Journal of Burn Care & Research最新文献

{"title":"Within-Patient, Quasi-Experimental Clinical Trial to Assess the Immediate Effects of Paraffin Wax on Adult, Post-Burn Hypertrophic Scar.","authors":"Yumi Amal Bellali, Stéphanie Jetté, Mathieu Delisle, Aude Pinard-LaRoche, Zoë Edger-Lacoursière, Bernadette Nedelec","doi":"10.1093/jbcr/iraf232","DOIUrl":"10.1093/jbcr/iraf232","url":null,"abstract":"<p><p>Paraffin wax is applied to scar tissue for its proposed benefits of increasing skin pliability and relieving pain. However, limited studies have objectively assessed hypertrophic scar (HSc) response. This study examined immediate HSc changes after paraffin treatment compared with intra-individual controls. A quasi-experimental, within-subject, evaluator-blinded, pre-post design was used. Two homogeneous HSc were identified per participant: one treated with paraffin wax and one with mineral oil for 20 minutes. Normal skin also received paraffin to assess scar-specific effects. Objective measures included elasticity (Cutometer), erythema and melanin (Mexameter), transepidermal water loss (TEWL) (Tewameter), thickness (High-frequency Ultrasound), and self-reported pain, itch, stiffness, and overall scar impression. Thirty-nine burn survivors were recruited; 35 completed the study. Paired t-tests showed increased elasticity and erythema in paraffin-treated HSc and normal skin, decreased pigmentation in paraffin-treated normal skin, and decreased TEWL in the mineral oil-treated control scars. ANCOVA of post-treatment values, controlling for baseline, revealed significant increases in erythema and TEWL in paraffin-treated versus control scars. Participants perceived greater improvement in paraffin-treated HSc than controls, though controls improved across all items. Although paraffin significantly increased elasticity in both HSc and normal skin, it did not significantly differ from mineral oil-treated scars, suggesting that some of the effect may be attributable to mineral oil, as there was a slight increase in skin elasticity within the mineral oil group. However, paraffin improved self-reported outcomes, highlighting its potential clinical value in relieving pain and itch rather than increasing scar elasticity. As mineral oil also improved self-reported items, its benefits need further investigation. Future studies should recruit participants with baseline pain and itch to ensure adequate power.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"796-806"},"PeriodicalIF":1.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13140681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145819435","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 ENGAGE Protocol: Enzymatic Debridement With NexoBrid Followed by Grafting After Graded Early Excision-A Retrospective Cohort Study.","authors":"Giuseppe A G Lombardo, Marco Mollica, Serafina Pepe, Dario Melita, Rosario Ranno, Paolo Marchica","doi":"10.1093/jbcr/irag030","DOIUrl":"10.1093/jbcr/irag030","url":null,"abstract":"<p><p>Enzymatic debridement with NexoBrid has become a cornerstone of modern burn care due to its selective tissue-sparing properties. However, the optimal timing and strategy for surgical intervention following enzymatic treatment remain debated. We aimed to evaluate the clinical outcomes of the ENGAGE protocol (ENzymatic debridement with NexoBrid, followed by Grafting After Graded early Excision), a structured algorithm integrating enzymatic debridement with scheduled wound reassessment and selective early excision. This before-and-after observational study included adult patients with burn injuries treated with NexoBrid between January 2020 and October 2025 (2020-2022 received standard NexoBrid management; 2023-2025 received the ENGAGE protocol, featuring day-7 reassessment and selective excision). Endpoints included autologous grafting rate, length of hospital stay (LOS), mortality, and number of surgical procedures. Eighty-eight patients were analyzed (27 standard NexoBrid management, 61 ENGAGE). Baseline characteristics and burn etiologies were comparable. The ENGAGE group showed a significantly shorter LOS (mean ± SD: 24 ± 13.8 vs 32 ± 19.2 days, median: 23 vs 27 days, P = .03) with no increase in grafting rate (60.7% vs 59.3%, P = .54) or mortality (9.8% vs 7.4%, P > .5). The number of surgical procedures per patient was higher in the ENGAGE group (4.36 ± 3.82 vs 2.74 ± 3.82, P = .029), reflecting planned early reassessment and targeted intervention rather than increased morbidity. The ENGAGE protocol reduces hospital stay without compromising grafting or survival outcomes. By incorporating early, biologically guided excision after enzymatic debridement, it offers a structured and effective refinement of modern burn wound management.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"944-949"},"PeriodicalIF":1.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146226993","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":"Impact of Heparin and Enoxaparin Anticoagulant Prophylaxis on Improving Acute Mortality in Burn Patients.","authors":"Manav M Patel, Shawn E Lim, Victoria A Cuello, Joshua E Lewis, Amina El Ayadi, Michael J Erickson, Steven E Wolf, Juquan Song","doi":"10.1093/jbcr/iraf080","DOIUrl":"10.1093/jbcr/iraf080","url":null,"abstract":"<p><p>Burn patients have a higher chance of developing thromboembolic complications, leading to worsened mortality rates, so prophylactic anticoagulation is important. Anticoagulants such as enoxaparin, a low-molecular-weight heparin, and unfractionated heparin (UFH) have been frequently used as chemical prophylactic treatments of thromboembolism. Enoxaparin has been shown to have lower mortality and higher efficacy in surgical patients and coronary artery disease patients. The aim of the study is to assess mortality and compare the safety of enoxaparin and heparin in acute burn patients. A retrospective cohort study of 26,572 burn patients was conducted using the TriNetX database. Patients were divided into 2 cohorts: those receiving only UFH (Cohort 1) and those receiving only enoxaparin (Cohort 2) prophylaxis within 24 hours after burn injury. Cohorts were matched with 1:1 propensity score matching to correct for differences in age, gender, ethnicity, race, burn severity, inhalation injury, diabetes mellitus, acute myocardial infarction, stroke, and central line venous catheter placement. Outcomes assessed included mortality and deep vein thrombosis within a month (30 days). After matching, the enoxaparin (n = 7,484) cohort showed significantly lower 30-day mortality (1.3%) compared to the UFH (n = 7,484) cohort (3.6%) (risk ratio [RR] = 2.70, 95% CI: 2.15-3.40, P < .05). Kaplan-Meier analysis demonstrated a higher survival probability in the enoxaparin group (98.6% vs 96.4%, P < .05). DVT risk was slightly higher with UFH but not statistically significant (RR = 1.18, 95% CI: 0.54-2.54, P = .68). Prophylactic anticoagulation with enoxaparin is associated with a significant lower 30-day mortality risk compared to UFH.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"773-779"},"PeriodicalIF":1.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997974","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":"Evaluating First Positive Cultures in Burns: Rethinking Broad-Spectrum Antibiotic Choices.","authors":"Pouriya Sadeghighazichaki, Alan D Rogers, Marion Elligsen, Rimona Natanson, Stephanie A Mason, Philip Lam, David L Wallace","doi":"10.1093/jbcr/iraf229","DOIUrl":"10.1093/jbcr/iraf229","url":null,"abstract":"<p><p>Infection is a nearly universal complication among patients with major burns, yet guidance on early empiric antibiotic therapy remains limited. Broad-spectrum antibiotics are commonly initiated in the early phase of care but carry risks of antimicrobial resistance and drug toxicities. This single-center, retrospective study evaluated the microbiological profiles and antibiotic prescribing patterns associated with first positive cultures (FPCs) in patients with major burn injuries admitted to Canada's highest-volume adult burn center between January 1, 2018 and May 1, 2023. A total of 114 patients with ≥ 20% total body surface area burns were included. Among 145 FPCs, the most commonly cultured sites were respiratory (55%) and wound (30%). The most frequently identified organisms were methicillin-sensitive Staphylococcus aureus (19%), Haemophilus influenzae (15%), Enterobacter cloacae complex (8%), Escherichia coli (7%), methicillin-resistant S aureus (MRSA) (7%), and Pseudomonas aeruginosa (6%). Notably, only 3% of patients who screened negative for MRSA on admission developed MRSA-positive cultures. Antibiotic therapy was initiated in 99% of patients with FPCs, most commonly with piperacillin-tazobactam (41%), vancomycin (16%), and cefazolin (14%). Dual therapy, typically piperacillin-tazobactam plus vancomycin, was used in 13% of cases. Sensitivity data demonstrated that meropenem (90%) and the combination of ciprofloxacin with cefazolin (83%) covered the highest proportion of isolates. While piperacillin-tazobactam remains effective for early empiric use, our findings indicate that targeted alternatives-such as reserving meropenem for select cases or using ciprofloxacin plus cefazolin in appropriate patients-could provide comparable coverage while adhering to antimicrobial stewardship principles. A negative MRSA screening swab on admission demonstrated a high negative predictive value (~97%), supporting the withholding of vancomycin in screen-negative patients. This study supports evidence-based antibiotic use in patients with burn injuries and underscores the need for local, data-driven stewardship.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"780-787"},"PeriodicalIF":1.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145774774","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":"Regional Socioeconomic Deprivation Predicts In-Hospital Burn Mortality in Texas-New Mexico Cohort: A Retrospective Analysis of Social Determinants of Health.","authors":"Cameron Lowell Miller, Isaac Terrence Edwards, Jordan Baechle, Ariel Santos","doi":"10.1093/jbcr/irag024","DOIUrl":"10.1093/jbcr/irag024","url":null,"abstract":"<p><p>Social determinants of health (SDOH) have been shown to contribute to disparities in burn outcomes. This study leverages patient data from a regional burn center serving Texas and New Mexico to evaluate whether national indices of social vulnerability accurately predict in-hospital mortality among patients with burn injuries from underserved areas. We conducted a retrospective cohort study of 1841 patients treated for burn injuries over a 5-year period (2019-2024). Sixteen ZIP code-level SDOH metrics including Social Vulnerability Index and socioeconomic status (SES) were quantified. Univariate and multivariable logistic regression analyses were performed to assess the impact of SDOH on mortality. Patients were stratified into quartiles to explore dose-response relationships. In univariate analysis, higher SES scores (indicating greater deprivation) were the strongest SDOH metric associated with mortality (odds ratio [OR] = 6.28, P = .0018). In multivariable analysis, patients in the most deprived SES quartile (Q4) had more than double the odds of mortality compared to the least deprived (Q1) (OR = 2.20, P = .0199). Significant clinical predictors included age, second- and third-degree TBSA, alcohol use disorder, chronic obstructive pulmonary disease, and obesity. Social Vulnerability Index was not independently associated with mortality after adjustment. Socioeconomic status was an independent predictor of in-hospital burn mortality in this regional cohort after adjusting for clinical factors. Other aggregate scores poorly predicted mortality after controlling for clinical variables. This is potentially due to the influence of urban demographics of these indices. Further research should investigate metrics to better capture rural SDOH to improve rural burn care.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"909-916"},"PeriodicalIF":1.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146165838","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":"Prescription Analysis of Antihistamines' Use in Patients With Moderate to Severe Burns.","authors":"Abbas A Karim, Nizam Karim, Suhaib Shah, Rashid Syed, Zain Akbar, Farhad Marzook, Juquan Song, George Golovko, Steven E Wolf, Amina El Ayadi","doi":"10.1093/jbcr/irag007","DOIUrl":"10.1093/jbcr/irag007","url":null,"abstract":"<p><p>Postburn pruritus (PBP) significantly affects patients, causing discomfort and hindering recovery. Antihistamines, which block H1 receptors, are commonly prescribed for PBP, yet large-scale studies on their usage patterns are limited. This study evaluates antihistamine prescription trends and provider practices for PBP across varying burn severities from moderate to severe burns (≥20% TBSA). A treatment-pathways analysis was performed using TriNetX, a global, federated, deidentified database. Patients with burns ≥ 20% TBSA from the past 20 years (2004-2024) who developed pruritus were identified and stratified into 4 cohorts: 20%-40%, 40%-60%, 60%-80%, and ≥ 80% TBSA. The analysis evaluated trends in antihistamine prescriptions, including the number of patients treated with antihistamines, types prescribed, and median times to treatment initiation, duration, and therapy switching. The total sample included 2754 patients (20%-40% TBSA, n = 1712; 40%-60%, n = 613; 60%-80%, n = 253; ≥80%, n = 176). Over 70% received antihistamines, with hydroxyzine as the most common first-line therapy, followed by diphenhydramine. Across all cohorts, the average of the median times for initiation, therapy duration, and time before switching was 16.75 days, 90.25 days, and 27.75 days, respectively. Significant variations in the timing of therapy initiation suggest a gap in consistent symptom management during critical recovery periods, potentially affecting patient comfort and overall outcomes. These findings underscore the importance of vigilant postburn assessment, stepwise escalation based on response, and complementary strategies to optimize PBP management. Frequent switching and prolonged durations suggest a need for more effective and tailored therapeutic approaches to improve recovery outcomes for patients with burn injuries.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"706-717"},"PeriodicalIF":1.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146029827","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":"Ablative Fractional Carbon Dioxide Laser Surgery Improves Sleep Disorder in Pediatric Patients With Hypertrophic Scars.","authors":"Huazhen Liu, Chunhui Xie, Pengfei Luo, Haiting Xu, Shichu Xiao, Kaiyang Lv","doi":"10.1093/jbcr/iraf234","DOIUrl":"10.1093/jbcr/iraf234","url":null,"abstract":"<p><p>Hypertrophic scarring from burns can lead to sleep disturbances in children and significantly impact their quality of life and that of their caregivers. This study investigated the sleep quality of 9 pediatric patients with hypertrophic scars who underwent ablative fractional carbon dioxide laser (CO2-AFL) surgery. Electrocardiography was recorded before the first CO2-AFL treatment and after the final treatment. Cardiopulmonary coupling software was used to automatically generate sleep reports, including total time in bed, total sleep time, sleep efficiency, sleep latency time, deep sleep time, light sleep time, rapid eye movement sleep time, wake time, and apnea-hypopnea index. This study found that pediatric patients with hypertrophic scars commonly experience sleep disorders, and CO2-AFL surgery could improve sleep quality, including sleep efficiency, deep sleep duration, awakening time, and apnea-hypopnea index. This study provides preliminary objective evidence that CO₂-AFL treatment is associated with improvements in sleep quality parameters in pediatric patients with hypertrophic scars.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"968-972"},"PeriodicalIF":1.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145892542","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 Between the Modified Frailty Index-5 and Clinical Outcomes in Burn Patients.","authors":"Jule Schmiechen, Thomas Kremer, Susanne Rein","doi":"10.1093/jbcr/irag019","DOIUrl":"10.1093/jbcr/irag019","url":null,"abstract":"<p><p>Frailty is a clinical state characterized by increased vulnerability to stressors, leading to an increased risk of adverse health outcomes. The modified Frailty Index (mFI-5), based on 5 comorbidities-diabetes mellitus, heart failure, pulmonary disease, hypertension, and totally or partially dependent functional health status-has shown predictive value for treatment outcomes and mortality. The primary objective of this study was to evaluate differences in clinical outcomes between patients with burn injuries who have mFI-5 scores of 0, 1, and ≥ 2. The secondary objective was to determine whether the mFI-5 score independently predicts adverse outcomes. A retrospective analysis of 644 patients with burn injuries treated between September 2018 and May 2022 was conducted. Data on comorbidities, complications, ventilation status, surgical procedures, length of stay, and discharge destination were analyzed. Statistical analyses included Pearson's chi-square test, Kruskal-Wallis test, and adjusted multivariate regression analysis. Higher mFI-5 scores were associated with worse overall outcomes, including longer hospital stays, higher rates of complications, more frequent need for mechanical ventilation, a greater number of skin grafts and necrectomies, and more frequent discharge to nonhome settings. Multivariate analyses showed that a higher mFI-5 score compared to mFI-5 = 0 was independently associated with higher rates of urinary tract infections (mFI-5 ≥ 2: odds ratio [OR] 2, 41, 95% CI, 1.19-4.86; P = .014) and nonhome discharge (mFI-5 = 1: OR 2.34; 95% CI, 1.00-5.45; P = .049). The mFI-5 is a strong predictor of complications and adverse outcomes in patients with burn injuries. Its quick, simple application makes it a valuable risk stratification tool in specialized burn centers.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"879-884"},"PeriodicalIF":1.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146125279","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":"Nigella sativa and Its Bioactive Compound Thymoquinone in Burn Therapy: Mechanisms, Efficacy, and Safety.","authors":"Sonali Karhana, Garzain Bint E Attar, Wala Alshammari, Mohd Ashif Khan","doi":"10.1093/jbcr/irag006","DOIUrl":"10.1093/jbcr/irag006","url":null,"abstract":"<p><strong>Introduction: </strong>Burn injuries represent a worldwide public health concern. Nigella sativa (NS), a herbal medicinal plant, widely used in Ayurveda, Unani, and Siddha holds potential to address this issue. This review evaluated the potential of NS extract and its key component, Thymoquinone (TQ), in accelerating burn wound healing, focusing on their mechanisms, safety, and efficacy.</p><p><strong>Methods: </strong>Studies were retrieved from PubMed, Google Scholar, and ScienceDirect using keywords \"Nigella sativa,\" \"Thymoquinone,\" \"burns,\" and \"wound healing.\" Reports were screened for suitability, and the scientific name was verified on www.worldfloraonline.org.</p><p><strong>Results: </strong>NS extract and TQ accelerate burn wound healing in vitro and in vivo through various mechanisms involving anti-inflammatory, anti-oxidative, anti-microbial, and tissue regenerative effects. TQ achieved 91.35% wound closure in NIH/3T3 cells and wound closure rate of 2.35% ± 0.05% in 3T3-CCL92 cells. It also reduced oxidative stress and inflammation in murine burn models. Nanoformulations of TQ showed higher safety (LD50: 300-2000 mg/kg) than pure TQ (LD50: 50-300 mg/kg). A Phase I trial confirmed the safety of black cumin oil (5% TQ) at 200 mg/day for 90 days in healthy adults.</p><p><strong>Conclusion: </strong>Formulations based on NS extract and TQ can manage burn injuries and be extrapolated into clinical settings.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"746-756"},"PeriodicalIF":1.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146029864","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":"Community-Level Disparities in the Inhalation Injury Patient Population.","authors":"Christopher J Fedor, Mare G Kaulakis, Hilary Y Liu, José Antonio Arellano, Sarah Tepe, Garth A Elias, Alain C Corcos, Matthew P Siedsma, Jenny A Ziembicki, Francesco M Egro","doi":"10.1093/jbcr/irag013","DOIUrl":"10.1093/jbcr/irag013","url":null,"abstract":"<p><p>Low-income neighborhoods face higher fire risk due to overcrowding, substandard housing, and limited access to safety devices, contributing to greater burn severity among affected residents. Inhalation injury, a frequent consequence, often necessitates early intubation and transfer to burn centers. Given the high degree of coordination required, this study examines how management strategies and outcomes vary across levels of social vulnerability and urbanicity, 2 community-level proxies for access to care. We retrospectively reviewed inhalation injuries diagnosed by bronchoscopy at a single ABA-certified burn center (2012-2024), limited to structure fires. Community vulnerability was estimated using the Social Vulnerability Index (SVI; low <0.5, moderate 0.5-0.74, and high ≥0.75) and urbanicity using Rural-Urban Commuting Area (RUCA) codes (<4 = urban). Clinical outcomes were compared across SVI and RUCA groups using univariate and multivariate analyses. Among 184 patients, higher social vulnerability was associated with a greater proportion of Black individuals and higher asthma prevalence. Clinical characteristics, burn severity, timing of intubation, intensive care unit/hospital length of stay, ventilator days, and surgical interventions did not differ significantly across SVI or rural-urban groups. Transfer from outside hospitals was more common among rural residents (51.4% vs 30.1%), who were also more likely to be intubated at the scene (35% vs 30%). In multivariable analyses, high social vulnerability independently predicted increased mortality risk, although it was not associated with pneumonia, acute respiratory distress syndrome, or ventilator duration. Most patients with inhalation injuries come from socially vulnerable communities, yet higher SVI did not convincingly affect clinical outcomes, suggesting equitable acute care delivery when resources are available.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"856-862"},"PeriodicalIF":1.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147377555","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}