Edward Santos, Kaitlyn L. Chacon, Lauren J. Shepler, K. McMullen, Mary D Slavin, Marc van de Rijn, K. Kowalske, Colleen M. Ryan, Jeffrey C Schneider
Balance is an important component of daily function and impairments can lead to injury and quality-of-life limitations. Balance is not well studied in the burn population. This study examines the frequency of long-term balance impairments and associated factors after a burn injury. The Burn Model System National Database was analyzed. Trouble with balance was self-reported at discharge, 6, 12, 24, and 60 months after injury. Regression analyses examined the associations between demographic and clinical characteristics and balance impairments at 12 months. Of 572 participants, balance impairments were most reported at discharge (40.3%), continuing over 60 months (26.8–36.0%). Those reporting balance impairments (n = 153) were more likely to be older, unemployed, have Medicaid or Medicare, receive inpatient rehabilitation, receive outpatient physical or occupational therapy, have vision problems, have leg or feet burns and swelling, and have foot numbness compared to those without (p ≤ 0.001). Regression analysis demonstrated a 4% increased odds of balance impairment for every increase in year of age (p < 0.001), 71% lower odds if employed at time of injury (p < 0.001), and 140% higher odds if receiving outpatient physical or occupational therapy at 12 months (p = 0.008). Common reports of balance impairments highlight the need for routine screenings to identify burn survivors that may benefit from targeted interventions.
{"title":"Balance Impairment in the Burn Population: A Burn Model System National Database Study","authors":"Edward Santos, Kaitlyn L. Chacon, Lauren J. Shepler, K. McMullen, Mary D Slavin, Marc van de Rijn, K. Kowalske, Colleen M. Ryan, Jeffrey C Schneider","doi":"10.3390/ebj5030023","DOIUrl":"https://doi.org/10.3390/ebj5030023","url":null,"abstract":"Balance is an important component of daily function and impairments can lead to injury and quality-of-life limitations. Balance is not well studied in the burn population. This study examines the frequency of long-term balance impairments and associated factors after a burn injury. The Burn Model System National Database was analyzed. Trouble with balance was self-reported at discharge, 6, 12, 24, and 60 months after injury. Regression analyses examined the associations between demographic and clinical characteristics and balance impairments at 12 months. Of 572 participants, balance impairments were most reported at discharge (40.3%), continuing over 60 months (26.8–36.0%). Those reporting balance impairments (n = 153) were more likely to be older, unemployed, have Medicaid or Medicare, receive inpatient rehabilitation, receive outpatient physical or occupational therapy, have vision problems, have leg or feet burns and swelling, and have foot numbness compared to those without (p ≤ 0.001). Regression analysis demonstrated a 4% increased odds of balance impairment for every increase in year of age (p < 0.001), 71% lower odds if employed at time of injury (p < 0.001), and 140% higher odds if receiving outpatient physical or occupational therapy at 12 months (p = 0.008). Common reports of balance impairments highlight the need for routine screenings to identify burn survivors that may benefit from targeted interventions.","PeriodicalId":72961,"journal":{"name":"European burn journal","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141804978","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}
Wei Lun Wong, Kristina Carlsson, M. Lindblad, Olivia Sjökvist, F. Huss
Burn mass casualty event occurrences are rare but will place significant burdens on any burn unit or healthcare system. Effective disaster preparedness plays a significant role in mitigating the aftermath of a burn mass casualty. The aim of this study was to assess the resource requirements during the initial two weeks of a burn mass casualty event. Eight patients in a burn mass casualty event were simulated using the Emergo Train System®. These simulated patients were matched with real historical patients treated in our burn centre, and their resource requirements were analysed. An average of eight staff is required to care for a patient per day along with almost 75 h of operating time (excluding anaesthesia and turnover time). A substantial quantity of consumables was used in the first two weeks. This study has demonstrated the substantial material consumption and staff requirements in the first two weeks of management in a burn mass casualty event. Such findings will offer valuable insight for disaster preparedness planning and resource management strategies.
{"title":"Resource Requirements in a Burn Mass Casualty Event","authors":"Wei Lun Wong, Kristina Carlsson, M. Lindblad, Olivia Sjökvist, F. Huss","doi":"10.3390/ebj5030022","DOIUrl":"https://doi.org/10.3390/ebj5030022","url":null,"abstract":"Burn mass casualty event occurrences are rare but will place significant burdens on any burn unit or healthcare system. Effective disaster preparedness plays a significant role in mitigating the aftermath of a burn mass casualty. The aim of this study was to assess the resource requirements during the initial two weeks of a burn mass casualty event. Eight patients in a burn mass casualty event were simulated using the Emergo Train System®. These simulated patients were matched with real historical patients treated in our burn centre, and their resource requirements were analysed. An average of eight staff is required to care for a patient per day along with almost 75 h of operating time (excluding anaesthesia and turnover time). A substantial quantity of consumables was used in the first two weeks. This study has demonstrated the substantial material consumption and staff requirements in the first two weeks of management in a burn mass casualty event. Such findings will offer valuable insight for disaster preparedness planning and resource management strategies.","PeriodicalId":72961,"journal":{"name":"European burn journal","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141685719","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}
R. S. M. Thambithurai, Lotte van Dammen, M. V. van Baar, H. Wanders, A. Weel-Koenders, T. Haanstra, C. V. van Schie, P. V. van Zuijlen, C. H. van der Vlies, E. Bosma, C. A. Lansdorp, I. Spronk, N. V. Van Loey
Burn care quality indicators are used to monitor and improve quality of care and for benchmark purposes. The perspectives of burn survivors, however, are not included in current sets of quality indicators while patient-centred care gains importance. The aim of this study was to explore burn survivors’ perspectives on quality aspects of burn care, which was used to translate their perspectives into patient-centred quality of care indicators. Qualitative descriptive research was conducted in a patient panel group. First, thematic analysis was applied to the focus groups to identify overarching themes. Second, patient-centred quality indicators, informed by burn survivors’ valued aspects of care, were defined. Ten burn survivors with an average age of 54 years (SD = 11; range 38–72 years) and mean TBSA burned of 14% (SD = 11%; range 5–35%) participated in two focus groups. Four overarching themes were identified, pointing to the importance of (1) information tailored to the different phases of recovery, (2) significant others’ wellbeing and involvement, (3) a therapeutic relationship and low-threshold access to healthcare professionals and (4) to participate in decision-making. Eighteen patient-centred process quality of care indicators within nine aspects of care were formulated. The overarching themes are reflected in patient-centred quality indicators, which present a broadened and complementary view of existing clinical quality indicators for burn care. Evaluating these patient-centred quality indicators may increase quality of care and refine patient-centred care.
{"title":"Qualitative Descriptive Research Investigating Burn Survivors’ Perspectives on Quality of Care Aspects","authors":"R. S. M. Thambithurai, Lotte van Dammen, M. V. van Baar, H. Wanders, A. Weel-Koenders, T. Haanstra, C. V. van Schie, P. V. van Zuijlen, C. H. van der Vlies, E. Bosma, C. A. Lansdorp, I. Spronk, N. V. Van Loey","doi":"10.3390/ebj5030021","DOIUrl":"https://doi.org/10.3390/ebj5030021","url":null,"abstract":"Burn care quality indicators are used to monitor and improve quality of care and for benchmark purposes. The perspectives of burn survivors, however, are not included in current sets of quality indicators while patient-centred care gains importance. The aim of this study was to explore burn survivors’ perspectives on quality aspects of burn care, which was used to translate their perspectives into patient-centred quality of care indicators. Qualitative descriptive research was conducted in a patient panel group. First, thematic analysis was applied to the focus groups to identify overarching themes. Second, patient-centred quality indicators, informed by burn survivors’ valued aspects of care, were defined. Ten burn survivors with an average age of 54 years (SD = 11; range 38–72 years) and mean TBSA burned of 14% (SD = 11%; range 5–35%) participated in two focus groups. Four overarching themes were identified, pointing to the importance of (1) information tailored to the different phases of recovery, (2) significant others’ wellbeing and involvement, (3) a therapeutic relationship and low-threshold access to healthcare professionals and (4) to participate in decision-making. Eighteen patient-centred process quality of care indicators within nine aspects of care were formulated. The overarching themes are reflected in patient-centred quality indicators, which present a broadened and complementary view of existing clinical quality indicators for burn care. Evaluating these patient-centred quality indicators may increase quality of care and refine patient-centred care.","PeriodicalId":72961,"journal":{"name":"European burn journal","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141714407","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 injuries are among the most traumatic events a person can endure, often causing significant psychological dysfunction and severe pain. Hypnosis shows promise as a complementary intervention to manage pain and reduce the psychological distress associated with burn injury and treatment. This paper reviews the literature regarding hypnosis and potential applications of hypnosis in the management of burns. Hypnosis offers an effective, low-cost intervention that is widely applicable in the management of burns and can play a role in more acute and austere settings where resources are often limited.
{"title":"Hypnosis in Burn Care: Efficacy, Applications, and Implications for Austere Settings","authors":"Deanna C. Denman","doi":"10.3390/ebj5030020","DOIUrl":"https://doi.org/10.3390/ebj5030020","url":null,"abstract":"Burn injuries are among the most traumatic events a person can endure, often causing significant psychological dysfunction and severe pain. Hypnosis shows promise as a complementary intervention to manage pain and reduce the psychological distress associated with burn injury and treatment. This paper reviews the literature regarding hypnosis and potential applications of hypnosis in the management of burns. Hypnosis offers an effective, low-cost intervention that is widely applicable in the management of burns and can play a role in more acute and austere settings where resources are often limited.","PeriodicalId":72961,"journal":{"name":"European burn journal","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141711481","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}
The European Burns Association (EBA), as the proud owner of the European Burn Journal (EBJ), is committed to fostering collaboration and maximizing the impact of our common goals, i [...]
{"title":"European Burns Association (EBA)—Summer 2024 News","authors":"Stian Almeland, Nadia Depetris","doi":"10.3390/ebj5020017","DOIUrl":"https://doi.org/10.3390/ebj5020017","url":null,"abstract":"The European Burns Association (EBA), as the proud owner of the European Burn Journal (EBJ), is committed to fostering collaboration and maximizing the impact of our common goals, i [...]","PeriodicalId":72961,"journal":{"name":"European burn journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141341725","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}
C. Smolle, Anna Alexandra Elisabeth Persson, Caroline Lind, F. Huss
Burns are common and devastating injuries, often necessitating intensive care treatment and long-term hospitalisation, making burn patients susceptible to hospital-acquired anaemia and blood transfusion. The purpose of this study was to assess diagnostic blood loss in burn patients at the burn intensive care unit (BICU) at Uppsala University Hospital between 1 September 2016 and 30 June 2019. Medical records were screened; age, gender, mechanism, % total body surface area (TBSA), Baux score, length of stay, days on the respirator, days of continuous renal replacement therapy, number of operations, and number of blood tests per patient were assessed. Volume per blood test was estimated as the volume needed for the specific test tube. A total of 166 patients were included in the study. The mean TBSA was 18.0% ± 20, and the mean length of stay was 17.0 ± 41 days. Median diagnostic blood loss was 13.1 mL/day/patient (IQR 7.0, 23.9) and correlated positively with burn extent, Baux score, and mortality. Daily diagnostic blood loss/%TBSA/patient was 1.2 mL (IQR 0.7, 2.3). Transfusion of blood products occurred in 73/166 patients (44%). In conclusion, diagnostic blood loss is greatly influenced by TBSA extent. The diagnostic blood loss can reach significant levels and may affect the transfusion rate.
{"title":"Total Body Surface Area Adjusted Daily Diagnostic Blood Loss May Be Higher in Minor Burns—Are Our Patients the Victims of Daily Routine?","authors":"C. Smolle, Anna Alexandra Elisabeth Persson, Caroline Lind, F. Huss","doi":"10.3390/ebj5020016","DOIUrl":"https://doi.org/10.3390/ebj5020016","url":null,"abstract":"Burns are common and devastating injuries, often necessitating intensive care treatment and long-term hospitalisation, making burn patients susceptible to hospital-acquired anaemia and blood transfusion. The purpose of this study was to assess diagnostic blood loss in burn patients at the burn intensive care unit (BICU) at Uppsala University Hospital between 1 September 2016 and 30 June 2019. Medical records were screened; age, gender, mechanism, % total body surface area (TBSA), Baux score, length of stay, days on the respirator, days of continuous renal replacement therapy, number of operations, and number of blood tests per patient were assessed. Volume per blood test was estimated as the volume needed for the specific test tube. A total of 166 patients were included in the study. The mean TBSA was 18.0% ± 20, and the mean length of stay was 17.0 ± 41 days. Median diagnostic blood loss was 13.1 mL/day/patient (IQR 7.0, 23.9) and correlated positively with burn extent, Baux score, and mortality. Daily diagnostic blood loss/%TBSA/patient was 1.2 mL (IQR 0.7, 2.3). Transfusion of blood products occurred in 73/166 patients (44%). In conclusion, diagnostic blood loss is greatly influenced by TBSA extent. The diagnostic blood loss can reach significant levels and may affect the transfusion rate.","PeriodicalId":72961,"journal":{"name":"European burn journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141381401","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}
Julie Beveridge, Curtis Budden, Abelardo Medina, Kathryne Faccenda, Shawn X Dodd, Edward Tredget
Acute coronary thrombosis is a known, but rare, contributor to morbidity and mortality in patients with thermal and electrical injuries. The overall incidence of myocardial infarction among burn patients is 1%, with an in-hospital post-infarction mortality of approximately 67%, whereas the overall mortality rate of the general burn patient population is from 1.4% to 18%. As such, early detection and effective peri-operative management are essential to optimize patient outcomes. Here, we report the details of the management of an adult male patient with a 65% total body surface area severe thermal injury, who developed an ST-elevation myocardial infarction (STEMI) in the resuscitation period. The patient was found to have 100% occlusion of his left anterior descending coronary artery, for which prompt coronary artery stent placement with a drug-eluting stent (DES) was performed. Following stent placement, the patient required dual antiplatelet therapy. The ongoing dual antiplatelet therapy required the development of a detailed peri-operative protocol involving pooled platelets, packed red blood cells, desmopressin (DDAVP™) and intraoperative monitoring of the patient’s coagulation parameters with thromboelastography for three staged operative interventions to achieve complete debridement and skin grafting of his burn wounds.
{"title":"Management of Concomitant Severe Thermal Injury and ST-Elevation Myocardial Infarction","authors":"Julie Beveridge, Curtis Budden, Abelardo Medina, Kathryne Faccenda, Shawn X Dodd, Edward Tredget","doi":"10.3390/ebj5020015","DOIUrl":"https://doi.org/10.3390/ebj5020015","url":null,"abstract":"Acute coronary thrombosis is a known, but rare, contributor to morbidity and mortality in patients with thermal and electrical injuries. The overall incidence of myocardial infarction among burn patients is 1%, with an in-hospital post-infarction mortality of approximately 67%, whereas the overall mortality rate of the general burn patient population is from 1.4% to 18%. As such, early detection and effective peri-operative management are essential to optimize patient outcomes. Here, we report the details of the management of an adult male patient with a 65% total body surface area severe thermal injury, who developed an ST-elevation myocardial infarction (STEMI) in the resuscitation period. The patient was found to have 100% occlusion of his left anterior descending coronary artery, for which prompt coronary artery stent placement with a drug-eluting stent (DES) was performed. Following stent placement, the patient required dual antiplatelet therapy. The ongoing dual antiplatelet therapy required the development of a detailed peri-operative protocol involving pooled platelets, packed red blood cells, desmopressin (DDAVP™) and intraoperative monitoring of the patient’s coagulation parameters with thromboelastography for three staged operative interventions to achieve complete debridement and skin grafting of his burn wounds.","PeriodicalId":72961,"journal":{"name":"European burn journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141387386","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}
Judith Lindert, Tina Straube, Beke Larsen, Julia Siebert, Eirini Liodaki, Kianusch Tafazzoli-Lari, Lutz Wünsch
To define the morphologic pattern of pediatric hand burns as visualized via optical coherence tomography (OCT) and dynamic OCT (D-OCT). We designed a scoring system to assess the depths of burn wounds on pediatric hands and tested this score in our cohort of children with burn injuries to the hand. Overall, 67 hand burns in 48 children (0–15 years) were prospectively examined. Scans were interpreted by two independent observers. Relevant OCT findings were surface irregularity, loss of epidermis, loss of dermal pattern (skin lines or papillary spots, loss of surface regularity and irregular vascular pattern of the plexus papillaris. Score values were calculated retrospectively. A score of 4 was associated with spontaneous healing without the need for skin grafting, with a positive predictive value of 97%. Deeper wounds with delayed healing and/or the need of skin grafting received a score of 5 or above, with an agreement of medical healing in 80% and a positive predictive value of 56%. OCT and D-OCT provide clinically useful additional information in cases of pediatric hand burns. The OCT burn score has the potential to support clinical decision making and, subsequently, improve clinical outcomes and shorten hospital stays.
{"title":"An Optical Tomography-Based Score to Assess Pediatric Hand Burns","authors":"Judith Lindert, Tina Straube, Beke Larsen, Julia Siebert, Eirini Liodaki, Kianusch Tafazzoli-Lari, Lutz Wünsch","doi":"10.3390/ebj5020013","DOIUrl":"https://doi.org/10.3390/ebj5020013","url":null,"abstract":"To define the morphologic pattern of pediatric hand burns as visualized via optical coherence tomography (OCT) and dynamic OCT (D-OCT). We designed a scoring system to assess the depths of burn wounds on pediatric hands and tested this score in our cohort of children with burn injuries to the hand. Overall, 67 hand burns in 48 children (0–15 years) were prospectively examined. Scans were interpreted by two independent observers. Relevant OCT findings were surface irregularity, loss of epidermis, loss of dermal pattern (skin lines or papillary spots, loss of surface regularity and irregular vascular pattern of the plexus papillaris. Score values were calculated retrospectively. A score of 4 was associated with spontaneous healing without the need for skin grafting, with a positive predictive value of 97%. Deeper wounds with delayed healing and/or the need of skin grafting received a score of 5 or above, with an agreement of medical healing in 80% and a positive predictive value of 56%. OCT and D-OCT provide clinically useful additional information in cases of pediatric hand burns. The OCT burn score has the potential to support clinical decision making and, subsequently, improve clinical outcomes and shorten hospital stays.","PeriodicalId":72961,"journal":{"name":"European burn journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140972460","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}
Maxime D. Cuijpers, Moniek Akkerman, Martin G. A. Baartmans, Paul P. M. van Zuijlen, Anouk Pijpe
Our study aimed to provide a description of the early childhood development of pediatric burn patients relative to Dutch reference values, using both pre- and post-burn data from the Dutch Development Instrument and the D-score. Data from the Dutch Development Instrument were used to calculate the D-score and age-standardized D-score. Similar to a growth chart, the D-score was used to plot pediatric burn patients’ development relative to Dutch reference values for their age. Pediatric burn patients’ (n = 38) median age at the time of injury was 1.0 (1.0–2.0) years old. Burn size ranged from 1.0% to 36.0% of the total body surface area. Ninety-five percent (± 6.0%) of pediatric burn patients passed each of the age-appropriate developmental milestones at the target age. The mean age-standardized D-score was just above the Dutch average (+0.49 SD [0.18, 0.80]) and did not vary depending on sex (p = 0.06) or burn size (p = 0.41). In conclusion, among pediatric patients aged up to two-and-a-half years old, with non-full thickness burns, development was on track relative to the Dutch reference values. Our findings offer valuable first insights into the early childhood development of pediatric burn patients and may alleviate some parental concerns.
{"title":"The Early Childhood Development of Pediatric Burn Patients","authors":"Maxime D. Cuijpers, Moniek Akkerman, Martin G. A. Baartmans, Paul P. M. van Zuijlen, Anouk Pijpe","doi":"10.3390/ebj5020012","DOIUrl":"https://doi.org/10.3390/ebj5020012","url":null,"abstract":"Our study aimed to provide a description of the early childhood development of pediatric burn patients relative to Dutch reference values, using both pre- and post-burn data from the Dutch Development Instrument and the D-score. Data from the Dutch Development Instrument were used to calculate the D-score and age-standardized D-score. Similar to a growth chart, the D-score was used to plot pediatric burn patients’ development relative to Dutch reference values for their age. Pediatric burn patients’ (n = 38) median age at the time of injury was 1.0 (1.0–2.0) years old. Burn size ranged from 1.0% to 36.0% of the total body surface area. Ninety-five percent (± 6.0%) of pediatric burn patients passed each of the age-appropriate developmental milestones at the target age. The mean age-standardized D-score was just above the Dutch average (+0.49 SD [0.18, 0.80]) and did not vary depending on sex (p = 0.06) or burn size (p = 0.41). In conclusion, among pediatric patients aged up to two-and-a-half years old, with non-full thickness burns, development was on track relative to the Dutch reference values. Our findings offer valuable first insights into the early childhood development of pediatric burn patients and may alleviate some parental concerns.","PeriodicalId":72961,"journal":{"name":"European burn journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140980645","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}
Burns are inevitable in modern warfare and have comprised between 5% and 20% of battlefield injuries. Involvement of the hands is the leading cause of postburn functional impairment. The purpose of this paper is to provide guidance on aspects of care necessary for the management of complex hand burns in a battlefield setting. Proper assessment and establishment of a comprehensive plan of care at the onset of injury help to ensure optimal functional outcomes in hand function. Basic treatment principles for the acutely burned hand include edema management; early wound coverage, including excision of the burn and skin grafting; early and aggressive hand therapy; and burn-scar contracture mitigation strategies.
{"title":"Acute Surgical and Rehabilitation Management of Complex Hand Burns in Combat Casualties","authors":"Jill M. Cancio, Jonathan B. Lundy, L. Cancio","doi":"10.3390/ebj5020011","DOIUrl":"https://doi.org/10.3390/ebj5020011","url":null,"abstract":"Burns are inevitable in modern warfare and have comprised between 5% and 20% of battlefield injuries. Involvement of the hands is the leading cause of postburn functional impairment. The purpose of this paper is to provide guidance on aspects of care necessary for the management of complex hand burns in a battlefield setting. Proper assessment and establishment of a comprehensive plan of care at the onset of injury help to ensure optimal functional outcomes in hand function. Basic treatment principles for the acutely burned hand include edema management; early wound coverage, including excision of the burn and skin grafting; early and aggressive hand therapy; and burn-scar contracture mitigation strategies.","PeriodicalId":72961,"journal":{"name":"European burn journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141011887","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}
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