Journal of Burn Care & Research最新文献_第2页

Beyond the Burn: Evaluating Insurance Support for Cosmetic Reconstruction After Burn Injury. 超越烧伤：评估烧伤后美容重建的保险支持。

IF 1.5 4区医学

Journal of Burn Care & Research Pub Date : 2025-07-11 DOI: 10.1093/jbcr/iraf133

Anastasiya Ivanko, Athena Hoppe, Jason P Heard, Jonathan E Schoen, M Victoria P Miles, Jeffrey E Carter

{"title":"Beyond the Burn: Evaluating Insurance Support for Cosmetic Reconstruction After Burn Injury.","authors":"Anastasiya Ivanko, Athena Hoppe, Jason P Heard, Jonathan E Schoen, M Victoria P Miles, Jeffrey E Carter","doi":"10.1093/jbcr/iraf133","DOIUrl":"https://doi.org/10.1093/jbcr/iraf133","url":null,"abstract":"Patients recovering from burn injuries face long-term psychological, physiological, and biomechanical challenges due to scarring. While interventions to address these challenges exist, insurance coverage is often limited. This study examines the insurance policies of major health insurers regarding cosmetic reconstruction (CR) following burn injuries. A comprehensive review of coverage policies was conducted for five major health insurance providers: UnitedHealth Group, Elevance Health (formerly Anthem), Humana, CVS (Aetna), and Centene Corporation. The review focused on invasive and noninvasive CR interventions for burn injuries. Data was collected from state-specific insurance documents using Microsoft Excel. As of 2024, UnitedHealth Group holds a 28% share of the Medicare Advantage market and 14% of the commercial market, serving all 50 states. Humana controls 18% of the Medicare Advantage market, while CVS (Aetna) holds 11% in both markets, with nationwide coverage. However, none provide coverage for CR unless there is documented significant functional impairment (FI). Elevance Health has limited coverage in 19 states, contingent on FI documentation, while Centene Corporation. covers CR on a case-by-case basis, leading to fragmented access across the United States. Standardized, equitable coverage for burn-related CR is needed to remove bureaucratic barriers hindering survivors' recovery. Inconsistent insurance policies prevent access to essential aftercare, exacerbating physical and emotional burdens. Policy reform is crucial to ensure all burn survivors receive the care needed for recovery and a restored quality of life.","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608490","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}

引用次数: 0

An Analysis of Face Validity for the Mobile-App Scenario and Biomimetic Simulator in the Burns for Providers Program (BP2). 移动应用程序场景和仿生模拟器在烧伤提供者计划（BP2）中的面部有效性分析。

IF 1.5 4区医学

Journal of Burn Care & Research Pub Date : 2025-07-11 DOI: 10.1093/jbcr/iraf134

Aaron K Hong, Mario Rivera-Barbosa, James E Johnson, Jeffrey E Carter, M Victoria P Miles, Dhanushka S Vitharana, Leopoldo C Cancio, Angela B Samosorn, Herb A Phelan

{"title":"An Analysis of Face Validity for the Mobile-App Scenario and Biomimetic Simulator in the Burns for Providers Program (BP2).","authors":"Aaron K Hong, Mario Rivera-Barbosa, James E Johnson, Jeffrey E Carter, M Victoria P Miles, Dhanushka S Vitharana, Leopoldo C Cancio, Angela B Samosorn, Herb A Phelan","doi":"10.1093/jbcr/iraf134","DOIUrl":"https://doi.org/10.1093/jbcr/iraf134","url":null,"abstract":"Introduction: The military funded a novel burn educational program called the Burns for Providers Program (BP2) which teaches cognitive skills via a scenario-based mobile app and psychomotor skills via biomimetic tabletop simulators. We sought to establish face validity for these prototypes.Methods: Instruments have face validity if subject matter experts (SMEs) feel they have verisimilitude for whatever they purport to represent. Booths were purchased at the 2024 American Burn Association (ABA) and Southern Region Burn meetings. Interested SMEs (defined as completion of a burn fellowship or >3 years in a practice consisting of >25% burns) engaged with prototypes depicting a patient presenting to a Role 2 or civilian emergency department (ED) with a femur fracture and a 44% burn. SMEs completed a 17-item survey consisting of positive statements about the prototypes which they rated from 1= \"Strongly disagree\" to 5= \"Strongly agree.\" These procedures were repeated for SMEs at the United States Army's Institute of Surgical Research.Results: 77 SMEs with 12.4 + 10.1 years' experience made up the study cohort (89% civilian, 11% military). The majority were nurses (43%), burn surgeons (26%), or advanced practice providers (APPs) (9%). Overall, 88% of SMEs answered 17/17 positively-phrased statements interrogating the software and model's importance, verisimilitude, and effectiveness with \"strongly agree\" or \"somewhat agree;\" 8% had at least 1 \"neutral\" response with the remainder being agreement; 4% registered at least one \"disagree\" response to the 17 positively-phrased statements.Conclusions: The resources, environment, and injuries portrayed in the prototype BP2 mobile app scenario and tabletop simulator appear to have high face validity.","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608489","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}

引用次数: 0

Therapeutic Strategies and Predictors of Functional Impairment in Hand Burns: A Retrospective Single-Center Study. 手部烧伤功能损害的治疗策略和预测因素：一项回顾性单中心研究。

IF 1.5 4区医学

Journal of Burn Care & Research Pub Date : 2025-07-09 DOI: 10.1093/jbcr/iraf126

Alfio Luca Costa, Cesare Tiengo, Gloria Fanton, Nexhmije Mjelli, Bruno Azzena

{"title":"Therapeutic Strategies and Predictors of Functional Impairment in Hand Burns: A Retrospective Single-Center Study.","authors":"Alfio Luca Costa, Cesare Tiengo, Gloria Fanton, Nexhmije Mjelli, Bruno Azzena","doi":"10.1093/jbcr/iraf126","DOIUrl":"https://doi.org/10.1093/jbcr/iraf126","url":null,"abstract":"Hand burns pose complex clinical challenges due to the intricate anatomy of the hand and its indispensable role in daily activities. In this retrospective cohort study, we evaluated 88 adult patients admitted to a specialized burn center with burns involving one or both hands. We collected demographics, burn characteristics, and clinical variables from medical records, and assessed functional outcomes one year after injury using the Disabilities of the Arm, Shoulder, and Hand (DASH) score. Nonparametric tests compared patient subgroups, a six-factor multivariable regression (age, %TBSA, depth, digital involvement, bilateral involvement, amniotic-membrane use) identified predictors of more severe functional impairment. Although larger burns required longer hospital stays, neither burn size nor depth emerged as independent predictors of hand function in the multivariable model. In contrast, anatomical burn site, particularly digital and bilateral hand involvement, was strongly associated with higher DASH scores, highlighting the importance of the precise location of the burn in long-term recovery. Age also played a critical role, with older patients showing worse outcomes regardless of other clinical factors. Surgical management varied across the cohort, with the use of amniotic membrane grafts standing out as a potentially favorable approach. Patients receiving these grafts showed lower DASH scores, suggesting better preservation of hand function compared to other methods. While these findings reinforce the need to focus on specific anatomical areas and patient age in treatment planning, they also point to innovative biologic materials as a promising avenue for functional recovery. Multicenter studies may help refine these observations and guide burn care in the future.","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591327","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}

引用次数: 0

Facial Burn Healing with a Polylactic Acid Dermal Matrix: A Case Report on Wound Modulation and Graft-Free Epithelialization. 聚乳酸真皮基质修复面部烧伤：伤口调节和无移植物上皮化一例报告。

IF 1.5 4区医学

Journal of Burn Care & Research Pub Date : 2025-07-08 DOI: 10.1093/jbcr/iraf127

Mario Aurelio Martínez-Jiménez, Ana Lorena Novoa-Moreno, Rodolfo Ariel Miranda-Altamirano, Olga Johnson-Ponce, Eleazar Samuel Kolosovas-Manchuca, Victor Manuel Loza-González

{"title":"Facial Burn Healing with a Polylactic Acid Dermal Matrix: A Case Report on Wound Modulation and Graft-Free Epithelialization.","authors":"Mario Aurelio Martínez-Jiménez, Ana Lorena Novoa-Moreno, Rodolfo Ariel Miranda-Altamirano, Olga Johnson-Ponce, Eleazar Samuel Kolosovas-Manchuca, Victor Manuel Loza-González","doi":"10.1093/jbcr/iraf127","DOIUrl":"https://doi.org/10.1093/jbcr/iraf127","url":null,"abstract":"Due to their functional and aesthetic implications, facial burns pose significant clinical challenges. Alkali burns can further complicate these injuries by causing deep tissue necrosis, which complicates healing and increases the risk of scarring. Traditional management involves early excision and autografting, but challenges such as donor site morbidity and poor aesthetic integration remain. SUPRA SDRM®, a fully synthetic, polylactic acid (PLA)- based resorbable dermal matrix, has demonstrated efficacy in different wound types but has not been previously reported in deep burn management. Here, we present the case of a 53-year-old male with deep alkali facial burns managed with SUPRA SDRM®. Initially applied as a bridge to grafting, rapid pain relief and early vascularization led to an alternative treatment course. The matrix formed an adherent synthetic wound barrier, modulating the healing environment and allowing full epithelialization within five weeks without the need for grafting. Histology confirmed enhanced angiogenesis and dermal remodelling, while infrared thermography (IRT) imaging demonstrated changes suggestive of perfusion improvements, supporting the bio-inductive effects of the matrix. This case suggests that PLA-based dermal matrices may serve as a viable alternative to autografting in select deep burns, warranting further investigation into their role in wound modulation, functional outcomes, and resource-limited burn care.","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584015","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}

引用次数: 0

Utilizing Indirect Intrapleural Pressure to Guide Mechanical Ventilation in Burn Patients with ARDS. 应用间接胸膜内压指导烧伤合并ARDS患者机械通气。

IF 1.5 4区医学

Journal of Burn Care & Research Pub Date : 2025-07-08 DOI: 10.1093/jbcr/iraf119

Amanda M Soo Ping Chow, Laura S Johnson, Tuan D Le, Melissa McLawhorn, Lauren T Moffatt, Taryn E Travis, Jeffrey W Shupp, Shawn Tejiram

{"title":"Utilizing Indirect Intrapleural Pressure to Guide Mechanical Ventilation in Burn Patients with ARDS.","authors":"Amanda M Soo Ping Chow, Laura S Johnson, Tuan D Le, Melissa McLawhorn, Lauren T Moffatt, Taryn E Travis, Jeffrey W Shupp, Shawn Tejiram","doi":"10.1093/jbcr/iraf119","DOIUrl":"https://doi.org/10.1093/jbcr/iraf119","url":null,"abstract":"Patients with severe burn injuries are at risk of developing acute respiratory distress syndrome (ARDS). Modern ARDS management does not typically factor in how burn injury influences lung dynamics during ventilator management. Obtaining indirect intrapleural pressures via esophageal pressure monitoring (Pes) may provide unique guidance on optimal positive end expiratory pressure (PEEP) titration to prevent alveolar collapse while ensuring safe plateau pressures but is not well described in burn injured patients. This work examined the use of Pes in burn injured patients with ARDS to determine its effect on ventilator changes. Burn injured patients admitted to an ABA verified burn center who developed ARDS by the Berlin definition and received Pes were retrospectively reviewed to determine ventilator settings and oxygenation trends. Severity of ARDS and oxygenation were determined by PaO2 to FiO2 (P/F) ratios and oxygenation indices (OI) prior to Pes use, and at 1-, 3- and 5-day intervals following initiation. Of the 23 patients included, the median revised Baux score was 91.6 (73.9-114.6), and the mortality rate was 82.6%. Increases in PEEP were required [12 (4) vs 17 (4); p<.0001] following Pes initiation. P/F ratios increased by day 5 post-Pes monitoring [300 (35.1)] compared to pre- [141 (26.5); p=.0020], 1 day post- [169 (26.5); p=.0134] and 3 days post- [179 (29.4); p=.0325] monitoring. OI between pre-Pes monitoring and day 5 post Pes monitoring, were not significant [17.3 (1.92) vs 13.4 (2.57)]. A strategy incorporating Pes to guide ventilator management in burn injured patients with ARDS may be used.","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584016","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}

引用次数: 0

Hemostatic Net in Non-Meshed Split-Thickness Grafts Enhances Graft Integration and Healing. 非网状分厚移植物的止血网促进移植物的融合和愈合。

IF 1.5 4区医学

Journal of Burn Care & Research Pub Date : 2025-07-07 DOI: 10.1093/jbcr/iraf124

José Ignacio Fonseca-Sada, Alan Amado Méndez-Pérez, Daniel Salas-Treviño, Hernán Jesus Chacón-Moreno, Enrique Quevedo-Fernández, Everardo Valdés-Flores, Yanko Castro-Govea, Cynthia Minerva-González Cantú

{"title":"Hemostatic Net in Non-Meshed Split-Thickness Grafts Enhances Graft Integration and Healing.","authors":"José Ignacio Fonseca-Sada, Alan Amado Méndez-Pérez, Daniel Salas-Treviño, Hernán Jesus Chacón-Moreno, Enrique Quevedo-Fernández, Everardo Valdés-Flores, Yanko Castro-Govea, Cynthia Minerva-González Cantú","doi":"10.1093/jbcr/iraf124","DOIUrl":"https://doi.org/10.1093/jbcr/iraf124","url":null,"abstract":"Skin grafts are essential in reconstructive surgery, although complications such as hematomas, seromas, infections, and shear forces can compromise their success. This study evaluated the effectiveness of a hemostatic net fixation technique to improve graft integration and reduce complications. Fifteen patients treated with non-meshed split-thickness grafts fixed using continuous sutures forming a hemostatic net were compared to meshed grafts fixed with staples or sutures along the edges (traditional technique). Both treatments were applied to split wound areas in the same patient. Six months of follow-up, assessing graft integration, aesthetic appearance, and complications, were reported. No patients experienced hematomas, seromas, or infections, and all grafts integrated successfully. Additionally, a blinded panel of plastic surgeons rated the aesthetic appearance of the two techniques. The aesthetic appearance was evaluated with higher scores in the grafts fixed with a hemostatic net. In conclusion, the fixation of skin grafts using a hemostatic net improves integration and aesthetic outcomes while minimizing complications such as hematoma or seroma. Further studies with more surgical areas are needed to confirm these benefits. The technique could represent a significant advancement in reconstructive and aesthetic surgery, optimizing clinical and cosmetic outcomes.","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575550","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}

引用次数: 0

Clinical utility of methicillin-resistant Staphylococcus aureus polymerase chain reaction nares swabs in burn injured patients. 耐甲氧西林金黄色葡萄球菌聚合酶链反应鼻拭子在烧伤患者中的临床应用。

IF 1.5 4区医学

Journal of Burn Care & Research Pub Date : 2025-07-04 DOI: 10.1093/jbcr/iraf120

Jade Montgomery, Rachel Burgoon, Aaron Hamby, Melanie Smith Condeni

{"title":"Clinical utility of methicillin-resistant Staphylococcus aureus polymerase chain reaction nares swabs in burn injured patients.","authors":"Jade Montgomery, Rachel Burgoon, Aaron Hamby, Melanie Smith Condeni","doi":"10.1093/jbcr/iraf120","DOIUrl":"https://doi.org/10.1093/jbcr/iraf120","url":null,"abstract":"Methicillin-resistant Staphylococcus aureus (MRSA) is a common pathogen in burn injured patients. Many studies have evaluated the overall utility of MRSA nares polymerase chain reaction (PCR) swabs for antimicrobial stewardship; however, there is a paucity of data in burns. This study evaluated the clinical utility of MRSA PCR in burn injured patients at an academic medical center. This retrospective, single-center chart review included admitted adult burn injured patients from July 2020 to June 2024. The primary objective was to determine the overall negative predictive value (NPV) of MRSA PCR in burn injury patients for suspected MRSA infections. Secondary objectives included determining the sensitivity, specificity, NPV, and positive predictive value (PPV) of MRSA PCR for specific culture types. There were 89 patients, and 289 cultures included. The overall prevalence of MRSA positive cultures was 13.4% for the study period. For the primary outcome, the NPV of MRSA PCR was 98.3% [95% Confidence interval 95.5-99.5%]. For the whole cohort the PPV was 22.5%, sensitivity was 73.4% and specificity was 86.1%. The total cost of vancomycin therapy (doses and levels) was US $37,935.75, which was estimated using average wholesale price. A cost avoidance of US $378.15 per patient was estimated for patients not meeting criteria for vancomycin therapy. Overall, this study found a high NPV for MRSA PCR for infections in burn injured patients. Additionally, MRSA PCR may be utilized along with other clinical markers to decrease use of antimicrobials targeting MRSA which may help decrease cost of therapy.","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560243","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}

引用次数: 0

Psychometric evaluation and development of a 3-item short form of the Posttraumatic Growth Inventory (PTGI-3): A National Institute on Disability, Independent Living, and Rehabilitation Research Burn Model System Study. 创伤后成长量表（PTGI-3）的心理测量评估与发展：国家残疾、独立生活和康复研究所烧伤模型系统研究。

IF 1.5 4区医学

Journal of Burn Care & Research Pub Date : 2025-07-04 DOI: 10.1093/jbcr/iraf122

Alyssa M Bamer, Kara McMullen, Andrew Humbert, Shelley Weichman, Kimberly Roaten, Jeffrey C Schneider, Dagmar Amtmann

{"title":"Psychometric evaluation and development of a 3-item short form of the Posttraumatic Growth Inventory (PTGI-3): A National Institute on Disability, Independent Living, and Rehabilitation Research Burn Model System Study.","authors":"Alyssa M Bamer, Kara McMullen, Andrew Humbert, Shelley Weichman, Kimberly Roaten, Jeffrey C Schneider, Dagmar Amtmann","doi":"10.1093/jbcr/iraf122","DOIUrl":"https://doi.org/10.1093/jbcr/iraf122","url":null,"abstract":"The Posttraumatic Growth Inventory (PTGI) was developed to measure positive psychological changes individuals can experience after trauma. While the 10-item form (PTGI-10) is relatively brief, an even shorter version would be valuable in situations where participant response burden is of particular concern. The PTGI-10 was administered to 1,076 adults recovering from moderate to severe burn injury between 6-months and 20-years after injury as part of an ongoing longitudinal study. Analyses completed to inform item selection included classical test theory analyses of reliability (i.e. Cronbach's alpha) and item performance, item response theory analyses, and qualitative item review. A focus group selected items for a new short form while considering results of the analyses as well as item content and acceptability. Score agreement between the PTGI-10 and the newly created short form was examined. A confirmatory factor analysis supported unidimensionality though reliability (α=0.94) and results of local dependency indicated items were highly redundant. A new three item short form (PTGI-3) was created and includes one item from each of the three categories of perceived benefits identified in posttraumatic growth theory. Reliability of the new short form is moderate (>0.8) for scores ±1 SD around the mean. Scores on the PTGI-3 correlate highly (r=0.94) with scores on the PTGI-10. The PTGI-3 has sufficient reliability for group comparisons, balances item content, and includes items that are acceptable to people with burn injury.","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560244","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}

引用次数: 0

Using Implementation Science to Understand Barriers to Telemedicine Use for Burn Care During a Crisis. 利用实施科学了解危机期间烧伤护理远程医疗使用的障碍。

IF 1.5 4区医学

Journal of Burn Care & Research Pub Date : 2025-07-02 DOI: 10.1093/jbcr/iraf041

Amanda P Bettencourt, Theresa M Davis, Subhash Aryal, Joseph Rhodes, Mark J Johnston, Cindy Wegryn, Matthew D Supple, Victor C Joe, John Schulz, Gary Vercruysse, Deena Kelly Costa, Colleen Ryan

{"title":"Using Implementation Science to Understand Barriers to Telemedicine Use for Burn Care During a Crisis.","authors":"Amanda P Bettencourt, Theresa M Davis, Subhash Aryal, Joseph Rhodes, Mark J Johnston, Cindy Wegryn, Matthew D Supple, Victor C Joe, John Schulz, Gary Vercruysse, Deena Kelly Costa, Colleen Ryan","doi":"10.1093/jbcr/iraf041","DOIUrl":"https://doi.org/10.1093/jbcr/iraf041","url":null,"abstract":"During a crisis, hospitals need help to meet the needs of burn patients. Very few clinicians (1% of Medical Doctors and Registered Nurses and few hospitals (2%) have burn care expertise. Due to these capacity limitations, patients with burns as extensive as 40% Total Body Surface Area (TBSA) remain outside of burn centers for days to weeks before reaching definitive care. Telemedicine technology (TT) effectively connects a caregiver in any location to an expert burn clinician. However, it remains underused for unknown reasons. Implementation science seeks to uncover the factors affecting the use of innovations like telemedicine to increase uptake. We administered a questionnaire to assess burn center (BC) and emergency department (ED) clinician perceptions of the feasibility, acceptability, and intention to use TT across a network of 24 hospitals representing 4 of the six current American Burn Association (ABA) disaster response regions, we also collected monthly current TT referral usage rates (# acute burn referrals using TT / # total acute burn referrals). Clinician ratings were generally in the neutral to agreeable (3.04 to 4.01) range for acceptability, feasibility, and intention to use; however, there was no significant relationship between these constructs and the actual use of teleconsultation across the sample. Strong correlations between feasibility and intention to use were observed. However, weaker correlations between ease of use and perceived usefulness suggest that interventions targeting these perceptions are needed to fully realize the potential of teleconsultation in improving the quality of initial and ongoing burn care during a crisis and usual care.","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540341","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}

引用次数: 0

A Preliminary Analysis of the Incidence of Transaminitis Observed in Oxandrolone Versus Testosterone Therapy in Major Burn Injury. 奥雄龙与睾酮治疗严重烧伤患者转氨炎发生率的初步分析。

IF 1.5 4区医学

Journal of Burn Care & Research Pub Date : 2025-06-26 DOI: 10.1093/jbcr/iraf118

Alexandra DeWitt, Athena Hoppe, Anastasiya Ivanko, Jeffrey E Carter, Majel V Miles

{"title":"A Preliminary Analysis of the Incidence of Transaminitis Observed in Oxandrolone Versus Testosterone Therapy in Major Burn Injury.","authors":"Alexandra DeWitt, Athena Hoppe, Anastasiya Ivanko, Jeffrey E Carter, Majel V Miles","doi":"10.1093/jbcr/iraf118","DOIUrl":"https://doi.org/10.1093/jbcr/iraf118","url":null,"abstract":"After major burn injury, patients experience a hypermetabolic response leading to catabolic effects. Anabolic steroids have been investigated to combat these effects. Oxandrolone, the primary anabolic steroid used to combat burn hypermetabolism, was removed from the U.S. market in June 2023, and our institution implemented testosterone as an alternative. A known side effect of anabolic steroid use is transaminitis. This study aims to compare the incidence of transaminitis between oxandrolone and testosterone in patients with major burn injury. A single-center, retrospective cohort was conducted to evaluate adult patients with at least 20% body surface area burn injury who received either testosterone or oxandrolone. The primary outcome evaluated was incidence of transaminitis. Secondary outcomes included the need for dose reduction or discontinuation of the steroid, length of stay, and mortality. Preliminary data was analyzed for significance. Seventy patients received either oxandrolone (n = 52) or testosterone (n = 18). Demographics were similar. The incidence of transaminitis was not statistically significant between oxandrolone and testosterone, 38% vs 28% (p=.596). The rate of dose decrease between the two groups was not significant, 17% vs 0% (p=.071). There was a statistically significant difference in early discontinuation of the drug between the groups, 33% oxandrolone vs 0% testosterone (p=.014). The median length of stay was 28 and 36 days, respectively, with a mortality rate of 21% and 6% in each group. Preliminary data from this study demonstrate a trend to higher incidence of oxandrolone transaminitis in comparison to testosterone, without statistical significance.","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144496784","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}

引用次数: 0