To compare the effectiveness of hypertonic solutions versus balanced crystalloids on mortality in severely burned patients.
Material and methods
A systematic review was performed, following the PRISMA guidelines and the recommendations of the Cochrane Collaboration. We searched Medline, EMBASE, CENTRAL, and LILACS for studies comparing hypertonic solutions (HTS) and balanced crystalloids (BCS) for resuscitation in burn patients. Outcomes included mortality, urine output, and total fluid volume infused at 24 h.
Results
The review and analysis included six studies. Meta-analysis showed a significant disadvantage in survival for HTS versus BCS (OR for survival 0.42, 95 % CI 0.25–0.70, I2: 0 %), equating to a higher mortality risk with HTS. This finding persisted even though HTS reduced fluid requirements in patients with major burns (>30 % TBSA).
Conclusion
This meta-analysis suggests that the use of hypertonic solutions for resuscitation of severely burned patients is associated with a significantly higher risk of mortality compared to balanced crystalloids. This strong signal advocates a cautious clinical approach, favoring balanced crystalloids for resuscitation. However, more methodologically robust studies are needed to establish causality.
目的比较高渗液与平衡晶体液对严重烧伤患者死亡率的影响。材料和方法按照PRISMA指南和Cochrane协作网的建议进行系统评价。我们检索了Medline、EMBASE、CENTRAL和LILACS，以比较高渗溶液（HTS）和平衡晶体（BCS）在烧伤患者复苏中的作用。结果包括死亡率、尿量和24小时输注总液体体积。结果回顾和分析包括6项研究。荟萃分析显示，与BCS相比，HTS在生存方面存在显著劣势（OR为0.42,95% CI 0.25-0.70, I2: 0%），相当于HTS的死亡风险更高。即使HTS降低了严重烧伤患者（30% TBSA）的液体需要量，这一发现仍然存在。结论：本荟萃分析表明，与平衡晶体液相比，使用高渗溶液对严重烧伤患者进行复苏与明显更高的死亡风险相关。这个强烈的信号提倡谨慎的临床方法，倾向于平衡晶体的复苏。然而，需要更多方法学上可靠的研究来确定因果关系。
{"title":"Hypertonic solutions versus balanced crystalloids in severely burned patients: A systematic review and meta-analysis","authors":"Romario Rivera-Sanabria , María-Paula Benavides , Paola-Fernanda Orbes","doi":"10.1016/j.burnso.2026.100444","DOIUrl":"10.1016/j.burnso.2026.100444","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the effectiveness of hypertonic solutions versus balanced crystalloids on mortality in severely burned patients.</div></div><div><h3>Material and methods</h3><div>A systematic review was performed, following the PRISMA guidelines and the recommendations of the Cochrane Collaboration. We searched Medline, EMBASE, CENTRAL, and LILACS for studies comparing hypertonic solutions (HTS) and balanced crystalloids (BCS) for resuscitation in burn patients. Outcomes included mortality, urine output, and total fluid volume infused at 24 h.</div></div><div><h3>Results</h3><div>The review and analysis included six studies. Meta-analysis showed a significant disadvantage in survival for HTS versus BCS (OR for survival 0.42, 95 % CI 0.25–0.70, I<sup>2</sup>: 0 %), equating to a higher mortality risk with HTS. This finding persisted even though HTS reduced fluid requirements in patients with major burns (>30 % TBSA).</div></div><div><h3>Conclusion</h3><div>This meta-analysis suggests that the use of hypertonic solutions for resuscitation of severely burned patients is associated with a significantly higher risk of mortality compared to balanced crystalloids. This strong signal advocates a cautious clinical approach, favoring balanced crystalloids for resuscitation. However, more methodologically robust studies are needed to establish causality.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"14 ","pages":"Article 100444"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146098584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.burnso.2025.100433
Kangdi Li , Jia Jia , Wu Jun , Yujie Cui , Xinfeng Huang , Jiaqi Xu
Background
Maintaining lower limb positioning is essential during burn debridement and grafting. Traditional manual traction or mechanical supports are labor-intensive and lack flexibility. We designed a novel ceiling-mounted traction system to optimize manpower use and improve surgical field exposure.
Methods
A ceiling-mounted elliptical track with an adjustable hook system was developed, allowing real-time adjustment of traction height (0–70 cm) and angle (0°–90°). Twenty-two patients (40 procedures) with deep partial- or full-thickness lower limb burns were.
randomized to an experimental group using the new device (n = 20) or a control group with manual traction (n = 20). Surgeon fatigue and surgical field exposure were assessed using a 10-point Visual Analog Scale (VAS).
Results
Compared with the control group, the experimental group reported significantly lower fatigue scores in medial, lateral, and posterior regions (p < 0.001), with no difference in the anterior region. Surgical field exposure satisfaction was also significantly higher in the experimental group for medial, lateral, and posterior regions (p < 0.001), with no difference in the anterior region.
Conclusion
The adjustable ceiling-mounted traction system enables rapid intraoperative repositioning, reduces surgeon fatigue, and enhances surgical field exposure, particularly in posterior lower limb areas. This method offers a feasible solution for manpower optimization in burn surgery.
{"title":"Workforce-optimized traction method for lower limb burn surgery: Intraoperative verification","authors":"Kangdi Li , Jia Jia , Wu Jun , Yujie Cui , Xinfeng Huang , Jiaqi Xu","doi":"10.1016/j.burnso.2025.100433","DOIUrl":"10.1016/j.burnso.2025.100433","url":null,"abstract":"<div><h3>Background</h3><div>Maintaining lower limb positioning is essential during burn debridement and grafting. Traditional manual traction or mechanical supports are labor-intensive and lack flexibility. We designed a novel ceiling-mounted traction system to optimize manpower use and improve surgical field exposure.</div></div><div><h3>Methods</h3><div>A ceiling-mounted elliptical track with an adjustable hook system was developed, allowing real-time adjustment of traction height (0–70 cm) and angle (0°–90°). Twenty-two patients (40 procedures) with deep partial- or full-thickness lower limb burns were.</div><div>randomized to an experimental group using the new device (n = 20) or a control group with manual traction (n = 20). Surgeon fatigue and surgical field exposure were assessed using a 10-point Visual Analog Scale (VAS).</div></div><div><h3>Results</h3><div>Compared with the control group, the experimental group reported significantly lower fatigue scores in medial, lateral, and posterior regions (p < 0.001), with no difference in the anterior region. Surgical field exposure satisfaction was also significantly higher in the experimental group for medial, lateral, and posterior regions (p < 0.001), with no difference in the anterior region.</div></div><div><h3>Conclusion</h3><div>The adjustable ceiling-mounted traction system enables rapid intraoperative repositioning, reduces surgeon fatigue, and enhances surgical field exposure, particularly in posterior lower limb areas. This method offers a feasible solution for manpower optimization in burn surgery.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"13 ","pages":"Article 100433"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-17DOI: 10.1016/j.burnso.2025.100441
Michelle Hui Chin NEO , Claire Marie SHRESTHA , Li Xin Hannah CHEANG , Hui Chai FONG
Background
The Revised Baux (rBaux) Score is used to predict mortality in burn patients but has reduced accuracy at extremes of age and does not account for comorbidities – factors relevant in an ageing population. This study assessed rBaux mortality thresholds for adult burn patients and formulates a burn mortality model for Southeast Asian patients that includes comorbidities.
Materials and methods
We conducted a retrospective analysis of 720 adult admissions to the Burns Unit at a Southeast Asian tertiary unit from January 2019 to December 2023. After excluding patients with Toxic Epidermal Necrolysis and Stevens-Johnson Syndrome, data from 649 patients on demographics, Total Body Surface Area (TBSA), inhalation injury, and Charlson Comorbidity Index (CCI) were analysed to identify mortality predictors, forming the basis of a new model.
Results
Of the 649 patients, 22 (3.39 %) died. Mortality was associated with higher age (median 53 vs. 42 years, p = 0.025), larger TBSA (73.5 % vs. 4.5 %, p < 0.001), inhalation injury (77.3 % vs. 33.5 %, p < 0.001), and higher CCI (2.5 vs. 0, p < 0.015). Predictive mortality thresholds were identified using rBaux, at 100 %, 75 %, and 50 % with scores of 159, 139, and 128, respectively. Multivariate analysis confirmed age, TBSA (in increments of 10 %)and Chronic Heart Failure (CHF) as independent predictors. Hence producing a new model with the following predictors: age, TBSA (in increments of 10 %), inhalation injury and Chronic Heart Failure (CHF). This new model had a Hosmer-Lemeshow. p-value of 0.77 and ROC area of 0.97, indicating excellent fit.
Conclusions
This model improves burn mortality predictions for Southeast Asian adults by incorporating comorbidities like CHF. Although more complex than rBaux, it offers better patient management potential, meriting further regional validation.
{"title":"Validation of the revised Baux score to predict mortality and formulation of a new model for burns mortality in Southeast Asian patients","authors":"Michelle Hui Chin NEO , Claire Marie SHRESTHA , Li Xin Hannah CHEANG , Hui Chai FONG","doi":"10.1016/j.burnso.2025.100441","DOIUrl":"10.1016/j.burnso.2025.100441","url":null,"abstract":"<div><h3>Background</h3><div>The Revised Baux (rBaux) Score is used to predict mortality in burn patients but has reduced accuracy at extremes of age and does not account for comorbidities – factors relevant in an ageing population. This study assessed rBaux mortality thresholds for adult burn patients and formulates a burn mortality model for Southeast Asian patients that includes comorbidities.</div></div><div><h3>Materials and methods</h3><div>We conducted a retrospective analysis of 720 adult admissions to the Burns Unit at a Southeast Asian tertiary unit from January 2019 to December 2023. After excluding patients with Toxic Epidermal Necrolysis and Stevens-Johnson Syndrome, data from 649 patients on demographics, Total Body Surface Area (TBSA), inhalation injury, and Charlson Comorbidity Index (CCI) were analysed to identify mortality predictors, forming the basis of a new model.</div></div><div><h3>Results</h3><div>Of the 649 patients, 22 (3.39 %) died. Mortality was associated with higher age (median 53 vs. 42 years, p = 0.025), larger TBSA (73.5 % vs. 4.5 %, p < 0.001), inhalation injury (77.3 % vs. 33.5 %, p < 0.001), and higher CCI (2.5 vs. 0, p < 0.015). Predictive mortality thresholds were identified using rBaux, at 100 %, 75 %, and 50 % with scores of 159, 139, and 128, respectively. Multivariate analysis confirmed age, TBSA (in increments of 10 %)and Chronic Heart Failure (CHF) as independent predictors. Hence producing a new model with the following predictors: age, TBSA (in increments of 10 %), inhalation injury and Chronic Heart Failure (CHF). This new model had a Hosmer-Lemeshow. p-value of 0.77 and ROC area of 0.97, indicating excellent fit.</div></div><div><h3>Conclusions</h3><div>This model improves burn mortality predictions for Southeast Asian adults by incorporating comorbidities like CHF. Although more complex than rBaux, it offers better patient management potential, meriting further regional validation.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"13 ","pages":"Article 100441"},"PeriodicalIF":0.0,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-17DOI: 10.1016/j.burnso.2025.100440
Soman Sen , Jason Heard , Tina Palmieri , Kathleen Romanowski
Burn injuries among unhoused individuals are a growing public health concern, with unique challenges related to the environments in which unhoused people live and the limited access they have to preventive resources and healthcare. Experiencing homelessness is associated with higher rates of morbidity and mortality from burns due to environmental exposure, inadequate living conditions, and delayed medical intervention. This review will discuss the epidemiology, mechanisms of burn injury, outcomes after burn injury, the role of mental health, preventive strategies, and the social and economic issues that heighten the risk of burns in unhoused populations. The review will also delve into areas of advocacy and research to reduce the risk of burn injury and address areas of treatment and recovery for unhoused patients.
{"title":"The unhoused burn patient: an unmet need for prevention, treatment, and recovery","authors":"Soman Sen , Jason Heard , Tina Palmieri , Kathleen Romanowski","doi":"10.1016/j.burnso.2025.100440","DOIUrl":"10.1016/j.burnso.2025.100440","url":null,"abstract":"<div><div>Burn injuries among unhoused individuals are a growing public health concern, with unique challenges related to the environments in which unhoused people live and the limited access they have to preventive resources and healthcare. Experiencing homelessness is associated with higher rates of morbidity and mortality from burns due to environmental exposure, inadequate living conditions, and delayed medical intervention. This review will discuss the epidemiology, mechanisms of burn injury, outcomes after burn injury, the role of mental health, preventive strategies, and the social and economic issues that heighten the risk of burns in unhoused populations. The review will also delve into areas of advocacy and research to reduce the risk of burn injury and address areas of treatment and recovery for unhoused patients.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"13 ","pages":"Article 100440"},"PeriodicalIF":0.0,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-11DOI: 10.1016/j.burnso.2025.100438
Huzaifah Khan , Mauz Asghar , Xi Ming Zhu , Shahriar Shahrokhi
Physicians often face time constraints that may impact the delivery of patient education. Large language models have illustrated promising results in patient education across various specialties. The present study’s aim was to investigate the quality and readability of ChatGPT- generated handouts on burns and compare these results to a published handout. We asked ChatGPT-4o to generate and regenerate patient handouts for seven topics regarding burns. These handouts, along with a patient handout with similar topics published by Hamilton Health Sciences, were assessed. The Quality of Generated Language Outputs for Patients (QGLOP) scale was used to assess handouts based on accuracy/comprehensiveness, bias, currency, and tone, where each domain was scored out of 4 for a total of 16. The Simple Measure of Gobbledygook (SMOG) score was calculated to assess handout readability. The threshold for statistical significance was set at p < 0.05. The mean QGLOP scores for the ChatGPT-4o generated handouts and the published handout did not significantly differ. The mean QGLOP scores between ChatGPT-4o and the published handout were not significantly different for accuracy, bias, currency, and tone. ChatGPT-4o had lower scores on the topic of skin care, but higher scores on coping with burns. The two groups did not significantly differ for any other topic. We found that ChatGPT could produce patient education handouts on burns with scores comparable to those of a patient handout published by a burn unit, suggesting that plastic surgeons would have a similar level of satisfaction for both groups.
{"title":"Assessment of patient handouts on burns created by burn surgeons compared to ChatGPT-4o","authors":"Huzaifah Khan , Mauz Asghar , Xi Ming Zhu , Shahriar Shahrokhi","doi":"10.1016/j.burnso.2025.100438","DOIUrl":"10.1016/j.burnso.2025.100438","url":null,"abstract":"<div><div>Physicians often face time constraints that may impact the delivery of patient education. Large language models have illustrated promising results in patient education across various specialties. The present study’s aim was to investigate the quality and readability of ChatGPT- generated handouts on burns and compare these results to a published handout. We asked ChatGPT-4o to generate and regenerate patient handouts for seven topics regarding burns. These handouts, along with a patient handout with similar topics published by Hamilton Health Sciences, were assessed. The Quality of Generated Language Outputs for Patients (QGLOP) scale was used to assess handouts based on accuracy/comprehensiveness, bias, currency, and tone, where each domain was scored out of 4 for a total of 16. The Simple Measure of Gobbledygook (SMOG) score was calculated to assess handout readability. The threshold for statistical significance was set at p < 0.05. The mean QGLOP scores for the ChatGPT-4o generated handouts and the published handout did not significantly differ. The mean QGLOP scores between ChatGPT-4o and the published handout were not significantly different for accuracy, bias, currency, and tone. ChatGPT-4o had lower scores on the topic of skin care, but higher scores on coping with burns. The two groups did not significantly differ for any other topic. We found that ChatGPT could produce patient education handouts on burns with scores comparable to those of a patient handout published by a burn unit, suggesting that plastic surgeons would have a similar level of satisfaction for both groups.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"13 ","pages":"Article 100438"},"PeriodicalIF":0.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145839976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Burn wounds are highly susceptible to microbial colonization, especially by multidrug-resistant organisms (MDROs), contributing significantly to morbidity in resource-limited settings. Understanding local microbial patterns is essential for guiding empirical antibiotic selection and infection control practices. This study investigated the temporal profile of bacterial colonization and antimicrobial resistance in burn wounds at a tertiary care center in Northeast India.
Methods
A prospective study of 100 burn patients was conducted over six months. Wound swabs were collected on admission (Day 0) and Day 7. Bacterial identification and antimicrobial susceptibility testing were performed using the VITEK®2 system, interpreted per CLSI guidelines. Clinical infection was defined based on standard signs correlated with culture results.
Results
Bacterial growth increased from 25% on Day 0 to 91% on Day 7. Early cultures showed predominance of Staphylococcus aureus, whereas Day 7 cultures revealed a shift toward Gram-negative organisms, mainly Pseudomonas aeruginosa (36%) and Acinetobacter baumannii (16%). More than 70% of Gram-negative isolates exhibited resistance to cephalosporins and fluoroquinolones. Clinical burn wound infection occurred in 23 patients (23%), most commonly due to MDR Pseudomonas. Carbapenem resistance was identified in a subset of Acinetobacter isolates.
Conclusion
Burn wound colonization in our center transitions rapidly toward MDR Gram-negative pathogens, reinforcing the need for updated local antibiograms, culture-guided therapy, and strengthened infection prevention strategies. Focused antimicrobial stewardship and improved wound care workflows are essential to reducing infection-related complications.
{"title":"Burn wound microbiology and antimicrobial resistance patterns in a tertiary care burn unit in Northeast India","authors":"Parthapratim Dutta, Vehuto Puro, Thounaojam Jeffchand Luwang, Utpal Kumar Bordoloi","doi":"10.1016/j.burnso.2025.100439","DOIUrl":"10.1016/j.burnso.2025.100439","url":null,"abstract":"<div><h3>Background</h3><div>Burn wounds are highly susceptible to microbial colonization, especially by multidrug-resistant organisms (MDROs), contributing significantly to morbidity in resource-limited settings. Understanding local microbial patterns is essential for guiding empirical antibiotic selection and infection control practices. This study investigated the temporal profile of bacterial colonization and antimicrobial resistance in burn wounds at a tertiary care center in Northeast India.</div></div><div><h3>Methods</h3><div>A prospective study of 100 burn patients was conducted over six months. Wound swabs were collected on admission (Day 0) and Day 7. Bacterial identification and antimicrobial susceptibility testing were performed using the VITEK®2 system, interpreted per CLSI guidelines. Clinical infection was defined based on standard signs correlated with culture results.</div></div><div><h3>Results</h3><div>Bacterial growth increased from 25% on Day 0 to 91% on Day 7. Early cultures showed predominance of Staphylococcus aureus, whereas Day 7 cultures revealed a shift toward Gram-negative organisms, mainly Pseudomonas aeruginosa (36%) and Acinetobacter baumannii (16%). More than 70% of Gram-negative isolates exhibited resistance to cephalosporins and fluoroquinolones. Clinical burn wound infection occurred in 23 patients (23%), most commonly due to MDR Pseudomonas. Carbapenem resistance was identified in a subset of Acinetobacter isolates.</div></div><div><h3>Conclusion</h3><div>Burn wound colonization in our center transitions rapidly toward MDR Gram-negative pathogens, reinforcing the need for updated local antibiograms, culture-guided therapy, and strengthened infection prevention strategies. Focused antimicrobial stewardship and improved wound care workflows are essential to reducing infection-related complications.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"13 ","pages":"Article 100439"},"PeriodicalIF":0.0,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-06DOI: 10.1016/j.burnso.2025.100437
Luiz Philipe Molina Vana , Derek Chaves Lopes , André Vinícius Martignago , Laura Pompermaier , Jose Adorno , Mauricio José Lopes Pereima , Fábio Ferreira Amorim , Edgar Merchán-Hamann , Sérgio Eduardo Soares Fernandes
Background
Brazil is a large country with a high incidence of burn injuries and socio-economic disparities among its states that affect access to burn care. However, Brazil does not have a national burn database, and most of the research on burns analyzes local burn units’ registries. This study aimed to assess burn-related pre- and in-hospital mortality in Brazil between 2010 and 2019 and to investigate its relationship with sociodemographic aspects.
Methods
We have performed a cross-sectional study using publicly available data. Two information systems were compared for data qualification, the Mortality Information System (SIM) and the Hospital Information System (SIH).
Results
Pre-hospital mortality depends on burn etiology, with a relative risk of an out-of-hospital death from electrical burns compared to thermal burns of 1.59 (95 % CI: 1.55–1.63). Among all burn deaths, 76.2 % occurred in males, with a statistical significance for all age groups (p < 0.001). Regions with the lowest demographic density in the country had areas with high mortality, with a difference of mean from 2.21 inhab/Km2 (median: 2.19) in municipalities with mortality ≥4/100,000inhab to 127 inhab/Km2 (median 27.8) in municipalities with mortality <4/100,000inhab (p < 0.001). The association between mortality and the socioeconomic variables studied was exactly the opposite between thermal and electrical causes. A mean difference of 0.61 (95 % CI: 0.55–0.68) in in-hospital mortality due to general burns per 100,000 inhabitants was observed between the SIM database (mean: 0.64/100,000 inhabitants) and the SIH database (mean: 0.03/100,000 inhabitants; p < 0.001).
Conclusions
Our findings demonstrate that studies related to burns must analyze thermal and electrical etiologies separately since they present different correlations with sociodemographic aspects. Also, SIH should not be used to estimate burn incidence or mortality, since it underreports data.
{"title":"Total burn mortalities in Brazil: 10 years study","authors":"Luiz Philipe Molina Vana , Derek Chaves Lopes , André Vinícius Martignago , Laura Pompermaier , Jose Adorno , Mauricio José Lopes Pereima , Fábio Ferreira Amorim , Edgar Merchán-Hamann , Sérgio Eduardo Soares Fernandes","doi":"10.1016/j.burnso.2025.100437","DOIUrl":"10.1016/j.burnso.2025.100437","url":null,"abstract":"<div><h3>Background</h3><div>Brazil is a large country with a high incidence of burn injuries and socio-economic disparities among its states that affect access to burn care. However, Brazil does not have a national burn database, and most of the research on burns analyzes local burn units’ registries. This study aimed to assess burn-related pre- and in-hospital mortality in Brazil between 2010 and 2019 and to investigate its relationship with sociodemographic aspects.</div></div><div><h3>Methods</h3><div>We have performed a cross-sectional study using publicly available data. Two information systems were compared for data qualification, the Mortality Information System (SIM) and the Hospital Information System (SIH).</div></div><div><h3>Results</h3><div>Pre-hospital mortality depends on burn etiology, with a relative risk of an out-of-hospital death from electrical burns compared to thermal burns of 1.59 (95 % CI: 1.55–1.63). Among all burn deaths, 76.2 % occurred in males, with a statistical significance for all age groups (p < 0.001). Regions with the lowest demographic density in the country had areas with high mortality, with a difference of mean from 2.21 inhab/Km<sup>2</sup> (median: 2.19) in municipalities with mortality ≥4/100,000inhab to 127 inhab/Km<sup>2</sup> (median 27.8) in municipalities with mortality <4/100,000inhab (p < 0.001). The association between mortality and the socioeconomic variables studied was exactly the opposite between thermal and electrical causes. A mean difference of 0.61 (95 % CI: 0.55–0.68) in in-hospital mortality due to general burns per 100,000 inhabitants was observed between the SIM database (mean: 0.64/100,000 inhabitants) and the SIH database (mean: 0.03/100,000 inhabitants; p < 0.001).</div></div><div><h3>Conclusions</h3><div>Our findings demonstrate that studies related to burns must analyze thermal and electrical etiologies separately since they present different correlations with sociodemographic aspects. Also, SIH should not be used to estimate burn incidence or mortality, since it underreports data.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"13 ","pages":"Article 100437"},"PeriodicalIF":0.0,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145738035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-28DOI: 10.1016/j.burnso.2025.100436
Shahla Faramarzi , Sara Hashemi , Laya Rahmani Pirouz , Kimia Ashrafpour , Azita Yazdani , Leila Erfannia
Background
As mobile phone users and smart phone penetration grow, the healthcare sector utilizes mobile apps to enhance health management, particularly in the case of burns.
Purpose
The purpose of this research is to evaluate the quality of m-Health apps available in the field of burns in Persian-English language for the Android operating system.
Methods
A systematic search for burn-related apps was conducted on three mobile app stores (Google Play, Cafe Bazaar, and Myket) from February 11 to February 21, 2024. The search utilized English terms like “burn”, “burns”, “thermal”, as well as Persian keywords equivalent in meaning to “burn”. The selected apps underwent independent evaluation using the Mobile App Rating Scale (MARS).
Results
A total of 4172 apps were found. Then, by removing the duplicate apps, and based on the inclusion and exclusion criteria and after a complete review of the content, six apps entered the final stage of quality evaluation. Among the reviewed apps, two types of apps were identified: calculators, information apps. Based on the MARS scale, the functionality domain received the highest mean score of 4.75, whereas the aesthetics, information, and engagement domains scored lower, with mean scores of 3.27, 3.18, and 3.16, respectively.
Conclusion
The study found that the studied apps generally exhibited good functionality quality, and in terms of engagement, aesthetics, and information, they possessed acceptable quality, potentially improving digital health services for burns.
{"title":"Evaluation of the quality of m-Health applications in burns using the mobile app rating scale (MARS): A systematic review","authors":"Shahla Faramarzi , Sara Hashemi , Laya Rahmani Pirouz , Kimia Ashrafpour , Azita Yazdani , Leila Erfannia","doi":"10.1016/j.burnso.2025.100436","DOIUrl":"10.1016/j.burnso.2025.100436","url":null,"abstract":"<div><h3>Background</h3><div>As mobile phone users and smart phone penetration grow, the healthcare sector utilizes mobile apps to enhance health management, particularly in the case of burns.</div></div><div><h3>Purpose</h3><div>The purpose of this research is to evaluate the quality of m-Health apps available in the field of burns in Persian-English language for the Android operating system.</div></div><div><h3>Methods</h3><div>A systematic search for burn-related apps was conducted on three mobile app stores (Google Play, Cafe Bazaar, and Myket) from February 11 to February 21, 2024. The search utilized English terms like “burn”, “burns”, “thermal”, as well as Persian keywords equivalent in meaning to “burn”. The selected apps underwent independent evaluation using the Mobile App Rating Scale (MARS).</div></div><div><h3>Results</h3><div>A total of 4172 apps were found. Then, by removing the duplicate apps, and based on the inclusion and exclusion criteria and after a complete review of the content, six apps entered the final stage of quality evaluation. Among the reviewed apps, two types of apps were identified: calculators, information apps. Based on the MARS scale, the functionality domain received the highest mean score of 4.75, whereas the aesthetics, information, and engagement domains scored lower, with mean scores of 3.27, 3.18, and 3.16, respectively.</div></div><div><h3>Conclusion</h3><div>The study found that the studied apps generally exhibited good functionality quality, and in terms of engagement, aesthetics, and information, they possessed acceptable quality, potentially improving digital health services for burns.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"13 ","pages":"Article 100436"},"PeriodicalIF":0.0,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145618427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-23DOI: 10.1016/j.burnso.2025.100435
Natalia Ziolkowski , Fiona M. Wood , Suzanne Rea , Inge Spronk , Dale W. Edgar , Helen Douglas
Introduction
Ablative fractional CO2 lasers (AFCO2L) have been shown to improve burn hypertrophic scars significantly. In this paper we describe the journey of setting up the laser service for burns patients, considerations in patient selection, treatment algorithms, and lessons learned.
Methods
This study is a retrospective cohort study including all patients who received AFCO2L at the Western Australian (WA) Statewide Adult Burn Unit since the start of the program in 2013–2024. Descriptive statistics present the number, timing and settings of AFCO2L events, as well as patient, injury, and treatment characteristics. Further, the profile of patients who underwent laser treatment was compared to those who did not, during the study period.
Results
Since the introduction of the AFCO2L, a total of 4005 laser sessions involving 837 burns patients has been completed in WA. The majority were performed as an outpatient (66 %), with the proportion and total numbers increasing with time to 2021. Compared to those not receiving laser for their scars, AFCO2L was more likely applied to younger (p < 0.0001), female (p < 0.0001) patients with higher %TBSA burns (p < 0.0001) involving multiple anatomic areas (p = 0.001), more often requiring surgery (p < 0.0001) and longer times to heal (p < 0.0001). In 2013, 100 % of all lasers were provided as an inpatient, under general anesthetic with an average age of scar > 5000 days. By 2023/4, only 18 % required an inpatient stay and the average age of scar was 111 days.
Conclusions
The SABU team evolved AFCO2L therapy into the model of care over time to achieve earlier, more equitable delivery of laser treatments to 80 % of patients as outpatients, supported by extensive multidisciplinary team involvement.
{"title":"12 Years of ablative fractional CO2 laser Practice: Logistics, lessons and evolving model of care","authors":"Natalia Ziolkowski , Fiona M. Wood , Suzanne Rea , Inge Spronk , Dale W. Edgar , Helen Douglas","doi":"10.1016/j.burnso.2025.100435","DOIUrl":"10.1016/j.burnso.2025.100435","url":null,"abstract":"<div><h3>Introduction</h3><div>Ablative fractional CO<sub>2</sub> lasers (AFCO<sub>2</sub>L) have been shown to improve burn hypertrophic scars significantly. In this paper we describe the journey of setting up the laser service for burns patients, considerations in patient selection, treatment algorithms, and lessons learned.</div></div><div><h3>Methods</h3><div>This study is a retrospective cohort study including all patients who received AFCO<sub>2</sub>L at the Western Australian (WA) Statewide Adult Burn Unit since the start of the program in 2013–2024. Descriptive statistics present the number, timing and settings of AFCO<sub>2</sub>L events, as well as patient, injury, and treatment characteristics. Further, the profile of patients who underwent laser treatment was compared to those who did not, during the study period.</div></div><div><h3>Results</h3><div>Since the introduction of the AFCO2L, a total of 4005 laser sessions involving 837 burns patients has been completed in WA. The majority were performed as an outpatient (66 %), with the proportion and total numbers increasing with time to 2021. Compared to those not receiving laser for their scars, AFCO2L was more likely applied to younger (p < 0.0001), female (p < 0.0001) patients with higher %TBSA burns (p < 0.0001) involving multiple anatomic areas (p = 0.001), more often requiring surgery (p < 0.0001) and longer times to heal (p < 0.0001). In 2013, 100 % of all lasers were provided as an inpatient, under general anesthetic with an average age of scar > 5000 days. By 2023/4, only 18 % required an inpatient stay and the average age of scar was 111 days.</div></div><div><h3>Conclusions</h3><div>The SABU team evolved AFCO<sub>2</sub>L therapy into the model of care over time to achieve earlier, more equitable delivery of laser treatments to 80 % of patients as outpatients, supported by extensive multidisciplinary team involvement.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"13 ","pages":"Article 100435"},"PeriodicalIF":0.0,"publicationDate":"2025-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.burnso.2025.100430
Radwan Safa, Simon Myers
We present a unique case of hyperthermia and lactic acidosis in a patient with massive burn injury occurring after the administration of Linezolid. These acute and rapidly progressive symptoms were attributed to separate; rare adverse effects associated with linezolid. Treatment focused on aggressive cooling measures, discontinuation of offending agents, and hemodynamic and respiratory support. Hyperthermia and lactic acidosis resolved quickly after initiation of therapy. Unfortunately, the patient never recovered normal mental status for the remainder of his prolonged ICU stay. He underwent surgical tracheostomy and remained bedbound with minimal movement or interactions and was discharged to a long term facility.
{"title":"Life-threatening drug-induced type B lactic acidosis & serotonin syndrome occurring simultaneously in a major burn patient: a case report","authors":"Radwan Safa, Simon Myers","doi":"10.1016/j.burnso.2025.100430","DOIUrl":"10.1016/j.burnso.2025.100430","url":null,"abstract":"<div><div>We present a unique case of hyperthermia and lactic acidosis in a patient with massive burn injury occurring after the administration of Linezolid. These acute and rapidly progressive symptoms were attributed to separate; rare adverse effects associated with linezolid. Treatment focused on aggressive cooling measures, discontinuation of offending agents, and hemodynamic and respiratory support. Hyperthermia and lactic acidosis resolved quickly after initiation of therapy. Unfortunately, the patient never recovered normal mental status for the remainder of his prolonged ICU stay. He underwent surgical tracheostomy and remained bedbound with minimal movement or interactions and was discharged to a long term facility.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"12 ","pages":"Article 100430"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145465644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号