Journal of Burn Care & Research最新文献

{"title":"Intranasal Atomized Dexmedetomidine in Combination With Intranasal Atomized Butorphanol for Dressing Change Sedation and Analgesia in Adult Burn Patients: A Randomized Clinical Trial.","authors":"Xianchao Ding, Daoming Shi, Honghua Cai, Zhixin Yan, Guoliang Shen","doi":"10.1093/jbcr/irae158","DOIUrl":"10.1093/jbcr/irae158","url":null,"abstract":"<p><p>We aimed to evaluate the efficacy of the intranasal atomized dexmedetomidine (IAD) + intranasal atomized butorphanol (IAB) combination therapy on adult patients with burns undergoing dressing changes. Herein, 46 adult patients with burns were enrolled and randomly divided into 2 groups: dexmedetomidine-butorphanol (DB) and saline-butorphanol, treated with atomized dexmedetomidine + butorphanol and saline + butorphanol, respectively. The primary outcomes were the Ramsay Sedation Scale (RSS) and the Visual Analog Scale (VAS) scores. The secondary outcomes were mean blood pressure (MBP), heart rate, respiratory rate (RR), peripheral blood oxygen saturation (SpO2), total butorphanol consumption, and adverse effects. The 2 groups were comparable in age, sex, weight, and total burn surface area. During dressing changes, the DB group exhibited significantly lower RSS levels (P < .05). Besides, the 2 groups showed no significant differences in VAS scores across all measurement time points. Notably, the DB group exhibited decreased MBP at the beginning of the operation (P < .0001), 10 min after (P < .0001), and 20 min after (P = .0205). Heart rate decreased significantly at the beginning (P = .0005) and 10 min after (P = .0088) in the DB group. Furthermore, the 2 groups showed no significant differences in RR and SpO2 levels. In addition, the rescue butorphanol dose was lower in the DB group (P < .001). Finally, dizziness and nausea incidences were significantly lower in the DB group (P < .05). In conclusion, besides its hemodynamic adverse reactions, the IAD + IAB combination therapy exerted a better sedation effect in adult patients with burns than IAB treatment alone.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"341-348"},"PeriodicalIF":1.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141912842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Need for Improved Burn Education in US Medical Schools.","authors":"Christopher J Fedor, Hilary Y Liu, José A Arellano, Francesco M Egro","doi":"10.1093/jbcr/irae170","DOIUrl":"10.1093/jbcr/irae170","url":null,"abstract":"","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"487-488"},"PeriodicalIF":1.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Engaging Burn Survivors, Their Families, and the Burn Community in Patient-Centered Outcomes Research: A Burn Survivor- and Burn Community Stakeholder-Generated and Prioritized Research Agenda.","authors":"Callie M Thompson, Amy Acton, William Alexander, Robel Beyene, Elisha G Brownson, Gretchen J Carrougher, Brennan Christensen, Kimberly Hoarle, Jessica Irven, Laura S Johnson, Monica P Kirkham, Giavonni M Lewis, J Xavier Lucio, Samoana Matagi, Laura Morris, Ann Marie B Prazak, Erin Price-Smith, Bridget Stuchly, Crystal Webb, Kristen Quinn","doi":"10.1093/jbcr/irae196","DOIUrl":"10.1093/jbcr/irae196","url":null,"abstract":"<p><p>Burn survivors are involved in burn research, but typically in the role of research subject. We believe that the outcomes and impact of burn research can be improved by engaging survivors as collaborators in the planning, implementation, and dissemination of burn research. The goal of this work was to produce the first burn research agenda generated and prioritized by burn survivors and other stakeholders from the burn community. A series of structured focus groups covering 5 topics (Patient and Family Education, Aftercare, Navigating the Healthcare System, Recovery: Physical and Psychosocial, and Barriers to Research) were held with burn survivors and their family members. Specific research questions/topics were identified from the transcripts and prioritized via an anonymous survey of burn survivors, their caregivers, and other stakeholders from the burn community. From these sessions, 37 specific research questions/topics were identified and ranked. In addition, 19 research barriers were identified and ranked. This work presents an innovative approach to burn research through co-production with survivors and other stakeholders. Burn survivors and their caregivers are experts in their lived experiences. By involving them in burn research as collaborators and contributors from the very first steps of research and throughout the continuum of the research planning, conducting projects, and distributing findings, we believe that the research will be both more successful and more impactful. We have taken the first steps in burn research co-production with this novel stakeholder-generated research agenda for the burn community.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"468-474"},"PeriodicalIF":1.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142501088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burn Center Verification and Safety Net Status: Are There Differences in Discharge to Inpatient Rehabilitation?","authors":"Devi Lakhlani, Samantha Steeman, Eloise W Stanton, Clifford Sheckter","doi":"10.1093/jbcr/irae113","DOIUrl":"10.1093/jbcr/irae113","url":null,"abstract":"<p><p>Discharge to acute rehabilitation following a major burn injury is crucial for patient recovery and quality of life. However, barriers to acute rehabilitation, including race and payor type, impede access. The effect of burn center organizational structure on discharge disparities remains unknown. This study aims to investigate associations between patient demographics, burn center factors, and discharge to acute rehabilitation on a population level. Using the California Healthcare Access and Information Database, 2009-2019, all inpatient encounters at verified and non-verified burn centers were extracted. The primary outcome was the proportion of patients discharged to acute rehabilitation. Key covariates included age, race, burn center safety net status, diagnosis-related group, American Burn Association (ABA) verification status, and American College of Surgeons Level 1 trauma center designation. Logistic regression and mixed-effects modeling were performed, with Bonferroni adjustment for multiple testing. Among 27 496 encounters, 0.8% (228) were discharged to inpatient rehabilitation. By race/ethnicity, the proportion admitted to inpatient rehabilitation was 0.9% for White, 0.6% for Black, 0.7% for Hispanic, and 1% for Asian. After adjusting for burn severity and age, notable predictors for discharge to inpatient rehabilitation included Medicare as payor (OR 0.30-0.88, P = .015) compared to commercial insurance, trauma center status (OR 1.45-3.43, P < .001), ABA verification status (OR 1.16-2.74, P = .008), and safety net facility status (OR 1.09-1.97, P = .013). Discharge to inpatient rehabilitation varies by race, payor status, and individual burn center. Verified and safety net burn centers had more patients discharge to inpatient rehabilitation adjusted for burn severity and demographics.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"294-302"},"PeriodicalIF":1.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141317454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Outcomes of a Cultured Autologous Dermo-Epidermal Skin Substitute in Children: 5-Year Results of a Phase I Clinical Trial.","authors":"Clemens Schiestl, Kathrin Neuhaus, Martin Meuli, Melinda Farkas, Fabienne Hartmann-Fritsch, Julia Elrod, Jenny Bressan, Ernst Reichmann, Sophie Böttcher-Haberzeth","doi":"10.1093/jbcr/irae150","DOIUrl":"10.1093/jbcr/irae150","url":null,"abstract":"<p><p>Limited donor sites and poor long-term outcomes with standard treatment for large skin defects remain a huge problem. An autologous, bilayered, laboratory-grown skin substitute (denovoSkin) was developed to overcome this problem and has shown to be safe in 10 pediatric patients in a Phase I clinical trial after transplantation. The goal of this article was to report on 48-month long-term results. The pediatric participants of the phase I clinical trial were followed up at yearly visits up to 5 years after transplantation. Safety parameters, including the occurrence of adverse events, possible deviations of vital signs, and changes in concomitant therapy as well as additional parameters regarding skin stability, scar quality, and tumor formation, were assessed. Furthermore, scar maturation was photographically documented. Of the 10 patients treated with denovoSkin in this phase I clinical trial, 7 completed the 5-year follow-up period. Skin substitutes continued to be deemed safe, remained stable, and practically unchanged, with no sign of fragility and no tumor formation at clinical examination. Scar quality, captured using the Patient and Observer Scar Assessment Scale, was evaluated as close to normal skin. Transplantation of this laboratory-grown skin substitute in children is to date considered safe and shows encouraging functional and aesthetical long-term results close to normal skin. These results are promising and highlight the potential of a life-saving therapy for large skin defects. A multicentre, prospective, randomized, phase II clinical trial is currently ongoing to further evaluate the safety and efficacy of this novel skin substitute. Clinicaltrials.gov identifier NCT02145130.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"326-334"},"PeriodicalIF":1.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Body Image on Physical Function and Return to Work After Burn: A Burn Model System Study.","authors":"Mashal Ali, Kara McMullen, Kyra Solis-Beach, Kimberly Roaten, Colleen M Ryan, Maiya I Pacleb, Gretchen J Carrougher, Haig A Yenikomshian, Karen Kowalske","doi":"10.1093/jbcr/irae182","DOIUrl":"10.1093/jbcr/irae182","url":null,"abstract":"<p><p>Burn injury can have a lasting impact on quality of life beyond the initial injury. The aim of this study was to examine the recovery process through analyzing the relationship between body image, physical function, and return to work. This study uses data from the Burn Model System National Longitudinal Database and includes 1001 participants injured between 2015 and 2023 who were measured using Patient-Reported Outcomes Measurement Information System-29 Physical Function, Employment Status, and the Body Image subscale. Associations were explored using multivariate linear and logistic regression analyses. Physical function was positively associated with body image and negatively associated with burn size, age, and amputation. Employment was positively correlated with body image and employment at injury, while negatively correlated with age. Other variables, including burn etiology, burn center site, race, and ethnicity, were significant at different time points. By understanding how these factors change and are associated with outcomes across recovery, the healthcare team can make more tailored efforts to improve the psychosocial and physical well-being of burn survivors.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"419-424"},"PeriodicalIF":1.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142288091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Enhanced Rehabilitation Program on Upper Limb Function in Patients Undergoing Abdominal Pedicle Flap Surgery.","authors":"Zhiyu Chen, Ling Huang, Ran Yu, Yaqin Zhou, Jianglin Tan","doi":"10.1093/jbcr/irae135","DOIUrl":"10.1093/jbcr/irae135","url":null,"abstract":"<p><p>To investigate the effect of an enhanced rehabilitation program on upper limb function in patients with abdominal pedicle flap surgery, we retrospectively analyzed 70 patients who received abdominal pedicled flap surgery between 2017 and 2022. Patients were categorized into the traditional rehabilitation group (rehabilitation initiated after the stage II pedicle dissection of the abdominal pedicle flap) and the enhanced rehabilitation group (rehabilitation initiated on the first day following the stage II abdominal pedicle flap surgery). All the patients received identical rehabilitation protocols. Passive Range of Motion (PROM), activities of daily living (ADL), Functional Independence Measure (FIM), and Manual Muscle Testing (MMT) were assessed at 5 days and 1 month following the stage II surgery. The main causes of injury were electrical burns in both groups. The hospital stay of patients in the enhanced group was significantly shorter than the traditional group. One month assessment indicated both groups showed significant improvements in the PROM of shoulder flexion, abduction, and elbow extension compared to the 5 days assessment. Notably, at 5 days assessment, the enhanced group had significantly higher PROM in shoulder abduction and elbow extension compared to the traditional group. Furthermore, the enhanced group continued to exhibit higher PROM in shoulder flexion and abduction than the traditional group at one month assessment. At one month assessment, a significant increase was observed in the ADL, FIM, and MMT of both groups compared to the 5 days. The study indicated the enhanced rehabilitation program immediately following the stage I surgery can effectively improve the PROM of the shoulder and elbow and reduce the length of hospital stay for patients.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"318-325"},"PeriodicalIF":1.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141544899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burn Injury Severity in Adults: Proposed Definitions Based on the National Burn Research Dataset.","authors":"Jason Heard, Yuni Ren, Sandra L Taylor, Soman Sen, Tina Palmieri, Kathleen Romanowski, David Greenhalgh","doi":"10.1093/jbcr/irae186","DOIUrl":"10.1093/jbcr/irae186","url":null,"abstract":"<p><p>Previous iterations of burn severity (mild, moderate, and severe) were not data-driven and were outdated. Clustering analyses have gained popularity for identifying homogenous subgroups from heterogeneous medical conditions, such as asthma, sepsis, and lung disease. There is no consensus in burn literature regarding what constitutes massive burns. The current classification includes a 20% total body surface area (TBSA) burn and a 95% TBSA burn as severe. Latent class and hierarchical clustering analyses were applied to the American Burn Association National Burn Research Dataset. Cluster variables included length of stay, length of stay, intensive care unit length of, number and type of procedures, and number and type of complications. Nonclustering variables were evaluated after clustering, including burned TBSA, inhalation injury, mortality, discharge disposition, age, sex, and race. Latent class analysis suggested 3 clusters. Hierarchical clustering analysis was applied to the most severe latent class, creating 4 total burn severity groups. In total, 112 297 patients were included in the final analysis. The mean TBSA burned for each class is 4.26 ± 4.91 for minor, 8.07 ± 8.39 for moderate, 22.76 ± 17.31 for severe and 36.72 ± 21.61 for massive. The age and sex proportions were similar among all clusters. The clustering variables steadily increased for each severity cluster. Mortality was the highest in the massive cluster (18.2%). Data-informed categories of burn severity were formed using clustering analyses, which will be helpful for triage, data benchmarking, and class-specific research.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"438-449"},"PeriodicalIF":1.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142347369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ibuprofen is Not Associated With an Elevated Bleeding Risk or Transfusion Requirement in Skin Grafting for Patients with Burn Injuries.","authors":"Artur Manasyan, Jordan O Gasho, Michael I Kim, Eloise W Stanton, Maxwell B Johnson, T Justin Gillenwater","doi":"10.1093/jbcr/iraf015","DOIUrl":"https://doi.org/10.1093/jbcr/iraf015","url":null,"abstract":"<p><p>Ibuprofen, a non-steroidal anti-inflammatory drug (NSAID), can increase the risk of bleeding, a significant concern in burn surgery, which often involves substantial blood loss. This study aims to evaluate the safety of ibuprofen use in burn patients undergoing skin grafting. A retrospective case-control chart review was conducted for patients admitted with acute burn injury from 01/01/2024 to 07/31/2024 who underwent skin grafting. The primary outcome variables included perioperative transfusion requirement, bleeding, skin graft failure, and other complications. A total of 53 patients met inclusion criteria, 24 (45.2%) of whom received scheduled ibuprofen therapy during their hospitalization. The total body surface area affected was 12.3±9.3% for the non-ibuprofen group and 14.3±12.1% for the ibuprofen group (p=0.62). A total of 79.3% of patients in the non-ibuprofen group received meshed grafts compared to 79.2% in the ibuprofen group (p=0.734). Perioperative transfusion requirements were similar between the two cohorts, averaging 4.6±3.1 for the non-ibuprofen group and 3.2±2.8 units of packed red blood cells for the ibuprofen group (p=0.207). Skin graft failure (defined as need for re-grafting) occurred in 6.9% (n=2) of the non-ibuprofen cohort versus none (n=0) in the ibuprofen group (p=0.112). Postoperative complications did not vary significantly between the two groups for seroma (p=0.259), hematoma (p=0.498), and infection (p=0.568). There were no cases of hypersensitivity or gastrointestinal bleeding. There is likely no increased risk of bleeding or skin graft failure in burn injury patients taking ibuprofen, suggesting that these medications may be safe in this context.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burn center versus burn unit, which is better?","authors":"Mehdi Ayaz","doi":"10.1093/jbcr/iraf003","DOIUrl":"https://doi.org/10.1093/jbcr/iraf003","url":null,"abstract":"","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}