ARAG contains several robust antioxidants (squalene, vitamin E, α-lipoic acid, and coenzyme Q 10) as well as a nonionic surfactant, D-α-tocopheryl polyethylene glycol 1000 succinate (TPGS). To address this problem, we combined agents that have both antioxidant and antimicrobial properties into ARAG. Given these points, the ideal burn therapy would address not only the prevention of infection but also the counteracting of overactivation of the inflammatory response. This can lead to additional tissue damage and further recruitment of inflammatory cells, resulting in a self-destructive inflammatory cycle. A good portion of the detrimental impact on wound healing is due to the production of reactive oxygen species, leading to a highly oxidative environment. While this is a natural bodily reaction and acts to prevent infection, it can have a detrimental impact on the healing process as well as cause severe systemic effects such as organ failure and death. Burns are well known to induce high levels of inflammation. For this reason, there is a need for new treatment modalities to be developed that can circumvent these resistance mechanisms.Īnother essential element in burn treatment is the prevention of a disproportionate inflammatory response. Current strategies to prevent infection include topical antibiotics, systemic antibiotics, and silver-eluting dressings however, the bacteria that are routinely found to infect burn victims have been rapidly gaining resistance to both antibiotics and silver over time. One key factor in burn treatment is the prevention of infection, which is the greatest and most common source of increased morbidity and mortality for patients. Additionally, these treatments may not fully address the underlying damage to the skin, which can lead to further complications and decreased quality of life for patients. Treatments, such as autologous skin grafts, require the generation of another wound elsewhere on the body, while other treatments, such as emollients and silver solutions, serve only to either keep the wound bed moisturized or to prevent bacterial growth. Existing treatments for deep partial-thickness burns, such as skin grafts, silver-containing dressings, and currently available topical medications, are often inadequate. They can have long-term physical, emotional, and psychological effects on patients. Of all burns, deep partial-thickness burns are some of the most serious and debilitating. Taken together, these findings show promise for ARAG as a superior alternative to the current standard of care.īurns are one of the most common causes of trauma worldwide and account for a large number of intensive care unit admissions every year. Histological findings indicate this is likely due to increased wound debridement and dampening of late inflammatory processes, leading to more balanced physiologic healing. We further show, using a porcine model for deep partial-thickness burns, that ARAG allows for enhanced wound healing over Mepilex-Ag, the current standard of care. This inhibition is comparable to that conferred by silver ion release from burn dressings such as Mepilex-Ag. In this study, we show that ARAG (an antioxidant-rich antimicrobial gel) can suppress the growth of multiple bacteria commonly found to infect burns ( Klebsiella pneumoniae, Proteus vulgaris, Pseudomonas aeruginosa, and Staphylococcus aureus). Infections are well known to destabilize this process through a variety of mechanisms, most notably through increased inflammation and the resulting oxidative stress. This leaves burn healing dependent on slow natural processes to debride the wound and reestablish the epidermal and dermal layers of the skin. Current treatments for deep tissue burns are limited, and most serve only to enhance hydration or prevent bacterial growth.
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