The British National Burn Care Standards highlight the importance of routine psychosocial screening to optimise psychological well-being following burn injury. Routine screening enables clinicians to identify those who may benefit from further psychological intervention. In this case, we outline how active follow-up from routine psychosocial screening and early intervention supports psychological recovery from a burn injury and how multidisciplinary care can be incorporated into cognitive therapy for post-traumatic stress disorder. This case also illustrates how psychologists are well positioned within physical healthcare to notice themes arising in patient care and use this to inform service development, for example, through staff training.
{"title":"The Roles of Clinical Psychologists in Burns Care: A Case Study Highlighting Benefits of Multidisciplinary Care","authors":"Anna V. Cartwright, E. Pounds-Cornish","doi":"10.3390/ebj4010010","DOIUrl":"https://doi.org/10.3390/ebj4010010","url":null,"abstract":"The British National Burn Care Standards highlight the importance of routine psychosocial screening to optimise psychological well-being following burn injury. Routine screening enables clinicians to identify those who may benefit from further psychological intervention. In this case, we outline how active follow-up from routine psychosocial screening and early intervention supports psychological recovery from a burn injury and how multidisciplinary care can be incorporated into cognitive therapy for post-traumatic stress disorder. This case also illustrates how psychologists are well positioned within physical healthcare to notice themes arising in patient care and use this to inform service development, for example, through staff training.","PeriodicalId":72961,"journal":{"name":"European burn journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74369906","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. Cords, C. H. van der Vlies, M. Stoop, M. Nieuwenhuis, K. Boudestein, F. Mattace-Raso, M. V. van Baar
Background: Frailty can have a negative influence on outcomes in elderly patients after burn injuries. The Dutch hospitals have used a four-domain frailty screening instrument from the Dutch Safety Management System (DSMS) since 2012. However, its feasibility and validity have hardly been studied. We aim to assess the feasibility and validity of frailty screening in specialized burn care. Methods: A multicentre retrospective cohort study was conducted in all Dutch burn centres. Patients aged ≥ 70, with a primary admission between 2012–2018, were included. Data were derived from electronic patient files. Results: In total, 515 patients were included. Frailty screening was complete in 39.6% and partially complete in 23.9%. Determinants for a complete screening were admission after 2015 (OR = 2.15, 95% CI 1.42–3.25) and lower percentage TBSA burned (OR = 0.12, 95% CI 0.05–029). In all completely screened patients, 49.9% were at risk of frailty. At risk patients were older, had more comorbidities (known group validity), a longer length of stay, and more frequently a non-home discharge (predictive validity). Conclusion: Frailty screening in specialized burn care is feasible and was conducted in 63.5% of admitted patients. In total, 44% of screened patients were at risk of frailty. Validity of frailty screening was confirmed. Frailty screening can contribute to optimal specialized burn care.
背景:虚弱会对老年烧伤患者的预后产生负面影响。自2012年以来，荷兰医院一直使用荷兰安全管理系统(DSMS)的四域虚弱筛查工具。然而，其可行性和有效性却鲜有研究。我们的目的是评估虚弱筛查在烧伤专科护理中的可行性和有效性。方法:在荷兰所有烧伤中心进行多中心回顾性队列研究。患者年龄≥70岁，首次入院时间为2012-2018年。数据来源于电子病历。结果:共纳入515例患者。39.6%的患者完成虚弱筛查，23.9%的患者部分完成虚弱筛查。完整筛查的决定因素是2015年后入院(OR = 2.15, 95% CI 1.42-3.25)和较低的TBSA烧伤百分比(OR = 0.12, 95% CI 0.05-029)。在所有完全筛查的患者中，49.9%有虚弱的风险。有风险的患者年龄较大，合并症较多(已知的组效度)，住院时间较长，并且更频繁地非家庭出院(预测效度)。结论:虚弱筛查在烧伤专科护理中是可行的，63.5%的住院患者进行了虚弱筛查。总的来说，44%的筛查患者有虚弱的风险。虚弱筛查的有效性得到了证实。虚弱筛查有助于最佳的专门烧伤护理。
{"title":"Frailty Screening Practice in Specialized Burn Care—A Retrospective Multicentre Cohort Study","authors":"C. Cords, C. H. van der Vlies, M. Stoop, M. Nieuwenhuis, K. Boudestein, F. Mattace-Raso, M. V. van Baar","doi":"10.3390/ebj4010009","DOIUrl":"https://doi.org/10.3390/ebj4010009","url":null,"abstract":"Background: Frailty can have a negative influence on outcomes in elderly patients after burn injuries. The Dutch hospitals have used a four-domain frailty screening instrument from the Dutch Safety Management System (DSMS) since 2012. However, its feasibility and validity have hardly been studied. We aim to assess the feasibility and validity of frailty screening in specialized burn care. Methods: A multicentre retrospective cohort study was conducted in all Dutch burn centres. Patients aged ≥ 70, with a primary admission between 2012–2018, were included. Data were derived from electronic patient files. Results: In total, 515 patients were included. Frailty screening was complete in 39.6% and partially complete in 23.9%. Determinants for a complete screening were admission after 2015 (OR = 2.15, 95% CI 1.42–3.25) and lower percentage TBSA burned (OR = 0.12, 95% CI 0.05–029). In all completely screened patients, 49.9% were at risk of frailty. At risk patients were older, had more comorbidities (known group validity), a longer length of stay, and more frequently a non-home discharge (predictive validity). Conclusion: Frailty screening in specialized burn care is feasible and was conducted in 63.5% of admitted patients. In total, 44% of screened patients were at risk of frailty. Validity of frailty screening was confirmed. Frailty screening can contribute to optimal specialized burn care.","PeriodicalId":72961,"journal":{"name":"European burn journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83528849","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}
I. Reid, Hadley Bortz, A. Burrell, D. Gantner, S. Rosenblum, H. Cleland
Background: Use of intravascular warming catheters following major burns has been shown to be effective to maintain normothermia, but their use may be associated with complications. The aim of this study was to determine what proportion of patients with an intravascular warming catheter developed a potentially catheter-related venous thromboembolism (VTE) and to identify contributing risk factors. Methods: This was a retrospective cohort study of patients admitted to the Victorian Adult Burns Service January 2013 to July 2018 with major burns (TBSA > 20%) who had an ICYTM intravascular warming catheter. Warming catheter insertion and other details were identified with a manual search of the patients’ medical records by a single author while incidence of VTE was determined by the coding department from a central database. Results: Forty patients had an intravascular warming catheter inserted during the study period. The number of patients in the catheter group that sustained a VTE was eight (20%), of which four (10%) could have been catheter-related due to the anatomical location. In the cases of the four potentially catheter-related VTE, other preventable VTE risk factors including suboptimal prophylactic anticoagulation (n = 2), prolonged catheter duration (n = 1) and prolonged haemoconcentration (n = 2) were identified. Conclusions: We found 20% of major burns patients with an intravascular warming device had significant VTE; however, only half of these may have been related to the catheter. A careful assessment for each patient that balances risks and benefits should be undertaken prior to using intravascular warming devices.
{"title":"Venous Thromboembolism in Severe Burns Patients with Intravascular Warming Catheter: A Retrospective Cohort Study","authors":"I. Reid, Hadley Bortz, A. Burrell, D. Gantner, S. Rosenblum, H. Cleland","doi":"10.3390/ebj4010008","DOIUrl":"https://doi.org/10.3390/ebj4010008","url":null,"abstract":"Background: Use of intravascular warming catheters following major burns has been shown to be effective to maintain normothermia, but their use may be associated with complications. The aim of this study was to determine what proportion of patients with an intravascular warming catheter developed a potentially catheter-related venous thromboembolism (VTE) and to identify contributing risk factors. Methods: This was a retrospective cohort study of patients admitted to the Victorian Adult Burns Service January 2013 to July 2018 with major burns (TBSA > 20%) who had an ICYTM intravascular warming catheter. Warming catheter insertion and other details were identified with a manual search of the patients’ medical records by a single author while incidence of VTE was determined by the coding department from a central database. Results: Forty patients had an intravascular warming catheter inserted during the study period. The number of patients in the catheter group that sustained a VTE was eight (20%), of which four (10%) could have been catheter-related due to the anatomical location. In the cases of the four potentially catheter-related VTE, other preventable VTE risk factors including suboptimal prophylactic anticoagulation (n = 2), prolonged catheter duration (n = 1) and prolonged haemoconcentration (n = 2) were identified. Conclusions: We found 20% of major burns patients with an intravascular warming device had significant VTE; however, only half of these may have been related to the catheter. A careful assessment for each patient that balances risks and benefits should be undertaken prior to using intravascular warming devices.","PeriodicalId":72961,"journal":{"name":"European burn journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77060590","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}
Johannes Weinreich, Christina Namatovu, S. Nsibirwa, L. Mbabazi, H. Kajumbula, Nadine Dietze, Christoph Lübbert, Hawah Nabajja, J. Musaazi, Charles Kabugo, A. von Braun
Nosocomial wound infections are a dreaded complication in patients with burns. However, access to the necessary microbiological diagnostics is impaired in low-resource settings. This prospective observational cohort study aimed to describe the bacterial pathogens, resistance profiles and clinical outcomes of patients with wound infections admitted to the largest specialized unit for burns and plastic surgery in Uganda. Blood and wound swab cultures were taken for bacterial species identification and antibiotic susceptibility testing. A total of 140 patients (female: n = 62, 44.3%) with a median age of 26 (IQR 7–35) years were included between October 2020 and April 2022, of which the majority (n = 101, 72.2%) had burn wounds (72.3% Grade 2b, 14.9% Grade 3). Gram-negative Enterobacterales, Pseudomonas spp. and Acinetobacter spp. were most commonly isolated from wound swabs and nearly all isolates were multidrug resistant with very limited treatment options. While the clinical outcome was favorable in 21 (15%) study participants, the majority were left with disabilities (minor: n = 41, 29.3%, moderate: n = 52, 37%, major: n = 14 (10%)). Twelve (8.6%) study participants died, mostly of Gram-negative sepsis. Our findings highlight the urgent need for routine access to microbiological diagnostics to improve patient care and local surveillance efforts on antimicrobial resistance.
{"title":"Microbiological Findings and Clinical Outcomes in Ugandan Patients with Infected Burn Wounds","authors":"Johannes Weinreich, Christina Namatovu, S. Nsibirwa, L. Mbabazi, H. Kajumbula, Nadine Dietze, Christoph Lübbert, Hawah Nabajja, J. Musaazi, Charles Kabugo, A. von Braun","doi":"10.3390/ebj4010007","DOIUrl":"https://doi.org/10.3390/ebj4010007","url":null,"abstract":"Nosocomial wound infections are a dreaded complication in patients with burns. However, access to the necessary microbiological diagnostics is impaired in low-resource settings. This prospective observational cohort study aimed to describe the bacterial pathogens, resistance profiles and clinical outcomes of patients with wound infections admitted to the largest specialized unit for burns and plastic surgery in Uganda. Blood and wound swab cultures were taken for bacterial species identification and antibiotic susceptibility testing. A total of 140 patients (female: n = 62, 44.3%) with a median age of 26 (IQR 7–35) years were included between October 2020 and April 2022, of which the majority (n = 101, 72.2%) had burn wounds (72.3% Grade 2b, 14.9% Grade 3). Gram-negative Enterobacterales, Pseudomonas spp. and Acinetobacter spp. were most commonly isolated from wound swabs and nearly all isolates were multidrug resistant with very limited treatment options. While the clinical outcome was favorable in 21 (15%) study participants, the majority were left with disabilities (minor: n = 41, 29.3%, moderate: n = 52, 37%, major: n = 14 (10%)). Twelve (8.6%) study participants died, mostly of Gram-negative sepsis. Our findings highlight the urgent need for routine access to microbiological diagnostics to improve patient care and local surveillance efforts on antimicrobial resistance.","PeriodicalId":72961,"journal":{"name":"European burn journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84926972","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}
Felicia Dinesen, Pernille Pape, M. Vestergaard, L. Rasmussen
The incidence of chemical burns appears to be increasing. Diphoterine is an amphoteric, chelating, polyvalent solution used for the decontamination of chemical splashes. In this systematic review, we aimed to assess the effect of diphoterine on chemical burns compared with water or no treatment. The primary endpoint was the depth of burn, and secondary outcomes included pain, duration of hospitalization, time to return to work, need for surgery, pH, and complications. PubMed, Embase, Cochrane Library, Web of Science, and Google Scholar were systematically searched using the terms “Diphoterine”, “Previn”, and ““Amphoteric solution” AND “burn””. A total of nine studies were included. One study evaluated the depth of chemical burns and found no difference between the diphoterine group and the control group. Four studies reported on pain, three of which found a more pronounced decrease in pain when using diphoterine compared to the control groups. Two studies found a significant neutralization of pH when using diphoterine. No differences were found for the remaining endpoints. Based on the very low certainty of evidence, this systematic review reports no observed difference between diphoterine and water or no treatment on the depth of a chemical burn. Diphoterine appeared to be associated with less pain and to have a neutralizing effect.
化学烧伤的发生率似乎在增加。二photerine是一种两性、螯合、多价溶液，用于清除化学溅污。在这篇系统综述中，我们的目的是评估二photerine对化学烧伤的影响，并与水或不处理进行比较。主要终点是烧伤深度，次要终点包括疼痛、住院时间、恢复工作时间、手术需求、pH值和并发症。系统地检索PubMed、Embase、Cochrane Library、Web of Science和Google Scholar，检索词为“Diphoterine”、“Previn”和“两性溶液”和“burn”。共纳入9项研究。一项研究评估了化学烧伤的深度，发现二photerine组和对照组之间没有差异。四项研究报告了疼痛，其中三项研究发现，与对照组相比，使用二photerine时疼痛的减轻更为明显。两项研究发现，当使用双蝶呤时，pH值有显著的中和作用。其余终点未发现差异。基于非常低的证据确定性，本系统评价报告没有观察到二磷蝶呤和水之间的差异，或者没有对化学烧伤的深度进行处理。双photerine似乎与疼痛减轻有关，并具有中和作用。
{"title":"Diphoterine for Chemical Burns of the Skin: A Systematic Review","authors":"Felicia Dinesen, Pernille Pape, M. Vestergaard, L. Rasmussen","doi":"10.3390/ebj4010006","DOIUrl":"https://doi.org/10.3390/ebj4010006","url":null,"abstract":"The incidence of chemical burns appears to be increasing. Diphoterine is an amphoteric, chelating, polyvalent solution used for the decontamination of chemical splashes. In this systematic review, we aimed to assess the effect of diphoterine on chemical burns compared with water or no treatment. The primary endpoint was the depth of burn, and secondary outcomes included pain, duration of hospitalization, time to return to work, need for surgery, pH, and complications. PubMed, Embase, Cochrane Library, Web of Science, and Google Scholar were systematically searched using the terms “Diphoterine”, “Previn”, and ““Amphoteric solution” AND “burn””. A total of nine studies were included. One study evaluated the depth of chemical burns and found no difference between the diphoterine group and the control group. Four studies reported on pain, three of which found a more pronounced decrease in pain when using diphoterine compared to the control groups. Two studies found a significant neutralization of pH when using diphoterine. No differences were found for the remaining endpoints. Based on the very low certainty of evidence, this systematic review reports no observed difference between diphoterine and water or no treatment on the depth of a chemical burn. Diphoterine appeared to be associated with less pain and to have a neutralizing effect.","PeriodicalId":72961,"journal":{"name":"European burn journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77398990","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}
Zosha J. van Gelder, Annabel Snoeks, P. V. van Zuijlen, R. de Vries, A. Pijpe
Over the past decades, long-term sequelae of burns have gained increasing attention. Women of childbearing age, who sustained abdominal burns earlier in life, may have unmet information needs on scar-related complications they can expect during pregnancy. We performed a review of the literature to identify abdominal, foetal, and potential other complications during pregnancy in women with abdominal burn scars. PubMed, Embase, and Scopus were searched from inception to 1 July 2020 and updated once on 23 April 2021 (PROSPERO CRD42022187883). Main search terms included pregnancy, scar, burns, and abdominal. Studies on burns obtained during pregnancy have been excluded. Screening, data extraction and bias assessment were conducted by two investigators. We included 22 studies comprising 217 patients. The time between burn injury and first pregnancy varied between 7 and 32 years. Most of the women had normal pregnancies regarding delivery mode and duration of pregnancy. The most reported abdominal burn scar complications were an increased feeling of tightness, itch, pain, and scar breakdown. In some cases, scar release surgery was performed during or prior to pregnancy. Some cases of foetal complications were described. Complications during pregnancy after abdominal burn scars may be limited. More quantitative and qualitative research is needed to assess the maternal and foetal outcomes and complications. The results may be used to inform women and contribute to personalised obstetric management.
{"title":"Complications during Pregnancy after Abdominal Burn Scars: A Review","authors":"Zosha J. van Gelder, Annabel Snoeks, P. V. van Zuijlen, R. de Vries, A. Pijpe","doi":"10.3390/ebj4010005","DOIUrl":"https://doi.org/10.3390/ebj4010005","url":null,"abstract":"Over the past decades, long-term sequelae of burns have gained increasing attention. Women of childbearing age, who sustained abdominal burns earlier in life, may have unmet information needs on scar-related complications they can expect during pregnancy. We performed a review of the literature to identify abdominal, foetal, and potential other complications during pregnancy in women with abdominal burn scars. PubMed, Embase, and Scopus were searched from inception to 1 July 2020 and updated once on 23 April 2021 (PROSPERO CRD42022187883). Main search terms included pregnancy, scar, burns, and abdominal. Studies on burns obtained during pregnancy have been excluded. Screening, data extraction and bias assessment were conducted by two investigators. We included 22 studies comprising 217 patients. The time between burn injury and first pregnancy varied between 7 and 32 years. Most of the women had normal pregnancies regarding delivery mode and duration of pregnancy. The most reported abdominal burn scar complications were an increased feeling of tightness, itch, pain, and scar breakdown. In some cases, scar release surgery was performed during or prior to pregnancy. Some cases of foetal complications were described. Complications during pregnancy after abdominal burn scars may be limited. More quantitative and qualitative research is needed to assess the maternal and foetal outcomes and complications. The results may be used to inform women and contribute to personalised obstetric management.","PeriodicalId":72961,"journal":{"name":"European burn journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91055340","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}
Dmitry Beylin, J. Haik, E. Biros, R. Kornhaber, M. Cleary, M. Harats, D. Cohn, Y. Sapir, O. Weisberg
Several so-called “smart” dressings are available for burn injuries to promote faster wound healing, and this technology has recently reported substantial advancements. However, the selection of an appropriate dressing for partial-thickness burns requires consideration of several crucial elements, including exudate management, conformability, antimicrobial properties, ease of application and removal, patient comfort, and cost-effectiveness. This preliminary feasibility study uses a porcine model to test the INTELIGELS product (Smart Bandage) for partial-thickness burns treatment. Artificially made wounds, mimicking partial-thickness burns, were assessed in two studies with and without antimicrobial additives, where wounds were randomly assigned to the experimental group treated with Smart Bandage and two control groups treated with a simple saline gauze dressing or Aquacel® products with and without silver additives. In addition, all dressings were evaluated for their ability to reduce wound size, quantified by histological analysis using punch biopsies. This study demonstrates comparable healing properties of Smart Bandage and Aquacel® dressings that are superior to the simple saline gauze dressing. The superiority is demonstrated by better regeneration, less inflammation of the epidermis and dermis, and better dermis remodeling with more granulation tissue maturation within the wound area when Smart Bandage/Aquacel® dressings are applied as compared with the simple gauze dressing.
{"title":"Smart Polymeric Wound Dressing for Treating Partial-Thickness Burns: A Preliminary Preclinical Study on the Porcine Model","authors":"Dmitry Beylin, J. Haik, E. Biros, R. Kornhaber, M. Cleary, M. Harats, D. Cohn, Y. Sapir, O. Weisberg","doi":"10.3390/ebj4010004","DOIUrl":"https://doi.org/10.3390/ebj4010004","url":null,"abstract":"Several so-called “smart” dressings are available for burn injuries to promote faster wound healing, and this technology has recently reported substantial advancements. However, the selection of an appropriate dressing for partial-thickness burns requires consideration of several crucial elements, including exudate management, conformability, antimicrobial properties, ease of application and removal, patient comfort, and cost-effectiveness. This preliminary feasibility study uses a porcine model to test the INTELIGELS product (Smart Bandage) for partial-thickness burns treatment. Artificially made wounds, mimicking partial-thickness burns, were assessed in two studies with and without antimicrobial additives, where wounds were randomly assigned to the experimental group treated with Smart Bandage and two control groups treated with a simple saline gauze dressing or Aquacel® products with and without silver additives. In addition, all dressings were evaluated for their ability to reduce wound size, quantified by histological analysis using punch biopsies. This study demonstrates comparable healing properties of Smart Bandage and Aquacel® dressings that are superior to the simple saline gauze dressing. The superiority is demonstrated by better regeneration, less inflammation of the epidermis and dermis, and better dermis remodeling with more granulation tissue maturation within the wound area when Smart Bandage/Aquacel® dressings are applied as compared with the simple gauze dressing.","PeriodicalId":72961,"journal":{"name":"European burn journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87916947","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}
High-quality academic publishing is built on rigorous peer review [...]
高质量的学术出版建立在严格的同行评审的基础上[…]
{"title":"Acknowledgment to the Reviewers of Eur. Burn J. in 2022","authors":"","doi":"10.3390/ebj4010003","DOIUrl":"https://doi.org/10.3390/ebj4010003","url":null,"abstract":"High-quality academic publishing is built on rigorous peer review [...]","PeriodicalId":72961,"journal":{"name":"European burn journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83027473","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}
L. Cabral, Leonor Rodrigues, A. Tavares, Gonçalo Tomé, Marisa Caetano, C. Chaves, V. Afreixo
Background: Infections by multidrug-resistant (MDR) microorganisms are associated with increased morbidity and mortality in burn patients. This study aimed to analyze the evolution of MDR bacteria over a five-year period at Coimbra Burns Unit (CBU) in Portugal, seeking to assess the possible associations of specific bacteria with presumed risk factors. Methods: The data obtained consisted of identified bacteria present in any microbiological sample from each patient (including blood, central venous catheter, urine, tracheal aspirate and/or wound exudate). Univariate models and a multivariate model were constructed for each of the MDR bacteria species that infected at least 50 patients or that had five or more MDR strains. Statistical hypothesis tests with a p-value less than 0.05 were considered significant. Results: Of a total of 341 samples obtained, 107 were MDR, corresponding to 10 species. Globally, there was no significant variation in MDR bacteria frequency over the period under analysis. Some risk factors and/or trends were identified for some species, but none was linked to all of them. Conclusions: The risks for the development of MDR in bacteria in burn patients are multifactorial, mainly linked to longer hospital stays, the use of invasive devices and inadequate antimicrobial treatment. However, the influence of these risks regarding specific bacterial species is not straightforward and may rely on individual characteristics, type of treatment and/or local prevalent flora. Due to the severity of multidrug-resistant infections, continued microbiological surveillance with the aid of rapid diagnostic tests and prompt institution of appropriate antimicrobial therapy are crucial to improving outcomes for burn patients.
{"title":"Analysis of Potential Risk Factors for Multidrug-Resistance at a Burn Unit","authors":"L. Cabral, Leonor Rodrigues, A. Tavares, Gonçalo Tomé, Marisa Caetano, C. Chaves, V. Afreixo","doi":"10.3390/ebj4010002","DOIUrl":"https://doi.org/10.3390/ebj4010002","url":null,"abstract":"Background: Infections by multidrug-resistant (MDR) microorganisms are associated with increased morbidity and mortality in burn patients. This study aimed to analyze the evolution of MDR bacteria over a five-year period at Coimbra Burns Unit (CBU) in Portugal, seeking to assess the possible associations of specific bacteria with presumed risk factors. Methods: The data obtained consisted of identified bacteria present in any microbiological sample from each patient (including blood, central venous catheter, urine, tracheal aspirate and/or wound exudate). Univariate models and a multivariate model were constructed for each of the MDR bacteria species that infected at least 50 patients or that had five or more MDR strains. Statistical hypothesis tests with a p-value less than 0.05 were considered significant. Results: Of a total of 341 samples obtained, 107 were MDR, corresponding to 10 species. Globally, there was no significant variation in MDR bacteria frequency over the period under analysis. Some risk factors and/or trends were identified for some species, but none was linked to all of them. Conclusions: The risks for the development of MDR in bacteria in burn patients are multifactorial, mainly linked to longer hospital stays, the use of invasive devices and inadequate antimicrobial treatment. However, the influence of these risks regarding specific bacterial species is not straightforward and may rely on individual characteristics, type of treatment and/or local prevalent flora. Due to the severity of multidrug-resistant infections, continued microbiological surveillance with the aid of rapid diagnostic tests and prompt institution of appropriate antimicrobial therapy are crucial to improving outcomes for burn patients.","PeriodicalId":72961,"journal":{"name":"European burn journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88810733","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. Moura, Marcela M Bittencourt, Maria Luíza Barreto Cazumbá, Alexandra M. Buda, Alexis N. Bowder, D. S. Corlew, Fábio Mendes Botelho Filho, L. Barboza, L. Pompermaier
During the COVID-19 pandemic, some of the strategies chosen to contain the spread, such as social isolation and use of alcohol-based hand sanitizer, were suspected to increase the risk of domestic accidents, especially burns. The aim of this study was, therefore, to investigate possible differences in epidemiological trends among burned patients admitted to the main referral hospital of the State of Minas Gerais, Brazil, before and during the pandemic. Methods: All categories of new burns admitted at the Burn Unit of the João XXIII Hospital in Belo Horizonte, Minas Gerais. The study group consisted of burn patients admitted between 1 March and 31 December 2020, and the control group consisted of those admitted between 1 March and 31 December 2019. The population was analyzed descriptively, and differences between patients admitted before and during the pandemic were tested using t-test, Wilcoxon Mann–Whitney Rank Sum test, the Chi-Squared test or Fisher’s exact test, as appropriate. Results: During the study period, 914 patients were admitted at the burns unit, 535 before the pandemic (control group) and 379 during the pandemic (study group). During the pandemic, referral from other hospitals decreased, while time between injury and admission remained unchanged. TBSA% and LOS diminished, while the depth of burns, presence of inhalation injuries, and in-hospital mortality did not. In adults, the place and mechanism of injury changed during the pandemic, while in children they did not. Conclusion: Fewer patients with burns were referred for specialized burn care during the pandemic, although patients admitted for specialized burn care had smaller TBSA% and shorter LOS.
在2019冠状病毒病大流行期间，为遏制传播而选择的一些策略，如社会隔离和使用含酒精的洗手液，被怀疑会增加家庭事故，特别是烧伤的风险。因此，本研究的目的是调查巴西米纳斯吉拉斯州主要转诊医院收治的烧伤患者在大流行之前和期间的流行病学趋势可能存在的差异。方法:在米纳斯吉拉斯州贝洛奥里藏特jo o XXIII医院烧伤科收治的所有类别的新烧伤。研究组由2020年3月1日至12月31日入院的烧伤患者组成，对照组由2019年3月1日至12月31日入院的患者组成。对人群进行描述性分析，并酌情使用t检验、Wilcoxon Mann-Whitney秩和检验、卡方检验或Fisher精确检验来检验大流行前和大流行期间入院患者之间的差异。结果:在研究期间，914例患者在烧伤病房住院，大流行前535例(对照组)，大流行期间379例(研究组)。在大流行期间，从其他医院转诊的人数减少，而受伤和入院之间的时间保持不变。TBSA%和LOS减少，而烧伤深度、吸入性损伤的存在和住院死亡率没有减少。在成人中，大流行期间损伤的部位和机制发生了变化，而在儿童中则没有变化。结论:在大流行期间，很少有烧伤患者转诊到专门的烧伤护理，尽管接受专门烧伤护理的患者TBSA%较小，LOS较短。
{"title":"The Impact of COVID-19 on Burns: A Brazilian Study","authors":"C. Moura, Marcela M Bittencourt, Maria Luíza Barreto Cazumbá, Alexandra M. Buda, Alexis N. Bowder, D. S. Corlew, Fábio Mendes Botelho Filho, L. Barboza, L. Pompermaier","doi":"10.3390/ebj4010001","DOIUrl":"https://doi.org/10.3390/ebj4010001","url":null,"abstract":"During the COVID-19 pandemic, some of the strategies chosen to contain the spread, such as social isolation and use of alcohol-based hand sanitizer, were suspected to increase the risk of domestic accidents, especially burns. The aim of this study was, therefore, to investigate possible differences in epidemiological trends among burned patients admitted to the main referral hospital of the State of Minas Gerais, Brazil, before and during the pandemic. Methods: All categories of new burns admitted at the Burn Unit of the João XXIII Hospital in Belo Horizonte, Minas Gerais. The study group consisted of burn patients admitted between 1 March and 31 December 2020, and the control group consisted of those admitted between 1 March and 31 December 2019. The population was analyzed descriptively, and differences between patients admitted before and during the pandemic were tested using t-test, Wilcoxon Mann–Whitney Rank Sum test, the Chi-Squared test or Fisher’s exact test, as appropriate. Results: During the study period, 914 patients were admitted at the burns unit, 535 before the pandemic (control group) and 379 during the pandemic (study group). During the pandemic, referral from other hospitals decreased, while time between injury and admission remained unchanged. TBSA% and LOS diminished, while the depth of burns, presence of inhalation injuries, and in-hospital mortality did not. In adults, the place and mechanism of injury changed during the pandemic, while in children they did not. Conclusion: Fewer patients with burns were referred for specialized burn care during the pandemic, although patients admitted for specialized burn care had smaller TBSA% and shorter LOS.","PeriodicalId":72961,"journal":{"name":"European burn journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81651821","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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