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The Two Facing Square Flaps Method for Release of Anterior and Posterior Axillary Line Burn Contractures 面向两方皮瓣解除腋窝前后线烧伤挛缩的方法
Q4 CRITICAL CARE MEDICINE Pub Date : 2023-10-04 DOI: 10.3390/ebj4040034
Whitney Laurel Quong, Rei Ogawa
With improved burn outcomes and survival rates, the focus of management in large burns has shifted from merely survival towards optimizing form and function for the burn survivor. Due to its unique structural features and functional demands however, the axilla is prone to contracture formation, and remains complex to reconstruct. Where contractures involve both the posterior and anterior axillary lines, the two facing square flaps method is a suitable choice for a wide range of patients. The flap design is flexible, and is relatively safe with a sufficient blood supply. Superior lengthening of approximately 3–4 times can be achieved, and is maintainable. In this surgical technique paper, we describe the strategy of the two facing square flaps, and present two patterns of its application, with representative cases of the local flap method.
随着烧伤预后和存活率的提高,大面积烧伤的管理重点已经从单纯的生存转向优化烧伤幸存者的形式和功能。然而,由于其独特的结构特点和功能要求,腋窝容易发生挛缩,重建起来仍然很复杂。当挛缩同时涉及腋后线和腋前线时,两个面向的方形皮瓣方法是广泛患者的合适选择。皮瓣设计灵活,相对安全,血液供应充足。可以达到大约3-4倍的优越延长,并且是可维护的。在这篇外科技术文章中,我们描述了两个面向正方形皮瓣的策略,并介绍了其两种应用模式,并以局部皮瓣法为代表。
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引用次数: 0
Psychological Evaluation of a Residential Children’s Burns Camp Programme: A Ten-Year Evaluation 住院儿童烧伤营计划的心理评估:十年评估
Q4 CRITICAL CARE MEDICINE Pub Date : 2023-09-21 DOI: 10.3390/ebj4030033
Alison M. Thomlinson, Niamh R. Farrell, Mamta Shah, Sarah L. Gaskell
Residential burns camp programmes provide help and support to children with burn injuries by providing activities designed to build their confidence and self-esteem. Our regional burns service has been running camps for over 20 years and evaluation is an important part of assessing their effectiveness. In this study, we report both qualitative and quantitative data from 10 consecutive years of burns camps. Qualitative feedback was gathered using Likert scales and free-response questionnaires at the end of camp and six weeks post-camp. Three quantitative outcome measures, the Paediatric Quality of Life Inventory v4, the Children’s Revised Impact of Event Scale (CRIES8) and the Satisfaction with Appearance scale (SWAP), were completed before and six weeks after camp. Both children and their parents/carers reported that attending the burns camp was helpful for them/their child; meeting other children with burn injuries and developing confidence and self-esteem were cited as reasons. Parents/carers also reported improvements in their child’s physical and psychological functioning post-camp in some years, although these results were not as clear as the qualitative findings. These findings confirm the importance of providing burns camp programmes for children with burn injuries as part of their post-burn rehabilitation.
住院烧伤营计划为烧伤儿童提供帮助和支持,为他们提供旨在建立自信和自尊的活动。我们的区域烧伤服务已经运行营地超过20年,评估是评估其有效性的重要组成部分。在这项研究中,我们报告了连续10年烧伤营的定性和定量数据。在训练营结束和训练营后六周,使用李克特量表和自由回答问卷收集定性反馈。三个定量结果测量,儿科生活质量量表v4,儿童修订事件影响量表(CRIES8)和外观满意度量表(SWAP),在营地前和营地后六周完成。儿童及其父母/照顾者均表示参加烧伤营对他们/他们的孩子有帮助;与其他有烧伤的孩子见面,培养自信和自尊被列为原因。父母/照顾者也报告说,在夏令营结束后的几年中,他们的孩子的身体和心理功能有所改善,尽管这些结果不像定性研究结果那样明确。这些发现证实了为烧伤儿童提供烧伤营方案作为其烧伤后康复的一部分的重要性。
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引用次数: 0
What Changes Have Occurred in the Pattern of Paediatric Burns in the Last Years with Special Attention to the COVID-19 Pandemic? 在过去几年中,特别关注COVID-19大流行的儿童烧伤模式发生了哪些变化?
Q4 CRITICAL CARE MEDICINE Pub Date : 2023-09-15 DOI: 10.3390/ebj4030032
Sophie Y. Mok, Susan E. Adams, Andrew J. A. Holland
Burns in children remain a prominent mode of injury, resulting in considerable morbidity and mortality globally and are a key cause of disability-adjusted life-years. Paediatric burns present a unique challenge, in part due to the developmental, physical and emotional differences between adults and children. Those living in low- and middle-income settings are particularly vulnerable, facing problems such as overcrowding and floor-level cooking. During the COVID-19 pandemic, stay at home orders and the closure of schools and childcare changed the pattern of paediatric injury across the world, resulting in a general increase in trauma-related presentations. This review will examine recent global trends in paediatric burns, including the impact of COVID-19, specifically focusing on the pattern of burn aetiology over the past decade. It will also look at any changes with regard to epidemiological characteristics; burn site, severity and extent; first aid and location; and management and outcomes.
儿童烧伤仍然是一种主要的伤害方式,在全球造成相当高的发病率和死亡率,是残疾调整生命年的一个主要原因。儿童烧伤是一项独特的挑战,部分原因是成人和儿童在发育、身体和情感方面存在差异。那些生活在低收入和中等收入环境中的人尤其脆弱,他们面临着过度拥挤和地板烹饪等问题。在2019冠状病毒病大流行期间,居家令以及学校和托儿服务的关闭改变了世界各地儿童受伤的模式,导致与创伤有关的症状普遍增加。本综述将研究最近全球儿科烧伤的趋势,包括COVID-19的影响,特别关注过去十年烧伤病因的模式。它还将研究流行病学特征方面的任何变化;烧伤部位、严重程度和程度;急救和定位;管理和结果。
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引用次数: 0
Living Skin Substitute Tissue-Is a Replacement for the Autograft Possible? 活体皮肤替代组织--自体移植的替代品可行吗?
IF 1 Q4 CRITICAL CARE MEDICINE Pub Date : 2023-09-05 DOI: 10.3390/ebj4030031
Angela L F Gibson

The ideal living tissue skin substitute for use in burn injury does not yet exist. The currently available alternatives to autologous skin grafting require an understanding of their characteristics and limitations to make an informed decision of surgical treatment options. In this review, living tissue substitutes are categorized by autologous and allogeneic cell sources and epidermal-only versus bilayered tissue options. A short summary of the tissue composition, clinical data, and indications is provided. Finally, the gap in technology is defined and future potential areas of research are explored.

用于烧伤的理想活组织皮肤替代物尚不存在。目前可用的自体皮肤移植替代品需要了解其特点和局限性,以便在知情的情况下决定手术治疗方案。在这篇综述中,活组织替代物按自体和异体细胞来源以及纯表皮组织和双层组织选择进行了分类。此外,还提供了有关组织成分、临床数据和适应症的简短摘要。最后,界定了技术差距,并探讨了未来潜在的研究领域。
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引用次数: 0
20th Congress of the European Burns Association (EBA). 第 20 届欧洲烧伤协会(EBA)大会。
IF 1 Q4 CRITICAL CARE MEDICINE Pub Date : 2023-09-04 DOI: 10.3390/ebj4030030
Nadia Depetris, Alette De Jong, Clemens Schiestl, Franck Duteille, Jill Meirte, Joan P Barret-Nerin, Paul Van Zuijlen, Jyrki Vuola, Stian Almeland

Abstracts of the plenary and special interest sessions, workshops, and oral and poster presentations of the 20th EBA Congress in Nantes, France from 6-9 September 2023.

2023 年 9 月 6 日至 9 日在法国南特举行的第 20 届欧洲生物伦理学大会全体会议、特别关注会议、研讨会、口头和海报展示摘要。
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引用次数: 0
Outcomes of Patients with Amputation following Electrical Burn Injuries. 电烧伤后截肢患者的预后。
IF 1 Q4 CRITICAL CARE MEDICINE Pub Date : 2023-08-17 DOI: 10.3390/ebj4030029
Eunyeop Kim, Bingchun Wan, Kyra Jeanine Solis-Beach, Karen Kowalske

This study aimed to examine patients who sustained amputation as a result of electrical burns and to evaluate their long-term health outcomes compared to non-electrical burn patients with amputation. A retrospective analysis was conducted on burn patients from 1993 to 2021, utilizing the Burn Model System National Database, which includes the Veterans RAND 12-Item Health Survey and the Patient-Reported Outcomes Measurement Information System 29. The data was collected at discharge, 6 months, and 12 months after the burns occurred. The findings revealed that the rate of amputation was significantly higher in electrical burn patients (30.3%) compared to non-electrical burn patients (6.6%) (p < 0.0001). At the time of discharge, electrical burn patients with amputation exhibited significantly lower physical component scores (PCS = 34.00 ± 8.98) than electrical burn patients without amputation (PCS = 44.66 ± 9.90) (p < 0.05). However, there were no significant differences in mental component scores observed between patients, regardless of the burn type or amputation. Among all patient groups, non-electrical burn survivors with amputation faced the greatest challenges in terms of physical and social well-being, likely due to larger total body surface area burns. This study emphasizes the importance of early rehabilitation for electrical burn patients with amputation and highlights the need for ongoing support, both physically and socially, for non-electrical burn survivors with amputation. These findings, consistent with previous studies, underscore the necessity of providing psychological support to all burn survivors.

本研究旨在对因电烧伤而截肢的患者进行检查,并评估他们与非电烧伤截肢患者相比的长期健康状况。研究利用烧伤模型系统国家数据库(包括退伍军人兰德 12 项健康调查和患者报告结果测量信息系统 29)对 1993 年至 2021 年期间的烧伤患者进行了回顾性分析。数据是在烧伤发生后出院、6 个月和 12 个月时收集的。研究结果显示,电烧伤患者的截肢率(30.3%)明显高于非电烧伤患者(6.6%)(p < 0.0001)。出院时,有截肢的电烧伤患者的体能成分评分(PCS = 34.00 ± 8.98)明显低于无截肢的电烧伤患者(PCS = 44.66 ± 9.90)(P < 0.05)。然而,无论烧伤类型或截肢情况如何,患者之间的精神成分得分均无明显差异。在所有患者群体中,截肢的非电烧伤幸存者在身体和社会福祉方面面临的挑战最大,这可能是由于烧伤的体表总面积较大。这项研究强调了截肢的电烧伤患者早期康复的重要性,并强调了对截肢的非电烧伤幸存者在身体和社交方面提供持续支持的必要性。这些研究结果与之前的研究结果一致,强调了为所有烧伤幸存者提供心理支持的必要性。
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引用次数: 0
Understanding the Barriers and Enablers for Seeking Psychological Support following a Burn Injury. 了解烧伤后寻求心理支持的障碍和促进因素。
IF 1 Q4 CRITICAL CARE MEDICINE Pub Date : 2023-07-24 DOI: 10.3390/ebj4030028
Lianne McDermott, Matthew Hotton, Anna V Cartwright

Burn injuries can be traumatic and distressing for patients, with a prolonged period of recovery. This qualitative study aimed to explore adult burn patients' perceptions of the barriers and facilitators to accessing psychological support in a Regional Burns Service in Southeast England. Participants (five females and six males) were under the care of the burns unit and were not currently accessing psychological support. Eleven semi-structured interviews were conducted. Responses were analysed using thematic analysis. Four main themes highlighted how access to psychology was influenced by communication between the patient and service, beliefs about mental health, environmental challenges, and patient hope. Recommendations for improving access to burn psychological care included (1) the provision of patient resources to increase awareness and reduce stigma; (2) psychological skills training to encourage staff to recognise distress and respond appropriately; (3) staff training in the practice of cultural humility; (4) increasing psychological presence in outpatient appointments and via routine follow-ups.

烧伤会给患者带来创伤和痛苦,并需要很长的恢复期。这项定性研究旨在探讨英格兰东南部地区烧伤服务机构的成年烧伤患者对获得心理支持的障碍和促进因素的看法。参与者(五名女性和六名男性)都在烧伤科接受治疗,目前尚未获得心理支持。共进行了 11 次半结构式访谈。采用主题分析法对参与者的回答进行了分析。四个主题突出了患者与服务机构之间的沟通、对心理健康的看法、环境挑战以及患者的希望是如何影响患者获得心理治疗的。改善烧伤心理护理的建议包括:(1)提供患者资源,以提高意识并减少耻辱感;(2)进行心理技能培训,以鼓励员工识别困扰并做出适当回应;(3)对员工进行文化谦逊方面的培训;(4)在门诊预约和常规随访中增加心理陪伴。
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引用次数: 0
Investigation of the "Surgical Cuts CO2 Laser Therapy Technique" to Treat Minor Burn Scar Contractures in Children. 研究用 "手术切口二氧化碳激光治疗技术 "治疗儿童轻度烧伤疤痕挛缩。
IF 1 Q4 CRITICAL CARE MEDICINE Pub Date : 2023-07-19 DOI: 10.3390/ebj4030027
Jennifer Zuccaro, Lisa Lazzarotto, Jamil Lati, Charis Kelly, Joel Fish

Fractional carbon dioxide (CO2) laser therapy has been shown to improve scar contractures following burns. However, the benefits of using other CO2 laser techniques to treat burn scar contractures are relatively unknown. This pilot study investigated a CO2 laser technique in which a series of perpendicular "surgical cuts" were created along the contracture. The aim of this study was to evaluate the effectiveness of using the "surgical cuts CO2 laser technique" in pediatric patients. This study included 12 participants with minor hand burn scar contractures that received one CO2 laser treatment using the surgical cuts technique. Trained assessors measured contractures pre- and post-laser therapy by assessing range of motion (ROM), digit length, and/or hand-span. All contractures were secondary to contact burns with the mean participant age equal to 5.5 years (SD 3.9). For all participants, at least one of the measured characteristics (ROM, hand-span, and digit length) improved after treatment. This pilot study demonstrated the benefit of using the surgical cuts CO2 laser technique to treat minor burn scar contractures. Future investigations are needed to further evaluate its effectiveness in comparison to the fractional CO2 laser therapy technique.

已有研究表明,点阵二氧化碳(CO2)激光疗法可改善烧伤后的疤痕挛缩。然而,使用其他二氧化碳激光技术治疗烧伤疤痕挛缩的益处还相对未知。本试验性研究调查了一种二氧化碳激光技术,即沿着挛缩部位进行一系列垂直的 "手术切口"。这项研究的目的是评估 "手术切口二氧化碳激光技术 "在儿童患者中的应用效果。这项研究包括 12 名患有轻微手部烧伤疤痕挛缩的参与者,他们接受了一次使用手术切口技术的二氧化碳激光治疗。训练有素的评估员通过评估活动范围(ROM)、手指长度和/或手掌跨度来测量激光治疗前后的挛缩情况。所有挛缩患者都是继发性接触性烧伤,平均年龄为 5.5 岁(标准差为 3.9 岁)。所有参与者在接受治疗后,至少有一项测量特征(ROM、手掌长度和手指长度)得到了改善。这项试点研究证明了使用手术切口二氧化碳激光技术治疗轻度烧伤疤痕挛缩的益处。未来的研究还需要进一步评估其与点阵二氧化碳激光治疗技术的有效性。
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引用次数: 0
Reply to Hall et al. Comment on "Dinesen et al. Diphoterine for Chemical Burns of the Skin: A Systematic Review. Eur. Burn J. 2023, 4, 55-68". 回复 Hall 等人对 "Dinesen 等人.治疗皮肤化学烧伤的二氢苏氨酸 "的评论:系统回顾。Eur.2023,4,55-68 "的评论。
IF 1 Q4 CRITICAL CARE MEDICINE Pub Date : 2023-06-29 DOI: 10.3390/ebj4030026
Felicia Dinesen, Pernille Pape, Martin Risom Vestergaard, Lars Simon Rasmussen

We thank Hall et al. [...].

我们感谢 Hall 等人[......]。
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引用次数: 0
Developing a Burn-Specific Family-Centered Care (BS-FCC) Framework: A Multi-Method Study. 开发烧伤专用的以家庭为中心的护理(BS-FCC)框架:多方法研究。
IF 1 Q4 CRITICAL CARE MEDICINE Pub Date : 2023-06-23 DOI: 10.3390/ebj4030025
Jonathan Bayuo, Anita Eseenam Agbeko

A burn has been described as a family injury warranting the delivery of family-centered care (FCC) across the continuum of burns management. This assertion notwithstanding, only limited progress has been made to develop and implement FCC interventions in the burn unit. As a starting point, this study sought to formulate a tentative framework to underpin FCC in burn care. A multi-method design comprising an umbrella review and the secondary data analysis of qualitative datasets was employed. Following these, the findings were merged and aligned to the Universal Model of FCC to formulate the burn-specific FCC framework. For the umbrella review, four review articles met the criteria for inclusion. Following a data synthesis of the review findings and their integration with the qualitative dataset, four meta-themes that encapsulate the shared needs/concerns of family members of both pediatric and adult burn survivors emerged: (1) psychosocial concerns, (2) issues relating to role changes, (3) logistical concerns, and (4) requiring information. These issues were mapped to the following components of the Universal Model of FCC: family support, education, collaboration, and communication. All these are underpinned by dedicated policies, procedures, and consideration of the family context. Testing and further empirical work are needed to refine and implement the framework across the continuum of burn management.

烧伤被描述为一种家庭伤害,需要在烧伤管理的整个过程中提供以家庭为中心的护理(FCC)。尽管有这样的论断,但在烧伤科制定和实施以家庭为中心的护理干预措施方面进展有限。作为起点,本研究试图为烧伤护理中的 "以家庭为中心的护理 "制定一个暂定框架。本研究采用了多种方法,包括综述和定性数据集的二次数据分析。之后,将研究结果进行合并,并与 FCC 通用模型保持一致,以制定烧伤专用 FCC 框架。在总体综述中,有四篇综述文章符合纳入标准。在对综述结果进行数据综合并与定性数据集进行整合后,产生了四个元主题,概括了小儿和成人烧伤幸存者家庭成员的共同需求/关注点:(1)社会心理关注点,(2)与角色转变相关的问题,(3)后勤关注点,以及(4)信息需求。这些问题被映射到 FCC 通用模式的以下组成部分:家庭支持、教育、合作和沟通。所有这些都以专门的政策、程序和对家庭背景的考虑为基础。需要进行测试和进一步的实证工作,以便在烧伤管理的整个过程中完善和实施该框架。
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引用次数: 0
期刊
European burn journal
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