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Download StatisticsLee, Kwang Chear (2020). The development of an anti-scarring burn dressing. University of Birmingham. Ph.D.
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Lee2020PhD.pdf
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Abstract
Introduction: Scarring has a significant impact on the function and quality of life in burn patients. This thesis describes selected stages of the development of an anti-scarring burn dressing and an objective scar assessment panel.
Methods: This thesis is divided into two sections. Section 1 covers the development of an objective scar measurement tool based panel and score via a systematic review and subsequent reliability testing and validation of selected devices. Section 2 covers different aspects of dressing formulation. The cytotoxicity effects of decorin were investigated in dermal fibroblast cultures to provide guidance to safe and effective decorin dosing. Manufacturing, sterilisation and clinical use exposes decorin to elevated temperatures and the effects of this on the structure of decorin and bio-activity of decorin is investigated with circular dichroism and in-vitro cell cultures respectively. Lastly, a skin contact study in healthy volunteers was performed to establish the safety of two gellan formulations (sheet and fluid gel).
Results: Objective scar measurement tools were found to be more reliable than subjective scar scores and an objective scar score was created consisting of high frequency ultrasound and pliability measures. Decorin had no measurable cytotoxicity on dermal fibroblasts even at high concentrations. Conformational change in decorin structure was seen at relatively low temperatures however results suggest that heating may enhance its bio-activity. Both gellan formulations were found to be safe for use on intact skin.
Conclusion: The new objective scar scale can be used to accurately measure the effects of antiscarring treatments. Decorin and gellan are safe to be used in patients but the dressings may need to be protected against high temperatures.
| Type of Work: | Thesis (Doctorates > Ph.D.) | ||||||||||||
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| Award Type: | Doctorates > Ph.D. | ||||||||||||
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| Licence: | All rights reserved | ||||||||||||
| College/Faculty: | Colleges (2008 onwards) > College of Medical & Dental Sciences | ||||||||||||
| School or Department: | School of Clinical and Experimental Medicine | ||||||||||||
| Funders: | Other, Wellcome Trust | ||||||||||||
| Other Funders: | Scar Free Foundation | ||||||||||||
| Subjects: | R Medicine > RD Surgery | ||||||||||||
| URI: | http://etheses.bham.ac.uk/id/eprint/10545 |
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