Pub Date : 2024-07-18DOI: 10.1016/j.burns.2024.07.019
Godpower C. Michael , Adewale O. Ashimi , Ibrahim Aliyu , Mohammad Riyad
Objectives
To assess burn injury knowledge and its predictors among reproductive-age women attending an urban and a semi-rural hospital in Northwest Nigeria
Design
A descriptive cross-sectional study
Setting
It was conducted in the general and paediatric outpatient clinics of Aminu Kano Teaching Hospital in Kano (urban setting) and the general outpatient, paediatric outpatient and antenatal clinics of Federal Medical Centre Birnin Kudu (semi-rural setting).
Participant
In 2021, 362 women aged 18–44 years were randomly selected from clinic attendees over six weeks. Of them, 217 were from the urban hospital. Data regarding their sociodemographic characteristics and knowledge of burn injuries was collected using a pretested, semi-structured interviewer-administered questionnaire.
Outcome measure
Knowledge of burn injuries
Results
About 83.4 %, 77.1 % and 77.6 % of respondents had adequate general, primary prevention and overall knowledge of burn injuries, respectively. Their mean overall knowledge score was 18.6 out of 24, but only 55.5 % had adequate first-aid knowledge. The study sites did not significantly differ in burns first-aid, prevention and overall knowledge scores. However, urban respondents were more ignorant about the cause of burns and knew that burn injuries could be fatal. More semi-rural respondents knew that flames and chemicals cause burn injuries. Predictors of overall knowledge were age, educational level, number of children in their household, previously seeing a burn-injured child, and primary source of burns-related information.
Conclusions
The proportion of respondents with adequate overall burn injury knowledge was high; however, knowledge gaps exist among them. Overall, their first-aid knowledge was relatively low. The urban and semi-rural respondents had no significant differences in first-aid, prevention, or overall knowledge of burn injuries. However, knowledge of the causes of burns and burn complications differed between the urban and semi-rural study locations. Therefore, the clinical settings of this study present opportunities for similar burn-related educational interventions.
{"title":"Differences in burn injury knowledge among reproductive-age women attending an urban and a semi-rural hospital in Northwest Nigeria: A cross-sectional study","authors":"Godpower C. Michael , Adewale O. Ashimi , Ibrahim Aliyu , Mohammad Riyad","doi":"10.1016/j.burns.2024.07.019","DOIUrl":"10.1016/j.burns.2024.07.019","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess burn injury knowledge and its predictors among reproductive-age women attending an urban and a semi-rural hospital in Northwest Nigeria</div></div><div><h3>Design</h3><div>A descriptive cross-sectional study</div></div><div><h3>Setting</h3><div>It was conducted in the general and paediatric outpatient clinics of Aminu Kano Teaching Hospital in Kano (urban setting) and the general outpatient, paediatric outpatient and antenatal clinics of Federal Medical Centre Birnin Kudu (semi-rural setting).</div></div><div><h3>Participant</h3><div>In 2021, 362 women aged 18–44 years were randomly selected from clinic attendees over six weeks. Of them, 217 were from the urban hospital. Data regarding their sociodemographic characteristics and knowledge of burn injuries was collected using a pretested, semi-structured interviewer-administered questionnaire.</div></div><div><h3>Outcome measure</h3><div>Knowledge of burn injuries</div></div><div><h3>Results</h3><div>About 83.4 %, 77.1 % and 77.6 % of respondents had adequate general, primary prevention and overall knowledge of burn injuries, respectively. Their mean overall knowledge score was 18.6 out of 24, but only 55.5 % had adequate first-aid knowledge. The study sites did not significantly differ in burns first-aid, prevention and overall knowledge scores. However, urban respondents were more ignorant about the cause of burns and knew that burn injuries could be fatal. More semi-rural respondents knew that flames and chemicals cause burn injuries. Predictors of overall knowledge were age, educational level, number of children in their household, previously seeing a burn-injured child, and primary source of burns-related information.</div></div><div><h3>Conclusions</h3><div>The proportion of respondents with adequate overall burn injury knowledge was high; however, knowledge gaps exist among them. Overall, their first-aid knowledge was relatively low. The urban and semi-rural respondents had no significant differences in first-aid, prevention, or overall knowledge of burn injuries. However, knowledge of the causes of burns and burn complications differed between the urban and semi-rural study locations. Therefore, the clinical settings of this study present opportunities for similar burn-related educational interventions.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"50 8","pages":"Pages 1957-1967"},"PeriodicalIF":3.2,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141781679","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 : 2024-07-18DOI: 10.1016/j.burns.2024.07.018
Kate Hunter , Courtney Ryder , Julieann Coombes , Kathleen Clapham , Tamara Mackean , Andrew J.A. Holland , Sarah Fraser , Hayley Williams , Bronwyn Griffin , Holger Möller , Rebecca Q. Ivers , on behalf of the Coolamon Study Investigators
Background
Despite known inequalities, little is understood about the burden and healthcare experiences of Aboriginal and Torres Strait Islander children who sustain a burn injury and their families.
Methods
The Coolamon Study recruited parents and carers whose children (aged <16 years) were Aboriginal and / or Torres Strait Islander children and had presented to burn units across four Australian states, New South Wales (Sydney), Northern Territory (Darwin), Queensland (Brisbane, Townsville) and South Australia (Adelaide), between 2015 and 2018. Consent was obtained and carers completed baseline and subsequent interviews at 3, 6, 12 and 24 months. Data were collected on the injury event, patient care and safety, sociodemographic factors, health related quality of life (PedsQual), and psychological distress (Kessler K-5).
Results
Of the 208 participants, 64 % were male; 26 % were aged less than 2 years and 37 % aged 2–4 years. The most common burn mechanisms were scalds (37 %), contact (33 %) and flame burns (21 %), with more severe burns and flame burns occurring in rural and remote settings. Most carers rated their child’s care as either excellent or very good (82 %). Family distress, measured by the K-5, lessened over the 24 months, however the changes were not statistically significant. While 77 % of carers reported that they received enough information, 18 % reported they would have liked more, and 3 % reported no information was provided before treatment. Parents described mixed access to information about the types of support available to them, such as accommodation, meals, travel or cultural support.
Conclusion
Data from this cohort provide rich new information about risk factors and care received from point of injury through to rehabilitation for Aboriginal and Torres Strait Islander children with burns, providing unique insights into what is needed for appropriate, culturally safe care.
{"title":"Understanding burn injury among Aboriginal and Torres Strait Islander children – results of a two-year cohort study","authors":"Kate Hunter , Courtney Ryder , Julieann Coombes , Kathleen Clapham , Tamara Mackean , Andrew J.A. Holland , Sarah Fraser , Hayley Williams , Bronwyn Griffin , Holger Möller , Rebecca Q. Ivers , on behalf of the Coolamon Study Investigators","doi":"10.1016/j.burns.2024.07.018","DOIUrl":"10.1016/j.burns.2024.07.018","url":null,"abstract":"<div><h3>Background</h3><div>Despite known inequalities, little is understood about the burden and healthcare experiences of Aboriginal and Torres Strait Islander children who sustain a burn injury and their families.</div></div><div><h3>Methods</h3><div>The Coolamon Study recruited parents and carers whose children (aged <16 years) were Aboriginal and / or Torres Strait Islander children and had presented to burn units across four Australian states, New South Wales (Sydney), Northern Territory (Darwin), Queensland (Brisbane, Townsville) and South Australia (Adelaide), between 2015 and 2018. Consent was obtained and carers completed baseline and subsequent interviews at 3, 6, 12 and 24 months. Data were collected on the injury event, patient care and safety, sociodemographic factors, health related quality of life (PedsQual), and psychological distress (Kessler K-5).</div></div><div><h3>Results</h3><div>Of the 208 participants, 64 % were male; 26 % were aged less than 2 years and 37 % aged 2–4 years. The most common burn mechanisms were scalds (37 %), contact (33 %) and flame burns (21 %), with more severe burns and flame burns occurring in rural and remote settings. Most carers rated their child’s care as either excellent or very good (82 %). Family distress, measured by the K-5, lessened over the 24 months, however the changes were not statistically significant. While 77 % of carers reported that they received enough information, 18 % reported they would have liked more, and 3 % reported no information was provided before treatment. Parents described mixed access to information about the types of support available to them, such as accommodation, meals, travel or cultural support.</div></div><div><h3>Conclusion</h3><div>Data from this cohort provide rich new information about risk factors and care received from point of injury through to rehabilitation for Aboriginal and Torres Strait Islander children with burns, providing unique insights into what is needed for appropriate, culturally safe care.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"50 8","pages":"Pages 1947-1956"},"PeriodicalIF":3.2,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-17DOI: 10.1016/j.burns.2024.07.017
M.D. Cuijpers, A. Meij - de Vries, P.P.M. van Zuijlen, M.G.A. Baartmans, M. Nieuwenhuis, M.E. van Baar, A. Pijpe, Dutch Burn Repository Group
This study aimed to examine the prevalence and predictors of reconstructive surgery among pediatric burn patients in the Netherlands. Pediatric burn patients were identified through the Dutch Burn Repository R3. Eligibility criteria included a burn requiring hospital admission or surgical treatment at one of the Dutch burn centers in 2009–2019. First, patient, burn, and treatment characteristics were summarized using descriptive statistics. Second, time to the first reconstructive surgery was modelled using Kaplan Meier curves. Third, a prediction model was developed using univariate and multivariate logistic regression. The model’s performance was assessed using calibration, discrimination, and explained variance. Fourth, internal validation was performed using bootstrapping. Approximately three percent (n = 84) of pediatric patients (n = 3072) required reconstructive surgery between the initial burn-related hospital admission and September 2021. Median time to the first reconstructive surgery was 1.2 (0.7–1.6) years. Most surgeries were performed on the face, arm, neck, hand, or anterior trunk, owing to contractures or hypertrophic scarring. Predictors of reconstruction included the etiology, anatomical site, extent of full-thickness burn, surgical treatment in the acute phase, and length of hospital stay. Our study provided an overview of the prevalence and independent predictors of reconstructive surgery in the pediatric burn population.
{"title":"The prevalence and predictors of reconstructive surgery in pediatric burn care","authors":"M.D. Cuijpers, A. Meij - de Vries, P.P.M. van Zuijlen, M.G.A. Baartmans, M. Nieuwenhuis, M.E. van Baar, A. Pijpe, Dutch Burn Repository Group","doi":"10.1016/j.burns.2024.07.017","DOIUrl":"https://doi.org/10.1016/j.burns.2024.07.017","url":null,"abstract":"This study aimed to examine the prevalence and predictors of reconstructive surgery among pediatric burn patients in the Netherlands. Pediatric burn patients were identified through the Dutch Burn Repository R3. Eligibility criteria included a burn requiring hospital admission or surgical treatment at one of the Dutch burn centers in 2009–2019. First, patient, burn, and treatment characteristics were summarized using descriptive statistics. Second, time to the first reconstructive surgery was modelled using Kaplan Meier curves. Third, a prediction model was developed using univariate and multivariate logistic regression. The model’s performance was assessed using calibration, discrimination, and explained variance. Fourth, internal validation was performed using bootstrapping. Approximately three percent (n = 84) of pediatric patients (n = 3072) required reconstructive surgery between the initial burn-related hospital admission and September 2021. Median time to the first reconstructive surgery was 1.2 (0.7–1.6) years. Most surgeries were performed on the face, arm, neck, hand, or anterior trunk, owing to contractures or hypertrophic scarring. Predictors of reconstruction included the etiology, anatomical site, extent of full-thickness burn, surgical treatment in the acute phase, and length of hospital stay. Our study provided an overview of the prevalence and independent predictors of reconstructive surgery in the pediatric burn population.","PeriodicalId":50717,"journal":{"name":"Burns","volume":"27 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141781680","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 : 2024-07-10DOI: 10.1016/j.burns.2024.07.009
Mahta Moghaddam Ahmadi, Moein Moghaddam Ahmadi
{"title":"Enhancing clinical outcomes in burn and surgical intensive care unit patients","authors":"Mahta Moghaddam Ahmadi, Moein Moghaddam Ahmadi","doi":"10.1016/j.burns.2024.07.009","DOIUrl":"10.1016/j.burns.2024.07.009","url":null,"abstract":"","PeriodicalId":50717,"journal":{"name":"Burns","volume":"50 8","pages":"Pages 2137-2138"},"PeriodicalIF":3.2,"publicationDate":"2024-07-10","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 : 2024-07-08DOI: 10.1016/j.burns.2024.07.003
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":"","doi":"10.1016/j.burns.2024.07.003","DOIUrl":"10.1016/j.burns.2024.07.003","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"50 8","pages":"Pages 1968-1976"},"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":"OA","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":"125 1","pages":""},"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 : 2024-06-27DOI: 10.1016/j.burns.2024.06.011
Yu-Xuan Zhang, Yuan Zhou, Yu-Yun Xiong, Yu-Mei Li
Various methods have been used for in vivo and in vitro skin regeneration, including stem cell therapy, tissue engineering, 3D printing, and platelet-rich plasma (PRP) injection therapy. However, these approaches are rooted in the existing knowledge of skin structures, which overlook the normal physiological processes of skin development and fall short of replicating the skin's regenerative processes outside the body. This comprehensive review, primarily focuses on skin organoids derived from human pluripotent stem cells, which have the capacity to regenerate human skin tissue by restoring the embryonic skin structure, thus offering a novel avenue for producing in vitro skin substitutes. Furthermore, they contribute to the repair of damaged skin lesions in patients with systemic sclerosis or severe burns. Particular emphasis will be placed on the origins, generations, and applications of skin organoids, especially in dermatology, and the challenges that must be addressed before clinical implementation.
{"title":"Beyond skin deep: Revealing the essence of ips cell-generated skin organoids in regeneration","authors":"Yu-Xuan Zhang, Yuan Zhou, Yu-Yun Xiong, Yu-Mei Li","doi":"10.1016/j.burns.2024.06.011","DOIUrl":"https://doi.org/10.1016/j.burns.2024.06.011","url":null,"abstract":"Various methods have been used for in vivo and in vitro skin regeneration, including stem cell therapy, tissue engineering, 3D printing, and platelet-rich plasma (PRP) injection therapy. However, these approaches are rooted in the existing knowledge of skin structures, which overlook the normal physiological processes of skin development and fall short of replicating the skin's regenerative processes outside the body. This comprehensive review, primarily focuses on skin organoids derived from human pluripotent stem cells, which have the capacity to regenerate human skin tissue by restoring the embryonic skin structure, thus offering a novel avenue for producing in vitro skin substitutes. Furthermore, they contribute to the repair of damaged skin lesions in patients with systemic sclerosis or severe burns. Particular emphasis will be placed on the origins, generations, and applications of skin organoids, especially in dermatology, and the challenges that must be addressed before clinical implementation.","PeriodicalId":50717,"journal":{"name":"Burns","volume":"74 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141502680","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 : 2024-06-24DOI: 10.1016/j.burns.2024.06.009
Marco Aurelio Cruciol Rodrigues, Marcos Toshiyuki Tanita, André José Yabar Alfaro, Cintia Magalhães Carvalho Grion
To analyze, through the responses of physicians who work in burn treatment units, their demographic profiles and academic backgrounds, the structure available for patient care, the adoption of care protocols, support from medical and multidisciplinary specialties, and the main challenges faced by these professionals. Cross-sectional study of the survey type carried out from March 2020 to April 2021 through a questionnaire constructed according to the Delphi method. The questionnaire was applied online to plastic surgeons and intensivists who work in burn units. A list was obtained of Brazilian centers, as well as the epidemiological and academic profile of the medical team, level of structure, treatment protocols, and restrictions and challenges encountered. The majority of the burn centers are located in the South and Southeast of the country, and are references for care for populations of over 1000,000 inhabitants. Professionals are between 30 and 60 years old, and have been concentrating on burn victims for between 5 and 15 years. For the most part, the professionals performed their skills training in the centers where they work, which, in turn, have a strong academic tendency, with medical residency programs and other specialties. Burn care protocols, together with related clinical conditions such as surgery, measurement of the burned area, use of antibiotics, thromboembolic prophylaxis, nutrition, physical therapy, and nursing care are widespread and the greatest difficulties pointed out are the serious nature of the burn and infections. The demand for procedures, and regulatory and reception flows seem to be coordinated and in line with regional needs. Burn treatment units are widespread throughout the country, at different levels of complexity. The most frequent organization is a regional reference center, with care for more than one million inhabitants, located within a tertiary hospital. Most professionals are between 30 and 60 years old, with more than 5 years of experience in burns. The majority of centers demonstrate well-established clinical, surgical, dressing, and global patient care protocols. The complexity of cases, patterns of resistance, and bacterial colonization are important challenges throughout Brazil.
{"title":"Patient care for burn victims in Brazil: A national survey","authors":"Marco Aurelio Cruciol Rodrigues, Marcos Toshiyuki Tanita, André José Yabar Alfaro, Cintia Magalhães Carvalho Grion","doi":"10.1016/j.burns.2024.06.009","DOIUrl":"https://doi.org/10.1016/j.burns.2024.06.009","url":null,"abstract":"To analyze, through the responses of physicians who work in burn treatment units, their demographic profiles and academic backgrounds, the structure available for patient care, the adoption of care protocols, support from medical and multidisciplinary specialties, and the main challenges faced by these professionals. Cross-sectional study of the survey type carried out from March 2020 to April 2021 through a questionnaire constructed according to the Delphi method. The questionnaire was applied online to plastic surgeons and intensivists who work in burn units. A list was obtained of Brazilian centers, as well as the epidemiological and academic profile of the medical team, level of structure, treatment protocols, and restrictions and challenges encountered. The majority of the burn centers are located in the South and Southeast of the country, and are references for care for populations of over 1000,000 inhabitants. Professionals are between 30 and 60 years old, and have been concentrating on burn victims for between 5 and 15 years. For the most part, the professionals performed their skills training in the centers where they work, which, in turn, have a strong academic tendency, with medical residency programs and other specialties. Burn care protocols, together with related clinical conditions such as surgery, measurement of the burned area, use of antibiotics, thromboembolic prophylaxis, nutrition, physical therapy, and nursing care are widespread and the greatest difficulties pointed out are the serious nature of the burn and infections. The demand for procedures, and regulatory and reception flows seem to be coordinated and in line with regional needs. Burn treatment units are widespread throughout the country, at different levels of complexity. The most frequent organization is a regional reference center, with care for more than one million inhabitants, located within a tertiary hospital. Most professionals are between 30 and 60 years old, with more than 5 years of experience in burns. The majority of centers demonstrate well-established clinical, surgical, dressing, and global patient care protocols. The complexity of cases, patterns of resistance, and bacterial colonization are important challenges throughout Brazil.","PeriodicalId":50717,"journal":{"name":"Burns","volume":"40 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141502681","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 : 2024-06-22DOI: 10.1016/j.burns.2024.06.005
Amal Sharaf , Philip Turpin, Neil Ullyott, Preetha Muthayya
We previously published the microbial profile of burn wounds managed with NexoBrid® in Pinderfields Regional Burns Centre, Wakefield, UK. Our results showed no significant changes in bacterial colonisation in burn wounds debrided with NexoBrid®. Previous studies described the antimicrobial properties of bromelain enzyme. To date, the effects of NexoBrid® on microorganisms have not been reported. In this study, a series of lab experiments were conducted to investigate the antimicrobial properties of NexoBrid®. Mueller-Hinton agar plates were pre-treated with NexoBrid® and inoculated with common pathogens after serial dilution. Our results revealed that the pre-treated plates showed reduction in the growth of E. faecalis and S. aureus. No zones of inhibition were observed around NexoBrid® after 18 h of incubation. Where a combination of controls and test solutions were added, no zones of inhibition were seen around the NexoBrid® wells in any of fifty tested organisms. The slightly lower infection rates observed in patients treated with NexoBrid® are more likely to be due to efficient selective debridement of necrotic skin rather than direct antimicrobial action.
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