Journal of Burn Care & Research最新文献

{"title":"Response to Letter to the Editor Concerning \"Caregivers and Clinic Providers View Soft Casts for Pediatric Hand Burns as Acceptable and Feasible: A Mixed Methods Survey\".","authors":"Jennifer M Schuh, Leanna L Shaman, Katherine T Flynn-O'Brien","doi":"10.1093/jbcr/iraf036","DOIUrl":"10.1093/jbcr/iraf036","url":null,"abstract":"","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"934"},"PeriodicalIF":1.8,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986442","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":"Time to Thrombolytics and Tissue Salvage: Assessing Response Following Severe Frostbite Injury.","authors":"Rachel M Nygaard, Emily Colonna, Rediat A Tilahun, Charly Vang, Gopal Punjabi, Alexandra Lacey, Kyle Schmitz, Derek C Lumbard","doi":"10.1093/jbcr/iraf051","DOIUrl":"10.1093/jbcr/iraf051","url":null,"abstract":"<p><p>Approximately 30% of severe frostbite injuries result in amputation. Thrombolytic therapy is used to reduce tissue loss following severe frostbite injury. This study evaluates factors impacting the effectiveness of thrombolytics using post-treatment perfusion imaging and amputation level as outcome measures. We hypothesize that categorizing thrombolytic-treated patients into full, partial, and nonresponders enable a nuanced evaluation of treatment effectiveness. A prospectively maintained frostbite database was reviewed for patients with post-rewarming perfusion deficits measured by Tc99 scans who received IV thrombolytics. Of 131 patients, 71% were full responders, 23.7% were partial responders, and 5.3% were nonresponders for surgical outcome. The median time to thrombolytics was 5.5 h (range 1-14.5) for full responders; 7 h (range 3.5-14) for partial responders; and 10 h (range 1.5-11.5) for nonresponders. Full responders exhibited smaller initial perfusion deficits. Psychosocial or comorbid factors were not significantly different across groups. Nonresponse was associated with a longer time to thrombolytics, larger perfusion deficits, and cellulitis/infection. Using imaging outcomes to reduce confounding by infection, 93 patients were evaluated: 28% were full responders, 57% were partial responders, and 15% were nonresponders. Full responders for imaging outcomes corresponded with surgical outcomes and had no amputations, while 37.7% of partial responders and 42.9% of nonresponders on imaging outcomes had amputations. This study is the largest to evaluate thrombolytic outcomes in severe frostbite-injured patients, showing nearly 95% of patients improve after thrombolytic treatment for severe frostbite injury. This provides new insight into thrombolytic responses and a novel assessment of thrombolytic treatment efficacy. These findings underscore the importance of timely thrombolytic administration and demonstrate benefits for patients treated outside the standard thrombolytic treatment windows.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"730-740"},"PeriodicalIF":1.8,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12397684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001719","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":"Chronic Dermatitis Following Chemical Burns: Case Reports on Long-Term Complications and Management Challenges.","authors":"B Hickson, S Jeffery","doi":"10.1093/jbcr/iraf025","DOIUrl":"10.1093/jbcr/iraf025","url":null,"abstract":"<p><p>This report highlights the experiences of 2 individuals who suffered chemical burns leading to chronic dermatitis. Both patients were exposed to concentrated chemical cleaning agents that resulted in the development of persistent cutaneous conditions that worsened over time despite initial treatment and recovery. These cases evidence the long-lasting effects of chemical burns and highlight the importance of workplace safety measures and effective treatment strategies to prevent long-term complications. The report emphasizes the role of early medical attention, proper protective gear, and awareness of potential chemical sensitivities, in preventing and managing such injuries.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"927-930"},"PeriodicalIF":1.8,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of Maintaining Nutrition Through Moderate Sedation for Burn Wound Care.","authors":"Amber D Kohler, Scott W Mueller, Naveen Kukreja, Thomas Orion Vogler, Blaire Balstad, Frederick W Endorf, Cameron Gibson, Alexandra E Halevi, Arek J Wiktor","doi":"10.1093/jbcr/iraf033","DOIUrl":"10.1093/jbcr/iraf033","url":null,"abstract":"<p><p>Burn patients often require frequent moderate sedation for burn wound care procedures. The American Society of Anesthesiology recommends patients be made nil per os prior to moderate sedation. Here, we aimed to assess the risk of moderate sedation in burn patients with uninterrupted nutrition. A 12-month single-center retrospective analysis on nonintubated/nontracheostomy burn patients receiving moderate sedation for wound care was performed. A total of 97 moderate sedations were completed on 24 patients. A median of 3 oral premedications and 3 intravenous analgesic/anxiolysis medications per patient were administered during each periprocedural period and achieved a median Richmond Agitation-Sedation Score of -2 (-3, -1). The median of any kind of nutrition was consumed 38 minutes prior to sedations, with a median of 113 minutes from consumption of a full meal. In 32 sedations (33%), patients had tube feeds continued throughout wound care. No complications related to aspiration were noted in any sedation event (97.5% upper Confidence Interval 3.7%), including no episodes of vomiting, evidence of aspiration, pneumonia, hypoxemia, complete airway obstruction, laryngospasm, or death. Hypertension was noted in 17 sedations. Hypotension was noted in 6 sedations. In conclusion, no harmful adverse events were associated with maintained nutrition throughout the peri- and intrasedative wound care periods, including ongoing gastric tube feeds in this small sample of burn patients. These data suggest that uninterrupted nutrition during burn wound care moderate sedation procedures is a safe practice and warrants further study.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"839-845"},"PeriodicalIF":1.8,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692272","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":"Integrating Addiction Medicine Into Burn Care: Optimizing Pain Management in Stimulant-Positive Patients.","authors":"Eloise W Stanton, Artur Manasyan, Michael I Kim, Sunnie Wong, Maxwell B Johnson, Justin Gillenwater","doi":"10.1093/jbcr/iraf049","DOIUrl":"10.1093/jbcr/iraf049","url":null,"abstract":"<p><p>Stimulant use poses significant challenges in burn care, complicating pain management and leading to poorer outcomes, including longer hospital stays, higher complication rates, and increased healthcare costs. This study evaluates burn-related outcomes in stimulant-positive patients, as well as tabulates how frequently addiction medicine consultations are used in burn patients with positive stimulant screens. Patients with positive urine toxicology screens for stimulants, including amphetamines and cocaine, were identified. The primary predictor variable was stimulant use, while primary outcomes included length of hospital stay, burn severity, complications, and overall outcomes of care. Out of 3403 burn patients (34% female, 66% male, with a mean age of 39.2 ± 22.8 years), 572 patients (16.8%) had positive urine toxicology screens for stimulants. Stimulant-positive patients had significantly longer hospital stays compared to stimulant-negative patients (17.7 vs. 10.7 days, P < .001), more severe burns (P = .001), and a higher incidence of complications (15.6% vs. 11.5%, P = .006). Despite these risks, only 12.6% (72 patients) of stimulant-positive burn patients received an addiction medicine consultation during their hospitalization. The use of addiction medicine consultations increased over time, rising from 3 consults in 2015 to 42 in 2023. A multidisciplinary approach that includes addiction medicine can help address both the complexities of pain management and substance use, leading to improved patient outcomes. Early involvement of addiction medicine could enhance pain management and recovery, emphasizing the need for more systematic integration of addiction medicine into burn care protocols.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"725-729"},"PeriodicalIF":1.8,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855307","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":"Scientific Production on Electrical Burns: A Bibliometric Analysis (1946-2023).","authors":"José Enrique Cueva-Ramírez, Gregorio Gonzalez-Alcaide, José-Manuel Ramos-Rincón","doi":"10.1093/jbcr/iraf008","DOIUrl":"10.1093/jbcr/iraf008","url":null,"abstract":"<p><p>Electrical burns constitute a serious public health challenge. It is crucial to identify trends, advancements, and possible future research areas in this field. The aim is to analyze the scientific production on electrical burns using bibliometric methods. Eligible documents contained the MeSH descriptor \"Burns, Electric\" and were listed both in PubMed and in the Web of Science Core collection. The bibliometric analysis was based on several quantitative indicators. The analysis included 1456 articles from 455 journals. The annual average was 28.1 articles, with a growth rate of 2.08% from 1946 to 2024. The United States produced the most articles (n = 657), followed by China (n = 184). The United States also led in international collaboration, working with 26 countries. Harvard University was the leading institution (n = 85) and Burns the leading journal (n = 265). The most common subject category of the research was Surgery (31.97% of documents). Wang XW was the most prolific author (n = 21), while Lee RC had the most citations (n = 648). The main clinical MeSH descriptors were \"Surgical flaps\" (n = 233), \"Skin transplantation\" (n = 159), and \"Electric injuries\" (n = 136). The results show slight growth in scientific production on electrical burns. The United States is leading research in this field.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"782-793"},"PeriodicalIF":1.8,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005951","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":"Distinct Transcriptome Signatures Associated With Mortality and Prolonged Recovery Following Burn Injury.","authors":"Burook Misganaw, Desiree N Pinto, Tuan D Le, Anthony Pusateri, Aarti Gautam, Bonnie C Carney, Lauren T Moffatt, Jeffrey W Shupp, Rasha Hammamieh","doi":"10.1093/jbcr/iraf012","DOIUrl":"10.1093/jbcr/iraf012","url":null,"abstract":"<p><p>A dysregulated immune response after severe burn injury is associated with detrimental short and long-term clinical outcomes. Key changes to gene expression within the first 24 h after burn injury have been identified, but longitudinal data is lacking. Therefore, this study aims to characterize gene expression during the first 3 weeks after burn injury and identify specific genes and pathways associated with distinct clinical outcomes. Patients presenting within 4 h of injury had blood RNA isolated for microarray gene expression at admission and set timepoints to 21 days. Inter- and intra-group comparisons were performed between 4 groups (G1 died within 7 days; G2 died after 7 days; G3 discharged after 7 days; and G4 discharged within 7 days). A total of 17 289 transcripts were quantified from 116 patients. At admission, there were 110, 80, and 31 differentially expressed genes in G1, G2, and G3, respectively, compared to G4, and were largely nonoverlapping. Longitudinal intra-group analyses also showed distinct group- and time-dependent patterns. Upregulation of genes and pathways related to the innate immune response and unfolded protein response predominated during early time points, while persistent upregulation of coagulation pathways and downregulation of immune-related pathways were identified days to weeks following injury. Overall, burn injury induces widespread transcriptomic responses, with larger and more sustained changes observed in patients with worse clinical outcomes. These gene expression signatures reveal underlying molecular mechanisms that occur immediately following injury and may have prognostic and diagnostic utility in the care of burn-injured patients.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"687-699"},"PeriodicalIF":1.8,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119722","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":"Post-burn Lung Inflammation Is Associated With Induction of Pulmonary Cathelicidin-related Antimicrobial Peptide and S100a8 in Mice.","authors":"Shanawaj Khair, Kevin M Najarro, Travis M Walrath, David J Orlicky, Rachel H McMahan, Elizabeth J Kovacs","doi":"10.1093/jbcr/iraf069","DOIUrl":"10.1093/jbcr/iraf069","url":null,"abstract":"<p><p>Burn trauma triggers dysregulated systemic inflammation, leading to multiorgan dysfunction. Respiratory failure often follows burn injury, resulting in morbidity and mortality, in part, because of excessive and prolonged release of local and systemic pro-inflammatory mediators. One class of important mediators of inflammation at mucosal surfaces are antimicrobial peptides (AMPs), and their expression is notably altered in inflammation. We sought to determine whether pulmonary AMPs are induced in inflammatory lung after burn. C57BL/6 male mice were given a 12%-15% full-thickness total body surface area dorsal scald burn or sham injury. Survival rate and pulmonary function of the mice were assessed at 24 h. Histopathological examination and quantification of pro-inflammatory mediators, IL-6 and CXCL1, in the lungs at 24 h after burn were performed. mRNA expression of a subset of prominent lung AMPs in whole lung, alveolar macrophages (AMs), and primary lung epithelial cells were measured. Our data showed decreased survival and impaired respiratory function after burn injury. Moreover, hematoxylin and eosin-stained lung sections of burned mice showed pulmonary edema and congestion, and pulmonary IL-6 and CXCL1 were elevated. AMP analysis revealed that burn triggered a dramatic rise in lung Camp and S100a8 above that of sham mice. To our surprise, lung epithelial cells, and not AMs, were the cellular source of burn-induced Camp and S100a8 in this murine model of burn injury. Taken together, these data reveal for the first time that lung inflammation post-burn involves a rise in AMPs, Camp and S100a8, from lung epithelial cells.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"917-926"},"PeriodicalIF":1.8,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003118","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":"Clearing the Air: Impact of COPD on Inhalation Injury Outcomes.","authors":"Christopher J Fedor, José Antonio Arellano, Hilary Y Liu, Mare G Kaulakis, Alain C Corcos, Matthew P Siedsma, Jenny A Ziembicki, Francesco M Egro","doi":"10.1093/jbcr/iraf071","DOIUrl":"10.1093/jbcr/iraf071","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease (COPD) involves airway obstruction and emphysema, leading to air trapping and shortness of breath. COPD may impair healing in patients with inhalation injuries, where there can be significant airway damage. This study examines the effect of COPD comorbidity on short-term clinical outcomes for patients with inhalation injuries sustained from residential or structure fires. A 12-year retrospective analysis was conducted utilizing patient records from a single burn center. Outcome variables, including hospital length of stay, ventilator days, and complications, were compared between patients with or without a prior diagnosis of COPD. One hundred eighty-four patients were diagnosed with inhalation injury via bronchoscopy, 69 (37.5%) of whom had COPD. These patients were older (P < .001) and more likely to be current smokers (P < .001). COPD did not predict a difference in hospital days (P = .060), ventilator days (P = .487), or complication rates. Moreover, COPD did not increase mortality risk (OR = 0.61, 95% CI: 0.24-1.53, P = .297). Instead, carbon monoxide poisoning arose as the predominant risk factor of mortality (OR = 3.80, 95% CI: 1.41-10.25, P = .008). Although the mortality rate was the same regardless of COPD status, among patients who died, those with obstructive disease survived 6.0 days longer (P = .007). These findings suggest that COPD does not independently worsen short-term outcomes following fire-related inhalation injuries. Rather, factors such as systemic toxicity and burn severity play a more significant role in prognosis. While COPD patients who died had a slightly longer survival period, further investigation is needed to determine whether this reflects a protective effect of COPD-related treatments or heightened medical intervention.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"746-752"},"PeriodicalIF":1.8,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248071","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":"Enhancing Transfer of Accountability in Burn ICU Nursing: A Quality Improvement Initiative.","authors":"Gavin Shantz, Anita Au, Ashley Callahan, Alan David Rogers","doi":"10.1093/jbcr/iraf169","DOIUrl":"https://doi.org/10.1093/jbcr/iraf169","url":null,"abstract":"<p><p>In the burn intensive care unit (ICU), effective nurse handovers are critical to patient safety. Communication gaps during the transfer of accountability (TOA) contribute to preventable safety incidents. We designed a quality improvement (QI) initiative to standardize TOA and improve safety culture. A baseline safety culture survey of 31 burn ICU nurses and a three-month review of incident reports (mean: 18/month) identified handover-related communication failures, including omitted treatments, delayed wound care, and missed monitoring responsibilities. We co-developed a structured, burn-specific TOA tool with frontline nurses and introduced it through targeted education. The intervention was implemented over eight weekly Plan-Do-Study-Act (PDSA) cycles. Outcomes included incident rates, nurse-reported safety culture, and process adherence. Post-intervention, safety incidents decreased by 50% (from 18 to 9/month), and TOA-related safety culture scores improved by 20%, achieving both SMART objectives. Tool adherence exceeded 90% by the final cycle. Nurses reported improved clarity, reduced cognitive load, and enhanced interprofessional communication. No adverse workflow impacts were observed. A co-designed TOA tool, integrated with education and iterative PDSA refinement, significantly improved handover safety and reduced incidents in the burn ICU. This initiative provides a practical, scalable model for enhancing communication and safety culture in high-risk clinical settings.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955497","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}