The optimal time for early burn wound excision to reduce pro-inflammatory cytokine production in a murine burn injury model.

Abstract

A potential solution to prevent post-burn deleterious inflammatory responses is early burn wound excision. However, the most beneficial time point remains controversial. This animal study investigated the optimal time point for burn wound excision to reduce pro-inflammatory cytokines production after burn. Forty-eight male Sprague-Dawley rats received scald burns with third-degree burns of 30% body surface area, and were then divided into eight groups by day of operation for excision. Group 1 (n=6) received burn eschar excision on post-burn day (PBD) 1. Group 2 received excision on PBD2 (n=6) and so on, while group 8 was the control group (n=6) that did not undergo excision. The skin defect after excision was covered with a bovine-derived collagen dressing. Interleukin-1 (IL-1), IL-6, IL-10 and tumour necrosis factor-α were serially analysed by enzyme-linked immunosorbent assay (ELISA). We found that levels of all pro-inflammatory cytokines appeared to be lower after excision of full-thickness burns, but as the excision time was delayed from group 1 to group 7, the differences showed progressive decline. We believe that the earlier the excision is performed, the more the level of pro-inflammatory cytokines can be lowered, and the better the post-burn inflammatory process can be modulated.