Pielesz A
Abstract
Introduction Burns are associated with significant inflammatory responses. An acute-phase response is elicited in burns, with increasing plasma levels of interleukin (IL)-6 and tumor necrosis factor (TNF)-a as well as stress hormones: catecholamines and cortisol. Cytokines such as interleukin 1β (ILlβ) and interleukin 6 (IL6) were significantly elevated in the plasma of patients with thermal injury compared to unburnt control subjects . Both cytokines were highest during the first week after injury and declined over time. Heat shock response, or stress response, is perhaps the oldest and most conserved form of reaction to stress. Heating cells or organisms generates the expression of a class of proteins known as heat shock proteins (HSP). HSP families include both constitutive and stress-inducible members whose primary function is to interact with native and denatured proteins to prevent the aggregation of aberrantly folded proteins, facilitate the folding of native proteins, facilitate the refolding of denatured proteins, and to aid intracellular protein trafficking. Wound infections may be caused by endogenous (patient’s flora) or exogenous microorganisms (environment, personnel’s flora, materials used during surgery and treatment). Most infections are caused by patient’s own flora. The most often isolated etiological factors among bacteria are the Gram-positive Staphylococcus aureus, Enterococcus sp., Coagulase-negative staphylococci, streptococci and Gram-negative Pseudomonas aeruginosa bacilli (often responsible for infecting diabetic foot ulcers and burns). The presence of microorganisms in open wounds is natural and generally does not lead to delayed healing. However, if the interactions between bacteria and the host turn into an infection, the wound condition deteriorates. Moist and abounding in nutrients, a chronic wound makes a perfect environment for multiplication of pathogens. Bacteria may live and reproduce as single cells, although an overwhelming majority of them have the ability to form a biofilm consisting mainly of Staphylococcus and Pseudomonas. A biofilm is an Organised structure of settled microorganisms (capable of adhering to the surface of a wound, other tissue of a living organism or inanimate elements), surrounded by an extracellular layer of mucus, which is made up of organic and inorganic substances produced by the bacteria. It protects them against adverse environmental conditions (pH, temperature, and radiation), antimicrobial agents (antibiotics) and the host’s immune system (antibodies, phagocytes, neutrophils).