Journal of Burn Care & Research最新文献

{"title":"Wound Management Strategy for Burn Injuries During Pelvic External Fixation: A Case Report on the Practical Use of Negative Pressure Wound Therapy.","authors":"Wakako Ohashi, Kazuhiro Yoneda, Daisuke Kanda, Kenichi Ueda, Hiroshi Ito, Ryosuke Takegawa, Tomoya Hirose, Tomohiko Sakai, Jun Oda","doi":"10.1093/jbcr/iraf231","DOIUrl":"10.1093/jbcr/iraf231","url":null,"abstract":"<p><p>Burn management in patients requiring pelvic external fixation is extremely challenging due to restricted positioning and difficulty maintaining airtight negative pressure wound therapy (NPWT). Practical techniques to secure NPWT in this setting are rarely described. A 53-year-old man sustained 26% TBSA deep burns and an unstable pelvic fracture treated with external fixation. Circumferential trunk eschar excision was achieved by alternating lateral positions, as prone positioning was not feasible. Negative pressure wound therapy was applied for wound bed preparation and graft fixation. Airtight sealing was obtained using stoma paste around fixation pins and a belt-like silver-containing dressing on raw surfaces, reinforced with stoma paste to create a stable adhesion ridge. These methods enabled sustained negative pressure and stable graft take without regrafting. (1) Safe circumferential debridement achieved by alternating lateral positions. (2) Stoma paste effectively sealed difficult contours. (3) Silver dressing under stoma paste created an antimicrobial, sealable ridge for film adhesion. (4) \"Double-sided film sealing\" around pins maintained airtight NPWT. This case highlights practical NPWT sealing strategies enabling safe burn care under pelvic external fixation.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"950-954"},"PeriodicalIF":1.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145774772","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":"Burns are a Chronic Disease.","authors":"Elise Travis, Derek Murray, Sandra Fletchall, Deborah Knight","doi":"10.1093/jbcr/irag017","DOIUrl":"10.1093/jbcr/irag017","url":null,"abstract":"","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"977"},"PeriodicalIF":1.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146119109","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":"Safety and Efficacy of an Early Low-Dose Fresh Frozen Plasma Infusion in Burn Resuscitation.","authors":"Arek J Wiktor, Thomas O Vogler, Heather Carmichael, Munib Far, Scott W Mueller","doi":"10.1093/jbcr/iraf233","DOIUrl":"10.1093/jbcr/iraf233","url":null,"abstract":"<p><p>Growing evidence supports the addition of fresh frozen plasma (FFP) to a standardized crystalloid-based burn resuscitation. Fresh frozen plasma is thought to mitigate endotheliopathy, decrease total fluids and improve outcomes; however, when and how much FFP to give remains controversial. Here, we assessed the safety and efficacy of adding a non-titratable, 8-hr FFP infusion of 0.5 mL/kg/% total body surface area (TBSA) to a burn resuscitation. We performed an unmatched retrospective cohort review on all patients with burn injuries aged > 18 years old with > 20% TBSA burns who underwent our nursing-driven resuscitation protocol that included this early, standardized FFP infusion, from November 2016 to May 2020. Fifty-three patients received FFP and met inclusion criteria. Patients were primarily male (85%), with a median age of 36 years and a TBSA burn of 39% (range 24.5%-94%). Median time to FFP administration was 7 h from injury with a median of 1517 mL infused. Median input/output (I/O) ratio improved from 0.8 at FFP initiation to 0.4 at 3 h post-FFP, P < .001. Median urine output (UOP) improved from 0.19 mL/kg/h prior to FFP administration to 0.52 mL/kg/h at 3 h post-FFP, P < .001. No complications related to resuscitation such as abdominal compartment syndrome, acute respiratory distress syndrome, or transfusion reactions occurred. Therefore, adding a low-dose, standardized FFP infusion to burn resuscitations significantly improved UOP, normalized I/O ratios, and did not cause any known complications. Standardizing a safe, effective, non-titratable FFP infusion provides the framework to systematically test how colloids can be optimized during burn resuscitations in the future.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"807-816"},"PeriodicalIF":1.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13140596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145856532","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 Presence and Presentation of Microstomia in Burn Survivors: A Burn Model System Study.","authors":"Miranda L Yelvington, Bernadette Nedelec, Andrew Humbert, Samuel P Mandell, Haig A Yenikomshian, Jeffrey C Schneider","doi":"10.1093/jbcr/irag029","DOIUrl":"10.1093/jbcr/irag029","url":null,"abstract":"<p><p>Microstomia, or small oral aperture, often results from facial burns. This condition appears as scars form within the oral tissue and at the oral commissures, narrowing the oral opening, and leading to mobility, speech, respiratory difficulties, emotional distress, and social interaction challenges. This study examines the presence of reported burn microstomia and its related clinical factors. Pediatric and adult data from a multicenter longitudinal database from 2003 to 2005 were analyzed to determine the frequency of microstomia at discharge. Summary statistics were used to describe clinical characteristics, demographics, and burn location in pediatric and adult burn survivors. Clinical and burn characteristics were then tested to determine if there was an association with the development of microstomia. Data revealed 4.7% (n = 10) of adult burn survivors (n = 214) and 11% (n = 10) of pediatric burn survivors (n = 91) presented with microstomia at hospital discharge. Those with microstomia had significantly larger TBSA burns, higher rate of inhalation injury, more days on ventilation, and higher rate of adjacent contractures. No differences were found when considering age, sex, race, ethnicity, etiology of burn, or discharge location. Burn size and length of time requiring ventilation were predictive of microstomia. Knowledge of these risk factors suggests that therapists should focus on early microstomia prevention, even during times of ventilation, especially in those with larger burn injuries. The high incidence of adjacent contractures demonstrates the impact of cutaneokinematic skin recruitment and suggests that areas beyond the perioral should be considered when developing a treatment and prevention program for microstomia following a burn injury.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"937-943"},"PeriodicalIF":1.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146219971","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":"Letter to the Editor: Toward Consensus-Based Referral Criteria for Palliative Care in Burn Injury.","authors":"Anjay Khandelwal, Sarah Friebert, Daniel H Grossoehme, Richard Lou","doi":"10.1093/jbcr/irag058","DOIUrl":"https://doi.org/10.1093/jbcr/irag058","url":null,"abstract":"","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838324","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":"Frostbite in January-Amputate in July: Is Watchful Waiting for Surgical Management Following Frostbite Injury Still Standard? An Examination of the National Readmission Database.","authors":"Lexy Kindt, Charly Vang, Derek C Lumbard, Kyle Schmitz, Rachel M Nygaard","doi":"10.1093/jbcr/irag001","DOIUrl":"10.1093/jbcr/irag001","url":null,"abstract":"<p><p>Frostbite injuries account for 2000-4000 hospital admissions annually in the United States, with 30% of severe cases requiring amputation and up to 70% of cases resulting in long-term sequelae or disability. Traditional practice following frostbite injury is to delay surgical intervention 4-6 weeks to preserve limb length, tissue coverage, and reduce complications. This study examines amputation timing among frostbite patients in the United States and identifies factors influencing early versus delayed amputation. This retrospective study used the Nationwide Readmission Database (NRD) from 2016 to 2020 to identify frostbite admissions. Logistic regression models identified predictors of early amputation. Among 4786 patients with frostbite injury, 1422 (29.7%) underwent amputation. Of these, 977 (68.7%) had early amputations. Drug and alcohol use and housing insecurity were more prevalent among amputated patients, but were not associated with early amputation. Female sex, drug or alcohol use, comorbidities, infection or cellulitis, and mental health diagnoses were associated with a lower likelihood of early amputation. In adjusted models, infection/cellulitis was associated with lower odds of early amputation in the full cohort and not associated with timing in the nonelective subset. Across US admissions captured in the NRD, amputations commonly occurred within 30 days of presentation, diverging from historical \"watchful waiting\" practices. Social drivers of health influence need for and timing of amputations. Infection and cellulitis, which may necessitate urgent intervention, were not associated with increased likelihood of early amputation timing. Future research should explore factors driving early amputation and assess the impact of amputation timing on functional outcomes.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"817-823"},"PeriodicalIF":1.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105618","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":"FGF2 in Burn Wound Healing: From Molecular Function to Clinical Application-A Systematic Review.","authors":"Tobias Niederegger, Thomas Schaschinger, Jule Brandt, Robert Munzinger, Emre Karakas, Leonard Knoedler, Samuel Knoedler, Alen Palackic, Adriana Panayi, Gabriel Hundeshagen","doi":"10.1093/jbcr/irag020","DOIUrl":"10.1093/jbcr/irag020","url":null,"abstract":"<p><p>Burn injuries trigger complex inflammatory and metabolic cascades that impair wound healing and increase morbidity. Fibroblast growth factor 2 (FGF2), a potent mediator of cellular proliferation, angiogenesis, and extracellular matrix remodeling, has emerged as a promising therapeutic agent in burn care. This systematic review evaluated the biological mechanisms, delivery strategies, and clinical outcomes associated with FGF2 in burn wound healing to clarify its therapeutic value and translational potential. Following PRISMA 2020 standards, a structured literature search was conducted across PubMed, EMBASE, Web of Science, Cochrane, and Google Scholar to identify studies investigating FGF2 in thermal injuries. Eligible records included clinical trials, in vivo models, and in vitro experiments. Methodological quality and risk of bias were assessed using the Newcastle-Ottawa Scale, the SYRCLE tool, and the Oxford Levels of Evidence. Thirty-three studies (1992-2025) met inclusion criteria, encompassing randomized controlled trials, animal models, and mechanistic analyses. Fibroblast growth factor 2 accelerated repair by stimulating fibroblast proliferation, keratinocyte migration, angiogenesis, and matrix organization. Topical FGF2 formulations shortened healing time and improved scar quality in partial-thickness burns. Innovative carriers, including hydrogels, liposomes, and gene-activated matrices, enhanced bioavailability and sustained local effects. In diabetic and complex burn models, FGF2 mitigated inflammation, preserved barrier integrity, and promoted re-epithelialization. Efficacy depended on dosage and wound characteristics. Studies reported favorable safety profiles with minimal and mild adverse events. Fibroblast growth factor 2 demonstrates regenerative and immunomodulatory potential in burn management. Broader adoption requires harmonized regulatory evaluation, optimized delivery systems, and multicenter validation to define its role in precision-guided burn care.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"757-772"},"PeriodicalIF":1.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146149828","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":"Metabolic and Immunomodulatory Effects of α-Ketoglutarate in Burn Injuries: A Systematic Review.","authors":"Tobias Niederegger, Robert Munzinger, Thomas Schaschinger, Jule Carlotta Brandt, Leonard Knoedler, Samuel Knoedler, Alen Palackic, Adriana C Panayi, Gabriel Hundeshagen","doi":"10.1093/jbcr/irag002","DOIUrl":"10.1093/jbcr/irag002","url":null,"abstract":"<p><p>Severe burns unleash a hyper-catabolic and immunosuppressive state that erodes lean tissue and delays repair. Alpha-ketoglutarate (α-KG), usually delivered enterally as the dipeptide ornithine α-ketoglutarate (OKG), feeds the tricarboxylic-acid cycle, donates nitrogen for amino-acid synthesis, and modulates collagen formation and immunity. We systematically appraised the biological mechanisms, delivery strategies, and clinical outcomes associated with α-KG/OKG in burn care to clarify its therapeutic value and translational readiness. A PRISMA-2020-compliant search of PubMed, EMBASE, Web of Science, Cochrane, and Google Scholar up to May 2025 identified clinical, in vivo, and relevant in vitro studies linking α-KG or OKG with thermal injury. Study quality was assessed using the Newcastle-Ottawa Scale, SYRCLE Risk-of-Bias tool, and Oxford Levels of Evidence. Fifteen studies published between 1984 and 2024 met inclusion criteria, including clinical, animal, and mechanistic work, most conducted in France. Across studies, OKG supplementation replenished glutamine and arginine pools, improved nitrogen balance, preserved muscle mass, and promoted wound healing through enhanced collagen synthesis and immune modulation. Clinical data confirmed improved nitrogen retention, reduced muscle breakdown, and faster wound closure. Preclinical studies further showed that α-KG preconditioning enhances stem cell-driven regeneration and vascularization. Additional effects, such as improved glucose tolerance and hepatic enzyme preservation, suggest some benefits occur independently of glutamine pathways. This review highlights α-KG and OKG as promising adjuncts to enhance metabolic recovery, wound repair, and immune competence after burns. Evidence supports improved nitrogen balance and healing, but findings remain limited by heterogeneity and small cohorts, warranting renewed and well-powered studies.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"730-745"},"PeriodicalIF":1.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145933386","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":"Association of the CAGE Questionnaire for Alcohol and Substance Misuse With Burn Patient Demographics and Outcomes.","authors":"Kiran U Dyamenahalli, Lauren J Shepler, Colleen M Ryan, Caitlin Orton, Haig A Yenikomshian, Nhi-Ha Trinh, Lewis E Kazis, Mary D Slavin, Kara McMullen, Jeffrey C Schneider, Jeremy Goverman","doi":"10.1093/jbcr/irag003","DOIUrl":"10.1093/jbcr/irag003","url":null,"abstract":"<p><p>The burden of alcohol and substance use disorder is disproportionately high among patients with burn injuries and portends worse clinical outcomes. The Cut down, Annoyed, Guilty, and Eye-opener (CAGE) questionnaire is a validated 4-question screen for alcohol and drug use. This study aimed to identify demographic and clinical variables that predict positive CAGE screens or negative-to-positive screen conversion in burn survivors and to examine psychosocial and functional outcomes. The Burn Model System database was used to assess characteristics of patients with burn injuries who completed a CAGE screen at discharge (1994-2023). The relationship between CAGE scores and Satisfaction with Life Scale (SWLS), PROMIS (Patient Reported Outcomes Measurement Information System)-Anxiety, -Depression, -Pain Interference, and -Physical Function were analyzed. Mean length of hospital stay was longer in patients with positive CAGE screens (34.0 vs 25.1 days, P < .001). Mean number of surgeries demonstrated a similar association (2.8 vs 2.2, P < .001). Significant differences were also observed by ethnicity, race, employment status, burn mechanism, marital status, and insurance type. Drug misuse at the time of injury was significantly higher in CAGE-positive patients (34.9% vs 6.6%, P < .001). Younger age (P = .004) and unemployment (P = .001) were significantly associated with transition to a positive CAGE screen within 24 months. At 12 months, a positive CAGE screen was associated with lower SWLS (P < .001) and higher (detrimental) PROMIS-Anxiety (P = .006) and -Depression (P = .019) scores. These data suggest significant associations between positive CAGE screens, as a surrogate for drug and alcohol misuse, and measures of burn severity (length of stay and number of surgeries), psychological stress (anxiety and depression), and social dysfunction (unemployment).</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"824-832"},"PeriodicalIF":1.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13063507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146227015","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":"Risk of Amputation and Associated Outcomes in Conveyance Burn Injuries, a Burn Model System Project.","authors":"Isabella Alexander, Eunyeop Kim, Andrew Humbert, M Victoria P Miles, Samuel P Mandell, Audra T Clark, Karen J Kowalske","doi":"10.1093/jbcr/iraf230","DOIUrl":"10.1093/jbcr/iraf230","url":null,"abstract":"<p><p>Despite improved safety standards, motor vehicle collisions remain a significant source of flame burn injury. The objective of this study is to characterize differences in demographics and outcomes between patients with burn injuries related to motor vehicle collisions and patients with flame burn injuries not involved in motor vehicle collisions. The analysis included participants enrolled in the Burn Model Systems from 2015 to 2023. Conveyance burn participants had more amputations than patients with non-conveyance burn injuries (15% vs 4.9%, P < .001), with an increase in lower extremity amputations (2.5% vs 0.7%, P = .027). In addition, conveyance burns involved a greater total body surface area (TBSA) (26% vs 23%, P < .034) and were associated with longer hospital stays (40 days vs 33 days, P < .006). Participants who sustained injuries during conveyance demonstrated significantly lower global physical health t-scores (42.3 vs 44.1, P = .037) and physical function t-scores (42.0 vs 46.1, P = .002) at 6 months postinjury compared with those with non-conveyance flame burns. In addition, conveyance burn participants reported significantly lower t-scores for their ability to participate in social roles at 6 months (48.8 vs 50.8, P = .044) and 12 months postinjury (49.9 vs 54.0, P = .015). This study highlights the significant impact of conveyance-related burn injuries, particularly with respect to higher amputation rates and poorer early physical outcomes, compared with non-conveyance flame burns. This supports the need for targeted preventive strategies, especially those focused on vehicle maintenance and safety among younger and underrepresented populations.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"788-795"},"PeriodicalIF":1.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145804714","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}