Journal of Burn Care & Research最新文献

{"title":"Pediatric Compassionate Use of DenovoSkin, a Novel, Autologous, Engineered, Hydrogel-Based Skin Graft With Keratinocytes and Fibroblasts.","authors":"Matthew Supple, Daniela Requena, Kathi Mujynya, Daniela Marino, Jeremy Goverman","doi":"10.1093/jbcr/irag014","DOIUrl":"10.1093/jbcr/irag014","url":null,"abstract":"<p><p>The development of an autologous, full-thickness skin replacement remains the holy grail for the treatment of full-thickness skin loss from burns, wounds, and trauma. With massive burn injury and limited donor-site, cultured epidermal autografts (CEAs) can be lifesaving, however, they have significant limitations. Furthermore, reconstruction in such patients is challenging. We describe the compassionate use of an autologous, engineered, hydrogel skin graft with keratinocytes and fibroblasts (EHSG-KF), in the treatment of a pediatric patient with massive burn injury. A compassionate use exemption was obtained from the US Food and Drug Administration allowing for up to 3 separate treatments using an EHSG-KF for a 3-year-old patient with a 90% TBSA burn. Grafts were based on plastically compressed collagen type I hydrogels with incorporated keratinocytes and fibroblasts. We retrospectively review our experience with 2 separate applications and early outcomes. A 2 × 2 cm split-thickness skin graft was harvested and shipped internationally for processing. At the same time, contracture releases were performed, and dermal matrices were applied. Engineered, hydrogel skin graft with keratinocytes and fibroblasts were then applied approximately 4 weeks after contracture release. In some areas, EHSG-KF was applied without a dermal matrix, immediately after debridement. Grafts were secured for 7 days with staples and covered with silver foam and tie over bolsters or circumferential gauze wrapping. Graft take was > 95%. This novel EHSG-KF was relatively easy to handle, apply, and care for, similar to a traditional autologous FTSG. Engraftment rate was > 95% and the resulting healed skin appears to be durable. Our impression has been extremely positive, particularly when compared to traditional CEAs. Additional trials in Europe using this particular EHSG-KF are ongoing.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"973-976"},"PeriodicalIF":1.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146085771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burn Anesthesia as a Subspecialty: Time to Formalize Advanced Training Pathways.","authors":"David Wallace, Roland Xu, Alan D Rogers","doi":"10.1093/jbcr/irag018","DOIUrl":"10.1093/jbcr/irag018","url":null,"abstract":"","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"703-705"},"PeriodicalIF":1.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146125300","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":"When Burns Lead to Silence: Catatonia a Case Report.","authors":"Carlos Semprun, Gabriel Bensimon, Mohammed Abdullah S Alothman, Shahriar Shahrokhi, Margarita Elloso","doi":"10.1093/jbcr/irag005","DOIUrl":"10.1093/jbcr/irag005","url":null,"abstract":"","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"955-957"},"PeriodicalIF":1.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146052183","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":"Correction to: Intraoperative Intravenous Methadone and Postoperative Opioid Requirements in Adult Patients With Burns.","authors":"","doi":"10.1093/jbcr/irag011","DOIUrl":"10.1093/jbcr/irag011","url":null,"abstract":"","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"978"},"PeriodicalIF":1.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13140605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146085692","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":"Effectiveness of Early Compression Therapy in Acute Hand Burns: A Randomized Controlled Trial.","authors":"João Pedro da Silva Mendes, Fátima Catarina Figueiredo Marques, António José Ferreira de Sousa, Lurdes Leal Morgado Miranda, José António Ferreira de Assunção, Joana Santos-Costa, José Luís de Almeida Cabral","doi":"10.1093/jbcr/irag022","DOIUrl":"10.1093/jbcr/irag022","url":null,"abstract":"<p><p>Hand burns pose significant rehabilitation challenges. While compression therapy is well-established for chronic scar management, evidence for its application during the acute phase remains limited. This study evaluated the effectiveness of early compression therapy on edema, passive range of motion (PROM), and grip strength in acute hand burns. A randomized controlled trial was conducted at a tertiary burn center between November 2023 and March 2025. Thirty-two adult patients (40 hands) with superficial and/or deep partial-thickness hand burns were randomly assigned to control (standard care; 16 patients, 20 hands) or intervention groups (standard care plus compression therapy at 8 mmHg; 16 patients, 20 hands). Outcomes measured at baseline and the end of the acute phase included hand edema, metacarpophalangeal joint PROM, and grip strength. Statistical analyses included paired and independent t-tests, analysis of covariance, and effect size calculations. Groups were homogeneous at baseline. The intervention group demonstrated significantly greater improvements: PROM increased 23.6 ± 12.8° vs 8.6 ± 16.7° (P = .003, Cohen's d = 1.00), grip strength improved 4.2 ± 5.9 kg vs declined 0.8 ± 5.0 kg (P = .006, d = 0.92), and edema reduced 4.2 ± 2.9 cm vs 2.3 ± 2.1 cm (P = .025, d = -0.74). Analysis of covariance confirmed significant effects after adjusting for baseline values (all P < .01). No adverse events occurred. Early compression therapy during acute hand burns significantly improves outcomes with large effect sizes. These findings support considering earlier initiation of compression therapy (48-72 h postinjury) as part of acute hand burn management protocols.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"891-898"},"PeriodicalIF":1.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146165767","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":"Clinical Competencies for the Burn Speech-Language Pathologist: A Multidisciplinary Development and Delphi Consensus Study.","authors":"Nicola A Clayton, Hadley Regal, Tiffany Mohr, Lori Arguello, Kathleen Kerr, Danielle Busch, Yekaterina Shemyakin, Heather Cappel, Emily Silverberg, Kathleen Webler, Nabil Jabbour, Amanda Ratner, Dani Carisse, Bernadette Nedelec, Michelle N Dwertman, Ingrid Parry, Lisa Forbes, Matthew Godleski","doi":"10.1093/jbcr/irag028","DOIUrl":"10.1093/jbcr/irag028","url":null,"abstract":"<p><p>Clinical competency guidelines promote optimal, safe standard of care. While nationally established clinical competencies exist for burn occupational therapists and physiotherapists, no equivalent frameworks exist for burn speech-language pathologists (SLPs). To address this gap, we developed a burn-specific SLP competency tool. Led by the American Burn Association (ABA) Rehabilitation Committee, an expert panel of burn SLPs, Burn Therapists-Certified (BT-C) clinicians, and a physiatrist implemented a staged process. Current national and international practice guidelines were synthesized through modified Delphi methodology, with expert consensus meetings to create and refine a burn SLP competency tool. The ABA Burn Rehabilitation Therapists Competency Tool served as the model framework. Eighteen multidisciplinary burn clinicians representing 14 burn centers, across 3 countries, refined the burn SLP competency tool. A steering group (5 SLPs, 1 burn physiatrist) identified 103 competency statements spanning 15 core clinical domains. These were presented across 2 rounds of Delphi survey and consensus meetings. The tool was refined with each survey resulting in a final tool comprising 81 knowledge and application competency statements covering 17 domains, tailored to the burn SLP across the continuum of care for adult and pediatric populations. The tool is structured into 2 tiered levels of expertise: level 1: minimum level of specialist skill required to manage a patient with burn injury; level 2: expert level of specialist skill and recognized resource to other SLPs. This initiative has produced the first internationally developed and consensus-based competency tool for burn SLPs. It establishes a standardized reference for SLPs to deliver specialized burn care throughout the acute and rehabilitative continuum.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"929-936"},"PeriodicalIF":1.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13140561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147306222","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":"Burned at Sea During the World's Largest Maritime Exercise: Implications for Large-Scale Combat Operations.","authors":"Jill M Cancio, Jeffrey E Carter, Stephanie Wallace, Dana F de la Campa, Jessica Woods, Sylvain Cardin, Matthew D Tadlock, Leopoldo C Cancio","doi":"10.1093/jbcr/irag031","DOIUrl":"10.1093/jbcr/irag031","url":null,"abstract":"<p><p>Burns are among the most devastating forms of trauma, and both immediate and long-lasting physical, physiological, psychosocial, and functional effects have been well documented in the civilian burn literature. From a military standpoint, burn injuries comprise approximately 5-10% of battlefield casualties during conventional (non-nuclear) conflict;3 the risk of thermal injury is particularly high during war at sea. Little data exist regarding the total costs of caring for those with battlefield burn injuries. These gaps in the literature impact our ability to plan medical support for combat operations and to develop effective strategies for returning burned servicemembers to duty and to community life. The purpose of this report is to describe the immediate and long-term resources utilized in the care of 2 coalition-nation Sailors severely burned on the Pacific Ocean and treated at the U.S. Army Burn Center, and to describe their long-term outcomes. Given the presence of burn injury on the modern battlefield, there is an urgent need to plan for the care of servicemembers who have sustained burn injury in future large scale combat operations, to include war at sea. It is imperative this plan be properly resourced and include an organized program of prehospital care, aeromedical evacuation, acute care, and long-term follow-up--addressing the complex, multi-domain, and chronic effects of severe thermal injury. These cases illustrate such a program.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"958-963"},"PeriodicalIF":1.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146226935","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 Housing Status on Mortality Following Frostbite Injury: A Multicenter Cohort Analysis.","authors":"Alexandra M Lacey, Emily Colonna, Rediat Tilahun, Charly Vang, Nicholas J Larson, Rachel M Nygaard","doi":"10.1093/jbcr/irag008","DOIUrl":"10.1093/jbcr/irag008","url":null,"abstract":"<p><p>Unhoused persons are particularly vulnerable to frostbite injury due to prolonged exposure to extreme temperatures. This study hypothesized that unhoused frostbite injured patients have a higher mortality risk compared to housed individuals. Data from 2 high-volume frostbite centers were analyzed and linked to state health department records. A longitudinal cohort of 933 frostbite patients who survived their initial hospital stay (n = 925) was examined with Cox proportional hazards regression to adjust for confounders (age, sex, race, alcohol use, and drug use). Nearly one-third of patients were unhoused at the time of injury. Most patients discharged home (56.7%), but alternative discharge locations included: [alternative housing (6.1%), inpatient psychiatric care (7.0%), acute rehabilitation (5.7%), nursing care (11.2%), shelter/street (6.4%), and AMA discharge (3.5%)]. During follow-up, 185 (19.8%) of the patients died. Time from frostbite injury to death ranged from 5 days to 17 years. Mortality between unhoused and housed frostbite patients was similar (19.7% vs 20.2%), but unhoused individuals died at significantly younger ages. Age was a significant predictor of mortality, while sex, race, and alcohol abuse were not. Living situation and drug use showed a trend toward increased mortality risk, but did not reach significance. The model (LR chi2 = 150.43, P < .001) indicated that the combined set of predictors significantly explained the variability in mortality risk. Findings highlight the need for targeted healthcare strategies to address socioeconomic disparities and improve outcomes for unhoused persons.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"718-722"},"PeriodicalIF":1.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146063623","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":"Rehabilitation Evaluation and Treatment for Skin Graft Complications of the Genitalia.","authors":"Chloé Tremblay, Zoë Edger-Lacoursière, Geneviève Schneider, Stéphanie Jean, Valérie Calva, Bernadette Nedelec","doi":"10.1093/jbcr/irag016","DOIUrl":"10.1093/jbcr/irag016","url":null,"abstract":"<p><p>Skin graft complications may include pain, contractures, hypertrophic scars (HSc), hypersensitivity, and recurrent wounds. Complications involving grafts to the genitalia, perineum, and/or buttocks can be particularly challenging, directly affecting walking, sitting, voiding, bowel elimination, sexual function, and intimacy, ultimately diminishing quality of life. Perineal and pelvic floor rehabilitation (PPFR) is commonly used to treat various pelvic floor disorders; however, its application following burn injury or necrotizing fasciitis has not been previously described. This manuscript presents the evaluation and treatment outcomes of patients with necrotizing fasciitis or Fournier's gangrene. Initial evaluation was conducted approximately 4 months postadmission by a certified pelvic floor physiotherapist and occupational therapist. Treatment included pelvic floor rehabilitation, patient education, sensory re-education, bladder and bowel training, use of adapted pressure garments, gel application, cutaneous and myofascial stretching, and manual therapy. This report details the outcomes of 2 male patients (37 and 69 years old) who underwent skin grafting and reconstructive surgery following necrotizing fasciitis and Fournier's gangrene. Both presented with complex wounds that closed approximately 4 months postadmission, accompanied by contractures, HSc, altered sensory perception, incontinence, and sexual intimacy dysfunction. Following PPFR treatment, improvements were observed in pruritus, urinary and fecal retention capacity, sexuality-related fear avoidance, penile deviation, lower extremity range of motion, satisfaction with sexual function, and sensory perception. This is the first description of a standardized PPFR protocol in this context, demonstrating that specialized interdisciplinary rehabilitation can enhance sexual function, body-image satisfaction, and overall quality of life in patients with genital, perineal, and/or buttock grafts.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"868-878"},"PeriodicalIF":1.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13140523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146085768","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":"Synthesis of Sericin-Based Stretchable and Self-healing Hydrogel Loaded With Psidium guajava L. Extract for Treatment of Burn Wound.","authors":"Sidra Arshad, Hafiz Muhammad Tahir, Rida Mahnoor, Aamir Ali, Ayesha Muzamil, Fariha Munir, Sania Faiz, Fatima Ijaz, Ayesha Afzal, Farwa Shafique","doi":"10.1093/jbcr/irag004","DOIUrl":"10.1093/jbcr/irag004","url":null,"abstract":"<p><p>Burn wounds pose significant challenges due to their susceptibility to microbial invasion and limited effective dressing options. This study aimed to evaluate the wound-healing potential of a sericin-based self-healing and stretchable hydrogel loaded with Psidium guajava L. extract against full-thickness burn wounds in mice. The hydrogel was characterized by physicochemical analyses including scanning electron microscopy, Fourier transform infrared spectroscopy, X-ray diffraction, viscosity, pH, swelling degree, weight loss, and mechanical strength. In vivo experiments used a Swiss albino mouse burn model, where 6 mm full-thickness wounds were induced with a hot metal rod. Hydrogels were applied topically at regular intervals, and wound healing was assessed through wound contraction measurements, healing time, and histological analysis. Hematological parameters and serum biomarkers, ie, pro- and anti-inflammatory cytokines, matrix metalloproteinases (MMPs), tissue inhibitors of metalloproteinases (TIMPs), antioxidants (glutathione [GSH], glutathione peroxidase [GPx], catalase [CAT], and superoxide dismutase [SOD]), angiogenic factors (vascular endothelial growth factor [VEGF]), and oxidative stress markers (malondialdehyde [MDA]) were also evaluated. Results demonstrated that the hydrogels exhibited high swelling capacity and notable weight loss, suggesting effective absorption of wound exudates and reduced infection risk. Notably, hydrogel 4 (3% sericin +3% P guajava L.) achieved significantly improved wound healing (89.66%) compared with controls (37.16%) by day 15. Histological examination confirmed collagen deposition and hair follicle regeneration, indicative of complete healing. Hematological findings showed increased red blood cell counts and reduced white blood cells, reflecting resolution of inflammation. Serum analyses revealed elevated anti-inflammatory markers (interleukin [IL]-10), TIMPs, and antioxidants (GSH, GPx, CAT, and SOD), alongside decreased pro-inflammatory cytokines (IL-6, IL-8, IL-1β, and tumor necrosis factor-α), MMPs, angiogenic factor VEGF, and oxidative stress marker MDA. Hydrogel 4 showed a 3.47-fold increase in SOD and a 68% reduction in MDA, underscoring its efficacy in mitigating oxidative stress. In conclusion, the sericin-based hydrogel infused with P guajava L. exhibited excellent physicochemical and biological properties, promoting effective burn wound healing. Hydrogel 4 demonstrated the most pronounced therapeutic benefits, making it a promising candidate for advanced wound dressing applications.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"833-849"},"PeriodicalIF":1.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145989122","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}