Pub Date : 2025-01-01DOI: 10.1016/j.burnso.2024.100385
Helena W.C. Hofland , Edris W. Kalanzi , Emmie Viyuyi , Tilinde Chokotho , Titus M. Opegu , Eduard E. Zijlstra
World-wide, burns are most common in low resource settings (LRS) with high mortality. Human resources, equipment and affordable, effective and safe treatments all influence outcome. Treatment of full thickness burns is particularly challenging and associated with high risk of complications. The presence of an eschar, infection and hypergranulation are important factors that delay wound closure. Tropical fruits are used for treatment of wounds and burns with excellent results. These fruits are usually available throughout the year and essentially inexpensive. The efficacy of papaya and pineapple is based on enzymes that have proteolytic activity and other compounds that have antimicrobial action. In the context of reverse technology, this enzymatic therapy has formed the basis of Nexobrid™ (based on enzymes derived from pineapple) that is now standard of care in high income countries. However, it is painful and very expensive. In LRS the use of papaya paste seems an alternative attractive option; however, evidence-based studies are needed on efficacy, safety, including standardization of the product used and treatment regimens.
{"title":"Increasing experience in the use of papaya for burn injuries in an African context, potential and limitations","authors":"Helena W.C. Hofland , Edris W. Kalanzi , Emmie Viyuyi , Tilinde Chokotho , Titus M. Opegu , Eduard E. Zijlstra","doi":"10.1016/j.burnso.2024.100385","DOIUrl":"10.1016/j.burnso.2024.100385","url":null,"abstract":"<div><div>World-wide, burns are most common in low resource settings (LRS) with high mortality. Human resources, equipment and affordable, effective and safe treatments all influence outcome. Treatment of full thickness burns is particularly challenging and associated with high risk of complications. The presence of an eschar, infection and hypergranulation are important factors that delay wound closure. Tropical fruits are used for treatment of wounds and burns with excellent results. These fruits are usually available throughout the year and essentially inexpensive. The efficacy of papaya and pineapple is based on enzymes that have proteolytic activity and other compounds that have antimicrobial action. In the context of reverse technology, this enzymatic therapy has formed the basis of Nexobrid™ (based on enzymes derived from pineapple) that is now standard of care in high income countries. However, it is painful and very expensive. In LRS the use of papaya paste seems an alternative attractive option; however, evidence-based studies are needed on efficacy, safety, including standardization of the product used and treatment regimens.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"9 ","pages":"Article 100385"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143155844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.burnso.2024.100387
Alberta A. Rockson , Natalie Benjamin-Damons , Sonti Imogene Pilusa
Background
Paediatric burns pose significant challenges in healthcare management. Paediatric burns require specialized care due to the distinct anatomical and physiological characteristics of children, which make them more vulnerable to complications. In resource-limited settings like Ghana, the absence of adequate supplies and standardized protocols can exacerbate these challenges, necessitating the need for a comprehensive understanding of the perspectives of healthcare practitioners involved in their care.
Study Objective.
To explore healthcare practitioners’ perspectives on paediatric burns management at a tertiary hospital, Ghana, covering current practices, barriers, impacts on patients and families, and recommendations for improvement.
Methodology
This study employed a qualitative research approach utilizing Focus Group Discussion (FGD) with 15 participants from various disciplines, including Plastic Surgery, Medicine, Anaesthetics, Physiotherapy, Occupational Therapy, Dietetics, Nursing, Pharmacy, Clinical Psychology, Public Health Nursing and. Laboratory Scientist. Participants were recruited through a convenience sampling technique. The discussion lasting approximately 90 min, were audio recorded, and facilitated by a discussion guide based on existing literature. The audio recordings were transcribed verbatim, and the transcripts were compared with handwritten notes for accuracy. The final transcribed data were coded and analyzed using thematic content analysis to identify recurring themes and patterns.
Results
Findings revealed four primary themes: strengths of current practices (multidisciplinary approach, experienced practitioners), barriers (lack of formal protocols, infrastructure limitations, financial burdens), contextual factors influencing burn care (psychological trauma, inadequate support, socio-cultural beliefs and socioeconomic status), and recommendations for enhancing burns care (improved social welfare, facility upgrades, staff training and mental health support).
Conclusion
While burns care has improved in Ghana, there are clear opportunities for improvement. A move towards more integrated care, the development of locally adapted protocols, better financial support, and enhanced caregiver education are essential next steps in elevating the quality of paediatric burn management in Ghana.
{"title":"Healthcare Practitioners’ perspectives on paediatric burns management at Korle Bu Teaching Hospital, Ghana","authors":"Alberta A. Rockson , Natalie Benjamin-Damons , Sonti Imogene Pilusa","doi":"10.1016/j.burnso.2024.100387","DOIUrl":"10.1016/j.burnso.2024.100387","url":null,"abstract":"<div><h3>Background</h3><div>Paediatric burns pose significant challenges in healthcare management. Paediatric burns require specialized care due to the distinct anatomical and physiological characteristics of children, which make them more vulnerable to complications. In resource-limited settings like Ghana, the absence of adequate supplies and standardized protocols can exacerbate these challenges, necessitating the need for a comprehensive understanding of the perspectives of healthcare practitioners involved in their care.</div><div>Study Objective.</div><div>To explore healthcare practitioners’ perspectives on paediatric burns management at a tertiary hospital, Ghana, covering current practices, barriers, impacts on patients and families, and recommendations for improvement.</div></div><div><h3>Methodology</h3><div>This study employed a qualitative research approach utilizing Focus Group Discussion (FGD) with 15 participants from various disciplines, including Plastic Surgery, Medicine, Anaesthetics, Physiotherapy, Occupational Therapy, Dietetics, Nursing, Pharmacy, Clinical Psychology, Public Health Nursing and. Laboratory Scientist. Participants were recruited through a convenience sampling technique. The discussion lasting approximately 90 min, were audio recorded, and facilitated by a discussion guide based on existing literature. The audio recordings were transcribed verbatim, and the transcripts were compared with handwritten notes for accuracy. The final transcribed data were coded and analyzed using thematic content analysis to identify recurring themes and patterns.</div></div><div><h3>Results</h3><div>Findings revealed four primary themes: strengths of current practices (multidisciplinary approach, experienced practitioners), barriers (lack of formal protocols, infrastructure limitations, financial burdens), contextual factors influencing burn care (psychological trauma, inadequate support, socio-cultural beliefs and socioeconomic status), and recommendations for enhancing burns care (improved social welfare, facility upgrades, staff training and mental health support).</div></div><div><h3>Conclusion</h3><div>While burns care has improved in Ghana, there are clear opportunities for improvement. A move towards more integrated care, the development of locally adapted protocols, better financial support, and enhanced caregiver education are essential next steps in elevating the quality of paediatric burn management in Ghana.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"9 ","pages":"Article 100387"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143155891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.burnso.2024.100391
Roos F.C. Salemans , Denise van Uden , Ymke Lucas , Anouk Pijpe , Eelke Bosma , Esther Middelkoop , Michiel H.J. Verhofstad , Margriet E. van Baar , Cornelis H. van der Vlies , National Burn Care, Education, Research group, the Netherlands, Dutch Burn Repository group
Early excision and grafting are standard care for severe burns, though implementation varies globally. In the Netherlands, surgery for moderate and severe burns tends to be relatively late. This study analysed the timing of surgery in Dutch burn care by examining patient, injury and treatment characteristics, and clinical outcomes. A multicentre registry-based cohort study was conducted using data from the Dutch Burn Repository R3 (2009–2021), including adult patients who underwent surgery at a Dutch burn centre. The primary outcome was surgical timing, with patients classified into early (≤7 days) and late surgery (>7 days) groups. Multivariable logistic regression identified predictors of early surgery, while trends in timing were assessed with quantile regression. The median time to surgery was 14 days (Q1–Q3: 9.0–19.0), with 670 of 3291 patients receiving early surgery (20 %). Surgical timing increased slightly over the 13-year period. Predictors of early surgery included older age, larger total body surface area burned, psychiatric medical history, and flame, flash, and contact burns compared to scald burns. This study underscores the nuanced Dutch policy regarding surgery and the influence of burn severity on surgical timing. Further research is needed, focusing on patient-centred outcomes and international perspectives.
{"title":"Timing of surgery in acute burn care: A multicentre registry-based cohort study","authors":"Roos F.C. Salemans , Denise van Uden , Ymke Lucas , Anouk Pijpe , Eelke Bosma , Esther Middelkoop , Michiel H.J. Verhofstad , Margriet E. van Baar , Cornelis H. van der Vlies , National Burn Care, Education, Research group, the Netherlands, Dutch Burn Repository group","doi":"10.1016/j.burnso.2024.100391","DOIUrl":"10.1016/j.burnso.2024.100391","url":null,"abstract":"<div><div>Early excision and grafting are standard care for severe burns, though implementation varies globally. In the Netherlands, surgery for moderate and severe burns tends to be relatively late. This study analysed the timing of surgery in Dutch burn care by examining patient, injury and treatment characteristics, and clinical outcomes. A multicentre registry-based cohort study was conducted using data from the Dutch Burn Repository R3 (2009–2021), including adult patients who underwent surgery at a Dutch burn centre. The primary outcome was surgical timing, with patients classified into early (≤7 days) and late surgery (>7 days) groups. Multivariable logistic regression identified predictors of early surgery, while trends in timing were assessed with quantile regression. The median time to surgery was 14 days (Q1–Q3: 9.0–19.0), with 670 of 3291 patients receiving early surgery (20 %). Surgical timing increased slightly over the 13-year period. Predictors of early surgery included older age, larger total body surface area burned, psychiatric medical history, and flame, flash, and contact burns compared to scald burns. This study underscores the nuanced Dutch policy regarding surgery and the influence of burn severity on surgical timing. Further research is needed, focusing on patient-centred outcomes and international perspectives.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"9 ","pages":"Article 100391"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143155845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.burnso.2024.100388
Milly S. van de Warenburg , Sophie A. Riesmeijer , Stefan Hummelink , Dietmar J.O. Ulrich , Mariëlle L.A.W. Vehmeijer-Heeman
Since the introduction of portable electronic devices in the past two decades, reports of burn injuries caused by exploding or leaking batteries have been increasing. We present a case of a 9-year-old patient suffering deep dermal burn wounds due to a power bank malfunctioning, highlighting the potential dangers associated with these devices. This case appears to be part of a growing trend of lithium battery-related accidents, which can lead to a combination of flame, chemical, electrical, and contact burns. Healthcare providers must be prepared to manage the distinctive and often complex nature of battery-related burn injuries, which may differ substantially from traditional thermal burns in terms of depth, severity, and the required treatment protocols.
{"title":"Burn by battery, the dangers of portable devices − A case report","authors":"Milly S. van de Warenburg , Sophie A. Riesmeijer , Stefan Hummelink , Dietmar J.O. Ulrich , Mariëlle L.A.W. Vehmeijer-Heeman","doi":"10.1016/j.burnso.2024.100388","DOIUrl":"10.1016/j.burnso.2024.100388","url":null,"abstract":"<div><div>Since the introduction of portable electronic devices in the past two decades, reports of burn injuries caused by exploding or leaking batteries have been increasing. We present a case of a 9-year-old patient suffering deep dermal burn wounds due to a power bank malfunctioning, highlighting the potential dangers associated with these devices. This case appears to be part of a growing trend of lithium battery-related accidents, which can lead to a combination of flame, chemical, electrical, and contact burns. Healthcare providers must be prepared to manage the distinctive and often complex nature of battery-related burn injuries, which may differ substantially from traditional thermal burns in terms of depth, severity, and the required treatment protocols.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"9 ","pages":"Article 100388"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143155440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.burnso.2024.100386
Juan Ludeña , Diana Rojas , Pedro Ciudad , Walter Navarro , Rafael Rossi , Annelisse Travi
Toxic epidermal necrolysis (TEN) is a rare immune-mediated adverse skin reaction; secondary in most cases to the administration of a drug. Due to its high mortality, immediate diagnosis and management in an intensive care unit is essential. In addition, temporary coverage of skin lesions should be performed to avoid fluid loss, reduce pain and prevent infection. An alternative for this is the use of porcine skin, which has been shown to have good aesthetic results in the management of TEN.
Objective
To demonstrate the benefits provided by the use of porcine skin as a biological dressing in TEN injuries in the Plastic, Reconstructive and Burn Surgery service of the Arzobispo Loayza National Hospital.
Method
Descriptive, retrospective study of TEN cases referred to our service from 2016 to 2020 where 9 patients were found, with dermal involvement >30 % of total body surface area (TBSA) and who underwent porcine skin as a biological dressing.
Results
The most frequent identifiable cause of TEN was the use of antibiotics. The mortality was 33 %. Total epithelialization of the lesions was obtained in 7 of the 9 patients (77 %) and the mean epithelialization time was 14.2 days.
Conclusion
The use of the porcine skin dressing is effective in patients with TEN and favors its re-epithelialization.
{"title":"Benefits of the use of porcine skin for the management of toxic epidermal necrolysis injuries: Review of the literature","authors":"Juan Ludeña , Diana Rojas , Pedro Ciudad , Walter Navarro , Rafael Rossi , Annelisse Travi","doi":"10.1016/j.burnso.2024.100386","DOIUrl":"10.1016/j.burnso.2024.100386","url":null,"abstract":"<div><div>Toxic epidermal necrolysis (TEN) is a rare immune-mediated adverse skin reaction; secondary in most cases to the administration of a drug. Due to its high mortality, immediate diagnosis and management in an intensive care unit is essential. In addition, temporary coverage of skin lesions should be performed to avoid fluid loss, reduce pain and prevent infection. An alternative for this is the use of porcine skin, which has been shown to have good aesthetic results in the management of TEN.</div></div><div><h3>Objective</h3><div>To demonstrate the benefits provided by the use of porcine skin as a biological dressing in TEN injuries in the Plastic, Reconstructive and Burn Surgery service of the Arzobispo Loayza National Hospital.</div></div><div><h3>Method</h3><div>Descriptive, retrospective study of TEN cases referred to our service from 2016 to 2020 where 9 patients were found, with dermal involvement >30 % of total body surface area (TBSA) and who underwent porcine skin as a biological dressing.</div></div><div><h3>Results</h3><div>The most frequent identifiable cause of TEN was the use of antibiotics. The mortality was 33 %. Total epithelialization of the lesions was obtained in 7 of the 9 patients (77 %) and the mean epithelialization time was 14.2 days.</div></div><div><h3>Conclusion</h3><div>The use of the porcine skin dressing is effective in patients with TEN and favors its re-epithelialization.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"9 ","pages":"Article 100386"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143155439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The burn wound is directly affected by the general condition of the patient and also has a direct impact on the same leading to conditions pathology of the musculoskeletal system. Purulent arthritis is a pathological condition in which the joints of the body get inflamed as a result of bacterial infection.
The aim of the present study was identification of purulent arthritis patients and to evaluate different surgical treatment in burn patients’ low extremities.
Material and methods
During a 11-year period, 39 patients with burn injuries complicated by purulent arthritis of the joints of the lower extremities treated in the burn department of the Samarkand Center of Emergency Medical Care, Samarkand, Uzbekistan between 2010 and 2020 were enrolled in the present study. The diagnosis is made on the basis of a characteristic anamnesis. Blood tests confirming the presence of acute inflammation. The main diagnostic method purulent arthritis is puncture of the joint with subsequent examination of the punctate. All patients received comprehensive general and local treatment included necrotomy, necrectomy and 1 to 3 operations were performed to plastically close deep and large burn wounds. We performed an arthrotomy in 31 patients. In all cases, arthrotomy was performed as a planned surgical intervention. Unfortunately we performed amputation in 8 patients.
Results
In the postoperative period, drainage of the joint cavity through the opening and wound, the application of paraphene to the surrounding tissues of the joints, massage, physical therapy, treatment physical physiotherapy exercises, laser application made it possible to achieve satisfactory results.
Conclusions
The described herein method of treatment of purulent arthritis of the lower extremities has improved treatment results, expanded survival rates, reduced probability of complications and disabilities.
{"title":"Our experience of treatment of purulent arthritis in lower extremities after burn injury","authors":"B.M. Shakirov , D.Sh. Karabaev , S.X. Zoxidova , Sh. Ziyadullaev","doi":"10.1016/j.burnso.2024.100383","DOIUrl":"10.1016/j.burnso.2024.100383","url":null,"abstract":"<div><h3>Background</h3><div>The burn wound is directly affected by the general condition of the patient and also has a direct impact on the same leading to conditions pathology of the musculoskeletal system. Purulent arthritis is a pathological condition in which the joints of the body get inflamed as a result of bacterial infection.</div><div><strong>The aim</strong> of the present study was identification of purulent arthritis patients and to evaluate different surgical treatment in burn patients’ low extremities.</div></div><div><h3>Material and methods</h3><div>During a 11-year period, 39 patients with burn injuries complicated by purulent arthritis of the joints of the lower extremities treated in the burn department of the Samarkand Center of Emergency Medical Care, Samarkand, Uzbekistan between 2010 and 2020 were enrolled in the present study. The diagnosis is made on the basis of a characteristic anamnesis. Blood tests confirming the presence of acute inflammation. The main diagnostic method purulent arthritis is puncture of the joint with subsequent examination of the punctate. All patients received comprehensive general and local treatment included necrotomy, necrectomy and 1 to 3 operations were performed to plastically close deep and large burn wounds. We performed an arthrotomy in 31 patients. In all cases, arthrotomy was performed as a planned surgical intervention. Unfortunately we performed amputation in 8 patients.</div></div><div><h3>Results</h3><div>In the postoperative period, drainage of the joint cavity through the opening and wound, the application of paraphene to the surrounding tissues of the joints, massage, physical therapy, treatment physical physiotherapy exercises, laser application made it possible to achieve satisfactory results.</div></div><div><h3>Conclusions</h3><div>The described herein method of treatment of purulent arthritis of the lower extremities has improved treatment results, expanded survival rates, reduced probability of complications and disabilities.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"9 ","pages":"Article 100383"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143155442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.burnso.2024.100390
Ginger Egberts , Fred Vermolen , Qiyao Peng , H.Ibrahim Korkmaz , Paul van Zuijlen
Severe second-degree ‘partial thickness’ and third-degree ‘full thickness’ burns are characterized by damage to the dermal layer of the skin. In the dermis, specialized cells called fibroblasts play a crucial role in wound healing. These cells produce collagen, a protein that provides strength and structure to the skin. After burn injury, fibroblasts migrate to the injured area and start producing and depositing collagen to help repair the damaged tissue. While contraction is essential for closing the wound, it can also result in scar contraction (contractures), especially in more severe burns. This contraction creates stresses on the skin, which can deteriorate the mobility of joints near the burn.
This article overviews the most recent research results in computer simulations of scar contraction after burns.
{"title":"How can mathematics be used to improve burn care?","authors":"Ginger Egberts , Fred Vermolen , Qiyao Peng , H.Ibrahim Korkmaz , Paul van Zuijlen","doi":"10.1016/j.burnso.2024.100390","DOIUrl":"10.1016/j.burnso.2024.100390","url":null,"abstract":"<div><div>Severe second-degree ‘partial thickness’ and third-degree ‘full thickness’ burns are characterized by damage to the dermal layer of the skin. In the dermis, specialized cells called fibroblasts play a crucial role in wound healing. These cells produce collagen, a protein that provides strength and structure to the skin. After burn injury, fibroblasts migrate to the injured area and start producing and depositing collagen to help repair the damaged tissue. While contraction is essential for closing the wound, it can also result in scar contraction (contractures), especially in more severe burns. This contraction creates stresses on the skin, which can deteriorate the mobility of joints near the burn.</div><div>This article overviews the most recent research results in computer simulations of scar contraction after burns.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"9 ","pages":"Article 100390"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143155438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-17DOI: 10.1016/j.burnso.2024.100382
Deepak K. Ozhathil , Teresa R. Kontos , Kim M. Priban , Evan P. Bailey , Elizabeth A. Halicki , Steven A. Kahn MD
Over the past four decades, obesity rates in the United States have consistently increased, with current estimates indicating that over 42% of adults are affected [1]. In contrast, burn injuries have decreased significantly during the same period, largely due to effective public awareness campaigns and improvements of safety regulations [2]. Despite these opposing trends, the percentage of burn patients at the author’s hospital with a concurrent diagnosis of obesity has risen, posing unique challenges for clinical providers. Patients with elevated body weight and extensive burns require special considerations for proper positioning, wound exposure, and minimizing ergonomic risks to healthcare workers [3]. Currently, there is a notable lack of comprehensive guidelines on operative strategies specifically tailored for this patient population. In response to this knowledge gap, the authors’ institution implemented novel surgical techniques designed to manage circumferential burn wounds in patients with higher body weight.
{"title":"Innovative surgical management of large burn wounds in patients with elevated body weight to enhance team safety","authors":"Deepak K. Ozhathil , Teresa R. Kontos , Kim M. Priban , Evan P. Bailey , Elizabeth A. Halicki , Steven A. Kahn MD","doi":"10.1016/j.burnso.2024.100382","DOIUrl":"10.1016/j.burnso.2024.100382","url":null,"abstract":"<div><div>Over the past four decades, obesity rates in the United States have consistently increased, with current estimates indicating that over 42% of adults are affected <span><span>[1]</span></span>. In contrast, burn injuries have decreased significantly during the same period, largely due to effective public awareness campaigns and improvements of safety regulations <span><span>[2]</span></span>. Despite these opposing trends, the percentage of burn patients at the author’s hospital with a concurrent diagnosis of obesity has risen, posing unique challenges for clinical providers. Patients with elevated body weight and extensive burns require special considerations for proper positioning, wound exposure, and minimizing ergonomic risks to healthcare workers <span><span>[3]</span></span>. Currently, there is a notable lack of comprehensive guidelines on operative strategies specifically tailored for this patient population. In response to this knowledge gap, the authors’ institution implemented novel surgical techniques designed to manage circumferential burn wounds in patients with higher body weight.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"9 ","pages":"Article 100382"},"PeriodicalIF":0.0,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142704036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-07DOI: 10.1016/j.burnso.2024.100378
Olivia Fruergaard, Mathias Ørholt, Christian Lyngsaa Lang, Jennifer Berg Drejøe, Mikkel Herly, Peter Vester-Glowinski, David Hebbelstrup Jensen
Background
Restoring a functional dermis following extensive, deep wounds, such as those caused by severe burns, presents a significant reconstructive challenge. Although split thickness skin graft (STSG) and full thickness skin graft (FTSG) can provide adequate coverage, dermal templates are becoming increasingly important in restoring function. The purpose of this systematic review is to assess the efficacy, advantages and limitations of employing NovoSorb® Biodegradable Temporizing Matrix (BTM) in the treatment of complex wounds.
Methods
The systematic review was carried out in accordance with PRISMA and MOOSE guidelines when appropriate. All studies until April 2024 involving patients treated with NovoSorb® BTM were considered. Infection, adverse events, and BTM loss were among the outcomes evaluated.
Results
We identified 725 studies, and 69 were included after screening. The included studies involved 880 participants and were mostly concerned with the management of burns, but other difficult wounds were also addressed. The infection rate was 10%, yet only few reported losing their BTM as a result of this consequence. The incidence of adverse events was low, with the majority of trials reporting no adverse events related to BTM.
Conclusion
Our systematic review focused primarily on case series and case reports that demonstrated the efficacy of Novosorp BTM and the rarity of side effects. However, there were very few comparison research. More research is needed to fully analyze the efficacy, limitations, and downsides of using Novosorb (BTM).
{"title":"A systematic review of the Novosorb® Biodegradable Temporizing Matrix in the treatment of complex wounds","authors":"Olivia Fruergaard, Mathias Ørholt, Christian Lyngsaa Lang, Jennifer Berg Drejøe, Mikkel Herly, Peter Vester-Glowinski, David Hebbelstrup Jensen","doi":"10.1016/j.burnso.2024.100378","DOIUrl":"10.1016/j.burnso.2024.100378","url":null,"abstract":"<div><h3>Background</h3><div>Restoring<!--> <!-->a<!--> <!-->functional<!--> <!-->dermis<!--> <!-->following<!--> <!-->extensive,<!--> <!-->deep<!--> <!-->wounds,<!--> <!-->such<!--> <!-->as<!--> <!-->those<!--> <!-->caused<!--> <!-->by<!--> <!-->severe<!--> <!-->burns,<!--> <!-->presents<!--> <!-->a<!--> <!-->significant<!--> <!-->reconstructive<!--> <!-->challenge. Although split thickness skin graft (STSG) and full thickness skin graft (FTSG) can provide adequate coverage, dermal templates are becoming increasingly important in restoring function. The purpose of this systematic review is to assess the efficacy, advantages and limitations of employing NovoSorb® Biodegradable Temporizing Matrix (BTM) in the treatment of complex wounds.</div></div><div><h3>Methods</h3><div>The systematic review was carried out in accordance with PRISMA and MOOSE guidelines when appropriate. All studies until April 2024 involving patients treated with NovoSorb® BTM were considered. Infection,<!--> <!-->adverse<!--> <!-->events,<!--> <!-->and<!--> <!-->BTM<!--> <!-->loss<!--> <!-->were<!--> <!-->among<!--> <!-->the<!--> <!-->outcomes<!--> <!-->evaluated.</div></div><div><h3>Results</h3><div>We identified 725 studies, and 69 were included after screening. The included studies involved 880 participants and were mostly concerned with the management of burns, but other difficult wounds were also addressed. The infection rate was 10%, yet only few reported losing their BTM as a result of this consequence. The incidence of adverse events was low, with the majority of trials reporting no adverse events related to BTM.</div></div><div><h3>Conclusion</h3><div>Our systematic review focused primarily on case series and case reports that demonstrated the efficacy of Novosorp BTM and the rarity of side effects. However, there were very few comparison research. More research is needed to fully analyze the efficacy, limitations, and downsides of using Novosorb (BTM).</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"9 ","pages":"Article 100378"},"PeriodicalIF":0.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142655861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-07DOI: 10.1016/j.burnso.2024.100381
Sinan Dogan , Arina Mahmoud , Ingrid Steinvall , Elin Albertsson , Elina Bergman , Jamila Halimi , Moustafa Elmasry
Background
It has been known for decades that early excision of burns reduces morbidity and mortality. Early surgical excision and skin grafting has become the most important part of successful healing in burn management, especially in major burns. However, it is not entirely clear whether early excision and skin transplantation has the same advantages in smaller burns and there is no consensus on the timing of skin grafting in this group. The aim was to investigate the effect of timing and other factors for skin graft take rate among minor burns.
Methods
This retrospective study included patients with thermal injury, a burn size smaller than 11 % total body surface area (TBSA), and who were treated with a skin graft operation. Take rate at the second dressing change after operation was used as main outcome, a cut-off of 95% take rate was for the multivariable logistic regression.
Results
A total of 195 patients were included, median (IQR) age was 42 (9–68) years, 65 % were male, and median (IQR) area of deep burns was 2 (1–4) % of the body surface area (BSA). Multivariable regression showed that smaller area of deep burns and scalds (compared with flame and contact burns) were associated with a take rate of ≥ 95 %. Age, timing of the skin graft transplantation, and plasma C-reactive protein showed no independent effect on take rate. The regression model was significant but weak (ROC AUC 0.71, 95 % CI 0.62–0.79).
Conclusion
Our results suggest that the extent and depth of the burn are the most important factors for skin graft take rate among minor burns, while timing of the transplantation is not associated with take rate for the skin graft. The advantageous effect of scalds may be interpreted to mean that scalds in general are more superficial than flame and contact burns, a difference that may not be detected by the use of a Lund and Browder chart. The conclusion is, however, tempered by the retrospective study design and the relatively low discriminatory power in our study.
背景数十年来，人们一直知道烧伤的早期切除可以降低发病率和死亡率。早期手术切除和皮肤移植已成为烧伤治疗中成功愈合的最重要部分，尤其是在大面积烧伤中。然而，对于较小面积的烧伤，早期切除和皮肤移植是否具有同样的优势尚不完全清楚，而且对于这类烧伤的植皮时机也没有达成共识。这项回顾性研究纳入了热损伤、烧伤面积小于总体表面积（TBSA）11%、接受植皮手术治疗的患者。结果 共纳入 195 名患者，中位（IQR）年龄为 42（9-68）岁，65% 为男性，中位（IQR）深度烧伤面积为体表面积（BSA）的 2（1-4）%。多变量回归显示，深度烧伤和烫伤（与火焰烧伤和接触性烧伤相比）面积越小，治愈率就越高（≥ 95%）。年龄、植皮时间和血浆 C 反应蛋白对取出率没有独立影响。我们的结果表明，烧伤的范围和深度是影响轻度烧伤植皮率的最重要因素，而移植时间与植皮率无关。烫伤的有利影响可解释为烫伤一般比火焰烧伤和接触性烧伤更浅，使用伦德和布劳德图表可能无法发现这种差异。不过，由于我们的研究采用的是回顾性研究设计，且鉴别力相对较低，因此这一结论并不成立。
{"title":"Skin graft take rate among minor burns – A cohort study to investigate the effect of factors such as burn depth, burn size, and timing of the operation","authors":"Sinan Dogan , Arina Mahmoud , Ingrid Steinvall , Elin Albertsson , Elina Bergman , Jamila Halimi , Moustafa Elmasry","doi":"10.1016/j.burnso.2024.100381","DOIUrl":"10.1016/j.burnso.2024.100381","url":null,"abstract":"<div><h3>Background</h3><div>It has been known for decades that early excision of burns reduces morbidity and mortality. Early surgical excision and skin grafting has become the most important part of successful healing in burn management, especially in major burns. However, it is not entirely clear whether early excision and skin transplantation has the same advantages in smaller burns and there is no consensus on the timing of skin grafting in this group. The aim was to investigate the effect of timing and other factors for skin graft take rate among minor burns.</div></div><div><h3>Methods</h3><div>This retrospective study included patients with thermal injury, a burn size smaller than 11 % total body surface area (TBSA), and who were treated with a skin graft operation. Take rate at the second dressing change after operation was used as main outcome, a cut-off of 95% take rate was for the multivariable logistic regression.</div></div><div><h3>Results</h3><div>A total of 195 patients were included, median (IQR) age was 42 (9–68) years, 65 % were male, and median (IQR) area of deep burns was 2 (1–4) % of the body surface area (BSA). Multivariable regression showed that smaller area of deep burns and scalds (compared with flame and contact burns) were associated with a take rate of ≥ 95 %. Age, timing of the skin graft transplantation, and plasma C-reactive protein showed no independent effect on take rate. The regression model was significant but weak (ROC AUC 0.71, 95 % CI 0.62–0.79).</div></div><div><h3>Conclusion</h3><div>Our results suggest that the extent and depth of the burn are the most important factors for skin graft take rate among minor burns, while timing of the transplantation is not associated with take rate for the skin graft. The advantageous effect of scalds may be interpreted to mean that scalds in general are more superficial than flame and contact burns, a difference that may not be detected by the use of a Lund and Browder chart. The conclusion is, however, tempered by the retrospective study design and the relatively low discriminatory power in our study.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"9 ","pages":"Article 100381"},"PeriodicalIF":0.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142655860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","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