Mesenchymal stem cells have a known regenerative potential and are used in many indications. They secrete many growth factors, including for fibroblasts (FGF), endothelium (VEGF), as well as 14 anti-inflammatory cytokines, and they stimulate tissue regeneration, promoting the secretion of proteins and glycosaminoglycans of extracellular matrices, such as collagen I, II, III, and V, elastin, and also metalloproteinases. They secrete exosomes that contain proteins, nucleic acids, lipids, and enzymes. In addition, they show the activity of inactivating free radicals. The aim of this study was an attempt to collect the existing literature on the use of stem cells in the treatment of a burn wound. There were 81 studies included in the analysis. The studies differed in terms of the design, burn wound model, source of stem cells, and methods of cellular therapy application. No major side effects were reported, and cellular therapy reduced the healing time of the burn wound. Few case reports on human models did not report any serious adverse events. However, due to the heterogeneity of the evidence, cellular therapy in burn wound treatment remains an experimental method.

Fibrosis of burn-related wounds remains an unresolved clinical issue that leads to patient disability. The aim of this study was to assess the efficacy of the transplantation of adipose-derived stromal cells seeded onto a collagen-based matrix in the reconstruction of burn-related scars. Here, we characterized an in vitro interaction between adipose-derived stromal cells and a collagen-based matrix, Integra^®DRT. Our results show that transcription of pro-angiogenic, remodeling, and immunomodulatory factors was more significant in adipose-derived stromal cells than in fibroblasts. Transcription of metalloproteinases 2 and 9 is positively correlated with the collagenolytic activity of the adipose-derived stromal cells seeded onto Integra^®DRT. The increase in the enzymatic activity corresponds to the decrease in the elasticity of the whole construct. Finally, we validated the treatment of a post-excision wound using adipose-derived stromal cells and an Integra^®DRT construct in a 25-year-old woman suffering from burn-related scars. Scarless healing was observed in the area treated by adipose-derived stromal cells and the Integra^®DRT construct but not in the reference area where Integra^®DRT was applied without cells. This clinical observation may be explained by in vitro findings: Enhanced transcription of the vascular endothelial growth factor as well as remodeling of the collagen-based matrix decreased mechanical stress. Our experimental treatment demonstrated that the adipose-derived stromal cells seeded onto Integra^®DRT exhibit valuable properties that may improve post-excision wound healing and facilitate skin regeneration without scars.

Proteus syndrome (PS) is an exceptionally uncommon genetic disorder that has been documented in only approximately 250 cases in the literature spanning the past four decades. It is characterized by a disproportionate, asymmetric overgrowth of all types of tissues, provoked by a somatic activating mutation in serine/threonine protein kinase 1. We report a case of PS in a two-year-old female patient with the following clinical features: unilateral overgrowth of connective tissue in the right buttock and right foot, where multiple surgeries were performed to achieve a desirable aesthetic outcome and ensure psychological comfort of the young patient. The insights provided by this case underscore the pivotal role of obtaining pleasing aesthetic outcomes in the surgical management of untreatable genetic disorders, with the aim of nurturing psychological contentment in affected children.

The local treatment of deep burn wounds involves the excision of the necrosis and covering the wounds with skin grafts. Surgical procedures are thought to have an impact on the inflammatory response, especially in severe burn patients requiring treatment in an intensive care unit. Currently, there are no available data in the literature regarding the correlation of the type of surgical procedure and the levels of the inflammatory markers. This study investigates the importance of monitoring c-reactive protein (CRP) around the time of surgical burn procedures and how it can aid in assessing the inflammatory response. Of the 810 burn patients, 93 patients aged 20 to 74 years with IIb- and III-degree burns covering 20% to 50% of the total burned body surface were included in this prospective study. Three subgroups were recognized based on the surgical procedure performed: fascial necrectomy, tangential necrectomy, and skin grafting. The research material included blood samples collected in the early postoperative hours. A total of 270 CRP level measurements were performed. A reduction in CRP levels was observed three hours post-procedure in patients who underwent skin harvesting for grafting. Conversely, a significant increase in CRP levels was noted between postoperative timepoints in patients who underwent tangential necrectomy.

Według aktualnie obowiązującej definicji sepsa to "zagrażająca życiu dysfunkcja narządowa spowodowana zaburzoną regulacją odpowiedzi ustroju na zakażenie". Obecnie wiadomo już dużo na temat tej niezwykle silnej odpowiedzi organizmu na toczący się proces zapalny, jednak wciąż jest to wiedza niewystarczająca. W populacji chorych oparzonych sepsa stanowi istotną przyczynę zgonów, a co za tym idzie – jest niezwykle ważnym problemem diagnostycznym oraz terapeutycznym. Kluczem do sukcesu w leczeniu tej jednostki chorobowej jest czas.

The problem of hard-to-heal wounds is associated with an increase in the incidence of civilization diseases. Venous leg ulcers, ischemic ulcers and wounds in diabetic foot syndrome are a particular problem, and the early detection of local wound infections is a serious interdisciplinary challenge in everyday practice. Local wound infections are often undetected or detected too late. They can impair physiological wound healing as well as lead to systemic infection and even sepsis. According to the statements that: “The fate of the wounded rests with the one who applies the first dressing” (Col. Nicholas Senna, 1897), and “The responsibility for the patient rests with the doctor who comes to the patient first” (John Murphy, Medical Society, Chicago, 1889) the success of the treatment of infected wounds depends to a particular extent on the prompt and proper response of those who come in contact with the patient first. The purpose of this document is to briefly present issues related to the problem of hard-to-heal wounds, indicate the direction of therapeutic management and diagnostic support for the staff (doctors and nurses) of primary healthcare units, care and treatment institutions and social welfare centers, general physicians and medical careers of patients suffering from hard-to-heal wounds. The developed TILI score is to facilitate the decision whether or not to use antiseptics and/or antimicrobial dressings in the effective therapy of a hard-to-heal wound.