Pub Date : 2026-01-05DOI: 10.1016/j.burns.2026.107851
Doha Obed , Huu H. Nguyen , Mustafa Salim , Nadjib Dastagir , Martynas Tamulevicius , Florian Bucher , Anieto O.M. Enechukwu , Peter M. Vogt
Background
Red cell distribution width (RDW), serum protein levels, platelet count (PLT), and RDW/protein and RDW/PLT ratios have been associated with adverse outcomes in various medical conditions such as sepsis and critical illness. This study aimed to investigate the association between these parameters and in-hospital mortality following severe burn injury.
Methods
Intensive care burn patients admitted between March 2007 and December 2020 with a total body surface area (TBSA) burned ≥ 20 % were analyzed. Multivariate analysis was conducted to examine variables associated with mortality. RDW/protein and RDW/PLT ratios on post-burn days 1, 3 and 7 were analyzed by receiver operating characteristic curves.
Results
A total of 288 patients were included. Mortality was 26 %, with non-survivors being significantly older, more frequently male, and presenting with an average of 49 % of TBSA burned. RDW, serum protein levels and PLT were not independent predictive values. The RDW/protein ratios on post-burn days 3 and 7 were significantly associated with in-hospital mortality. The respective AUC value exceeded 0.8 on post-burn day 7, indicating good predictive ability.
Conclusion
Post-burn evaluation of the RDW/protein ratio may provide a simple, cost-effective, and valuable predictor for mortality risk assessment following burn injury.
{"title":"Prognostic value of red blood cell distribution width/protein and red blood cell distribution width/platelet count ratios in intensive care burn patients","authors":"Doha Obed , Huu H. Nguyen , Mustafa Salim , Nadjib Dastagir , Martynas Tamulevicius , Florian Bucher , Anieto O.M. Enechukwu , Peter M. Vogt","doi":"10.1016/j.burns.2026.107851","DOIUrl":"10.1016/j.burns.2026.107851","url":null,"abstract":"<div><h3>Background</h3><div>Red cell distribution width (RDW), serum protein levels, platelet count (PLT), and RDW/protein and RDW/PLT ratios have been associated with adverse outcomes in various medical conditions such as sepsis and critical illness. This study aimed to investigate the association between these parameters and in-hospital mortality following severe burn injury.</div></div><div><h3>Methods</h3><div>Intensive care burn patients admitted between March 2007 and December 2020 with a total body surface area (TBSA) burned ≥ 20 % were analyzed. Multivariate analysis was conducted to examine variables associated with mortality. RDW/protein and RDW/PLT ratios on post-burn days 1, 3 and 7 were analyzed by receiver operating characteristic curves.</div></div><div><h3>Results</h3><div>A total of 288 patients were included. Mortality was 26 %, with non-survivors being significantly older, more frequently male, and presenting with an average of 49 % of TBSA burned. RDW, serum protein levels and PLT were not independent predictive values. The RDW/protein ratios on post-burn days 3 and 7 were significantly associated with in-hospital mortality. The respective AUC value exceeded 0.8 on post-burn day 7, indicating good predictive ability.</div></div><div><h3>Conclusion</h3><div>Post-burn evaluation of the RDW/protein ratio may provide a simple, cost-effective, and valuable predictor for mortality risk assessment following burn injury.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"52 2","pages":"Article 107851"},"PeriodicalIF":2.9,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023667","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 : 2026-01-05DOI: 10.1016/j.burns.2026.107850
Marcel Chua , Lindsay Damkat-Thomas , Belinda J. Gabbe , Bronwyn Griffin , Courtney Ryder , Lincoln M. Tracy
Burns patients with recorded discharges against medical advice (DAMA) face potential medical and financial consequences associated with future readmissions. This study aimed to investigate the characteristics and outcomes of patients with recorded DAMA from burns services in Australia and New Zealand. In an observational study using data from individuals aged ≥ 16 years captured by the Burns Registry of Australia and New Zealand with a burn-related admission between July 2009 and June 2022, 325 patients (1.4 %) had recorded DAMA. A greater proportion of patients with recorded DAMA were aged 30–44 years, of Australian Aboriginal and Torres Strait Islander origin, from outer regional Australia, had pre-existing mental health conditions, with substance use, and sustained their injury through suspected assault or abuse. Injuries in patients with recorded DAMA were more severe. Compared to patients without DAMA, a greater proportion of patients with DAMA were readmitted within 28 days of discharge (13.8 % versus 4.9 %), with failed discharge processes (45.5 %) and infection (18.2 %) being the most frequently recorded reasons. They required readmission to the intensive care unit (20 % versus 8.6 %) with longer lengths of stay. Outcome findings remained similar in a matched cohort analysis between those with and without recorded DAMA. These findings highlight the consequences of DAMA, necessitating primary measures to address modifiable, cultural, and social factors preemptively to prevent DAMA among disadvantaged individuals, and secondary measures to minimize the impact of DAMA (e.g., adequate pain and wound discharge management, follow-up care, community-based treatments, etc.).
{"title":"Characteristics and outcomes of patients who discharge against medical advice from Australian and New Zealand burns services","authors":"Marcel Chua , Lindsay Damkat-Thomas , Belinda J. Gabbe , Bronwyn Griffin , Courtney Ryder , Lincoln M. Tracy","doi":"10.1016/j.burns.2026.107850","DOIUrl":"10.1016/j.burns.2026.107850","url":null,"abstract":"<div><div>Burns patients with recorded discharges against medical advice (DAMA) face potential medical and financial consequences associated with future readmissions. This study aimed to investigate the characteristics and outcomes of patients with recorded DAMA from burns services in Australia and New Zealand. In an observational study using data from individuals aged ≥ 16 years captured by the Burns Registry of Australia and New Zealand with a burn-related admission between July 2009 and June 2022, 325 patients (1.4 %) had recorded DAMA. A greater proportion of patients with recorded DAMA were aged 30–44 years, of Australian Aboriginal and Torres Strait Islander origin, from outer regional Australia, had pre-existing mental health conditions, with substance use, and sustained their injury through suspected assault or abuse. Injuries in patients with recorded DAMA were more severe. Compared to patients without DAMA, a greater proportion of patients with DAMA were readmitted within 28 days of discharge (13.8 % versus 4.9 %), with failed discharge processes (45.5 %) and infection (18.2 %) being the most frequently recorded reasons. They required readmission to the intensive care unit (20 % versus 8.6 %) with longer lengths of stay. Outcome findings remained similar in a matched cohort analysis between those with and without recorded DAMA. These findings highlight the consequences of DAMA, necessitating primary measures to address modifiable, cultural, and social factors preemptively to prevent DAMA among disadvantaged individuals, and secondary measures to minimize the impact of DAMA (e.g., adequate pain and wound discharge management, follow-up care, community-based treatments, etc.).</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"52 3","pages":"Article 107850"},"PeriodicalIF":2.9,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146039691","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}
Background: This study aimed to evaluate the antimicrobial and restorative effects of a topical hydrogel formulation of Scrofularia striata (S. striata) plant extract, Scrofularia Striata Hydrogel (SSH), on superficial partial thickness burn wounds.
Methods: In this randomized, double-blind clinical trial conducted in 2022, 80 patients with superficial partial thickness burns at Besat and Imam Hossein hospitals in Hamadan, Iran, were selected using convenience sampling. Patients were randomly assigned to four groups: SSH+ 1 % SSD, SSH alone, SSD alone, and SSD+Vehicle control (VC). Wound area (mm²) was measured daily using transparent paper tracings analyzed with ImageJ software until complete healing. Data were analyzed using ANOVA, t-test, and Chi-square tests with SPSS software (version 23).
Results: The SSH group exhibited significantly shorter wound healing times (8 days) compared to the SSD+SSH (10 days), SSD alone, and SSD+VC groups (p < 0.001). No infections were reported across all groups.
Conclusion: SSH significantly accelerates the healing of superficial partial thickness burn wounds and is recommended as a promising alternative or adjunct to SSD.
背景：本研究旨在评价一种局部应用的刺蒺藜（S. striata）植物提取物——刺蒺藜水凝胶（SSH）对部分浅烧伤创面的抗菌和修复作用。方法：在这项于2022年进行的随机双盲临床试验中，采用方便抽样的方法选择伊朗哈马丹Besat和Imam Hossein医院的80例浅表部分厚度烧伤患者。患者随机分为4组：SSH+ 1 % SSD、SSH单独、SSD单独、SSD+Vehicle control （VC）。创面面积（mm²）每日用透明纸描痕测量，用ImageJ软件分析，直至完全愈合。数据分析采用方差分析、t检验和卡方检验，采用SPSS软件（版本23）。结果：与SSD+SSH（10天）、单纯SSD和SSD+VC组相比，SSH组创面愈合时间（8天）显著缩短（p ）。结论：SSH可显著加速浅表部分厚度烧伤创面愈合，被推荐为SSD的替代或辅助治疗方法。
{"title":"Antimicrobial and restorative effects of topical hydrogel formulation of Scrofularia striata plant extract on second-degree burn wounds: A clinical trial study.","authors":"Zahra Bagheri, Babak Yousefi, Meysam Safi-Keykaleh, Maryam Zand, Amir Larki-Harchegani, Arash Khalili","doi":"10.1016/j.burns.2026.107849","DOIUrl":"https://doi.org/10.1016/j.burns.2026.107849","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the antimicrobial and restorative effects of a topical hydrogel formulation of Scrofularia striata (S. striata) plant extract, Scrofularia Striata Hydrogel (SSH), on superficial partial thickness burn wounds.</p><p><strong>Methods: </strong>In this randomized, double-blind clinical trial conducted in 2022, 80 patients with superficial partial thickness burns at Besat and Imam Hossein hospitals in Hamadan, Iran, were selected using convenience sampling. Patients were randomly assigned to four groups: SSH+ 1 % SSD, SSH alone, SSD alone, and SSD+Vehicle control (VC). Wound area (mm²) was measured daily using transparent paper tracings analyzed with ImageJ software until complete healing. Data were analyzed using ANOVA, t-test, and Chi-square tests with SPSS software (version 23).</p><p><strong>Results: </strong>The SSH group exhibited significantly shorter wound healing times (8 days) compared to the SSD+SSH (10 days), SSD alone, and SSD+VC groups (p < 0.001). No infections were reported across all groups.</p><p><strong>Conclusion: </strong>SSH significantly accelerates the healing of superficial partial thickness burn wounds and is recommended as a promising alternative or adjunct to SSD.</p>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"52 3","pages":"107849"},"PeriodicalIF":2.9,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146127441","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 : 2025-12-29DOI: 10.1016/j.burns.2025.107848
Matthew Q. Dao , Anika Y. Kim , Sarah Wang , Paul Won , Matteo Laspro , T. Justin Gillenwater , Haig A. Yenikomshian , Maxwell B. Johnson
Introduction
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are widely prescribed for glycemic control and weight loss. In addition, these medications have been associated with anti-inflammatory activity, modulation of wound healing, and reduction of substance use disorders. Therefore, GLP-1 RAs may have therapeutic benefits in burn care. This study investigates whether early administration of GLP-1 RAs after burn injury is associated with clinical outcomes.
Methods
The Global Collaborative Network was queried in TriNetX, a database of electronic health records. The treatment group included burn patients who received GLP-1 RAs within 30 days of injury. This group was propensity matched with patients who did not receive GLP-1 RAs. Patients were matched by demographics, comorbidities, and burn characteristics. Outcomes at 90 days and 1 year following burn injury were compared, with statistical significance defined as p < 0.05.
Results
Following matching, each group was composed of 3231 patients. At 90 days post-burn, the GLP-1 RA group had significantly lower rates of soft tissue infection, opioid prescriptions, readmission, and mortality (all p < 0.05). At 1 year post-burn, lower rates of opioid prescriptions, readmission, and mortality persisted (all p < 0.05), while soft tissue infection rates remained numerically lower but did not reach statistical significance. No significant differences were observed for wound disruption, hypertrophic scar formation, or contracture formation at either time point.
Conclusions
GLP-1 RAs after recent burn injury were associated with lower risk of infection, opioid prescriptions, readmission, and mortality. Their utility in burn care is promising, and additional research is needed.
{"title":"Glucagon-like peptide-1 receptor agonists after recent burn injury are associated with lower rates of infection, mortality, and opioid prescriptions","authors":"Matthew Q. Dao , Anika Y. Kim , Sarah Wang , Paul Won , Matteo Laspro , T. Justin Gillenwater , Haig A. Yenikomshian , Maxwell B. Johnson","doi":"10.1016/j.burns.2025.107848","DOIUrl":"10.1016/j.burns.2025.107848","url":null,"abstract":"<div><h3>Introduction</h3><div>Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are widely prescribed for glycemic control and weight loss. In addition, these medications have been associated with anti-inflammatory activity, modulation of wound healing, and reduction of substance use disorders. Therefore, GLP-1 RAs may have therapeutic benefits in burn care. This study investigates whether early administration of GLP-1 RAs after burn injury is associated with clinical outcomes.</div></div><div><h3>Methods</h3><div>The Global Collaborative Network was queried in TriNetX, a database of electronic health records. The treatment group included burn patients who received GLP-1 RAs within 30 days of injury. This group was propensity matched with patients who did not receive GLP-1 RAs. Patients were matched by demographics, comorbidities, and burn characteristics. Outcomes at 90 days and 1 year following burn injury were compared, with statistical significance defined as p < 0.05.</div></div><div><h3>Results</h3><div>Following matching, each group was composed of 3231 patients. At 90 days post-burn, the GLP-1 RA group had significantly lower rates of soft tissue infection, opioid prescriptions, readmission, and mortality (all p < 0.05). At 1 year post-burn, lower rates of opioid prescriptions, readmission, and mortality persisted (all p < 0.05), while soft tissue infection rates remained numerically lower but did not reach statistical significance. No significant differences were observed for wound disruption, hypertrophic scar formation, or contracture formation at either time point.</div></div><div><h3>Conclusions</h3><div>GLP-1 RAs after recent burn injury were associated with lower risk of infection, opioid prescriptions, readmission, and mortality. Their utility in burn care is promising, and additional research is needed.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"52 2","pages":"Article 107848"},"PeriodicalIF":2.9,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023660","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 : 2025-12-26DOI: 10.1016/j.burns.2025.107844
Ronald M. Cornely , Sara C. Chaker , Andrew J. James , Ariel Vinson , Barite Gutama , Ronnie N. Mubang , Elizabeth Slater , William Lineaweaver
Background
The COVID-19 pandemic caused major societal disruptions, including shifts in childcare, remote learning, and parental work-from-home responsibilities, potentially altering pediatric burn incidence. This study compares pediatric burn admission numbers, etiology, and severity at a regional burn center to national trends before and during the pandemic.
Methods
A retrospective cohort study analyzed pediatric burn admissions and reported their proportion of total burns from a regional burn center and the American Burn Association National Burn Repository (2017–2022). Patient demographics, burn etiology, and total body surface area burned were examined. Chi-squared tests and logistic regression assessed differences between pre-pandemic (2017–2019) and pandemic (2020–2022) cohorts.
Results
Among 618 pediatric burn patients, regional admissions increased by 26 % in 2020, whereas national data demonstrated a 41 % decline. Thermal burns remained the most common etiology, though non-thermal burns increased. Burn admissions rose in infants (<1 year) and school-aged children (5–18 years) but declined in toddlers (1–5 years). Older pediatric age (p = 0.03) and thermal burns (p < 0.01) were significant risk factors.
Conclusions
Regional pediatric burn admissions rose during the pandemic despite a national decline, underscoring the need for targeted prevention strategies and improved burn center preparedness for future public health crises.
{"title":"Comparative analysis of changes in pediatric burn epidemiology between national burn registry and regional burn center data during the COVID-19 pandemic","authors":"Ronald M. Cornely , Sara C. Chaker , Andrew J. James , Ariel Vinson , Barite Gutama , Ronnie N. Mubang , Elizabeth Slater , William Lineaweaver","doi":"10.1016/j.burns.2025.107844","DOIUrl":"10.1016/j.burns.2025.107844","url":null,"abstract":"<div><h3>Background</h3><div>The COVID-19 pandemic caused major societal disruptions, including shifts in childcare, remote learning, and parental work-from-home responsibilities, potentially altering pediatric burn incidence. This study compares pediatric burn admission numbers, etiology, and severity at a regional burn center to national trends before and during the pandemic.</div></div><div><h3>Methods</h3><div>A retrospective cohort study analyzed pediatric burn admissions and reported their proportion of total burns from a regional burn center and the American Burn Association National Burn Repository (2017–2022). Patient demographics, burn etiology, and total body surface area burned were examined. Chi-squared tests and logistic regression assessed differences between pre-pandemic (2017–2019) and pandemic (2020–2022) cohorts.</div></div><div><h3>Results</h3><div>Among 618 pediatric burn patients, regional admissions increased by 26 % in 2020, whereas national data demonstrated a 41 % decline. Thermal burns remained the most common etiology, though non-thermal burns increased. Burn admissions rose in infants (<1 year) and school-aged children (5–18 years) but declined in toddlers (1–5 years). Older pediatric age (p = 0.03) and thermal burns (p < 0.01) were significant risk factors.</div></div><div><h3>Conclusions</h3><div>Regional pediatric burn admissions rose during the pandemic despite a national decline, underscoring the need for targeted prevention strategies and improved burn center preparedness for future public health crises.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"52 2","pages":"Article 107844"},"PeriodicalIF":2.9,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145866156","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 : 2025-12-25DOI: 10.1016/j.burns.2025.107846
Bastian Garmroudi , Thomas Haider , Carmen Haider , Philipp Hacker , Gregor Werba , Hendrik Jan Ankersmit , Stefan Hacker
Background
Severe burn injuries trigger a complex systemic response, including dysregulated inflammation and immunosuppression. Heat shock proteins (HSPs) regulate cellular stress responses and have immunomodulatory functions when released into the extracellular compartment. Our aim was to investigate the release of systemic HSP27 and 70 in patients suffering from severe burn injury.
Methods
We analyzed serum HSP27 and HSP70 concentrations in 32 burn patients admitted to our burn intensive care unit with a total body surface area (TBSA) affected of > 10 % in comparison to eight healthy control probands. HSP27 and 70 concentrations were determined serially for four weeks using enzyme-linked immunosorbent assays (ELISA).
Results
The mean TBSA was 32.5 % ± 19.6 %, and in-hospital mortality occurred in six patients (18.8 %). HSP27 and HSP70 concentrations were significantly elevated in burn patients compared to controls, with peak concentrations on the day of admission (HSP27: 590 ± 335 vs. 83 ± 42 pg/mL, p < 0.001; HSP70: 1961 ± 2214 vs. 189 ± 130 pg/mL, p < 0.001). HSP70 concentrations were significantly higher in non-survivors (1143 vs. 946 pg/mL, p < 0.05) and were significantly higher in patients with more than 29 % TBSA compared to patients with lower TBSA (p < 0.01). Receiver operating characteristic curve analysis identified HSP70 measured on the day of admission as a significant predictor of patient mortality.
Conclusion
Severe thermal trauma results in elevated HSP27 and HSP70 concentrations. Increased HSP70 levels are associated with higher in-hospital mortality in burn patients, suggesting potential use as a prognostic biomarker.
{"title":"Increased systemic heat-shock protein 27 and 70 following severe burn injury","authors":"Bastian Garmroudi , Thomas Haider , Carmen Haider , Philipp Hacker , Gregor Werba , Hendrik Jan Ankersmit , Stefan Hacker","doi":"10.1016/j.burns.2025.107846","DOIUrl":"10.1016/j.burns.2025.107846","url":null,"abstract":"<div><h3>Background</h3><div>Severe burn injuries trigger a complex systemic response, including dysregulated inflammation and immunosuppression. Heat shock proteins (HSPs) regulate cellular stress responses and have immunomodulatory functions when released into the extracellular compartment. Our aim was to investigate the release of systemic HSP27 and 70 in patients suffering from severe burn injury.</div></div><div><h3>Methods</h3><div>We analyzed serum HSP27 and HSP70 concentrations in 32 burn patients admitted to our burn intensive care unit with a total body surface area (TBSA) affected of > 10 % in comparison to eight healthy control probands. HSP27 and 70 concentrations were determined serially for four weeks using enzyme-linked immunosorbent assays (ELISA).</div></div><div><h3>Results</h3><div>The mean TBSA was 32.5 % ± 19.6 %, and in-hospital mortality occurred in six patients (18.8 %). HSP27 and HSP70 concentrations were significantly elevated in burn patients compared to controls, with peak concentrations on the day of admission (HSP27: 590 ± 335 vs. 83 ± 42 pg/mL, p < 0.001; HSP70: 1961 ± 2214 vs. 189 ± 130 pg/mL, p < 0.001). HSP70 concentrations were significantly higher in non-survivors (1143 vs. 946 pg/mL, p < 0.05) and were significantly higher in patients with more than 29 % TBSA compared to patients with lower TBSA (p < 0.01). Receiver operating characteristic curve analysis identified HSP70 measured on the day of admission as a significant predictor of patient mortality.</div></div><div><h3>Conclusion</h3><div>Severe thermal trauma results in elevated HSP27 and HSP70 concentrations. Increased HSP70 levels are associated with higher in-hospital mortality in burn patients, suggesting potential use as a prognostic biomarker.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"52 2","pages":"Article 107846"},"PeriodicalIF":2.9,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023666","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 : 2025-12-25DOI: 10.1016/j.burns.2025.107843
Qinyuan Wang, Chao Sun, Meihong Zhang
{"title":"Comment on \"Clinical study comparing full-thickness skin columns and split-thickness skin graft donor sites in terms of pain and healing outcomes\"","authors":"Qinyuan Wang, Chao Sun, Meihong Zhang","doi":"10.1016/j.burns.2025.107843","DOIUrl":"10.1016/j.burns.2025.107843","url":null,"abstract":"","PeriodicalId":50717,"journal":{"name":"Burns","volume":"52 1","pages":"Article 107843"},"PeriodicalIF":2.9,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145866173","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 : 2025-12-25DOI: 10.1016/j.burns.2025.107845
Nicole J.M. Schweizer , Thomas C. Scheier , Philipp K. Buehler , Bong-Sung Kim , Mauro Vasella , Chun-Chi Chang , Silvio D. Brugger , Pascal M. Frey , Daniel A. Hofmaenner
Background
Burn injuries are associated with significant morbidity and mortality, with infections being a major factor influencing outcomes. Given evidence of sex-related differences in infection risk, we investigated whether such disparities extend to bacteremia in critically ill burn patients.
Methods
We conducted a single-centre cohort study of critically ill patients with severe burn injuries admitted to the Burn Center at the University Hospital Zurich between January 2017 and December 2021. The primary outcome was the association between sex and the development of a first bacteremia episode, analysed using a competing risk regression model accounting for the competing risk of death. Secondary outcomes included the association between sex and ICU mortality, assessed with Cox regression, and the variation of pathogens causing bacteremia by sex.
Results
269 patients were included, of whom 69 (26 %) were female. Median age was 50 years (interquartile range [IQR] 33–65), and the affected median total body surface area was 19 % (IQR 11–30). A first bacteremia occurred in 61 patients (23 %) after a median of 7 days (IQR 5–13), including 21 of 69 female patients (30 %) and 40 of 200 male patients (20 %, p = 0.10). In the fully adjusted competing risk regression model, female sex was associated with the development of bacteremia (subhazard ratio [SHR] 1.98, 95 % CI 1.06–3.70, p = 0.03). Overall ICU mortality was 15 % (n = 40). Although crude mortality was higher among female patients (25 % vs. 12 %, p = 0.01), this difference was not significant after adjustment. Among those with bacteremia (n = 61), the most frequently identified pathogens were Staphylococcus aureus (19 %), Klebsiella pneumoniae (8 %), and Streptococcus mitis/oralis (8 %), with no difference in pathogen distribution between sexes (p = 0.21).
Conclusion
Female sex was associated with a higher bacteremia risk, suggesting sex-specific vulnerability that warrants further investigation. These findings support more tailored infection monitoring and diagnostic strategies in female burn patients during ICU care.
{"title":"Impact of sex on the development of bacteremia in critically ill burn patients: A retrospective cohort study","authors":"Nicole J.M. Schweizer , Thomas C. Scheier , Philipp K. Buehler , Bong-Sung Kim , Mauro Vasella , Chun-Chi Chang , Silvio D. Brugger , Pascal M. Frey , Daniel A. Hofmaenner","doi":"10.1016/j.burns.2025.107845","DOIUrl":"10.1016/j.burns.2025.107845","url":null,"abstract":"<div><h3>Background</h3><div>Burn injuries are associated with significant morbidity and mortality, with infections being a major factor influencing outcomes. Given evidence of sex-related differences in infection risk, we investigated whether such disparities extend to bacteremia in critically ill burn patients.</div></div><div><h3>Methods</h3><div>We conducted a single-centre cohort study of critically ill patients with severe burn injuries admitted to the Burn Center at the University Hospital Zurich between January 2017 and December 2021. The primary outcome was the association between sex and the development of a first bacteremia episode, analysed using a competing risk regression model accounting for the competing risk of death. Secondary outcomes included the association between sex and ICU mortality, assessed with Cox regression, and the variation of pathogens causing bacteremia by sex.</div></div><div><h3>Results</h3><div>269 patients were included, of whom 69 (26 %) were female. Median age was 50 years (interquartile range [IQR] 33–65), and the affected median total body surface area was 19 % (IQR 11–30). A first bacteremia occurred in 61 patients (23 %) after a median of 7 days (IQR 5–13), including 21 of 69 female patients (30 %) and 40 of 200 male patients (20 %, p = 0.10). In the fully adjusted competing risk regression model, female sex was associated with the development of bacteremia (subhazard ratio [SHR] 1.98, 95 % CI 1.06–3.70, p = 0.03). Overall ICU mortality was 15 % (n = 40). Although crude mortality was higher among female patients (25 % vs. 12 %, p = 0.01), this difference was not significant after adjustment. Among those with bacteremia (n = 61), the most frequently identified pathogens were <em>Staphylococcus aureus</em> (19 %), <em>Klebsiella pneumoniae</em> (8 %), and <em>Streptococcus mitis/oralis</em> (8 %), with no difference in pathogen distribution between sexes (p = 0.21).</div></div><div><h3>Conclusion</h3><div>Female sex was associated with a higher bacteremia risk, suggesting sex-specific vulnerability that warrants further investigation. These findings support more tailored infection monitoring and diagnostic strategies in female burn patients during ICU care.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"52 2","pages":"Article 107845"},"PeriodicalIF":2.9,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145866118","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 : 2025-12-23DOI: 10.1016/j.burns.2025.107842
Thomas Langer
{"title":"Ringer’s lactate alone or combined with isotonic sodium bicarbonate for burn resuscitation: Does acid–base correction translate into clinical benefit?","authors":"Thomas Langer","doi":"10.1016/j.burns.2025.107842","DOIUrl":"10.1016/j.burns.2025.107842","url":null,"abstract":"","PeriodicalId":50717,"journal":{"name":"Burns","volume":"52 1","pages":"Article 107842"},"PeriodicalIF":2.9,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879199","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 : 2025-12-23DOI: 10.1016/j.burns.2025.107841
Charlotte I. Cords , Margriet E. van Baar , Ymke Lucas , Sonja M.H.J. Scholten , Marianne K. Nieuwenhuis , Matthea Stoop , Anouk Pijpe , Francesco U.S. Mattace-Raso , Michiel H.J. Verhofstad , Cornelis H. van der Vlies , FRAIL group, Dutch Burn Repository group, FRAIL group , Dutch Burn Repository group , Burn Centre Rotterdam , Burn Centre Groningen , Alliance of Dutch Burn Care
Introduction
Frailty is frequently seen in burn patients aged ≥ 50 years and can negatively influence outcomes, yet performance of available screening tools in specialized burn care remains unclear. This study evaluated feasibility, reliability, and validity of the Clinical Frailty Scale (CFS), Burn Frailty Index (BFI), and Groningen Frailty Indicator (GFI), and determined the prevalence of frailty among patients with burns.
Methodology
A multicentre prospective cohort study was conducted in Dutch burn centres in patients aged ≥ 50 years. Feasibility, inter-rater reliability, predictive validity, known-group validity, convergent validity, and prevalence of frailty and its association with patient characteristics and clinical outcomes were assessed.
Results
Among 145 patients (median age 66 years, median TBSA burned 6.4 %), the CFS and GFI were highly feasible (completion rate up to 97 %), while the BFI was less feasible. Inter-rater reliability was moderate to good for CFS and BFI. Frailty (CFS, BFI, GFI) predicted non-home discharge, but not complications or length of stay. Frail patients were more likely to be older (CFS, BFI), have more comorbidity (CFS, BFI, GFI), and have polypharmacy (CFS, GFI). Frailty scores correlated moderately with reference standards. Frailty prevalence varied: 42.1 % (GFI), 19.4 % (CFS), and 6.2 % (BFI).
Conclusion
Systematic frailty screening can play an important role in acute burn care for older patients, with the CFS emerging as most feasible, reliable, and valid option for clinical implementation.
{"title":"Frailty assessment in middle-aged and older patients with burn injuries, a prospective comparative study on the clinimetric properties of existing screening tools","authors":"Charlotte I. Cords , Margriet E. van Baar , Ymke Lucas , Sonja M.H.J. Scholten , Marianne K. Nieuwenhuis , Matthea Stoop , Anouk Pijpe , Francesco U.S. Mattace-Raso , Michiel H.J. Verhofstad , Cornelis H. van der Vlies , FRAIL group, Dutch Burn Repository group, FRAIL group , Dutch Burn Repository group , Burn Centre Rotterdam , Burn Centre Groningen , Alliance of Dutch Burn Care","doi":"10.1016/j.burns.2025.107841","DOIUrl":"10.1016/j.burns.2025.107841","url":null,"abstract":"<div><h3>Introduction</h3><div>Frailty is frequently seen in burn patients aged ≥ 50 years and can negatively influence outcomes, yet performance of available screening tools in specialized burn care remains unclear. This study evaluated feasibility, reliability, and validity of the Clinical Frailty Scale (CFS), Burn Frailty Index (BFI), and Groningen Frailty Indicator (GFI), and determined the prevalence of frailty among patients with burns.</div></div><div><h3>Methodology</h3><div>A multicentre prospective cohort study was conducted in Dutch burn centres in patients aged ≥ 50 years. Feasibility, inter-rater reliability, predictive validity, known-group validity, convergent validity, and prevalence of frailty and its association with patient characteristics and clinical outcomes were assessed.</div></div><div><h3>Results</h3><div>Among 145 patients (median age 66 years, median TBSA burned 6.4 %), the CFS and GFI were highly feasible (completion rate up to 97 %), while the BFI was less feasible. Inter-rater reliability was moderate to good for CFS and BFI. Frailty (CFS, BFI, GFI) predicted non-home discharge, but not complications or length of stay. Frail patients were more likely to be older (CFS, BFI), have more comorbidity (CFS, BFI, GFI), and have polypharmacy (CFS, GFI). Frailty scores correlated moderately with reference standards. Frailty prevalence varied: 42.1 % (GFI), 19.4 % (CFS), and 6.2 % (BFI).</div></div><div><h3>Conclusion</h3><div>Systematic frailty screening can play an important role in acute burn care for older patients, with the CFS emerging as most feasible, reliable, and valid option for clinical implementation.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"52 2","pages":"Article 107841"},"PeriodicalIF":2.9,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023665","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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