days post-surgery for many of the sites treated with petrolatum and scarlet red dressings. By 21 days, the skin elasticity of the petrolatum-dressed sites was not significantly different from that of sham-exposed skin. Upon dressing removal on post-surgery day 4, the neoepidermis of allograft- and thin film-dressed sites was partially removed, with resultant petechial hemorrhaging. Mean pathology scores for hydro- colloid-dressed sites were significantly lower than those of untreated HD- exposed sites on postsurgery day 14. CONCLUSIONS: Care must be taken during bandage changes, and a non-adherent dressing that could be left in place for a longer period of time (e.g., 7 days) would be beneficial. The use of cultured epithelial allograft material may have a potential role if grown on a completely non-adherent backing and left undisturbed for at least a week. Xeroform Petrolatum and Scarlet Red Ointment dressings are effective and inexpensive treatment adjuncts for HD injuries.