Pub Date : 2024-07-08DOI: 10.1016/j.burns.2024.07.003
H Matar, P R Vuddanda, R P Chilcott
The incidence of "acid attacks" (vitreolage) is a global concern, with those affected often receiving lifelong medical care due to physical and psychological damage. The purpose of this study was to evaluate the effectiveness of several emergency skin decontamination approaches against concentrated (>99 %) sulphuric acid and to identify the effective window of opportunity for decontamination. The effects of four decontamination methods (dry, wet, combined dry & wet and cotton cloth) were assessed using an in vitro diffusion cell system containing dermatomed porcine skin. Sulphuric acid (H2SO4) was applied to the skin with decontamination protocols performed at 10 s, 30 s, 8 min, and 30 min post exposure. Skin damage was quantified by tritiated water (3H2O) penetration, receptor fluid pH and photometric stereo imaging (PSI), with quantification of residual sulphur (by SEM-EDS) to determine overall decontamination efficiency. Skin translucency (quantified by PSI) demonstrated a time-dependent loss of dermal tissue integrity from 10 s. Quantification of dermal sulphur content confirmed the rapid (exponential) decrease in decontamination efficiency with time. The pH of the water effluent indicated complete neutralisation of acid from the skin surface after 90 s of irrigation. Wet decontamination (either alone or immediately following dry decontamination) was the most effective intervention evaluated, although no decontamination technique was statistically effective after 30 s exposure to the acid. These data demonstrate the time-critical consequences of dermal exposure to concentrated sulphuric acid: we find no practical window of opportunity for acid decontamination, as physical damage is virtually instantaneous.
{"title":"Evaluation of emergency skin decontamination protocols in response to an acid attack (vitreolage).","authors":"H Matar, P R Vuddanda, R P Chilcott","doi":"10.1016/j.burns.2024.07.003","DOIUrl":"https://doi.org/10.1016/j.burns.2024.07.003","url":null,"abstract":"<p><p>The incidence of \"acid attacks\" (vitreolage) is a global concern, with those affected often receiving lifelong medical care due to physical and psychological damage. The purpose of this study was to evaluate the effectiveness of several emergency skin decontamination approaches against concentrated (>99 %) sulphuric acid and to identify the effective window of opportunity for decontamination. The effects of four decontamination methods (dry, wet, combined dry & wet and cotton cloth) were assessed using an in vitro diffusion cell system containing dermatomed porcine skin. Sulphuric acid (H<sub>2</sub>SO<sub>4</sub>) was applied to the skin with decontamination protocols performed at 10 s, 30 s, 8 min, and 30 min post exposure. Skin damage was quantified by tritiated water (<sup>3</sup>H<sub>2</sub>O) penetration, receptor fluid pH and photometric stereo imaging (PSI), with quantification of residual sulphur (by SEM-EDS) to determine overall decontamination efficiency. Skin translucency (quantified by PSI) demonstrated a time-dependent loss of dermal tissue integrity from 10 s. Quantification of dermal sulphur content confirmed the rapid (exponential) decrease in decontamination efficiency with time. The pH of the water effluent indicated complete neutralisation of acid from the skin surface after 90 s of irrigation. Wet decontamination (either alone or immediately following dry decontamination) was the most effective intervention evaluated, although no decontamination technique was statistically effective after 30 s exposure to the acid. These data demonstrate the time-critical consequences of dermal exposure to concentrated sulphuric acid: we find no practical window of opportunity for acid decontamination, as physical damage is virtually instantaneous.</p>","PeriodicalId":50717,"journal":{"name":"Burns","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592040","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 : 2024-07-04DOI: 10.1016/j.burns.2024.06.013
Arushi Biswas, Zachary H. Zamore, Zohra Aslami, Rafael Felix P. Tiongco, Ayman Ali, Carisa M. Cooney, Mark D. Fisher, Julie A. Caffrey, Sheera F. Lerman
Burns can cause long-term complications including pain and poor physical function. While neighborhood disadvantage is associated with burn severity, its effect on long-term complications has not been investigated. We hypothesized that patients from areas of higher area of deprivation index (ADI) will report poorer long-term outcomes. We linked patient data from the Burn Model System with ADI state decile (1 =least, 10 =most disadvantaged) using year and residence at time of injury. We performed bivariate analyses to identify associations between ADI and patient and burn characteristics and multivariate regressions to determine whether ADI was associated with PROMIS-29 pain and physical function 6- and 24-months post-burn. We included 780 patients; 69 % male, median age= 46 years, median ADI= 6, and median TBSA= 8 %. Multivariate regressions adjusting for TBSA, race, age, sex, anxiety, depression, and pain interference demonstrated that higher ADI was a significant predictor of higher pain intensity 6- (p = 0.001) and 24-months (p = 0.037) post-burn but not worse physical function 24-months post-burn (p = 0.089). Higher neighborhood disadvantage was associated with higher long-term pain intensity post-burn. This study highlights the importance of socioeconomic factors that may impact long-term outcomes and the use of aggregate markers to identify patients at risk for worse outcomes.
{"title":"The association between neighborhood disadvantage and patient-reported outcomes in burn survivors","authors":"Arushi Biswas, Zachary H. Zamore, Zohra Aslami, Rafael Felix P. Tiongco, Ayman Ali, Carisa M. Cooney, Mark D. Fisher, Julie A. Caffrey, Sheera F. Lerman","doi":"10.1016/j.burns.2024.06.013","DOIUrl":"https://doi.org/10.1016/j.burns.2024.06.013","url":null,"abstract":"Burns can cause long-term complications including pain and poor physical function. While neighborhood disadvantage is associated with burn severity, its effect on long-term complications has not been investigated. We hypothesized that patients from areas of higher area of deprivation index (ADI) will report poorer long-term outcomes. We linked patient data from the Burn Model System with ADI state decile (1 =least, 10 =most disadvantaged) using year and residence at time of injury. We performed bivariate analyses to identify associations between ADI and patient and burn characteristics and multivariate regressions to determine whether ADI was associated with PROMIS-29 pain and physical function 6- and 24-months post-burn. We included 780 patients; 69 % male, median age= 46 years, median ADI= 6, and median TBSA= 8 %. Multivariate regressions adjusting for TBSA, race, age, sex, anxiety, depression, and pain interference demonstrated that higher ADI was a significant predictor of higher pain intensity 6- (p = 0.001) and 24-months (p = 0.037) post-burn but not worse physical function 24-months post-burn (p = 0.089). Higher neighborhood disadvantage was associated with higher long-term pain intensity post-burn. This study highlights the importance of socioeconomic factors that may impact long-term outcomes and the use of aggregate markers to identify patients at risk for worse outcomes.","PeriodicalId":50717,"journal":{"name":"Burns","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141577607","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 : 2024-07-01DOI: 10.1016/j.burns.2024.07.014
V. Haug, C. Tapking, A. Panayi, Anamika Veeramani, S. Knoedler, B. Tchiloemba, Obada Abdulrazzak, Nikita Kadakia, B. Bonaventura, Derek Culnan, U. Kneser, G. Hundeshagen
{"title":"Outcome comparison of the most commonly employed wound coverage techniques in patients with massive burns ≥50% TBSA – A systematic review and meta-analysis","authors":"V. Haug, C. Tapking, A. Panayi, Anamika Veeramani, S. Knoedler, B. Tchiloemba, Obada Abdulrazzak, Nikita Kadakia, B. Bonaventura, Derek Culnan, U. Kneser, G. Hundeshagen","doi":"10.1016/j.burns.2024.07.014","DOIUrl":"https://doi.org/10.1016/j.burns.2024.07.014","url":null,"abstract":"","PeriodicalId":50717,"journal":{"name":"Burns","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141839604","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}
{"title":"National Academy of Burns India (NABI) online tutorials: A pursuance of excellence in burns education","authors":"Veena Kumari Singh, Sanjeev Uppal, Raj Manas, Sameek Bhattacharya","doi":"10.1016/j.burns.2024.07.027","DOIUrl":"https://doi.org/10.1016/j.burns.2024.07.027","url":null,"abstract":"","PeriodicalId":50717,"journal":{"name":"Burns","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141846957","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 : 2024-07-01DOI: 10.1016/j.burns.2024.07.028
Hans-Oliver Rennekampff, Isabelle Rennekampff, M. Tenenhaus
{"title":"Dental health concerns for patients suffering from facial, peri-oral burns and inhalation injury: A persistent yet underappreciated challenge","authors":"Hans-Oliver Rennekampff, Isabelle Rennekampff, M. Tenenhaus","doi":"10.1016/j.burns.2024.07.028","DOIUrl":"https://doi.org/10.1016/j.burns.2024.07.028","url":null,"abstract":"","PeriodicalId":50717,"journal":{"name":"Burns","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141849447","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 : 2024-07-01DOI: 10.1016/j.burns.2024.07.009
Mahta Moghaddam Ahmadi, Moein Moghaddam Ahmadi
{"title":"Enhancing Clinical Outcomes in Burn and Surgical Intensive Care Units Patients","authors":"Mahta Moghaddam Ahmadi, Moein Moghaddam Ahmadi","doi":"10.1016/j.burns.2024.07.009","DOIUrl":"https://doi.org/10.1016/j.burns.2024.07.009","url":null,"abstract":"","PeriodicalId":50717,"journal":{"name":"Burns","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141698590","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 : 2024-07-01DOI: 10.1016/j.burns.2024.07.001
J. Gorenflo, B. Reichert, German Burn Registry, S. Reif, I-F Megas, M. Billner
{"title":"The prognostic relevance of full-thickness burns on ABSI","authors":"J. Gorenflo, B. Reichert, German Burn Registry, S. Reif, I-F Megas, M. Billner","doi":"10.1016/j.burns.2024.07.001","DOIUrl":"https://doi.org/10.1016/j.burns.2024.07.001","url":null,"abstract":"","PeriodicalId":50717,"journal":{"name":"Burns","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141695926","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}
{"title":"The national burden of mortality and its associated factors among burn patients in Ethiopia. A systematic review and meta-analysis","authors":"Mengistu Abebe Messelu, Nega Nigussie Abrha, Haymanot Kitaw Jemberie, Tiruye Azene Demile, Asnake Gashaw Belayneh","doi":"10.1016/j.burns.2024.07.005","DOIUrl":"https://doi.org/10.1016/j.burns.2024.07.005","url":null,"abstract":"","PeriodicalId":50717,"journal":{"name":"Burns","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141709542","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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