Burns open : an international open access journal for burn injuries最新文献_第4页

Burden and associated factors of unintentional household burn injuries in South Asia: A systematic review 南亚家庭意外烧伤的负担和相关因素：一项系统综述

Q3 Medicine

Burns open : an international open access journal for burn injuries

Pub Date : 2025-05-31 DOI: 10.1016/j.burnso.2025.100411

Ahmer Adnan , Salman Muhammad Soomar , Asaad Nafees , Wafa Aftab , Zafar Fatmi

Background

Burn injuries account for almost 0.3 million deaths annually worldwide. Household burn injury is one of the common causes of burn injuries. This issue in South Asia is concerning and is an important epidemiological problem that needs to be explored and reported. This study aimed to estimate the current burden, types, and severity of unintentional household burn injuries and identify the associated factors of unintentional household burn injuries.

Methods

We reviewed all available studies (qualitative or quantitative) on unintentional household injuries in South Asia. All studies on household burn injuries from 2000 to 2020, including all the relevant published information as described in the inclusion criteria.

Results

The findings of the study revealed that in South Asian regions the low socio-economic status, and poor prevention and treatment policies for the burden of burn injuries are the predominant factors and that the associated risk factors play a role in unintentional burn injury incidents with lack of education and awareness effecting mainly women and children to have accidents at households suffering from burn injuries, morbidity, and mortality. No data is available for the Maldives and Bhutan.

Conclusion

Unintentional burn injuries cause morbidity and mortality, primarily among women and children. With the lack of financial resources and inadequate policies for burn care, prevention, and treatment in South Asian countries, it is essential to reduce the burden.

背景：全世界每年有近30万人死于烧伤。家庭烧伤是造成烧伤的常见原因之一。南亚的这一问题令人担忧，是一个重要的流行病学问题，需要加以探讨和报告。本研究旨在评估目前家庭意外烧伤的负担、类型和严重程度，并确定家庭意外烧伤的相关因素。方法回顾了南亚地区所有关于家庭意外伤害的定性或定量研究。2000年至2020年关于家庭烧伤的所有研究，包括纳入标准中描述的所有相关出版信息。结果在南亚地区，社会经济地位低下和对烧伤负担的预防和治疗政策不健全是造成意外烧伤的主要因素，相关危险因素在意外烧伤事件中起着重要作用，教育和意识的缺乏主要影响妇女和儿童在家庭中发生意外事故，造成烧伤的发病率和死亡率。没有马尔代夫和不丹的数据。结论非故意烧伤的发病率和死亡率高，以妇女和儿童为主。由于南亚国家缺乏财政资源和烧伤护理、预防和治疗政策不充分，因此必须减轻负担。

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引用次数: 0

Unmasking the silent threat: deep tissue impacts of chemical burns – a case report 揭露无声的威胁：化学烧伤对深层组织的影响——一个案例报告

Q3 Medicine

Burns open : an international open access journal for burn injuries

Pub Date : 2025-05-31 DOI: 10.1016/j.burnso.2025.100412

Satbir S.G. , Fatimah Mat Johar , Ahmad Sukari Halim , Wan Azman Wan Sulaiman

Chemical burns, often caused by corrosive substances like sulfuric acid, can result in severe physical and psychological harm. These injuries are challenging to manage due to difficulties in assessing burn depth and ongoing tissue damage beneath the eschar. This case report details a 21-year-old female with 9 % total body surface area full-thickness chemical burns from a battery acid assault affecting her face, chest, limbs, and eyes. Initial treatment included irrigation and pH monitoring, followed by early tangential excision, hydrosurgery, and skin allograft application. While surface eschar pH normalized after irrigation, subeschar tissue remained acidic, indicating deeper damage. The patient developed hypertrophic scarring, reflecting ongoing tissue damage beyond the visible eschar. Persistent subeschar acidity suggests that current treatment protocols may not sufficiently address the penetration of corrosive substances, leading to prolonged inflammatory processes and unfavorable scarring outcomes. This underscores the need for improved strategies to prevent prolonged inflammation and unfavorable outcomes in chemical burn management.

化学烧伤通常由硫酸等腐蚀性物质引起，可造成严重的身体和心理伤害。由于难以评估烧伤深度和痂下持续的组织损伤，这些损伤很难处理。本病例报告详细描述了一名21岁的女性，她的面部、胸部、四肢和眼睛受到电池酸攻击，全身面积为9%的全层化学烧伤。初始治疗包括冲洗和pH监测，随后早期切向切除，水手术和皮肤移植应用。虽然表面疮痂的pH值在冲洗后恢复正常，但痂下组织仍呈酸性，表明损伤更深。患者出现增生性瘢痕形成，反映了可见痂外持续的组织损伤。持续的痂下酸性表明，目前的治疗方案可能无法充分解决腐蚀性物质的渗透，导致炎症过程延长和不利的疤痕结果。这强调了需要改进的策略，以防止长期炎症和不良后果的化学烧伤管理。

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引用次数: 0

Severe burns from viral TikTok challenge involving candied sugar: A case series report 涉及糖的病毒性TikTok挑战导致严重烧伤：病例系列报告

Q3 Medicine

Burns open : an international open access journal for burn injuries

Pub Date : 2025-05-29 DOI: 10.1016/j.burnso.2025.100410

Kristen Storey , Nicola Burns , Rachel Kerr , Maleea Holbert , Roy Kimble , Bronwyn Griffin

Burn injuries rank among the top five most common non-fatal injuries within the paediatric population. Scald injuries continue to be the leading cause of burn in the children, closely followed by contact burns, particularly in the six to 16 age group. Recently, there have been increasing reports of children sustaining scald and contact burns, after attempting to replicate videos viewed on social media platforms such as TikTok and YouTube.

A recent trend of heating sugar and water in a plastic container within the microwave to make candied fruit is resulting in children and adolescents presenting with deep burns. The plastic container becomes so hot that it melts causing the hot sugar water and plastic to drip onto the child. There has been an increase in presentations to all burn centres throughout Australia resulting from this mechanism.

Method

A retrospective chart review was undertaken of six children presenting with toffee burns that attended the Pegg Leditschke Children’s Burns Centre at the Queensland Children’s Hospital over a period of four weeks.

Result

Six children presented with similar burns and were treated within the specialist burns centre. The lower limb was affected in four cases while two cases sustained burns on the hand. Skin grafts were required in two cases and four children continue to require long term scar management.

Conclusion

Social media plays an important role in our children’s lives however mimicking videos can result in increased risk of serious physical and psychological harm occurring. How to make candied sugar has gone viral causing numerous burns throughout Australia. While we do not want to restrict children from watching and participating with these videos, we require parents and moderators of these videos to ensure these videos are performed in a safe environment to decrease risks of injury occurring.

烧伤是儿科人群中最常见的五种非致命伤害之一。烫伤仍然是儿童烧伤的主要原因，其次是接触性烧伤，特别是在6至16岁年龄组。最近，有越来越多的报道称，儿童在试图复制在TikTok和YouTube等社交媒体平台上观看的视频后，被烫伤和接触烧伤。最近一种趋势是，在微波炉中加热塑料容器中的糖和水来制作糖果水果，这导致儿童和青少年出现深度烧伤。塑料容器变得非常热，以至于融化，导致热糖水和塑料滴到孩子身上。由于这种机制，澳大利亚所有烧伤中心的报告有所增加。方法对6名因太妃糖烧伤而在昆士兰州儿童医院Pegg Leditschke儿童烧伤中心就诊的儿童进行了为期四周的回顾性分析。结果6例患儿均出现类似烧伤，均在专科烧伤中心治疗。4例下肢受累，2例手部烧伤。2例需要植皮，4例儿童继续需要长期疤痕处理。结论社交媒体在孩子的生活中扮演着重要的角色，然而模仿视频会增加孩子发生严重身体和心理伤害的风险。如何制作糖糖在澳大利亚疯传，导致许多人烧伤。虽然我们不想限制儿童观看和参与这些视频，但我们要求这些视频的家长和版主确保这些视频在安全的环境中播放，以减少受伤发生的风险。

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引用次数: 0

Characteristics of burn injuries in old and extremely old patients: A city-wide study 老年和极老年患者烧伤的特点：一项全市范围的研究

Q3 Medicine

Burns open : an international open access journal for burn injuries

Pub Date : 2025-05-12 DOI: 10.1016/j.burnso.2025.100408

Takahiro Yamanaka, Ryo Yamamoto, Junichi Sasaki

Background

The global population is aging rapidly. However, research on the characteristics of burn injuries in extremely old individuals remains limited. The current study aimed to identify the characteristics of burn injuries among elderly people by examining a city-wide burn database in Tokyo.

Methods

This observational study was conducted at 14 burn centers, and data from the Tokyo Burn Unit Association registry from 1999 to 2020 were used. Demographic characteristics, burn mechanisms and severity, and clinical outcomes were compared among three age groups: >80 (very old), 65–79 (old), and 18–64 years.

Results

In total, 11,876 patients with burn, including 1,150 aged > 80 years, 1,916 aged 65–79 years, and 8,810 aged 18–64 years, were analyzed. Older patients had a higher incidence of flame burns, burns in the closed space, and trunk, perineum, and lower extremity injuries. The older population had a greater injury severity, longer length of hospital stay, and higher in-hospital mortality rate. Similar trends were observed in the very old population.

Conclusion

This study elucidated the characteristics of burn injuries, which included injury mechanisms and anatomical burn sites, among elderly individuals.

全球人口正在迅速老龄化。然而，对极老个体烧伤特征的研究仍然有限。目前的研究旨在通过检查东京全市烧伤数据库来确定老年人烧伤的特征。方法：本观察性研究在14个烧伤中心进行，使用1999年至2020年东京烧伤协会登记的数据。人口统计学特征、烧伤机制、严重程度和临床结果在三个年龄组中进行比较：80岁（高龄）、65-79岁（高龄）和18-64岁。结果烧伤患者11876例，其中老年1150例；80例，65-79岁1916例，18-64岁8810例。老年患者火焰烧伤、密闭空间烧伤、躯干、会阴和下肢损伤发生率较高。老年人群损伤严重程度更大，住院时间更长，住院死亡率更高。在高龄人群中也观察到类似的趋势。结论本研究阐明了老年人烧伤的特点，包括损伤机制和烧伤解剖部位。

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引用次数: 0

Fusarium isolates in burn-injured patients: Clinical characteristics and susceptibility patterns 烧伤患者分离的镰刀菌：临床特征和易感模式

Q3 Medicine

Burns open : an international open access journal for burn injuries

Pub Date : 2025-04-25 DOI: 10.1016/j.burnso.2025.100407

Robyn Stoianovici , Sierra Young , Jeremiah J. Duby , Naomi Hauser , Erin Louie

Introduction/Objective

Fusarium species are ubiquitous in the environment and can cause opportunistic infection in burn-injured patients. The purpose of this retrospective cohort observational study is to characterize Fusarium susceptibilities, antifungal and surgical management, and the effect on survival in this patient population.

Methods

All burn ICU patients with a positive Fusarium culture were retrospectively identified between November 2017 to June 2023 at a regional burn center. Demographic, clinical, and microbiologic susceptibility data was collected from the electronic medication record.

Results

Eighteen patients with positive Fusarium wound cultures were included. The median age was 35 (32–41) years and 28 % were female. The average %TBSA was 55 ± 23 % and r-Baux score of 93 ± 22. The most common mechanism of injury was thermal burn (17 patients, 94 %). This cohort experienced prolonged ICU [53 (46–95) days] and hospital [57 (48– 97) days] lengths of stay. The median time from burn injury to positive Fusarium cultures was 18 (14–24) days. Mechanical ventilation was common (94 %) and prolonged [42 (34–55) days]. Sixty percent of isolates resulted with a minimal inhibitory concentration (MIC) ≥ 16 mcg/ml for voriconazole and 93 % isolates resulted with an MIC < 1 mcg/ml for amphotericin B. All patients underwent surgical debridement for source control. Ten of 18 patients (55 %) with Fusarium-positive infections survived to hospital discharge. Infection complicated by multisystem organ failure and sepsis was the most common attributable cause of death (88 %).

Conclusion

Patients infected with Fusarium were severely burned, critically ill, and exposed to prolonged mechanical ventilation and to central venous catheterization. The high mortality rate associated with Fusarium infection and prolonged time to antifungal susceptibility results emphasize the importance of appropriate empiric therapy.

摘要目的镰刀菌广泛存在于环境中，可引起烧伤患者的机会性感染。本回顾性队列观察研究的目的是表征镰刀菌的敏感性，抗真菌和手术治疗，以及对患者生存的影响。方法回顾性分析某地区烧伤中心2017年11月至2023年6月收治的所有镰刀菌培养阳性烧伤ICU患者。从电子用药记录中收集人口统计学、临床和微生物敏感性数据。结果18例伤口镰刀菌培养阳性。中位年龄为35岁（32-41岁），28%为女性。平均%TBSA为55±23%，r-Baux评分为93±22。最常见的损伤机制为热烧伤（17例，94%）。该队列经历了延长的ICU[53（46-95）天]和住院[57（48 - 97）天]的住院时间。从烧伤到镰刀菌培养阳性的中位时间为18（14-24）天。机械通气常见（94%）且时间延长[42（34-55）天]。60%的分离株voriconazole最小抑菌浓度(MIC)≥16 mcg/ml， 93%的分离株voriconazole最小抑菌浓度≥16 mcg/ml；两性霉素b 1微克/毫升。所有患者均行手术清创以控制传染源。镰刀菌阳性感染的18例患者中有10例（55%）存活至出院。感染合并多系统器官衰竭和败血症是最常见的可归因死亡原因（88%）。结论镰刀菌感染患者烧伤严重，病情危重，需长期机械通气和中心静脉置管。镰孢菌感染的高死亡率和较长的抗真菌敏感性结果强调了适当的经验性治疗的重要性。

{"title":"Fusarium isolates in burn-injured patients: Clinical characteristics and susceptibility patterns","authors":"Robyn Stoianovici , Sierra Young , Jeremiah J. Duby , Naomi Hauser , Erin Louie","doi":"10.1016/j.burnso.2025.100407","DOIUrl":"10.1016/j.burnso.2025.100407","url":null,"abstract":"<div><h3>Introduction/Objective</h3><div><em>Fusarium</em> species are ubiquitous in the environment and can cause opportunistic infection in burn-injured patients. The purpose of this retrospective cohort observational study is to characterize <em>Fusarium</em> susceptibilities, antifungal and surgical management, and the effect on survival in this patient population.</div></div><div><h3>Methods</h3><div>All burn ICU patients with a positive <em>Fusarium</em> culture were retrospectively identified between November 2017 to June 2023 at a regional burn center. Demographic, clinical, and microbiologic susceptibility data was collected from the electronic medication record.</div></div><div><h3>Results</h3><div>Eighteen patients with positive <em>Fusarium</em> wound cultures were included. The median age was 35 (32–41) years and 28 % were female. The average %TBSA was 55 ± 23 % and r-Baux score of 93 ± 22. The most common mechanism of injury was thermal burn (17 patients, 94 %). This cohort experienced prolonged ICU [53 (46–95) days] and hospital [57 (48– 97) days] lengths of stay. The median time from burn injury to positive <em>Fusarium</em> cultures was 18 (14–24) days. Mechanical ventilation was common (94 %) and prolonged [42 (34–55) days]. Sixty percent of isolates resulted with a minimal inhibitory concentration (MIC) ≥ 16 mcg/ml for voriconazole and 93 % isolates resulted with an MIC < 1 mcg/ml for amphotericin B. All patients underwent surgical debridement for source control. Ten of 18 patients (55 %) with <em>Fusarium-</em>positive infections survived to hospital discharge. Infection complicated by multisystem organ failure and sepsis was the most common attributable cause of death (88 %).</div></div><div><h3>Conclusion</h3><div>Patients infected with <em>Fusarium</em> were severely burned, critically ill, and exposed to prolonged mechanical ventilation and to central venous catheterization. The high mortality rate associated with <em>Fusarium</em> infection and prolonged time to antifungal susceptibility results emphasize the importance of appropriate empiric therapy.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"11 ","pages":"Article 100407"},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891620","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}

引用次数: 0

Shifting dynamics of self-immolation in the capital of Iran? The rising trend among young, unmarried, less-educated men 伊朗首都自焚的动态变化？这在年轻、未婚、受教育程度较低的男性中呈上升趋势

Q3 Medicine

Burns open : an international open access journal for burn injuries

Pub Date : 2025-04-18 DOI: 10.1016/j.burnso.2025.100406

MohammadAli Shokri , SaeedehSadat Khalili , Abdol-Hossein Vahabie , Atefeh Ghanbari Jolfaei , Amir-Abbas Keshavarz-Akhlaghi , Mostafa Dehmardei , Fatemeh Sadat Mirfazeli

In our study, we aimed to explore the psychiatric disorders, risk factors, and predictors of self-immolation among individuals admitted to Shahid Motahari Hospital in Tehran from 2019 to 2020. This cross-sectional study examines 64 hospitalized patients who received psychiatric counseling following self-immolation incidents.

The rate of self-immolation varies significantly based on specific demographics. It is observed that in our population men had a higher rate of being unmarried (70.96 % vs 15.15 %), lower levels of education (70.96 % vs 63.63 % did not have a university degree), higher level of unemployment (54.83 % vs 30.30 %), younger age average with most men aging 15–24 (29.06 (SD = 9.33)) vs women 35–44 (35.27(SD = 10.27)) and higher prevalence of addiction (67.74 % vs 36.36 %) compared to women. On the other hand, women who attempted self-immolation mainly were married, involved in housekeeping, and tended to exhibit higher rates of depression (63.63 % vs 32.25 %) than men. Furthermore, these self-immolation incidents are often impulsive (64.1 %) and occur shortly (under an hour) after experiencing a stressor (39.1 %). Self-immolation accidents are frequently carried out using gasoline (50 %). Geographically, the majority of self-immolation cases of our study are concentrated in the central region of Iran (76.6 %), followed by the western region (15.6 %) this may be due to the proximity of these regions to our center while patients of other regions were hospitalized in their referral hospitals and were rarely transferred to the capital. To effectively address the issue of self-immolation and reduce its prevalence, it is essential to identify vulnerable populations and explore targeted preventive measures. Based on our findings, future pilot studies could investigate the feasibility of specific interventions, such as crisis hotlines to reduce impulsivity-related acts of self-immolation. Additionally, small-scale feasibility projects could explore the effectiveness of impulse control management or interpersonal skills training in high-risk populations, but further research is needed to assess their practicality and impact.

在我们的研究中，我们旨在探讨2019年至2020年在德黑兰Shahid Motahari医院住院的个体的精神疾病、危险因素和自焚的预测因素。本研究对64名自焚事件后接受精神辅导的住院患者进行了调查。根据特定的人口统计数据，自焚率差异很大。可以观察到，在我们的人口中，男性的未婚率较高（70.96%对15.15%），受教育程度较低（70.96%对63.63%没有大学学位），失业率较高（54.83%对30.30%），平均年龄较低，大多数男性年龄在15-24岁（29.06 (SD = 9.33)），而女性年龄在35-44岁（35.27(SD = 10.27)），与女性相比，成瘾率较高（67.74%对36.36%）。另一方面，试图自焚的女性主要是已婚、从事家务的女性，她们往往比男性表现出更高的抑郁率（63.63%对32.25%）。此外，这些自焚事件通常是冲动的（64.1%），发生在经历压力源后不久（不到一小时）（39.1%）。自焚事故经常使用汽油（50%）。在地理上，我们研究的大多数自焚病例集中在伊朗中部地区（76.6%），其次是西部地区（15.6%），这可能是由于这些地区靠近我们的中心，而其他地区的患者在其转诊医院住院，很少转移到首都。为了有效解决自焚问题并减少其流行，必须确定弱势群体并探索有针对性的预防措施。基于我们的研究结果，未来的试点研究可以探讨具体干预措施的可行性，如危机热线，以减少冲动相关的自焚行为。此外，小规模的可行性项目可以探索冲动控制管理或人际交往能力培训在高危人群中的有效性，但需要进一步的研究来评估其实用性和影响。

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引用次数: 0

Comprehensive management and recovery of reproductive function after testicular necrosis from scrotal burn: A case report 阴囊烧伤致睾丸坏死后生殖功能的综合治疗与恢复1例

Q3 Medicine

Burns open : an international open access journal for burn injuries

Pub Date : 2025-03-28 DOI: 10.1016/j.burnso.2025.100404

Yuya Miyoshi , Takashi Hongo , Takatoshi Moriwake , Taisuke Kanno , Kohei Tsukahara , Tetsuya Yumoto , Hiromichi Naito , Atsunori Nakao

Genital burns are uncommon injuries; however, they present significant concerns regarding reproductive function, particularly in younger populations. Despite this, the literature on the long-term follow-up of reproductive function after genital burns remains insufficient. A 20-year-old Japanese man suffered severe burns in his lower body including genital area following a motorcycle accident. Doppler ultrasonography revealed reduced blood flow to the right testis, which gradually atrophied. The patient underwent longitudinal monitoring through semen analysis, which revealed declining sperm function. Considering the adverse effects on the contralateral testis, right orchiectomy was performed six months after injury, and subsequent semen analysis showed normalization of sperm parameters. Genital burns with testicular necrosis can result in decreased testicular function, emphasizing the need for continuous monitoring through ultrasonography and semen analysis, and the potential necessity of orchiectomy.

生殖器烧伤是罕见的伤害；然而，它们对生殖功能，特别是年轻人口的生殖功能提出了重大关切。尽管如此，关于生殖器烧伤后生殖功能的长期随访的文献仍然不足。一名20岁的日本男子在摩托车事故中下半身严重烧伤，包括生殖器部位。多普勒超声显示右睾丸血流量减少，逐渐萎缩。通过精液分析对患者进行纵向监测，发现精子功能下降。考虑到对对侧睾丸的不良影响，伤后6个月行右睾丸切除术，随后精液分析显示精子参数恢复正常。生殖器烧伤伴睾丸坏死可导致睾丸功能下降，强调需要通过超声检查和精液分析进行持续监测，并可能需要进行睾丸切除术。

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引用次数: 0

Our initial experience with rapid enzymatic debriding agent for burn eschar: Case series from an ABA verified burn center 我们的初步经验，快速酶清剂烧伤痂：病例系列从ABA验证烧伤中心

Q3 Medicine

Burns open : an international open access journal for burn injuries

Pub Date : 2025-03-27 DOI: 10.1016/j.burnso.2025.100403

Cole L. Bird , Yair Saucedo , Jessica Reynolds , Dhaval Bhavsar

We reviewed 14 consecutive patients at our ABA-verified burn center who received enzymatic debridement with anacaulase-bcdb (NexoBrid®) from January 2020 to May 2023. These patients, part of the NEXT study, had deep partial or full-thickness burns. We aimed to evaluate NexoBrid’s effect on eschar removal, wound healing, surgical needs, and scar quality.

Data included total body surface area (TBSA) burned, enzymatically treated area, amount of NexoBrid used, grafting details, time to healing, and scar characteristics. Analysis was descriptive, reporting medians, ranges, and percentages.

All 14 patients achieved ≥ 95 % eschar removal with a single NexoBrid application. Their ages ranged from 15–65 years, and mean burn size was 9.25 % TBSA. Eight patients required grafting, but these grafts covered only about 60 % of the treated area. Time to 95 % wound closure averaged 36 days. Scar assessment using the Vancouver Scar Scale showed improvement from a mean score of 3.8 at three months to 0.5 at twelve months. Despite this, four patients developed hypertrophic scars and one required intervention for a contracture.

In summary, NexoBrid facilitated rapid, consistent non-surgical eschar removal, timely wound closure, and favorable scar outcomes within one year. In nearly half of the patients, it eliminated the need for skin grafting. Among those who did require grafts, smaller graft areas were needed. These findings suggest that early eschar removal and dermal preservation contribute to improved outcomes. Further studies with larger cohorts will help confirm these results.

我们回顾了从2020年1月至2023年5月在我们的aba验证烧伤中心连续接受anacaulase-bcdb （NexoBrid®）酶清创的14例患者。这些患者是NEXT研究的一部分，有深度、部分或全层烧伤。我们的目的是评估NexoBrid在痂清除、伤口愈合、手术需求和疤痕质量方面的效果。数据包括烧伤的总体表面积（TBSA）、酶处理面积、NexoBrid的使用量、移植细节、愈合时间和疤痕特征。分析是描述性的，报告中位数、范围和百分比。所有14例患者均通过单次应用NexoBrid实现了≥95%的痂清除。年龄15 ~ 65岁，平均烧伤面积为9.25% TBSA。8名患者需要移植，但这些移植只覆盖了约60%的治疗面积。至95%伤口愈合的平均时间为36天。使用温哥华疤痕量表进行疤痕评估显示，从3个月时的平均得分3.8分改善到12个月时的0.5分。尽管如此，4名患者出现了增生性疤痕，1名患者因挛缩需要干预。总之，NexoBrid在一年内促进了快速、一致的非手术结痂清除、及时的伤口愈合和良好的疤痕结局。在近一半的患者中，它消除了植皮的需要。在那些确实需要移植的患者中，需要较小的移植面积。这些发现表明，早期去除痂和皮肤保存有助于改善预后。更大规模的进一步研究将有助于证实这些结果。

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引用次数: 0

Estimating the probability of survival of hospitalized burn patients at a tertiary hospital in Ghana 估计加纳一家三级医院住院烧伤患者的生存概率

Q3 Medicine

Burns open : an international open access journal for burn injuries

Pub Date : 2025-03-03 DOI: 10.1016/j.burnso.2025.100402

Julius Kwabena Karikari , Samuel Nana Forjuoh , Emmanuel Konadu , Ebenezer Otu Ayeboafo Ansah , Nicholas Karikari Mensah , Sulemana Baba Abdulai , Jennifer Fordjour , Lydia Oduro , Emmanuel Kweku Nakua

This retrospective study estimated the survival patterns and mortality predictors among burn patients admitted to Komfo Anokye Teaching Hospital in Ghana, where burn-related mortality remains high due to challenges in providing comprehensive care. Data from 457 burn patients admitted from January 2021 to December 2023 were extracted from the Lightwave Health Information Management System. Descriptive analyses were conducted for continuous and categorical variables. Survival probabilities were estimated using Lifetable and Kaplan-Meier analyses, while Cox proportional hazard regression model was used to identify mortality predictors. Hazard ratios (HR) were used to estimate mortality risk with 95 % confidence intervals (CI) and a p-value of 0.05 to express the association between significant predictors and the treatment outcome (mortality). Data analysis was performed in Stata/SE Version 17.0. Diagnoses of Systemic Inflammatory Response Syndrome (SIRS) and inhalation injury as well as mechanical ventilation usage were associated with lower survival probabilities. Mortality risk increased with larger total body surface area (TBSA) burned (adjusted hazard ratio [aHR] = 1.05, 95 % CI: 1.04–1.06), full-thickness burns (aHR = 4.86, 95 % CI: 2.70–8.74), and inhalation injury (aHR = 1.66, 95 % CI: 1.05–2.61). Conversely, hemo-transfusion (aHR = 0.50, 95 % CI: 0.31–0.79) and surgical intervention (aHR = 0.15, 95 % CI: 0.06–0.37) were associated with improved survival. TBSA burned, full-thickness burns, and inhalation injuries significantly predicted increased mortality risk, while hemo-transfusion and surgical interventions were associated with improved survival. The findings of this study suggest that early surgical intervention significantly improved survival outcomes.

这项回顾性研究估计了在加纳Komfo Anokye教学医院住院的烧伤患者的生存模式和死亡率预测因素，由于提供全面护理的挑战，该医院的烧伤相关死亡率仍然很高。从2021年1月至2023年12月入院的457名烧伤患者的数据提取自光波健康信息管理系统。对连续变量和分类变量进行描述性分析。使用Lifetable和Kaplan-Meier分析估计生存概率，使用Cox比例风险回归模型确定死亡率预测因子。使用危险比（HR）估计死亡风险，95%置信区间（CI）和p值0.05表示显著预测因子与治疗结果（死亡率）之间的关联。数据分析在Stata/SE Version 17.0中进行。全身性炎症反应综合征（SIRS）和吸入性损伤的诊断以及机械通气的使用与较低的生存概率相关。烧伤总体表面积（TBSA）（校正危险比[aHR] = 1.05, 95% CI: 1.04-1.06）、全层烧伤（aHR = 4.86, 95% CI: 2.70-8.74）和吸入性损伤（aHR = 1.66, 95% CI: 1.05 - 2.61）的死亡风险增加。相反，输血（aHR = 0.50, 95% CI: 0.31-0.79）和手术干预（aHR = 0.15, 95% CI: 0.06-0.37）与生存率提高相关。TBSA烧伤、全层烧伤和吸入性损伤显著预示着死亡风险的增加，而输血和手术干预与生存率的提高有关。本研究结果表明，早期手术干预可显著改善生存结果。

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引用次数: 0

The addition of lactate to SOFA score improves the prediction of mortality in patients with severe burns–A retrospective cohort study 在SOFA评分中加入乳酸可提高严重烧伤患者死亡率的预测——一项回顾性队列研究

Q3 Medicine

Burns open : an international open access journal for burn injuries

Pub Date : 2025-02-28 DOI: 10.1016/j.burnso.2025.100398

Martin Huss Knave , Romans Elvihs , Jyrki Tenhunen , Fredrik Huss , Filip Fredén , Annelie Barrueta Tenhunen

Background

Major burn injury is a serious condition associated with high morbidity and mortality. In addition to Baux and revised Baux scores, several scores for prediction of outcome have been employed during the years, including SOFA (Sequential Organ Failure Assessment) score and lactate on admission.

Methods

The goal of the present study was to investigate two early composite indexes, with the hypothesis that they would more accurately predict mortality. SOFALx was formulated by adding the highest blood lactate of day 1, 2 and 3 after admission to the SOFA score of the corresponding day. CCIrBS was defined as the sum of Charlson Comorbidity Index with revised Baux Score and SAPS-3 (Simplified Acute Physiology Score). We investigated the prognostic value of these composite indexes in patients admitted to the burn center at Uppsala University Hospital with major burn injury (≥ 20 % TBSA) between January 2017 and December 2022. Primary outcome was 180-day mortality.

Results

Among the 95 patients that were included, 38 were non-survivors and 57 were survivors. Both composite indexes had a proper prognostic value. The prognostic accuracy was best for SOFALx on day 2 (SOFAL2) with median value (IQR) of 8.3 (4.8) for survivors vs. 16.5 (7.9) for non-survivors (p < 0.001) and the area under the ROC curve of 0.923. CCIrBS gave an area under the ROC curve of 0.916. The value of this composite index was 138 (63) in survivors vs. 212 (52) in non-survivors (p < 0.001).

Conclusion

Both SOFALx and CCIrBS are accurate prognostic indexes. Since SOFALx, in comparison to the more complex CCIrBS, is easy to use, this composite index is interesting for future studies.

背景：严重烧伤是一种高发病率和死亡率的严重疾病。除了Baux评分和修订后的Baux评分外，近年来还采用了几种预测预后的评分，包括SOFA（序期器官衰竭评估）评分和入院时的乳酸水平。方法本研究的目的是探讨两个早期综合指数，并假设它们能更准确地预测死亡率。将患者入院后第1、2、3天的最高血乳酸值与当天的SOFA评分相加，配制SOFALx。CCIrBS定义为Charlson合并症指数与修订Baux评分和SAPS-3（简化急性生理评分）的总和。我们研究了2017年1月至2022年12月期间入住乌普萨拉大学医院烧伤中心的严重烧伤（TBSA≥20%）患者的这些综合指标的预后价值。主要终点为180天死亡率。结果纳入的95例患者中，38例为非幸存者，57例为幸存者。两项综合指标均有较好的预后价值。SOFALx在第2天（SOFAL2）的预后准确性最好，幸存者的中位值（IQR）为8.3(4.8)，非幸存者为16.5 (7.9)(p <；0.001)， ROC曲线下面积为0.923。CCIrBS给出的ROC曲线下面积为0.916。该综合指数在幸存者中为138（63）比在非幸存者中为212 (52)(p <；0.001)。结论SOFALx和CCIrBS均为准确的预后指标。与更复杂的CCIrBS相比，SOFALx易于使用，因此该综合指数对未来的研究很有意义。

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