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March 30, 2012

New Skin Grows Over Third Degree Burn Injuries, Thanks to Hydrogel


A recent article from the Institute for NanoBioTechnology discussed the developments that Johns Hopkins researchers have made in creating a jelly-like material for burn wound treatment which, in early experiments on skin damaged by severe burns, seemed to regenerate healthy tissue with no sign of the previous burn scars.

In a mid-December report from the National Academy of Sciences, the researchers reported their promising results from tests using mouse tissue. The new treatment has not yet been tested on human patients, but the researchers say that the procedure, which promotes the formation of new blood vessels and skin, could lead to greatly improved healing for victims of third degree burns.

The treatment involved a simple wound dressing that included a specially designed hydrogel: a water-based, three-dimensional framework of polymers. This material was developed by researchers at Johns Hopkins' Whiting School of Engineering, working with clinicians at the Johns Hopkins Bayview Medical Center Burn Center and the School of Medicine's Department of Pathology.

Third degree burns typically destroy the several layers of skin right down to the muscle tissue. They require complex medical care and leave behind significant scars. But in the journal article, the Johns Hopkins team reported that its hydrogel method yielded much better results than typical outcomes. "This treatment promoted the development of new blood vessels and the regeneration of complex layers of skin, including hair follicles and the glands that produce skin oil," said Sharon Gerecht, an assistant professor of chemical and biomolecular engineering, who was principal investigator on the study.

Gerecht said that the hydrogel could form the basis of an inexpensive burn wound treatment that works better than currently available clinical therapies, adding that the product would be easy to manufacture on a large scale. Gerecht suggested that because the hydrogel contains no drugs or biological components to make it work, the Food and Drug Administration would most likely classify it as a device. Further animal testing is planned before trials on human patients begin, but Gerecht said that "it could be approved for clinical use after just a few years of testing."

John Harmon, a professor of surgery at the Johns Hopkins School of Medicine and director of Surgical Research at Bayview, described the mouse study results as "absolutely remarkable...We got complete skin regeneration, which never happens in typical burn wound treatment," he said.

Gerecht says that the hydrogel is constructed in such a way that it allows tissue regeneration and blood vessel formation to occur very quickly. "Inflammatory cells are able to easily penetrate and degrade the hydrogel, enabling blood vessels to fill in and support wound healing and the growth of new tissue," she said. For burns, Gerecht added, the faster this process occurs, the less there is a chance for scarring. After 21 days, the gel is harmlessly absorbed, and the tissue continues to return to the appearance of normal skin.

If the treatment succeeds in human patients, it could address a serious form of injury. Harmon, a co-author of the NAS journal article, pointed out that 100,000 third degree burns are treated in the U.S. every year in burn centers.

If you or someone you know suffers an injury such as third degree burns or smoke inhalation, you should call Kramer & Pollack LLP in Mineola, New York so that the personal injury attorneys in that firm can determine whether another party has legal liability for injuries suffered, and if the injured party has a strong legal case.

March 24, 2012

Burn Victims Can Reduce Pain Through Virtual Reality Games

In August 2011, Randy McAllister suffered third degree burns while trying to save equipment from a fire in wheat field. Today, he says that when he goes for his burn treatments, "it gets me to the threshold where I can't stand it, but then I find out it can hurt even more," says the 60-year-old farmer. During five weeks at the Oregon Burn Center at Legacy Emanuel Medical Center in Portland, Oregon, McAllister needed repeated rounds of burn wound care to remove dead tissue from his extensive burns. "It's more painful than the fire."

Then a nurse told him about SnowWorld, a computer game designed to help burn patients escape from agonizing pain by distracting their minds during burn treatments. During his next wound care session, McAllister wore headphones and looked through virtual reality goggles. He found himself floating through an icy canyon rendered almost three-dimensional by the wrap-around goggles. By tapping on a computer mouse, McAllister fired snowballs at animated penguins, snowmen and dolphins in the canyon to a soundtrack of upbeat music. And the virtual world made his real-world pain less overwhelming.

It's one of the most successful examples of non-drug pain management techniques to emerge from the work of psychologists and neuroscientists. The search for non-drug options has gained urgency amid a worsening epidemic of overdoses linked to prescription opioid pain relievers such as oxycodone and hydrocodone, which killed 14,800 Americans in 2008 - more those killed from heroin and cocaine overdoses combined.

In clinical trials, burn patients using SnowWorld reported 35 to 50 percent reductions in pain. The system was developed at the University of Washington by research scientist Hunter Hoffman and psychologist David Patterson, with input from burn care experts at Harborview Burn Center in Seattle.

Virtual reality therapy isn't a substitute for opioids and other pain-relieving medications, but it can boost the effectiveness of drugs - and possibly reduce the dosage. Researchers who developed the technology say it might also help people with chronic pain syndromes, although those clinical trials are incomplete.

Theresa McSherry, burn and wound care coordinator at the Oregon Burn Center, says burn patients need more options. Pharmaceutical research has provided safer and more effective anesthetics and opioid pain relievers, but drugs have limits.

"You can't safely give burn patients enough medication to provide adequate pain relief," says McSherry, a registered nurse who has worked with burn patients for more than 10 years. A grant from the Legacy Foundation allowed the Oregon Burn Center to buy the $66,000 virtual reality system in August. About a dozen are being used worldwide.

Preventing pain not only relieves immediate suffering, but also seems to help burn patients weeks and months later. Patterson, the UW psychologist, says the amount of pain during treatment is a stronger predictor of depression, anxiety and distress six months to a year later than the extent of burns or the length of hospital stay. "If you can control more of the acute pain, it can result in better long-term outcomes," he says.

Scientists have known for decades that the human brain can interpret the same signal transmitted by a pain receptor as painful or not, depending on what a person is thinking. Mood and expectation also play a big role. German researchers recently showed that a sad mood consistently makes people experience more pain. In another recent experiment, tricking people to think time passed more quickly reduced perception of pain.

Entering a rich, three-dimensional, sound-filled virtual reality might use so much of the brain's attention resources that less is available to process pain. "We're taking advantage of the malleability of human perception to deliberately divert mental resources away from the pain," Hoffman says.

Burn patients come to associate the sights and sounds of the wound treatment room with excruciating pain so that just entering the room can amplify the suffering, Hoffman says. Putting on headphones and goggles blocks the anxiety-stirring sights and sounds.

But distraction of attention appears to be the main way that virtual reality reduces pain. Hoffman's team has compared differing gear and found that the more realistic and "immersive" the gear, the greater the reduction in pain reported.

That matches McAllister's experience. His burned fingers made it difficult to hold the computer mouse during his SnowWorld experience. When the mouse slipped from his hand and he lost engagement with the snowball throwing, the pain of the procedure immediately intruded.

McAllister expects to continue intensive physical therapy for several months to regain more use of his fingers and hands. He may need additional surgery to remove scar tissue and increase joint mobility. But he's optimistic about returning to work next year.

Patterson believes virtual reality can help treat chronic pain as well. The UW researchers also developed a virtual reality program that induces hypnosis. The goal is to use post-hypnotic suggestion to change the way the brain handles chronic pain signals long after therapy sessions.

If you or someone you know suffers an injury such as third degree burns or smoke inhalation, you should call Kramer & Pollack LLP in Mineola, New York so that the personal injury attorneys in that firm can determine whether another party has legal liability for injuries suffered, and if the injured party has a strong legal case.

October 26, 2011

New Burn Center Opens in Phoenix, Arizona to Help Burn Victims Heal

In October 2011, Grossman Burn Centers announced the official opening of its new burn center in Phoenix, Arizona, at St. Luke's Medical Center. The eight-bed unit is the fifth Grossman Burn Center, and the second outside the state of California.

GBC Medical Director Dr. Peter H. Grossman commented that "It is a privilege to partner with St. Luke's Medical Center to bring additional state-of-the-art burn care services to Arizona. Our facility will complement Phoenix's existing burn center by making more beds available to Arizona's growing population, and by providing patients and referring physicians with more options for their burn treatment regimen. This is a very positive development for the Grossman Burn Centers, for St. Luke's, and for Arizona."

The Grossman Burn Center at St. Luke's Medical Center provides a comprehensive suite of burn care services, from acute and reconstructive burn care, to rehabilitation and post-treatment emotional and psychological support. The center is under the direction of GBC Medical Director, Dr. Peter H. Grossman. It is managed on a day-to-day basis by Dr. Robert Bonillas and Dr. Anthony Admire, and staffed by physicians on the medical staff at St. Luke's Medical Center trained in restorative burn care.

The Grossman Burn Centers have been involved in the treatment of second degree burns and third degree burns for four decades. GBC's approach to burn care focuses on more than just patient survival. Its surgeons and health care professionals seek to restore patients to as close to their pre-injury status as possible in terms of physical ability, cosmetic appearance, and emotionally.

Besides California and Arizona, the company also has a Louisiana burn center.

May 13, 2010

University Hospital Burn Center

State University of New York at Stony Brook

Stony Brook, NY 11794-0001 United States

516-444-2270

The stony Brook University Burn Center is one the centers specialized in providing comprehensive treatment for both pediatric and adult burn patients. The burn team is trained to provide the patient with expert care throughout his/her stay.

April 16, 2010

New York Hospital Burn center:

525 E. 68th St.
New York, NY 10021-4873 United States
212-746-5317

The William Randolph Hearst Burn Center at New York- Presbyterian Hospital/Weill Cornell Medical Center has an excellent reputation not only in New York but worldwide. It is the largest Burn Center in the busiest in the state with sophisticated technology and treatment methods. The burn center team is highly specialized and qualified to provide all the services needed for the patient and his/her family.

April 16, 2010

Westchester County Medical Center

Grasslands Reservation
Valhalla, NY 10595-1689 United States
914-493-7000

The Trauma and Burn Center in Westchester County is the only burn center between New York City in Eastern New York and the Canadian border. It responds to emergencies around the clock and consists of the adult trauma center; the pediatric trauma center and the burn enter. The specialized team in the center offers the best services and survival chances with their dedication and expertise. They provide care for every aspect of injury. This center treats and save hundreds of burn victims and provides them with hope. This center as well as treating patients with burns, treats people with a wide variety of wounds and injuries as the center is also the home to the regional advanced wound therapy and hyperbaric center.