Skin Burns: Review of Molecular Mechanisms and Therapeutic Approaches

Ahad Ferdowsi Khosroshahi, PhD; Jafar Soleimani Rad, PhD; Raziyeh Kheirjou, PhD student; Mohammad Reza Ranjkesh, MD; Leila Roshangar, PhD


Wounds. 2019;31(12):308-315. 

In This Article

Future Direction

Honey has been used for thousands of years as a wound treatment, but more recently its efficiency has been the focus of scientific investigation. Molan and Rhodes[66] found honey is a biological therapy with numerous bioactive and physical properties that aid wound healing. The high osmolarity of honey absorbs fluid from the wound bed and creates a negative pressure for lymph flow from the lymphatic vessels into the wound bed. The acidity of honey releases oxygen from the hemoglobin, as a result, destructive proteases would not be able to function in the wound environment. In addition, honey has broad antibacterial properties mainly related to hydrogen peroxide, which is deactivated by the blood catalase enzyme, serum, and wound tissue. Used in wound care products, Manuka honey can resist dilution with significant amounts of wound exudate and maintain sufficient activity to inhibit bacterial growth. There is good evidence honey contains bioactivities that stimulate the immune response, suppress inflammation, and cause fast autolytic debridement, thus promoting the growth of tissues for wound repair.[66,67]

Hyperbaric oxygen treatment for burn wounds was first used in the 1960s[68] and further developed in the decades following. However, there are still problems regarding the risks and possible costs. A 2013 murine model[69] showed hyperbaric oxygen improved healing time and scar formation in burn injuries.

Mineral pitch (also known as mummy and shilajit) exists in mountainous areas and flows through the rocks as a brown to black sticky substance that is a physiologically active organic matter. It is used in folk medicine to treat bone fractures, gastric disorders, joint inflammation, impotence, neurological and cardiovascular diseases, and muscle and tendon strain. It also is said to be an effective treatment for gastric ulcers, ulcers, diabetes, and urinary tract infections. It has antioxidant, anti-inflammatory, and immune-enhancing properties. One study[70] showed fulvic acid, a key ingredient in mineral pitch, acts as an antioxidant and anti-inflammatory agent. Therefore, the use of mineral pitch may help reduce free radicals and cellular damage within injuries. Pant et al[71] suggested mineral pitch may be a factor in a diet that may lower the risk of cancer and inhibit tumor growth.