Purpose: A porcine model was utilized to determine the clinical and histological impact of several currently available therapies for wound healing modification following partial-thickness thermal burn injury. Methods: A prospective study in a porcine model of partial-thickness thermal burn injury was performed, assessing immediate adjuvant wound therapy with amniotic membrane grafting, onabotulinum toxin A injection, and verteporfin injection compared with intermediate wound adjuvant therapy by intralesional 5-fluorouracil with microneedling, verteporfin injection, and triamcinolone injection with and without 5-fluorouracil. Clinical assessments were conducted by blinded plastic surgeons utilizing a validated porcine burn scar scale. Histologic analysis was accomplished with hematoxylin and eosin stains and Masson’s trichrome stains. A repeated measures mixed model analysis of variance was performed to identify clinical or histological statistical significance. Results: Comparing immediate versus intermediate treatments, a statistically significant difference in regards to mean clinical grade at the postinjury day 14 and postinjury day 28 time points was identified, yielding a 0.57 scale difference ( p = 0.0096) and 0.7 scale difference ( p = 0.0006), respectively. A statistically significant difference in regards to decreased mean histologic grade at the postinjury day 28 time points was identified for epithelial hyperplasia (−30.532 mean difference, p -value <0.0001), inflammatory response (−11.472 mean difference, p = 0.0133), and dermal remodeling (−13.78 mean difference, p = 0.0058). Conclusions: The results of this study suggest immediate treatment of partial-thickness thermal injury with adjuvant wound therapy decreases subsequent burn scar formation when compared with adjuvant wound therapy applied in the intermediate phase of healing.
Reed et al. (2025) studied this question.