Wound Healing Potential of Intermittent Negative Pressure under Limited Access Dressing in Burn Patients: Biochemical and Histopathological Study

BACKGROUND Malondialdehyde (MDA) is an oxidant that causes damage to membranes, DNA, proteins, and lipids at the cellular level. Antioxidants minimize the effects of oxidants and thus help in formation of healthy granulation tissues with higher level of hydroxyproline and total protein. This study compared the effect of limited access dressing (LAD) with conventional closed dressing biochemically and histopathologically.  METHODS Seventy-two 12-65 years old burn patients with mean wound size of 14 cm2 were divided to two groups of LAD (n=37), and conventional dressing groups (n=35). Various biochemical parameters were measured in granulation tissue.  Histopathological analysis of the granulation tissue was studied too.  RESULTS LAD group showed significant increase in hydroxyproline, total protein, GSH, and GPx and decrease in MDA levels compared to conventional dressing group. A significant negative correlation between GSH and MDA was noted in LAD group, but in conventional dressing group there was no significant correlation. A significant negative correlation between GPx and MDA was noticed in LAD group, but in conventional dressing group was not significant. There was a histologically fewer inflammatory cells, increased and well organized extracellular matrix deposit, more angiogenesis in LAD group after 10 days while the difference was significant between the groups. CONCLUSION Our study showed a significant reduction in oxidative stress biomarker of MDA, increase in hydroxyproline, total protein, antioxidants and amount of ECM deposition, number of blood vessels and a decrease in the amount of inflammatory cells and necrotic tissues in LAD group indicating the better healing effect of burn wounds.