Burns最新文献

{"title":"Selenoprotein P as a prognostic biomarker of burn sepsis: A prospective cohort study","authors":"Tabael L. Turan ,&nbsp;Holger J. Klein ,&nbsp;Eddy Rijntjes ,&nbsp;Theresia Reding Graf ,&nbsp;Kamil Demircan ,&nbsp;Jan A. Plock ,&nbsp;Lutz Schomburg","doi":"10.1016/j.burns.2024.107314","DOIUrl":"10.1016/j.burns.2024.107314","url":null,"abstract":"<div><h3>Introduction</h3><div>Severely burned patients exhibit increased nutritional requirements and are at high risk of developing sepsis. Selenium is an essential trace element supporting antioxidant and anti-inflammatory pathways, mediated by incorporation into selenoproteins. The selenium status may affect sepsis risk in burn injury.</div></div><div><h3>Methods</h3><div>This prospective cohort study included 90 adult patients admitted to Zurich Burn Center, Switzerland. All patients received a continuous intravenous infusion of 1000 μg sodium selenite per day during the first week as part of local standard of care. Three complementary biomarkers of serum selenium status were determined at nine time-points up to six months postburn, namely total selenium, selenoprotein P, and glutathione peroxidase 3. The resulting data were correlated to clinical parameters and outcomes, with sepsis as the primary end point.</div></div><div><h3>Results</h3><div>A high fraction of the patients displayed selenium deficiency already at admission, and developed sepsis during hospitalization (<em>n</em> = 55; 61 %). Selenium status at admission was inversely related to burn severity. Low baseline selenoprotein P was associated with sepsis incidence, irrespective of trauma severity (adjusted HR, 1.94; 95 % CI, 1.05–3.63; <em>p</em> = 0.035). Burn severity and baseline concentrations of selenoprotein P and white blood cells together predicted sepsis with an area under the curve of 0.84 (95 % CI, 0.75–0.93; <em>p</em> &lt; 0.0001). Supplemental selenium was associated with a transient normalization of selenium status.</div></div><div><h3>Conclusion</h3><div>Considering its rapid decline following severe burn injury, the assessment of serum selenoprotein P upon admission may contribute to an early prediction of sepsis risk.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 1","pages":"Article 107314"},"PeriodicalIF":3.2,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics and outcomes of myocardial infarction among burn patients: A nationwide analysis.","authors":"Ramy Sedhom, Mohamed Khedr, Rafail Beshai, Emmanouil S Brilakis, Mir B Basir, Khaldoon Alaswad, Liset Stoletniy, Dmitry Abramov, Aditya Bharadwaj, Michael Megaly","doi":"10.1016/j.burns.2024.107313","DOIUrl":"https://doi.org/10.1016/j.burns.2024.107313","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the characteristics and outcomes of myocardial infarction (MI) among burn patients.</p><p><strong>Materials and methods: </strong>The Nationwide Readmissions Database was utilized to identify hospitalizations of patients with burns from 2016 to 2020. The main outcome was the difference in all-cause in-hospital mortality between burn patients with and without MI.</p><p><strong>Results: </strong>Of 200,130 hospitalizations with burns, 1997 (1 %) developed acute MI. Burn patients with MI were older, more likely to be men, and had a higher prevalence of cardiovascular risk factors. Only burns affecting the trunk and respiratory tract, and those affecting > 20 % of body surface area (BSA), were associated with an increased risk of MI. All-cause in-hospital mortality was higher among patients with MI (18.7 % vs. 3 %, adjusted odds ratio (aOR) 4.59, 95 % confidence interval (CI) 3.66, 5.76). Cardiogenic shock, ventricular tachycardia, and stroke rates were higher among patients with MI. Revascularization was associated with lower in-hospital mortality (aOR 0.33, 95 % CI 0.17, 0.64) CONCLUSIONS: The incidence of MI in burn patients is low but is associated with high mortality and morbidity. Burns involving the trunk and respiratory tract, and those affecting > 20 % BSA, were associated with an increased risk of MI. Revascularization was associated with lower in-hospital mortality.</p>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 1","pages":"107313"},"PeriodicalIF":3.2,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correspondence: Efficacy of a burn prevention educational program to diminish the incidence of burn injuries in the pediatric population","authors":"Dhivya Viswanathan,&nbsp;Rajakumar Govindasamy,&nbsp;Harish SL","doi":"10.1016/j.burns.2024.107309","DOIUrl":"10.1016/j.burns.2024.107309","url":null,"abstract":"","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 1","pages":"Article 107309"},"PeriodicalIF":3.2,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survey about target temperature and thermal management in intensive care for severe thermal trauma in burn centres of Germany, Austria and Switzerland","authors":"Stefan Trojan ,&nbsp;Friedemann Stein ,&nbsp;Rolf Lefering ,&nbsp;Thorsten Annecke ,&nbsp;Frank Wappler ,&nbsp;Ulrich Limper","doi":"10.1016/j.burns.2024.107308","DOIUrl":"10.1016/j.burns.2024.107308","url":null,"abstract":"<div><div>Burn trauma induces hypermetabolism and alters thermoregulation resulting in elevated body temperature. Because patients with burns are prone to heat loss and hypothermia, maintaining physiologic body temperature is important. However, optimal target temperature is widely unknown because thermoregulation of burn trauma has mainly been studied in the previous century, when treatment concepts differed from current era. The aim of this study was to investigate current thermal management of burn treatment and to investigate the discrepancies between classical concepts of thermoregulation in burn trauma and current practice of temperature management. A paper-based survey was conducted in burn centres in Germany, Austria, and German-speaking Switzerland. Participants were asked for expected temperatures, temperature goals, and thermal management of severely burned patients. Results were evaluated for adults and children. 37 of 38 approached burn centres participated in this survey. 59 % expected that adults with burn trauma would develop hyperthermia (&gt;37.5 °C) but only 27 % expected hyperthermia in children (&gt;38 °C). The average target body temperature was 37.1 °C for adults and 36.9 °C for children. Adults below 35.7 °C and children below 36.0 °C were assessed to be hypothermic. Temperatures above 38.8 °C in adults and 38.7 °C in children raised suspicion for sepsis. Antipyretic treatment was assumed to be justified at temperatures above 39.1 °C in adults and 38.5 °C in children. Although the most common warming method was to increase ambient temperature, 89 % of all participants felt their wellbeing was affected by an increased ambient temperature and 68 % were concerned about temperature-related negative effects. Although 57 % of the responding centres had established a standard operating procedure for thermal management, only 41 % considered the available literature to be very relevant in daily practice and 89 % criticized the lack of guidelines. Limit and target temperatures in European burn centres are heterogeneous. Classic concepts of thermal management in burn care are not universally adopted. A majority of the centers expresses the need for specific guidelines. The basis for this should be multicentre clinical trials on temperature management in burn trauma.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 1","pages":"Article 107308"},"PeriodicalIF":3.2,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The overlooked role of cell viability in stem cell therapy for burn wound repair","authors":"Chong Yao,&nbsp;Yu Chen,&nbsp;Hong Yan","doi":"10.1016/j.burns.2024.107310","DOIUrl":"10.1016/j.burns.2024.107310","url":null,"abstract":"","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 1","pages":"Article 107310"},"PeriodicalIF":3.2,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Altered resting-state functional brain activity in patients with chronic post-burn pruritus","authors":"Zhi-Kai Lu ,&nbsp;Yin Huang ,&nbsp;Bin Wang ,&nbsp;Qian Zheng ,&nbsp;Pei-Yi Bai ,&nbsp;Wan-Li Guo ,&nbsp;Wen-Jin Bian ,&nbsp;Jin-Liang Niu","doi":"10.1016/j.burns.2024.107305","DOIUrl":"10.1016/j.burns.2024.107305","url":null,"abstract":"<div><h3>Background</h3><div>Pruritus, a common symptom of burn wounds, arises from skin tissue damage and abnormal tissue healing. Chronic post-burn pruritus (CPBP) is defined as itching that persists for six weeks or more. The brain mechanisms underlying CPBP are not understood adequately. This study aims to explore abnormal brain function in CPBP patients and identify potential pathogenesis of pruritus.</div></div><div><h3>Materials and methods</h3><div>Twenty patients with CPBP and twenty healthy controls (HCs) participated in the study and underwent resting-state functional magnetic resonance imaging (fMRI) scans. Brain activity was evaluated using regional homogeneity (ReHo), amplitude of low-frequency fluctuations (ALFF), and fractional ALFF (fALFF) measures. Preprocessing of fMRI data involved steps such as slice timing correction, motion correction, and nuisance regression to account for physiological noise and head motion. Statistical analyses included two-sample t-tests to compare ReHo, ALFF, and fALFF values between CPBP patients and HCs, with age as a covariate, and Spearman correlation analysis to explore relationships between brain activity measures and clinical characteristics.</div></div><div><h3>Results</h3><div>The study revealed significant differences in brain activity between CPBP patients and HCs. CPBP patients exhibited altered higher ReHo in regions including the bilateral middle frontal gyrus, medial superior frontal gyrus, precuneus, left insula, right caudate, and bilateral cerebellar tonsils, with decreased ReHo in the right precentral gyrus. ALFF analysis showed increased activity in the bilateral middle frontal gyrus, medial superior frontal gyrus, right precuneus, and right inferior frontal gyrus, and decreased ALFF in the left precentral gyrus and right postcentral gyrus. fALFF values were notably higher in the bilateral medial superior frontal gyrus and precuneus. Several brain regions with significant differences in ReHo, ALFF, and fALFF were extensively correlated with the burned area and pruritus scale scores.</div></div><div><h3>Conclusion</h3><div>Our data suggest that patients with CPBP show alterations in ReHo, ALFF, and fALFF values primarily in brain regions associated with the default mode network and sensorimotor areas. These results may provide valuable insights relevant to the neuropathology of CPBP.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 1","pages":"Article 107305"},"PeriodicalIF":3.2,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The rate of burnout, depression, and anxiety among burn care team members in a tertiary burn hospital: A descriptive cross-sectional study","authors":"Seyed Hamid Salehi ,&nbsp;Soodabeh Hoveidamanesh ,&nbsp;Mahsa Moghanlou ,&nbsp;Parviz Namazi ,&nbsp;Tayyeb Ghadimi ,&nbsp;Seyyed Amirhossein Salehi","doi":"10.1016/j.burns.2024.107306","DOIUrl":"10.1016/j.burns.2024.107306","url":null,"abstract":"<div><h3>Background</h3><div>Working in burn units has its unique challenges and may increase the rate of depression, anxiety, and burnout in burn care staff. We aimed to estimate the rate of depression, anxiety, and burnout among the members of the burn care team.</div></div><div><h3>Methods</h3><div>This descriptive cross-sectional survey was conducted from 1 January 2024 to 22 February 2024 in a tertiary burn hospital. The measurement tools of study were the validated Farsi versions of Beck’s Depression Inventory (BDI), Beck’s Anxiety Inventory (BAI), and Copenhagen Burnout Inventory (CBI).</div></div><div><h3>Results</h3><div>We found that the rate of depression, anxiety, and burnout was 54.2%, 62.7% and 50.7% in respondents, respectively. The correlation between burnout (CBI), depression (BDI), and anxiety (BAI) scores was significantly positive (p &lt; 0.01). The rate of burnout was significantly higher in younger staff, females, bachelor's degree holders, and burn ICU staff (P &lt; 0.05). Female burn care providers had higher anxiety (P &lt; 0.05). The rate of depression was significantly higher in younger participants and in those with incomes less than 300 dollars .(P &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Our results indicated that a significant number of burn care team members met the criteria for anxiety, depression, and burnout. The relationship between anxiety, depression, and burnout was significantly positive<strong>.</strong> Timely and proper intervention is necessary to reduce anxiety, depression, and burnout in burn care providers.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 1","pages":"Article 107306"},"PeriodicalIF":3.2,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of collecting long-term patient-reported outcome data in burns patients using a centralised approach","authors":"Lincoln M. Tracy ,&nbsp;Elizabeth Capell ,&nbsp;Heather J. Cleland ,&nbsp;Dale W. Edgar ,&nbsp;Yvonne Singer ,&nbsp;Warwick J. Teague ,&nbsp;Belinda J. Gabbe","doi":"10.1016/j.burns.2024.107304","DOIUrl":"10.1016/j.burns.2024.107304","url":null,"abstract":"<div><h3>Background</h3><div>Collecting patient-reported outcome measures (PROMs) has been a longstanding priority for the Burns Registry of Australia and New Zealand (BRANZ). An earlier pilot of hospital-led PROM collection encountered low participation rates and high loss to follow-up, indicating consideration for an alternative model was warranted.</div></div><div><h3>Aims</h3><div>To establish the feasibility of implementing centralised long-term PROM collection within the BRANZ.</div></div><div><h3>Methods</h3><div>Two burn services participated in this prospective, longitudinal pilot. PROMs were collected from patients admitted to the services between January and December 2021 who survived to discharge. Follow-up occurred via telephone or online self-completion at three, six, and 12 months post-injury using burn-specific and generic health-related quality-of-life measures.</div></div><div><h3>Results</h3><div>There were 450 patients (423 adult patients [≥ 16 years] and 27 paediatric patients [&lt; 16 years]) who could be contacted and agreed to participate in the follow-ups. Most patients initially opted for telephone rather than online self-completion (n = 305, 67.5 %). No key sociodemographic or injury event factors were associated with specifically opting for online self-completion. The follow-up rates were 81.1 % at three months, 81.9 % at six months, and 77.3 % at 12 months. Data missingness was low (i.e., &lt; 2 %) for all instrument items, excluding the visual analogue scale scores of the 5-Level EuroQoL 5 Dimensions Questionnaire and the two paediatric burn-specific measures.</div></div><div><h3>Conclusions</h3><div>Collecting PROMs from burns patients in the first 12 months after injury via a centralised approach was shown to be feasible, with higher participation rates and low missingness.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 1","pages":"Article 107304"},"PeriodicalIF":3.2,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recovery in patients undergoing ablative fractional carbon dioxide laser for adult hypertrophic burn scars: A longitudinal cohort study","authors":"Noah Betar ,&nbsp;Michelle Donovan ,&nbsp;Zephanie Tyack ,&nbsp;Jacelle Warren ,&nbsp;Steven M. McPhail ,&nbsp;Elizabeth Vujcich ,&nbsp;Jason Brown","doi":"10.1016/j.burns.2024.107300","DOIUrl":"10.1016/j.burns.2024.107300","url":null,"abstract":"<div><h3>Introduction</h3><div>Ablative fractional carbon dioxide laser (AFCO2L) is widely used as a treatment for hypertrophic burn scars. This study aimed to evaluate clinician and patient-reported outcomes after AFCO2L treatment, safety, and identify factors influencing outcomes.</div></div><div><h3>Methods</h3><div>This longitudinal study recruited adult patients with hypertrophic burn scars treated with AFCO2L at a single Australian burn unit. Patients received up to four AFCO2L treatments over approximately 12 months. Outcomes were ultrasound scar thickness, the Patient and Observer Scar Assessment Scale (POSAS), and the Brisbane Burn Scar Impact Scale (BBSIP), measured at baseline and 3, 6, and 12 months after the first AFCO2L treatment. Analysis used mixed effects linear models.</div></div><div><h3>Results</h3><div>47 patients were included with median age 32 years (IQR: 24, 53) and median burn TBSA of 35 % (IQR: 7.5 %, 48 %). Statistically significant improvements between baseline and 12-month follow-up occurred in scar thickness, and all POSAS and BBSIP subscores. Most improvements remained when accounting for TBSA, Fitzpatrick skin type, scar maturity, and body area treated. Patients reported transient symptoms after 61 of 89 (69 %) AFCO2L treatments, but infection or delayed wound healing occurred after only 4 of 89 (4 %) treatments.</div></div><div><h3>Conclusion</h3><div>This study supports safety and improved clinician and patient-reported outcomes in patients undergoing AFCO2L for hypertrophic burn scars.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 1","pages":"Article 107300"},"PeriodicalIF":3.2,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on Promising anti-inflammatory activity of a novel designed anti-microbial peptide for wound healing","authors":"Chunfu Wei,&nbsp;Wenhao Wang,&nbsp;Xuejuan Zhang","doi":"10.1016/j.burns.2024.107301","DOIUrl":"10.1016/j.burns.2024.107301","url":null,"abstract":"","PeriodicalId":50717,"journal":{"name":"Burns","volume":"50 9","pages":"Article 107301"},"PeriodicalIF":3.2,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}