Journal of Burn Care & Research最新文献_第7页

A Novel Spray-on Dressing is Comparable to Silver Impregnated Foam Dressing in Controlling MRSA Infection and Promoting Healing. 一种新型喷雾敷料在控制MRSA感染和促进愈合方面可与银浸渍泡沫敷料相媲美。

IF 1.9 4区医学

Journal of Burn Care & Research Pub Date : 2026-08-22 DOI: 10.1093/jbcr/irag151

Lian Daniel N Manalo, Abby Bruhm, Kai V Myree Lindsey, Eriks E Ziedins, Amanda Soo Ping Chow, Casey Meretta, Jeffrey Shupp, Lauren T Moffatt, Bonnie C Carney

{"title":"A Novel Spray-on Dressing is Comparable to Silver Impregnated Foam Dressing in Controlling MRSA Infection and Promoting Healing.","authors":"Lian Daniel N Manalo, Abby Bruhm, Kai V Myree Lindsey, Eriks E Ziedins, Amanda Soo Ping Chow, Casey Meretta, Jeffrey Shupp, Lauren T Moffatt, Bonnie C Carney","doi":"10.1093/jbcr/irag151","DOIUrl":"https://doi.org/10.1093/jbcr/irag151","url":null,"abstract":"Burn injuries disrupt the skin barrier, increasing susceptibility to infection, delaying healing, and can potentially becoming life-threatening. Wound dressings mitigate this risk by protecting the wound from environmental pathogens. This study evaluated a novel antimicrobial spray-on dressing designed to conform to irregular skin surfaces for its ability to control burn wound infection and promote wound healing. Evaluation was conducted in two stages. Experiment 1 used a rat scald model (n=19) inoculated with MRSA to compare the spray-on dressing's antimicrobial efficacy against silver-impregnated foam and control groups over 8 days. Experiment 2 used a porcine burn model to assess healing kinetics, skin biomechanics (elasticity, hardness), and histoarchitecture (rete ridge ratio, epidermal thickness) through Day 13.In the rat model, the spray-on dressing achieved bacterial control comparable to silver-impregnated foam; both groups demonstrated significantly lower MRSA burden compared to positive controls on Day 5 (p < 0.01), with no evidence of systemic dissemination. In the porcine model, the spray-on dressing supported timely wound closure with re-epithelialization rates comparable to the foam dressing (97.7% vs. 92.1%, p = 0.3). Skin biomechanic measurements, including tissue elasticity and stiffness, were indistinguishable from uninjured skin. Histoarchitecture analysis confirmed that the spray-on dressing facilitated a high-quality dermal-epidermal interface equivalent to the clinical standard. Overall, the novel spray-on dressing is comparable to the standard silver-impregnated foam dressing in both antimicrobial efficacy and tissue regeneration. Its superior conformability and simplified application make it a viable, efficient alternative for managing complex burn wounds in both routine and high-demand clinical settings.","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793713","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

Topical MSC-Derived Extracellular Vesicles Accelerate Healing of Second-Degree Burns: A Case Report. 局部msc来源的细胞外囊泡加速二度烧伤愈合：一例报告。

IF 1.9 4区医学

Journal of Burn Care & Research Pub Date : 2026-08-20 DOI: 10.1093/jbcr/irag148

Carl I Schulman, Nicholas Namias, Louis Pizano, Booker T King, Shelley Hartman, Gloria Mathews, Willistine Lenon, Heidi Kempinski, Luis Rodriguez-Menocal, Wellington Guzman, Arron Sandoval, Evangelos V Badiavas

引用次数: 0

TMAO Correlates with Transcriptomic Signatures of Leukocyte Activation and Systemic Inflammation Following Burn Injury. 氧化三甲胺与烧伤后白细胞活化和全身炎症的转录组特征相关。

IF 1.9 4区医学

Journal of Burn Care & Research Pub Date : 2026-08-19 DOI: 10.1093/jbcr/irag147

Mary Grace Murray, Melissa M McLawhorn, Natalia Carbajal Garcia, Irene B Helenowski, J Mark Brown, Lauren T Moffatt, Jeffrey W Shupp, John C Kubasiak, Mashkoor A Choudhry

{"title":"TMAO Correlates with Transcriptomic Signatures of Leukocyte Activation and Systemic Inflammation Following Burn Injury.","authors":"Mary Grace Murray, Melissa M McLawhorn, Natalia Carbajal Garcia, Irene B Helenowski, J Mark Brown, Lauren T Moffatt, Jeffrey W Shupp, John C Kubasiak, Mashkoor A Choudhry","doi":"10.1093/jbcr/irag147","DOIUrl":"10.1093/jbcr/irag147","url":null,"abstract":"Background: Severe burn injury induces gastrointestinal dysfunction and bacterial dysbiosis, yet the systemic impact of altered bacterial metabolites remains poorly understood. We assessed whether changes in plasma levels of trimethylamine N-oxide (TMAO), a gut-derived metabolite, have a relationship with changes in the whole blood transcriptomic profile following burn injury.Methods: Using previously harvested plasma from 67 burn patients, we quantified circulatory levels of TMAO via ELISA. To assess TMAO's impact on the blood transcriptome, we applied a linear model to previously published whole blood microarray data from a subset of these patients (n = 22) with paired TMAO measurements.Results: While initial TMAO levels were comparable across small and larger burns, concentrations significantly increased 24 to 36 hours post admission in patients with >10% total body surface area (TBSA) burns, independent of age or sex. Elevated TMAO positively correlated with both burn size and Baux score. Furthermore, transcriptomic analysis revealed that high TMAO levels were strongly associated with the enrichment of inflammatory and leukocyte activation pathways, despite a lack of association between TMAO levels and imputed fractions of immune cells.Conclusion: Burn injury is associated with a delayed, severity-dependent elevation in circulating TMAO. This increase in TMAO correlates with transcriptomic signatures of robust immune activation and systemic inflammation, suggesting that targeting the gut microbiome and its metabolites may offer a novel therapeutic avenue to address post burn inflammatory complications.","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793644","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}

引用次数: 0

Impact of Diabetes Mellitus on Wound Healing and Clinical Outcomes After Burn Injury: An Analysis Using the Burn Care Quality Platform. 糖尿病对烧伤创面愈合及临床结局的影响：基于烧伤护理质量平台的分析

IF 1.9 4区医学

Journal of Burn Care & Research Pub Date : 2026-08-19 DOI: 10.1093/jbcr/irag149

Arthur Kom Sipowa, Jacob Furcolo, Tuan D Le, Melissa M McLawhorn, Bonnie C Carney, Lauren T Moffatt, Jeffrey W Shupp, Shawn Tejiram

{"title":"Impact of Diabetes Mellitus on Wound Healing and Clinical Outcomes After Burn Injury: An Analysis Using the Burn Care Quality Platform.","authors":"Arthur Kom Sipowa, Jacob Furcolo, Tuan D Le, Melissa M McLawhorn, Bonnie C Carney, Lauren T Moffatt, Jeffrey W Shupp, Shawn Tejiram","doi":"10.1093/jbcr/irag149","DOIUrl":"https://doi.org/10.1093/jbcr/irag149","url":null,"abstract":"Diabetes mellitus causes vascular dysfunction, immune dysregulation, and cellular abnormalities. Prior studies suggest worse outcomes in burn patients with diabetes mellitus but are limited by single- institution studies and small sample sizes. National databases like the Burn Care Quality Platform (BCQP) can provide higher-powered multi-institutional datasets to determine outcomes otherwise unseen. Using the BCQP, adult burn patients admitted for burn care from 2016 to 2018 were retrospectively reviewed for diabetes status. Primary outcomes were time to 95% wound closure. Secondary outcomes were hospital and intensive care unit (ICU) length of stay (LOS), rates of acute respiratory distress syndrome (ARDS), ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLABS), operative intervention rates, and in-hospital mortality. Diabetic patients had longer wound closure time (25 versus 22 days, p = 0.0006) and more operative procedures (15.8 versus 1.3, p < 0.0001) than non-diabetic patients. Diabetic patients also had longer hospital LOS (8 versus 5 days, p < 0.0001) and higher mortality (5.7% vs. 4.1%, p = 0.045) than non-diabetic patients, with no differences in ARDS, VAP, or CLABSI. On multivariable analysis, diabetes mellitus itself was not an independent predictor of complications or mortality, but early hyperglycemia was the strongest modifiable predictor of ARDS, VAP, and CLABSI. Overall, diabetes mellitus was associated with delayed wound healing, longer hospital LOS, and ICU LOS. Acute complications were driven by early hyperglycemia following admission and injury severity, highlighting early glycemic optimization in burn care.","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793697","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

Analysis of Risk Factors for Early Acute Kidney Injury in Critically Ill Burn Patients. 烧伤危重患者早期急性肾损伤的危险因素分析。

IF 1.9 4区医学

Journal of Burn Care & Research Pub Date : 2026-08-19 DOI: 10.1093/jbcr/irag146

Jie Wu, Qingwei Zhu, Yuanxian Zou, Xinyue Wang, Nanxin Zhang, Yuxin Xiao, Jingshu Ci, Rongtao Cui

{"title":"Analysis of Risk Factors for Early Acute Kidney Injury in Critically Ill Burn Patients.","authors":"Jie Wu, Qingwei Zhu, Yuanxian Zou, Xinyue Wang, Nanxin Zhang, Yuxin Xiao, Jingshu Ci, Rongtao Cui","doi":"10.1093/jbcr/irag146","DOIUrl":"https://doi.org/10.1093/jbcr/irag146","url":null,"abstract":"Acute kidney injury (AKI) is a common early complication in critically ill burn patients, but its risk factors remain incompletely understood. This study aimed to identify independent risk factors for early AKI in this population. A retrospective study enrolled 98 critically ill burn patients admitted to the participating medical center from January 2016 to September 2025. Patients were divided into AKI and non-AKI groups based on AKI occurrence within 3 days post-injury. Admission data (demographics, laboratory parameters, inflammatory indices) were analyzed. Independent risk factors were identified via univariate analysis, multicollinearity diagnosis, and multivariate logistic regression; a prediction model was constructed and evaluated using ROC curve analysis. The incidence of early AKI in critically ill burn patients was 28.6%. The multivariate logistic regression analysis revealed that blood urea nitrogen (BUN; OR = 1.519; 95% CI: 1.042 ~ 2.214; p = 0.030), cystatin C (CYS; OR = 12.142; 95% CI: 1.240 ~ 118.858; p = 0.032), and D-dimer (OR = 1.136; 95% CI: 1.006 ~ 1.283; p = 0.040) levels were independent risk factors for early AKI. The prediction model equation was Logit(P) = -9.159 + 0.418 × BUN (mmol/L) + 2.497 × CYS (mg/L) + 0.127 × D-dimer (mg/L). The area under the ROC curve (AUC) for this model was 0.887 (95% CI: 0.816 ~ 0.958; p < 0.001), and the optimal cut-off value was determined by the maximum Youden index, which was 0.235. According to the prediction equation, a calculated probability p ≥ .235 indicates a high risk of early AKI. Elevated BUN, CYS, and D-dimer levels increase early AKI risk in critically ill burn patients.","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793669","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

The Geometry of Skin Grafting: Boundary, Seams, and Epithelialization. 皮肤移植的几何学：边界、接缝和上皮化。

IF 1.9 4区医学

Journal of Burn Care & Research Pub Date : 2026-08-19 DOI: 10.1093/jbcr/irag144

Alexandra L R Rogers, David L Wallace, Alan D Rogers, Roberto Cartotto

{"title":"The Geometry of Skin Grafting: Boundary, Seams, and Epithelialization.","authors":"Alexandra L R Rogers, David L Wallace, Alan D Rogers, Roberto Cartotto","doi":"10.1093/jbcr/irag144","DOIUrl":"https://doi.org/10.1093/jbcr/irag144","url":null,"abstract":"Split-thickness skin grafting remains central to definitive wound closure in burn surgery. Although the biology of successful engraftment is well established, less attention has been paid to the geometric and mechanical determinants of graft behaviour. Broader grafts often appear more stable and require fewer peripheral fixation points per unit area than surfaces reconstructed from multiple narrow pieces. We propose a clinically grounded framework in which graft geometry defines boundary, interior, seams, and epithelialization gaps. Larger grafts have a lower perimeter-to-area ratio and proportionally more interior, whereas multiple graft pieces create internal seams and additional interface length. These principles apply to unmeshed sheet and meshed grafts. Geometry is not an isolated determinant: central fixation, fibrin adhesion, bolsters, wraps, splints, and negative-pressure wound therapy improve coupling and reduce displacement, but do not remove physical edges, seams, or gap geometry. Seam orientation is clinically consequential. Straight seams should be avoided across flexion creases, joints, and concavities when an alternative is available; unavoidable seams should be reoriented, staggered, interrupted, or constructed nonlinearly. In donor-limited grafting, the objective changes. At comparable high expansion ratios of 3:1 or greater, widely meshed grafts and Meek micrografts distribute epithelial fronts and migration distances differently. This conditional framework translates common operative observations into a vocabulary for planning, teaching, and research. It identifies practical decisions under the surgeon's control and generates testable hypotheses regarding interface length, stabilization, seam orientation, and epithelialization distance.","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793651","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

Burn Care in Prisons: Ethical Dilemmas in Correctional Health Care. 监狱烧伤护理：惩教保健的伦理困境。

IF 1.9 4区医学

Journal of Burn Care & Research Pub Date : 2026-08-18 DOI: 10.1093/jbcr/irag139

Joshua Khorsandi, Jason Mirharooni, Michael Kahen, Joshua Ahdout, Ava Niknejad, Demitri Franzoni, Joshua MacDavid

{"title":"Burn Care in Prisons: Ethical Dilemmas in Correctional Health Care.","authors":"Joshua Khorsandi, Jason Mirharooni, Michael Kahen, Joshua Ahdout, Ava Niknejad, Demitri Franzoni, Joshua MacDavid","doi":"10.1093/jbcr/irag139","DOIUrl":"https://doi.org/10.1093/jbcr/irag139","url":null,"abstract":"Burn injuries among incarcerated individuals represent an underexplored intersection of medical ethics, correctional policy, and health equity. Although scholarship increasingly examines vulnerable groups such as refugees and undocumented patients, incarcerated burn patients remain largely absent. Dual loyalty-balancing duty to the patient with obligations to the institution or state-creates distinctive challenges that are intensified in burn care, where timely intervention, pain control, rehabilitation, and psychosocial support are critical but often constrained by security protocols and systemic neglect. We conducted a narrative review of PubMed, Embase, and Scopus to identify peer-reviewed articles, position statements, and ethical analyses addressing incarcerated healthcare, dual loyalty, and burn treatment (English-language, 2000-2025). A thematic synthesis identified recurring ethical tensions, clinical barriers, and potential frameworks for resolution. Findings highlight a major gap in both literature and professional discourse. Recurrent themes included restricted access to specialized burn centers, compromised informed consent under custodial oversight, inadequate rehabilitative services, and disproportionate suffering linked to institutional neglect. Dual loyalty emerged as a central driver of ethical conflict, often pitting patient dignity against correctional authority. Elevating incarcerated burn care within burn scholarship and advocacy is necessary to uphold standards of care. Explicit attention to dual loyalty can support reforms that preserve patient dignity while maintaining institutional safety, improve outcomes, and reaffirm professional ethical commitments.","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793723","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

Charles Goldhamer and the Visual Record of Wartime Burn Care. 查尔斯·戈德哈默和战时烧伤护理的视觉记录。

IF 1.9 4区医学

Journal of Burn Care & Research Pub Date : 2026-08-18 DOI: 10.1093/jbcr/irag145

Alan D Rogers, John L Semple

{"title":"Charles Goldhamer and the Visual Record of Wartime Burn Care.","authors":"Alan D Rogers, John L Semple","doi":"10.1093/jbcr/irag145","DOIUrl":"https://doi.org/10.1093/jbcr/irag145","url":null,"abstract":"The Second World War generated a distinctive population of aircrew survivors with severe burns of the face and hands who required prolonged reconstruction and rehabilitation. At Queen Victoria Hospital, East Grinstead, Canadian official war artist Charles Goldhamer portrayed this clinical world between 1944 and 1946. His works have often been interpreted as humane records of burn survivorship, but their historical significance is clearer when they are placed within the longer visual history of reconstructive surgery. This historical review compares six Goldhamer works in the Canadian War Museum with nineteenth-century surgical illustration and photography, the First World War records of Harold Gillies and Henry Tonks, and the operative drawings of Mollie Lentaigne at East Grinstead. Goldhamer did not inaugurate the visual documentation of disfigurement or reconstruction. His distinct contribution was to bring an established clinical-artistic tradition into an official national war-art programme and to emphasize rehabilitation, postoperative waiting, staged reconstruction, and the recovering patient rather than only deformity, technique, or final result. Museum inscriptions also provide case-specific information for selected sitters, including Flying Officer John Smith and Sergeant James F. Gourley. After 1945, clinical photography and professional medical illustration became the dominant means of surgical documentation, while Goldhamer returned to teaching and painting. His burn series therefore represents both continuity with earlier medical art and a distinctive wartime convergence of clinical record, portraiture, and public memory.","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793642","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

Determining the Value of Screening and Decolonization in Burn Unit Management. 确定筛查和非殖民化在烧伤管理中的价值。

IF 1.9 4区医学

Journal of Burn Care & Research Pub Date : 2026-08-13 DOI: 10.1093/jbcr/irag121

Chinaemelum C Akpunonu, Yueran Zhang, Jemima Carroll, Beth McGuire, Michael R Young, Nidhi Aravapalli, Shandra Day, Ariel Rodgers, John Loftus, Nicole P Bernal

{"title":"Determining the Value of Screening and Decolonization in Burn Unit Management.","authors":"Chinaemelum C Akpunonu, Yueran Zhang, Jemima Carroll, Beth McGuire, Michael R Young, Nidhi Aravapalli, Shandra Day, Ariel Rodgers, John Loftus, Nicole P Bernal","doi":"10.1093/jbcr/irag121","DOIUrl":"https://doi.org/10.1093/jbcr/irag121","url":null,"abstract":"Methicillin-resistant Staphylococcus aureus (MRSA) is consistently associated with more severe wound complications and worse outcomes in burn patients. Many burn centers who have implemented routine MRSA screening and decolonization protocols have reported reduced MRSA transmission, lower rates of device-associated infections such as CAUTI and CLABSI, and decreased LOS. At the Ohio State University, Wexner Medical Center (OSUWMC), we initiated a multidisciplinary quality improvement two-phase project to implement routine screening. Phase 1: all patients who screened positive for MRSA received a decolonization protocol consisting of intranasal mupirocin twice daily for 5 days and daily chlorhexidine gluconate baths; Phase 2: all patients were screened but no decolonization measures were taken. We aimed to determine if MRSA decolonization aids in decreasing incidence of MRSA, LOS, and incidence of wound infections. Phase 1: 45 patients were admitted in March 2025, with 93% compliance for admission MRSA screening (n = 36). 19 (49%) were negative, 10 (26%) were MSSA+, and 7 (18%) were MRSA+. All MRSA+ patients completed the decolonization protocol. Only 2 of the 45 patients (4%) developed MRSA wound infections requiring treatment. Phase 2: 103 patients from July-September 2025, with a 52.4% compliance rate for screening on admission (n = 54). 36 (66.7%) were negative, 5 (9.3%) were MRSA+, and 13 (24.1%) were MSSA+. 13 patients developed non-MRSA wound infections. No differences in length of stay, LOS/TBSA, incidence of infection by screened result or TBSA (once adjusted) or mortality were observed in either phase. The additional cost and resource utilization required for screening and decolonization did not appear to provide meaningful clinical advantage.","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759695","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

Bridging Acuity and Anesthesia: A Novel Tiered Framework for Anesthetic Stratification in Operative Burn Management. 桥接敏锐度和麻醉：手术烧伤管理中麻醉分层的新分层框架。

IF 1.9 4区医学

Journal of Burn Care & Research Pub Date : 2026-08-13 DOI: 10.1093/jbcr/irag136

Nicole Margiotta, Lane L Palmisano, Cherry Song, Abraham Houng

{"title":"Bridging Acuity and Anesthesia: A Novel Tiered Framework for Anesthetic Stratification in Operative Burn Management.","authors":"Nicole Margiotta, Lane L Palmisano, Cherry Song, Abraham Houng","doi":"10.1093/jbcr/irag136","DOIUrl":"https://doi.org/10.1093/jbcr/irag136","url":null,"abstract":"Burn injuries vary widely in clinical severity, operative complexity, and physiologic burden. Although scoring systems exist for predicting morbidity and mortality in burn patients, a standardized framework for coordinating burn case acuity with anesthesia expertise has yet to be implemented in clinical practice. In this retrospective, single-center study, we analyzed 132 operative burn cases performed over a one-year period to evaluate a novel tiered classification system that stratifies anticipated anesthesia requirements by clinical severity. Cases were categorized as Green (low risk), Yellow (moderate risk), or Red (high risk) based on physiologic risk factors, including burn extent as percentage of total body surface area (TBSA), hemodynamic instability, and vasopressor dependence. Patient demographics and clinical variables, including age, mechanism of injury, TBSA, and intraoperative transfusion requirements were collected and statistically analyzed. Results showed that the pediatric cohort (<18 years old) demonstrated significantly greater mean TBSA burns (43.3% vs. 21.8%, p=0.0017, 95% CI [-33.70, -9.00]) and represented a higher proportion of Red-tier (high-risk) cases than adult patients (p=0.0011), with a similar mechanism of injury observed across cohorts (p=0.50). A statistically significant difference was observed in the distribution of intraoperative blood product administration across severity tiers (p<0.001). The findings of this study suggest that the proposed tiered system identifies clinically distinct groups of operative burn cases based on injury severity and physiologic instability. We propose that implementing this framework in clinical practice may improve outcomes for patients with acute burns, facilitate more efficient allocation of anesthesia resources, and guide standardized educational structures for management of acute burn injuries.","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761754","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