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

Abstract and Introduction


Burn wounds are one of the main causes of skin damage. Based on World Health Organization statistics, almost 300 000 people worldwide die of burns each year. In severe burns, the cells and blood vessels are often injured and the blood supply to the wound is disturbed. Many factors such as oxygenation, infection, aging, hormones, and nutrition potentially can influence burn progression and disrupt repair with unbalanced release of various growth factors and cytokines. Different treatment approaches such as dressings and skin substitutes have been applied to aid wound healing. A thorough understanding of the effective factors on burns can improve wound healing outcomes. This review evaluates articles published on the Scopus, EMBASE, and PubMed databases that attempt to explain the pathophysiology, molecular components, and therapeutic approaches involved in the burn wound healing process.


Skin, composed of the epidermis, dermis, and hypodermis layers, is the largest organ of the body. Its functions are absolutely necessary for self-preservation. The skin is prone to damage by microorganisms and thermal, mechanical, and chemical factors. An important cause of skin damage is burn wounds.[1,2] According to World Health Organization reports, about 300 000 individuals worldwide die of burns annually.[3,4] In the United States, 500 000 patients undergo burn wound treatment annually, of which more than 40 000 are hospitalized and 3400 die.[4]

Burn wounds lead to various local and systemic pathophysiological processes in the body. They, like all wound types, initiate a continuous inflammatory process associated with the release of different cytokines.[5] The study of the molecular and physiological bases of cutaneous wound healing could lead to more therapeutic possibilities. For example, studies have proposed the expression of inflammatory mediators (cytokines, chemokines, and growth factors) within a damaged area is essential for the wound healing process.[6,7] Therefore, this review discusses local and systemic pathophysiological responses, molecular components, and some of the therapeutic approaches involved in the burn wound healing process.