Artem M. Mozherov

This review systematizes the principal methods for imaging and morphological analysis of burn wounds, ranging from light, electron, and fluorescence microscopy to tomographic techniques and mass spectrometry imaging. Light microscopy with histological staining and immunohistochemistry remains the morphological gold standard, enabling visualization of the zones of coagulation, stasis, and hyperemia, as well as molecular characterization of inflammation, angiogenesis, and fibrosis. Electron microscopy allows the study of the ultrastructure of cells and the extracellular matrix at nanometer resolution. Among optical methods, wide-field indocyanine green angiography demonstrates high accuracy in burn depth stratification, whereas fluorescence lifetime imaging microscopy assesses cellular metabolism without exogenous labels. Among tomographic techniques, high-frequency ultrasound is the most accessible bedside modality with submillimeter resolution, permitting evaluation of tissue anatomy, perfusion, and biomechanical properties. magnetic resonance imaging is limited by its high cost and long examination time, while mass spectrometry imaging is used solely for research purposes. For clinical practice, the optimal combination is high-frequency ultrasound and wide-field fluorescence imaging. All methods retain high relevance for experimental research, enabling the validation of novel therapeutic strategies.

Burn injury represents a complex trauma involving numerous local and systemic pathological alterations, which are frequently exacerbated by the phenomenon of burn wound conversion or secondary deepening. Conventional clinical management relies heavily on the application of skin grafts, which primarily serve to provide temporary wound coverage and environmental isolation. However, such grafting procedures often prove insufficiently effective and fail to prevent the progression of the burn wound. While contemporary tissue engineering strategies aim to correct specific pathological processes, they fall short of achieving complete and functional restoration of the skin. Consequently, there is a pressing need for the development of novel therapeutic interventions capable of exerting a multifactorial influence on the regeneration process. A promising avenue of research involves microRNA-based therapeutics. These RNA molecules function as master regulators of gene expression, capable of simultaneously modulating entire clusters of genes implicated in wound regeneration and the prevention of burn wound conversion. Therapeutic strategies focused on the targeted delivery of microRNAs to the wound bed hold the potential for creating effective treatment modalities that surpass existing options and effectively prevent burn deepening. This review consolidates current knowledge on the pathogenesis of burn wounds, elucidates the complex interplay between genes and microRNAs during tissue regeneration and describes both existing and experimental microRNA-based delivery approaches aimed at minimizing burn-related complications and enhancing the quality of tissue repair.