Journal of Burn Care & Research最新文献

{"title":"Gut Microbiota Differences Among Patients with Burns with Varied Pruritus Responses: A Case Report.","authors":"Yeongyun Jung, Yoon Soo Cho","doi":"10.1093/jbcr/iraf029","DOIUrl":"https://doi.org/10.1093/jbcr/iraf029","url":null,"abstract":"<p><p>Pruritus-a common symptom in patients with burns- impairs the quality of life and contributes to anxiety and depression. Although the mechanisms underlying post-burn pruritus remain unclear, gut microbiome dysbiosis may affect systemic inflammation and drug responsiveness. This study analyzed the gut microbiome composition of six male patients (40-50 years old) with burns and categorized them into three groups based on pruritus outcomes-non-pruritus (NP, did not receive antihistamine), responder (R, pruritus reduced with antihistamine treatment), and non-responder (NR, pruritus persisted despite antihistamine treatment). Fecal samples were collected at baseline (week 0) and after eight weeks. The NP and R groups exhibited enhanced alpha diversity, increased Firmicutes/Bacteroidota (F/B) ratios, and reduced Proteobacteria over time, indicating microbiome recovery. In contrast, the NR group exhibited inconsistent results, with case 5 demonstrating reduced diversity and increased F/B and Proteobacteria, whereas case 6 exhibited increased diversity and decreased F/B and Proteobacteria. Faecalibacterium was absent in the NR group, whereas the relative abundance of unclassified Lachnospiraceae increased. This study highlights the potential effects of dysbiosis on pruritus outcomes and drug responsiveness in patients with burns. Future studies with larger cohorts are necessary to assess these findings and explore microbiome-targeted therapies to enhance treatment outcomes.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605019","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":"Enhancing Mechanisms of p38MAPK/NF-κB in Regulating Post-Debridement Inflammatory Response during the Shock Period in Burned Rats.","authors":"Jin-Li Zhang, De-Yun Wang, Wei-Guo Xie","doi":"10.1093/jbcr/iraf028","DOIUrl":"https://doi.org/10.1093/jbcr/iraf028","url":null,"abstract":"<p><p>This study aimed to observe the temporal changes in inflammatory factors and explore the mechanisms regulating inflammation during the shock period following debridement in rats. A burn model was established in SD rats using a 30% total body surface area III-degree scald. Rats were divided into three groups: control group, debridement group (12 hours post-burn debridement with heterograft skin coverage), and sham surgery group (simulated debridement with autograft skin coverage). Serum samples were collected at 12, 24, 48, 72, and 96 hours post-injury to assess levels of inflammatory factors and proteins related to the p38 MAPK/NF-κB pathway. The levels of lipopolysaccharide-binding protein (LBP), high-mobility group box 1 (HMGB1), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and IL-10 in the control group peaked between 12 and 48 hours post-injury, while HMGB1 increased gradually, peaking at 96 hours. Compared to the control group, both the debridement and sham surgery groups showed significant reductions in these inflammatory factors (P<0.01 or P<0.05), except for LBP. Liver p38MAPK levels showed no significant difference between groups, but phosphorylated p38MAPK and NF-κB levels significantly decreased (P<0.05 or P<0.01). In the debridement group, intra-group comparisons revealed a significant downward trend in inflammatory factors and liver p38MAPK and NF-κB phosphorylation levels. These results suggest that debridement during the shock period can reduce inflammation through the p38MAPK/NF-κB pathway, promoting a faster decline in systemic inflammatory response.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597129","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":"Lessons Learned Evaluating Ablative Fractional CO2 Laser for Burn-Related Donor Site Scars.","authors":"Cameron S D'Orio, Bonnie C Carney, Jasmine H Wong, Angela Golding, Alison Ross, Melissa M McLawhorn, Rebekah R Allely, Jeffrey W Shupp, Shawn Tejiram, Taryn E Travis","doi":"10.1093/jbcr/iraf030","DOIUrl":"https://doi.org/10.1093/jbcr/iraf030","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Hypertrophic scar (HTS) remains a comorbidity of burn injury, often requiring split thickness skin grafting (STSG) and resulting in symptomatic HTS at grafted sites and STSG donor sites (DS). Literature supports the use of ablative fractional CO2 laser (FLSR) to treat HTS, however many trials lack of control sites and tissue-level examinations. Given the widespread adoption of FLSR for HTS, delegation of non-treated scar sites for the sake of randomized controlled trial (RCT) is troubling for many clinicians. We trialed using STSG DS scars for randomization rather than withholding FLSR from HTS at grafted sites. Patients (n=20) were treated for DS scar with FLSR. DS scars were randomized and treated with either 6 FLSR treatments, follow-ups, and standard of care (SOC) or SOC only. Prior to treatment, DS skin and normal skin (NS) were evaluated for trans-epidermal water loss (TEWL), melanin index (MI), elasticity, and erythema. Serial biopsies were analyzed for epidermal thickness, rete ridge ratio (RRR), and papillary dermal cellularity. All sites, including a separate burn scar (BS) site, were evaluated using the patient and observer scar assessment scale (POSAS) -observer (-O), -patient (-P), Vancouver Scar Scale (VSS), and an institutional Scar Comparison Scale (SCS). Prior to treatment, the DS control (DS C), DS treated (DS T), and BS sites were hyperpigmented compared to normal skin. BS was less elastic than all other sites and had increased TEWL compared to normal skin. DS skin had increased cellularity, decreased rete ridge ratios, and increased epidermal thickness compared to NS. Clinician observers and patients perceived the BS site as more severe versus DS skin through the POSAS-O, POSAS-P, and VSS. Over time, DS C and DS T sites were not different in TEWL, elasticity, erythema, MI, cellularity, RRR, epidermal thickness, POSAS-O scores, POSAS-P scores, VSS scores, or SCS scores. Over time, burn scar did not change in TEWL, elasticity, erythema, MI, POSAS-O scores, POSAS-P scores, and VSS scores. Decreased SCS scores within the DS C, DS T, and BS sites indicated patient-perceived improvement in all scars throughout the study time course. NS and DS skin possess inherent physiological differences, though not to the degree of burn scars vs. NS. FLSR may not alter the rate of maturation and remodeling of DS skin compared to current SOC. While improvement in scar assessment was observed in laser-treated BS HTS, no specific control for these sites was analyzed. Due to differences in pathophysiology of HTS formation at grafted and donor sites, the STSG DS may not be an adequate substitute for BS HTS when designing RCTs to evaluate the effect of FLSR. Prior studies evaluating the use FLSR in burn-related HTS consist of low-powered clinical trials or case studies without control sites or tissue level examinations, prompting the design of a RCT in DS scars. However, this scar type may not be suitable for this study design. Future work should","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604986","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":"Prevalence, pattern, and long-term outcome of facial burns among Riyadh city population: a 10-year study.","authors":"Dr Mohammed Alfawzan, Dr Abdulmajeed Saad M Alhadlaq, Dr Malak Alsaif, Lulwah Saleh Alhumaidan, Nawaf Abdulaziz Aljahili, Bader Hammad Alharbi, Enas Mubarak Al Hadi","doi":"10.1093/jbcr/iraf018","DOIUrl":"https://doi.org/10.1093/jbcr/iraf018","url":null,"abstract":"<p><p>This study aimed to investigate the patterns and prevalence of facial burns among adults in Riyadh city, Saudi Arabia on September 2023. Retrospective data collection was carried out from the hospital's Electronic Health Record database, and the subsequent data entry, management, and analysis were executed using R Studio (V.4.1.3). The incidence rate of facial burns was higher in males, comprising 71.61% (n=111) of cases, while females accounted for 28.39% (n=44). Employment status varied, with 22.58% (n=35) of patients being employed and only 7.10% (n=11) identified as students. Flame burns were the most common type, constituting 78.06% (n=121) with second-degree burns constituting 38.7% (n=60). The study revealed that the facial burns were mostly associated with upper limb burns (n=88) with majority of the patients undergoing medical treatment constituting 71.61% (n=111). The study revealed that the major cause of ICU admission was intubation constituting 72.22% (n=52), while septic shock was the leading cause of death among ICU-admitted patients, representing 72.73% (n=16) of cases. In this study of 155 facial burn cases, flame burns, often resulting in second-degree injuries, were the most common type. Intubation emerged as a leading cause of ICU admission, with septic shock as the primary cause of death among ICU patients. These findings underscore the need for specialized care and preventive measures for facial burns.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605025","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":"Intravenous Glutathione and Vitamin Supplementation Causing Stevens-Johnsons Syndrome: A Case Report.","authors":"J S Johnson, N R Jarvis, A M Martinez, J E Dvorak","doi":"10.1093/jbcr/iraf027","DOIUrl":"https://doi.org/10.1093/jbcr/iraf027","url":null,"abstract":"<p><p>Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis are severe mucocutaneous reactions with high morbidity and mortality, most commonly triggered by prescribed medications. Here, we report a case of a 33-year-old female who developed Stevens-Johnson/Toxic Epidermal Necrolysis after receiving an IV vitamin infusion containing glutathione, vitamin C, and vitamin D. While not commonly associated with the development of Stevens-Johnson Syndrome glutathione has been previously reported to have been the inciting agent in Stevens-Johnson Syndrome cases. Concerns over glutathione's association with Stevens-Johnson Syndrome has led the FDA in the Republic of the Philippines to issue a warning over the potential associations between glutathione and Stevens-Johnson Syndrome. With the rise in relatively unregulated IV hydration clinics in the United States, where IV vitamin infusions are frequently completed, our case highlights the potential severe risks. Additionally, our case highlights the need for providers to complete a thorough review of a patient's history, including inquiring about hydration and wellness center infusions, when trying to determine potential inciting factors in Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585775","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":"Opinion: Burn Survivors, You, and the ABA.","authors":"Robert Cartotto","doi":"10.1093/jbcr/iraf023","DOIUrl":"https://doi.org/10.1093/jbcr/iraf023","url":null,"abstract":"","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573064","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":"Triage and Admission of Burn Patients Based on Race and Payer.","authors":"Samantha Steeman, Devi Lakhlani, Eloise Stanton, Clifford Sheckter","doi":"10.1093/jbcr/iraf024","DOIUrl":"https://doi.org/10.1093/jbcr/iraf024","url":null,"abstract":"<p><p>For-profit burn centers may prioritize commercially insured burn patients, exacerbating disparities for Medicaid (Medi-Cal) and uninsured patients who are more often racial minorities. We hypothesize that for-profit burn centers accept fewer burn transfers with Medi-Cal compared to safety-net and nonprofit centers. California's all-payer database was queried from 2009-2019 to evaluate ED-to-inpatient transfers for all burn patients within the state. The proportion of transfers with Medi-Cal payer was compared relative to profit status, safety-net status, and trauma center status. The likelihood of a burn transfer being accepted to for-profit center was modeled with logistic regression, adjusting for burn severity and demographics. Among 5,728 ED transfers, 89% went to nonprofit centers. Medi-Cal was the primary payer in 37.3% of transfers to nonprofit centers versus 24.0% to for-profit centers (p<.001). Medi-Cal payer (aOR 95% CI 0.49-0.76), Black race (aOR 95% CI 0.36-0.73), and Hispanic race (aOR 0.51-0.77) were all independently associated with reduced odds of transfer to for-profit burn centers. Profit status was negatively associated with the proportion of Medi-Cal transfers, while trauma center status and safety-net center status were not correlated. There was an overall increase in the proportion of Medi-Cal patients treated at nonprofit (21.8%) and for-profit (16.48%) centers over the study period. Disparities persist in burn care access by race, ethnicity, and insurance status. Nonprofit centers more frequently serve Medi-Cal and minority patients, while for-profit centers appear to demonstrate potential preference for caring for commercially insured, white patients.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573066","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":"Complex Regional Pain Syndrome Following Minor Burns: A Rare but Significant Complication.","authors":"A D Rogers, D L Wallace, P McHardy, H Meng","doi":"10.1093/jbcr/iraf022","DOIUrl":"https://doi.org/10.1093/jbcr/iraf022","url":null,"abstract":"","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573062","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 Rare Use of Glabrous Donor for Palmar and Ventral Foot Burns Should Not Be So Rare: Recognition of a Seldom-Used Technique That Should Be in the Armamentarium of Every Burn, Plastic, Hand, and Foot Surgeon.","authors":"Peter Sienko, Amir Dehdashtian, Gary A Vercruysse","doi":"10.1093/jbcr/iraf020","DOIUrl":"https://doi.org/10.1093/jbcr/iraf020","url":null,"abstract":"<p><p>The hairless, thickened glabrous skin of the palms and soles differs significantly from the rest of the body, presenting unique challenges to surgeons treating wounds in these areas, such as burns. Traditionally, full-thickness, non-glabrous skin grafts have been used for repairs, often leading to complications such as hyperkeratosis and epidermolysis. These grafts can also be cosmetically displeasing, resulting in unwanted hair growth and hyperpigmentation, particularly in individuals with darker skin. Multiple grafting techniques for wounds to the palms and soles have been reported; in this report, we focus on the rare use of healthy glabrous skin to replace like skin when presented with full-thickness loss of the injured glabrous portions of the hand or foot.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567069","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":"Epidemiology and Prognostic Factors Analysis of Electrical Injuries in Shaanxi, China: A Single-Center Observational Study of 385 Cases.","authors":"Huaqiang Zhao, Zhanjun Lei, Ming Yang, Xueyong Li, Jiezhang Tang, Yuchen Dong, Jian Feng, Yongqian Bian","doi":"10.1093/jbcr/irae112","DOIUrl":"10.1093/jbcr/irae112","url":null,"abstract":"<p><p>The objective of this research is to investigate the epidemiological features of electrical injuries in Shaanxi Province, China, examine their prognosis, and ascertain the factors that impact the outcomes. Telephone follow-ups were conducted with patients with electrical injuries at our hospital between 2011 and 2021, yielding the following results: Most electrical injuries occur in males (94.3%) and younger or middle-aged individuals. The most common voltages involved are 220 and 380 V. Since 2016, there has been a 20.1% annual decrease in electrical injuries, with most cases occurring from April to September. Patients typically undergo 1 surgical procedure (0.3), with a 14.8% amputation rate and an average hospital stay of 21 days (9.43). A total of 1.8% of patients with electrical injuries have died, 17.1% have permanent nerve damage, and 10.8% need help with daily tasks; 18.5% have psychological issues, and 9.6% have posttraumatic stress disorder; and 93.7% return-to-work in an average of 6 months (2.12). Amputation risk is influenced by voltage, muscle injury, and current pathway; skin grafting risk is mainly due to voltage. Heart injuries are affected by unconsciousness and current pathways; labor loss risk factors include voltage, falls from heights, and muscle injury; and nerve damage is linked to muscle injury. Cataract development risk is associated with electric shock to the head and neck. It is crucial to address the psychological well-being of patients and provide necessary support. Patient input should be taken into account when deciding on treatment for nonfunctional limbs. Physicians should evaluate prognostic factors and provide appropriate treatment to enhance patient outcomes.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"285-293"},"PeriodicalIF":1.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141317367","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}