Pub Date : 2025-10-10DOI: 10.1016/j.burns.2025.107738
Noora-Ilona Lahdenperä , Jussi P. Repo , Hannu Kautiainen , Jyrki Vuola , Andrew Lindford
Background
A burn-specific health-related quality of life (HRQL) measure is needed to assess burn patients’ specific health needs. The HRQL measure, the CARe Burn Scale, was previously translated into Finnish. The aim of this study was to assess the psychometric properties of the Finnish version of the CARe Burn Scale Adult form in burn patients.
Methods
Study participants were adults with deep second- or third-degree burn treated with skin grafting at the Helsinki Burn Centre between 2006 and 2017. The Finnish version of the CARe Burn Scale, background information form, and the generic HRQL instrument 15D were sent to potential participants. The CARe Burn Scale was completed twice to assess repeatability.
Results
Altogether 194 previous burn patients participated in this study. 150 (77 %) of them also returned the retest questionnaire. 70.6 % (137) of the participants were male. The internal consistency of all scores was good to excellent (Cronbach’s alpha 0.80–0.94). All 12 subscales of the CARe Burn Scale showed good or excellent reproducibility (ICC 0.73–0.92). The ceiling effect was present in all scores except for positive growth, in which the floor effect was proved.
Conclusion
The Finnish version of the CARe Burn Scale Adult version has now been psychometrically validated. The internal consistency and the reproducibility in the Scale ranged from good to excellent. The ceiling effect occurred in all but one score, so it needs to be further tested in patients with more recent burns.
{"title":"Psychometric validation of the CARe Burn Scale—Adult Form Finnish version","authors":"Noora-Ilona Lahdenperä , Jussi P. Repo , Hannu Kautiainen , Jyrki Vuola , Andrew Lindford","doi":"10.1016/j.burns.2025.107738","DOIUrl":"10.1016/j.burns.2025.107738","url":null,"abstract":"<div><h3>Background</h3><div>A burn-specific health-related quality of life (HRQL) measure is needed to assess burn patients’ specific health needs. The HRQL measure, the CARe Burn Scale, was previously translated into Finnish. The aim of this study was to assess the psychometric properties of the Finnish version of the CARe Burn Scale Adult form in burn patients.</div></div><div><h3>Methods</h3><div>Study participants were adults with deep second- or third-degree burn treated with skin grafting at the Helsinki Burn Centre between 2006 and 2017. The Finnish version of the CARe Burn Scale, background information form, and the generic HRQL instrument 15D were sent to potential participants. The CARe Burn Scale was completed twice to assess repeatability.</div></div><div><h3>Results</h3><div>Altogether 194 previous burn patients participated in this study. 150 (77 %) of them also returned the retest questionnaire. 70.6 % (137) of the participants were male. The internal consistency of all scores was good to excellent (Cronbach’s alpha 0.80–0.94). All 12 subscales of the CARe Burn Scale showed good or excellent reproducibility (ICC 0.73–0.92). The ceiling effect was present in all scores except for positive growth, in which the floor effect was proved.</div></div><div><h3>Conclusion</h3><div>The Finnish version of the CARe Burn Scale Adult version has now been psychometrically validated. The internal consistency and the reproducibility in the Scale ranged from good to excellent. The ceiling effect occurred in all but one score, so it needs to be further tested in patients with more recent burns.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 9","pages":"Article 107738"},"PeriodicalIF":2.9,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-09DOI: 10.1016/j.burns.2025.107734
Mahta Moghaddam Ahmadi, Moein Moghaddam Ahmadi
{"title":"An insight into the variables related to intraoperative stressors on the surgical team","authors":"Mahta Moghaddam Ahmadi, Moein Moghaddam Ahmadi","doi":"10.1016/j.burns.2025.107734","DOIUrl":"10.1016/j.burns.2025.107734","url":null,"abstract":"","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 9","pages":"Article 107734"},"PeriodicalIF":2.9,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-08DOI: 10.1016/j.burns.2025.107737
Morteza Alipour, Amirhossein Jafari, Mohammad Javad Tabatabaei Fallah, Zakiyeh Jafaryparvar
{"title":"Comments on: \"The effect of music therapy on background pain, anxiety, depression, vital signs, and medication usage in adult burn patients in the intensive care unit: A randomized controlled trial\"","authors":"Morteza Alipour, Amirhossein Jafari, Mohammad Javad Tabatabaei Fallah, Zakiyeh Jafaryparvar","doi":"10.1016/j.burns.2025.107737","DOIUrl":"10.1016/j.burns.2025.107737","url":null,"abstract":"","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 9","pages":"Article 107737"},"PeriodicalIF":2.9,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145453909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-04DOI: 10.1016/j.burns.2025.107735
Wei Shen , Hui Sun , Ying-Ming Ma , Yuan Wu, Hua-Jie Zhong, Xiao-Lei Xie
{"title":"Causal effects of skin microbiota on hypertrophic scars via cytokines and immune phenotypes","authors":"Wei Shen , Hui Sun , Ying-Ming Ma , Yuan Wu, Hua-Jie Zhong, Xiao-Lei Xie","doi":"10.1016/j.burns.2025.107735","DOIUrl":"10.1016/j.burns.2025.107735","url":null,"abstract":"","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 9","pages":"Article 107735"},"PeriodicalIF":2.9,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-04DOI: 10.1016/j.burns.2025.107732
Dallan P. Dargan, Lawrence J. Gottlieb, Sebastian Q. Vrouwe
{"title":"DermaBlade: A flexible scalpel for precise excision of burns","authors":"Dallan P. Dargan, Lawrence J. Gottlieb, Sebastian Q. Vrouwe","doi":"10.1016/j.burns.2025.107732","DOIUrl":"10.1016/j.burns.2025.107732","url":null,"abstract":"","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 9","pages":"Article 107732"},"PeriodicalIF":2.9,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145268236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Burns are the fourth most common accidental injury worldwide, predominantly occurring in developing countries. Wound healing in burns involves reduced cytokine secretion but increased chemokine and growth factor production compared to surgical wounds. Keratinocyte growth factor (KGF) regulates epidermal regeneration, an essential process in wound healing; while epidermal stem cells (ESCs) play a crucial role in wound closure and have potential for cell therapy. Negative pressure wound therapy (NPWT) promotes healing by improving blood flow, enhancing re-epithelialization, and reducing infection risk. This study investigates the effects of NaCl 0.9 %, intermittent and continuous NPWT, and silver sulfadiazine on ESC and KGF levels in deep dermal burns.
Method
Six male Yorkshire pigs received 20 deep dermal burns on the flank and dorsum, divided into four treatment groups: NaCl 0.9 %, continuous NPWT, intermittent NPWT, and silver sulfadiazine. Samples were collected on days 1, 3, 7, 14, and 21. ESCs were evaluated using CK19 immunohistochemistry as a marker. KGF levels were measured via ELISA. Data were analyzed with ANOVA, with significance set at p < 0.05.
Result
Continuous NPWT showed the highest ESC counts at the wound edge on all observation days and at the wound center on days 3 and 21, though without statistical significance. KGF levels differed significantly among the groups on days 1, 3, and 7 (p < 0.05), with the continuous NPWT group consistently showing the highest KGF levels. Statistical analysis revealed that treatment, observation day, and KGF levels significantly influenced ESC counts, accounting for 45 % of the variability (p < 0.05).
Conclusion
The continuous NPWT group demonstrated significantly elevated KGF levels on days 1, 3, and 7, which corresponded to a significant increase in ESC. Further research is warranted to confirm these findings.
{"title":"The impact of negative pressure wound therapy on epidermal stem cells and keratinocyte growth factor in deep dermal burn injury: An experimental study","authors":"Muhammad Rosadi Seswandhana , Hamim Majdy Awliya Humani , Gita Christy Gabriela , Ishandono Dachlan , Estelita Liana , Yohanes Widodo Wirohadidjojo , Teguh Aryandono , Budi Mulyono , Irianiwati Widodo","doi":"10.1016/j.burns.2025.107719","DOIUrl":"10.1016/j.burns.2025.107719","url":null,"abstract":"<div><h3>Introduction</h3><div>Burns are the fourth most common accidental injury worldwide, predominantly occurring in developing countries. Wound healing in burns involves reduced cytokine secretion but increased chemokine and growth factor production compared to surgical wounds. Keratinocyte growth factor (KGF) regulates epidermal regeneration, an essential process in wound healing; while epidermal stem cells (ESCs) play a crucial role in wound closure and have potential for cell therapy. Negative pressure wound therapy (NPWT) promotes healing by improving blood flow, enhancing re-epithelialization, and reducing infection risk. This study investigates the effects of NaCl 0.9 %, intermittent and continuous NPWT, and silver sulfadiazine on ESC and KGF levels in deep dermal burns.</div></div><div><h3>Method</h3><div>Six male Yorkshire pigs received 20 deep dermal burns on the flank and dorsum, divided into four treatment groups: NaCl 0.9 %, continuous NPWT, intermittent NPWT, and silver sulfadiazine. Samples were collected on days 1, 3, 7, 14, and 21. ESCs were evaluated using CK19 immunohistochemistry as a marker. KGF levels were measured via ELISA. Data were analyzed with ANOVA, with significance set at <em>p</em> < 0.05.</div></div><div><h3>Result</h3><div>Continuous NPWT showed the highest ESC counts at the wound edge on all observation days and at the wound center on days 3 and 21, though without statistical significance. KGF levels differed significantly among the groups on days 1, 3, and 7 (<em>p</em> < 0.05), with the continuous NPWT group consistently showing the highest KGF levels. Statistical analysis revealed that treatment, observation day, and KGF levels significantly influenced ESC counts, accounting for 45 % of the variability (<em>p</em> < 0.05).</div></div><div><h3>Conclusion</h3><div>The continuous NPWT group demonstrated significantly elevated KGF levels on days 1, 3, and 7, which corresponded to a significant increase in ESC. Further research is warranted to confirm these findings.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 9","pages":"Article 107719"},"PeriodicalIF":2.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/j.burns.2025.107721
Nethmi Nuwanji Amarasekera , Ayush Jha , Walton N. Charles , Atul Dutt , Helena Milton-Jones , Eleana Kumana , Joseph Eliahoo , Ken Dunn , Suveer Singh
Background
One-third of major burns are complicated by burns-related smoke inhalation injury (BII), which increases mortality risk. Fibreoptic bronchoscopy is the gold standard for BII diagnosis, with the Abbreviated Injury Score (AIS) being the most widely used grading system. While BII severity has been linked to poorer outcomes, this is the first systematic review and meta-analysis evaluating the association between bronchoscopic grading of BII and mortality, pneumonia, and acute respiratory distress syndrome (ARDS).
Methods
Primary human clinical studies assessing BII severity via bronchoscopy were reviewed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework. Outcomes included mortality, pneumonia, ARDS, and intubation. Meta-analyses were conducted using random-effects models to determine risk differences (RD) with 95 % confidence intervals (CI). Further analyses explored alternative grading systems and thresholds for defining milder or more severe injury.
Results
Of 457 studies screened, 30 were included, with 12 providing sufficient data for meta-analysis. More severe BII (AIS grades 3–4) was associated with higher risks of pneumonia (RD: 0.319, 95 % CI: 0.020–0.618, p = 0.037) and ARDS (RD: 0.242, 95 % CI: 0.118–0.367, p < 0.001) compared to milder BII (AIS grades 1–2). While mortality was also higher for more severe BII (RD: 0.068, 95 % CI: −0.017–0.153, p = 0.116), there was insufficient statistical evidence to support this association. Findings were inconsistent in further analyses accounting for alternative grading systems and severity thresholds.
Conclusion
Higher bronchoscopic grades of BII are associated with increased pneumonia and ARDS. However, substantial study heterogeneity and inconsistent grading methodologies limit confidence in these associations. While AIS remains the most widely used classification, other systems with differing definitions of severity further complicate comparisons. Future research should focus on standardising bronchoscopic classification and integrating objective clinical parameters for improved risk stratification.
背景：三分之一的严重烧伤并发烧伤相关的烟雾吸入性损伤（BII），这增加了死亡风险。纤维支气管镜检查是诊断BII的金标准，简易损伤评分（AIS）是最广泛使用的分级系统。虽然BII严重程度与较差的预后有关，但这是第一个评估支气管镜下BII分级与死亡率、肺炎和急性呼吸窘迫综合征（ARDS）之间关系的系统综述和荟萃分析。方法：通过支气管镜评估BII严重程度的主要人类临床研究使用系统评价和荟萃分析框架的首选报告项目进行回顾。结果包括死亡率、肺炎、ARDS和插管。采用随机效应模型进行meta分析，以95% %置信区间（CI）确定风险差异（RD）。进一步的分析探讨了定义较轻或较严重损伤的替代分级系统和阈值。结果：在筛选的457项研究中，纳入了30项，其中12项提供了足够的数据进行meta分析。更严重的BII （AIS分级3-4）与更高的肺炎（RD: 0.319, 95 % CI: 0.020-0.618, p = 0.037）和ARDS （RD: 0.242, 95 % CI: 0.118-0.367, p ）风险相关。结论：更高的支气管镜下BII分级与肺炎和ARDS增加相关。然而，大量的研究异质性和不一致的分级方法限制了对这些关联的信心。虽然AIS仍然是最广泛使用的分类，但其他具有不同严重性定义的系统进一步使比较复杂化。未来的研究应集中在规范支气管镜分类和整合客观临床参数，以改善风险分层。
{"title":"Evaluating the association between bronchoscopic severity of burns-related smoke inhalation injury and clinical outcomes: A systematic review and meta-analysis","authors":"Nethmi Nuwanji Amarasekera , Ayush Jha , Walton N. Charles , Atul Dutt , Helena Milton-Jones , Eleana Kumana , Joseph Eliahoo , Ken Dunn , Suveer Singh","doi":"10.1016/j.burns.2025.107721","DOIUrl":"10.1016/j.burns.2025.107721","url":null,"abstract":"<div><h3>Background</h3><div>One-third of major burns are complicated by burns-related smoke inhalation injury (BII), which increases mortality risk. Fibreoptic bronchoscopy is the gold standard for BII diagnosis, with the Abbreviated Injury Score (AIS) being the most widely used grading system. While BII severity has been linked to poorer outcomes, this is the first systematic review and meta-analysis evaluating the association between bronchoscopic grading of BII and mortality, pneumonia, and acute respiratory distress syndrome (ARDS).</div></div><div><h3>Methods</h3><div>Primary human clinical studies assessing BII severity via bronchoscopy were reviewed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework. Outcomes included mortality, pneumonia, ARDS, and intubation. Meta-analyses were conducted using random-effects models to determine risk differences (RD) with 95 % confidence intervals (CI). Further analyses explored alternative grading systems and thresholds for defining milder or more severe injury.</div></div><div><h3>Results</h3><div>Of 457 studies screened, 30 were included, with 12 providing sufficient data for meta-analysis. More severe BII (AIS grades 3–4) was associated with higher risks of pneumonia (RD: 0.319, 95 % CI: 0.020–0.618, p = 0.037) and ARDS (RD: 0.242, 95 % CI: 0.118–0.367, p < 0.001) compared to milder BII (AIS grades 1–2). While mortality was also higher for more severe BII (RD: 0.068, 95 % CI: −0.017–0.153, p = 0.116), there was insufficient statistical evidence to support this association. Findings were inconsistent in further analyses accounting for alternative grading systems and severity thresholds.</div></div><div><h3>Conclusion</h3><div>Higher bronchoscopic grades of BII are associated with increased pneumonia and ARDS. However, substantial study heterogeneity and inconsistent grading methodologies limit confidence in these associations. While AIS remains the most widely used classification, other systems with differing definitions of severity further complicate comparisons. Future research should focus on standardising bronchoscopic classification and integrating objective clinical parameters for improved risk stratification.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 9","pages":"Article 107721"},"PeriodicalIF":2.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-28DOI: 10.1016/j.burns.2025.107720
Muhammad Umar Rafique, Nouman Asad, Syed Hassan Naeem, Mahnoor Naeem, Muhammad Ahmad Nadeem, Hira Saleem, Abdullah Ahmad
{"title":"Disparities and trends in the epidemiology of pediatric burn patient mortality in the United States: A 21-year analysis of a national database","authors":"Muhammad Umar Rafique, Nouman Asad, Syed Hassan Naeem, Mahnoor Naeem, Muhammad Ahmad Nadeem, Hira Saleem, Abdullah Ahmad","doi":"10.1016/j.burns.2025.107720","DOIUrl":"10.1016/j.burns.2025.107720","url":null,"abstract":"","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 9","pages":"Article 107720"},"PeriodicalIF":2.9,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145410748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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