Cerium nitrate treatment prevents progressive tissue necrosis in the zone of stasis following burn

• Published in: Burns 2012-03, Vol.38 (2), p.283-289
• Main Authors: Eski, Muhitdin, Ozer, Firat, Firat, Cemal, Alhan, Doğan, Arslan, Nuri, Senturk, Tolga, Işik, Selcuk
• Format: Article
• Language: English
• Subjects: Analysis of Variance; Animals; Anti-Infective Agents, Local - therapeutic use; Biological and medical sciences; Burn; Burns; Burns - drug therapy; Burns - physiopathology; Cerium - therapeutic use; Cerium nitrate; Critical Care; Disease Models, Animal; Female; Medical sciences; Necrosis - prevention & control; Prevention and actions; Public health. Hygiene; Public health. Hygiene-occupational medicine; Random Allocation; Rats; Rats, Sprague-Dawley; Regional Blood Flow - drug effects; Skin - blood supply; Skin - drug effects; Skin - pathology; Traumas. Diseases due to physical agents; Zone of stasis
• ISSN: 0305-4179; 1879-1409
• DOI: 10.1016/j.burns.2011.08.008

Abstract Cerium nitrate (CN) was used as a topical antiseptic agent for the treatment of burn wounds and found to reduce the number of anticipated death in burn. This decreased burn related mortality cannot be explained by the control of wound infection alone. In the studies performed to elucidate the unexplained effects of CN treatment, it was shown that CN treatment reduced the alarm cytokine levels, decreased leukocyte activation, reduced macromolecular leakage and finally burn edema formation. We hypothesized that CN treatment prevents the conversion of the zone of stasis to progressive tissue necrosis by decreasing leukocyte activation and reducing macromolecular leakage and burn edema. This was investigated on a well-described burn comb model in the rats. Fifty-four rats were randomly divided into control and CN treatment groups. Each rat in CN treatment group received 0.04 M CN bathing 30 min after burn whereas rats in control group received 0.09% saline bathing. Viability of zone of stasis is assessed with99m Tc-sestamibi scintigraphy. Nine rats in each group were scintigraphically evaluated at the 3rd and 7th day after burn and remaining 9 rats had macroscopic and histological examination at the 21st day after burn to confirm the scintigraphic results. In CN treatment groups, the scintigraphic uptake ratios were higher both at post burn day 3rd and 7th when compared to that of control groups. This was statistically significant ( p ≤ 0.05). In the CN treatment group, the results of the average percentage of the re-epithelialization in the zone of stasis were higher than that of control groups. The difference between the groups was also statistically significant ( p ≤ 0.05). These results were accepted that CN treatment prevents progressive tissue necrosis in the zone of stasis. This study further elucidates the unexplained effects of CN treatment on burn.