Healing potential of chitosan and decellularized intestinal matrix with mesenchymal stem cells and growth factor in burn wound in rat

Burns are one of the most common and devastating forms of trauma. Patients with serious thermal injury require immediate specialized care in order to minimize morbidity and mortality. The objective of this study was to evaluate the healing potential of porcine decellularized small intestinal submucosa (SIS) matrix and chitosan with mesenchymal stem cells (rMSC) and epidermal growth factor (mEGF) on the healing of full thickness burn wound in rat model. One 2 × 2 cm2 size full thickness burn wound was created on the dorsum of each animal under general anaesthesia. Burn wounds were treated with silver sulfadiazine; medical grade chitosan; chitosan with rMSC; chitosan with rMSC and mEGF; decellularized porcine SIS; rMSC seeded with SIS; rMSC seeded with SIS and mEGF in groups A, B, C, D, E, F and G, respectively. Healing was evaluated on the basis of percentage of wound contraction, colour digital imaging, immunological, histopathological, immunohistochemistry and gelatin zymography observations. A decrease in wound area was noticed in stem cell and m-EGF treated groups. Early angiogenesis and epithelialisation was observed in groups, where decellularized SIS matrix was combined with r-MSC and m-EGF. Type III collagen was found more in control group by immunohistochemistry which indicated abnormal collagen deposition. Gelatin zymography revealed expression of MMPs in the control group suggesting a chronic nature of wound. Chitosan in combination of rMSC and mEGF proved to be efficient for full-thickness burn wound healing. Decellularized SIS matrix when combined with r-MSC and m-EGF has healing potential and showed best healing response than conventional treatment for the reconstruction of full-thickness skin burn wounds in rats.