Clinical Application of wIRA Irradiation in Burn Wounds

Abstract

AbstractBesides operative procedures (e.g., necrosectomies, skin grafting), conservative treatments of thermal injuries are increasingly important. wIRA as an additional therapy for burns, scalds, and chemically induced injuries and for treating severe skin reactions (e.g., toxic epidermal necrolysis) is used in our clinic on a daily basis. The most successful therapy involves 3–4 irradiations/30 min/day. Therefore, patients with superficial partial-thickness burns are treated with topical polyhexanide ointment and wIRA 2–4 days after the accident. In these cases, we see a quick wound-drying and a rapid re-epithelialization of the skin. The approach in deep partial-thickness burns depends on whether surgical procedures must be postponed due to poor general conditions. In these patients, preservation of the wound perfusion in regions that are not fully damaged is intended, avoiding extensive necrosectomies.Although third-degree burns are dry and do not require wIRA irradiation, it can be used for adjacent regions with minor degree burns. Preliminary in vitro data suggest a wIRA-induced migration of adipose-derived stem cells.Postoperatively, wIRA is used on areas transplanted with split-thickness skin grafts. After removal of the tie-over bolsters, wIRA is applied 3–4 times/20–30 min/day. The grafts exhibit a faster epithelialization of the fenestrated spots, and postoperative infections seem to be less frequent.