Burns最新文献

{"title":"Cement burns among manual labourers in the UK: An urgent call for improved safety measures and education.","authors":"Dana Elsalman, Omar Alnobani, Karl Walsh","doi":"10.1016/j.burns.2024.09.001","DOIUrl":"https://doi.org/10.1016/j.burns.2024.09.001","url":null,"abstract":"","PeriodicalId":50717,"journal":{"name":"Burns","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331727","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":"Single-cell sequencing analysis and bulk-seq identify IGFBP6 and TNFAIP6 as novel differential diagnosis markers for postburn pathological scarring.","authors":"Chi Zhong, Ke Shi, Peiting Li, Xiaohui Qiu, Xianrui Wu, Shuyue Chen, Yang Liu, Fuying Li, Zitong Zhao, Jianda Zhou, Geao Liang, Dan Xu","doi":"10.1016/j.burns.2024.08.021","DOIUrl":"https://doi.org/10.1016/j.burns.2024.08.021","url":null,"abstract":"<p><strong>Background: </strong>If not accurately diagnosed and treated, postburn pathological scars, such as keloids and hypertrophic scars, can lead to negative clinical outcomes. However, differential diagnosis at the molecular level for postburn pathological scars remains limited. Using single-cell sequencing analysis, we investigated the genetic nuances of pathological scars at the cellular level. This study aimed to identify molecular diagnostic biomarkers to distinguish between postburn keloids and hypertrophic scars.</p><p><strong>Methods: </strong>Single-cell sequencing, differential expression, and weighted co-expression network analyses were performed to identify potential key genes for discriminating between keloids and hypertrophic scars. Postburn clinical samples were collected from our centre to validate the expression levels of the identified key genes.</p><p><strong>Results: </strong>Single-cell sequencing analysis unveiled 29 and 30 cell clusters in keloids and hypertrophic scars, respectively, predominantly composed of fibroblasts. Bulk differential gene analysis showed 96 highly expressed genes and 69 lowly expressed genes in keloids compared to hypertrophic scars. By incorporating previous research, Gene Set Enrichment Analysis was conducted to select fibroblasts as the focus of research. According to the single-cell data, 301 genes were stably expressed in fibroblasts from both types of pathological scars. Consistently, Weighted Gene Co-expression Network Analysis revealed that the blue module genes were mostly hub genes associated with fibroblasts. After intersecting fibroblast-related genes in single-cell data, Weighted Gene Co-expression Network Analysis-hub module genes, and bulk differential expression genes, insulin-like growth factor binding protein 6 and tumour necrosis factor alpha-induced protein 6 were identified as key genes to distinguish keloids from hypertrophic scars, resulting in diagnostic accuracies of 1.0 and 0.75, respectively. Immunohistochemical Staining and Quantitative Reverse Transcription PCR revealed that the expression levels of tumour necrosis factor alpha induced protein 6 and insulin-like growth factor binding protein 6 were significantly lower in postburn keloids than in hypertrophic scars- CONCLUSIONS: Tumour necrosis factor alpha induced protein 6 and insulin-like growth factor binding protein 6, exhibiting high diagnostic accuracy, provide valuable guidance for the differential diagnosis and treatment of postburn pathological scars.</p>","PeriodicalId":50717,"journal":{"name":"Burns","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331781","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":"Predictive values of methicillin-resistant Staphylococcus aureus nasal swabs for pneumonia in burn ICU patients.","authors":"Zachary Carlson, Robyn Stoianovici, Sierra Young, Jeremiah Duby, Erin Louie","doi":"10.1016/j.burns.2024.08.025","DOIUrl":"https://doi.org/10.1016/j.burns.2024.08.025","url":null,"abstract":"<p><strong>Introduction/objective: </strong>This retrospective cohort study aimed to determine the sensitivity, specificity, and positive (PPV) and negative predictive values (NPV) of MRSA nasal swabs for pneumonia in burn-injured intensive care unit (ICU) patients.</p><p><strong>Methods: </strong>Patients 18 years or older admitted to the Burn ICU at a tertiary medical center from 2016 to 2021 were included if they had any burns, a pneumonia ICD-10 code, an MRSA nasal swab obtained during admission, and any respiratory cultures associated with at least five consecutive days of antibiotics.</p><p><strong>Results: </strong>There were 267 occurrences of pneumonia across 136 patients. MRSA nasal swabs had an overall sensitivity of 39 %, specificity of 98.7 %, PPV of 84.2 %, and NPV of 89.9 %. MRSA nasal swabs obtained less than seven days from antibiotic initiation had a specificity of 98.6 % and NPV of 98.6 %; meanwhile, swabs obtained at least seven days from antibiotic initiation had a specificity of 98.7 % and NPV of 86.4 %.</p><p><strong>Conclusions: </strong>The high specificity and NPV indicate that negative MRSA nasal swabs obtained less than seven days from antibiotic initiation may be used to de-escalate anti-MRSA antibiotics in clinically stable burn-injured patients with suspicion of pneumonia. The decrease in NPV suggests that it may be beneficial to obtain a repeat swab periodically.</p>","PeriodicalId":50717,"journal":{"name":"Burns","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331779","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":"Does the heat source affect the risk of wound infection in children with scalds?","authors":"Matilda Karlsson, Arthur Johnson, Ingrid Steinvall, Laura Pompermaier","doi":"10.1016/j.burns.2024.08.023","DOIUrl":"https://doi.org/10.1016/j.burns.2024.08.023","url":null,"abstract":"<p><strong>Introduction: </strong>Scalds are the leading cause of burns in children younger than 5 years of age with most being related to food preparation and consumption. Hot substances causing scalds have different degrees of viscosity varying from low (liquid substances, such as water), to high (semi-solids or solids, such as oils or grease). It is still underknown whether heat substances with different viscosities are associated with varying risks of developing burn wound infections (BWI). The aim of this study was to investigate the association between heat sources of different viscosities and development of BWI within the first week after injury in children with scalds.</p><p><strong>Method: </strong>Children 5 years and younger of age admitted at the Linköping Burn Center for new scalds between 2015 and 2020 were included. Data source for the study population was the Burn Unit Database. BWI was defined as fulfilment of at least two ABA criteria at the time of systemic antibiotic therapy (AB) initiation between day 2-7 following scald. Medical record review was undertaken to identify the heat source causing the scald, BWI criteria, and the use of AB. Legal guardians were contacted in cases in which information was missing. Logistic regression was used to analyse the association between heat source and development of BWI.</p><p><strong>Result: </strong>The study population consisted of 271 children, median age was 1.5 years, 61 % were boys, median burn size was 3.5 % of the total body surface area (TBSA), 10 (4 %) had a full thickness burn. BWI were identified in 69 (26 %) of the children. Most scalds were caused by contact with hot liquids (n=184), followed by semisolids (n=52) and solids (n=35). The logistic regression model showed that the size of the burn (TBSA) was associated with BWI, while type of heating agent was not.</p><p><strong>Conclusion: </strong>Our results indicate that the viscosity of the heat source does not affect the risk of wound infection in children with scalds; only the size of the area burned was an independent factor for BWI.</p>","PeriodicalId":50717,"journal":{"name":"Burns","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331739","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 treatment effect of operative intervention for flame versus scald burns in resource-limited settings","authors":"Sarah Peiffer, Linda Kayange, Selena An, Olivia Boddie, Anthony Charles, Jared Gallaher","doi":"10.1016/j.burns.2024.08.014","DOIUrl":"https://doi.org/10.1016/j.burns.2024.08.014","url":null,"abstract":"In resource-limited environments, it is critical to triage burn patients most likely to benefit from operative intervention. This study sought to identify patients with a more significant treatment effect after operative intervention following burn injury at a tertiary burn center in Lilongwe, Malawi. This is a retrospective analysis of burn patients presenting to Kamuzu Central Hospital from 2011 to November 2022. We compared patients based on whether they had scald or flame burns. Using logistic regression, we estimated the adjusted treatment effect of operative intervention on in-hospital mortality. Operative intervention was defined as burn excision and debridement with or without skin grafting. We included 3266 patients. 2099 (64.7 %) patients had a scald burn, and 1144 (35.3 %) had a flame burn. 630 patients (19.3 %) underwent surgery. Crude mortality among all patients was 18.1 %, and for patients who underwent surgery, it was 9.7 %. When adjusted for %TBSA (total burn surface area) and age, the average treatment effect of surgery on mortality was − 0.07 (95 % CI − 0.11, − 0.033) for patients with scald burns and − 0.17 (95 % CI − 0.22, − 0.11) for patients with flame burns (Fig. 1). For patients with flame burns, the adjusted odds ratio of death associated with surgery was 0.26 (95 % CI 0.17, 0.39). Operative intervention confers a survival advantage for patients with flame burns, and the average treatment effect was more significant compared to patients with scald burns. In resource-limited environments, flame burns should be prioritized for surgery over scald burns to improve patient outcomes.","PeriodicalId":50717,"journal":{"name":"Burns","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142186267","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":"Clinical comparison study of square flap method and five-flap Z-plasty technique for correction of post-burn axillary contractures: Analysis of length gain and evaluation of functional outcome","authors":"Mahmoud A. Hifny, Ahmed Gaber Abdelmegeed","doi":"10.1016/j.burns.2024.08.012","DOIUrl":"https://doi.org/10.1016/j.burns.2024.08.012","url":null,"abstract":"While there is no consensus on the best surgical procedure for post-burn axillary contractures, it is crucial to consider the elongation rate along the scar axis as a useful measurement index for determining the optimal surgical approach. The square flap and five flap z-plasty techniques are commonly employed scar lengthening procedures to address scar contractures in the axilla. These approaches successfully disrupt the linear scar, leading to significant elongation while reducing transverse tension. Our study aims to compare the increase in band length and functional results of these two approaches for treating post-burn contractures in the axilla. A retrospective study was carried out utilizing data from 34 patients with mild-to-moderate band-like contractures located on the anterior or posterior axillary lines and underwent surgical correction through either the square flap technique or five-flap z-plasty method. The effectiveness of surgical methods was evaluated using two objective indices: improvement in contracture band length and improvement in abduction angle at the shoulder joint. All patients achieved complete contracture release. There is no statistically significant difference between the two groups regarding the improvement in the degree of abduction postoperatively. Although there was a significant increase in the length of the contracture band postoperatively in both groups, the average increase in length for cases treated with a square flap was significantly greater than those managed with a five-flap Z-plasty (87.7381 ± 44.8192 % vs. 38.80 ± 11.119 %,) respectively. The square flap technique is considered a better alternative to the commonly used 5-flap Z-plasty method because it can achieve higher elongation in the contracture band, restore joint function, and create optimal shape when dealing with single linear band contractures over the axilla.","PeriodicalId":50717,"journal":{"name":"Burns","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142186269","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 added value of cultured cells in burn treatment: A systematic review","authors":"Marie Simaey, Ignace De Decker, Florian Vanlauwe, Phillip Blondeel, Stan Monstrey, Karel E.Y. Claes","doi":"10.1016/j.burns.2024.08.013","DOIUrl":"https://doi.org/10.1016/j.burns.2024.08.013","url":null,"abstract":"Advancements in resuscitative care and burn surgery have improved survival rates after extensive burn injuries, shifting focus to enhancing the quality of survival. Conventional treatment with split-thickness skin grafts (STSG) presents limitations like donor-site morbidity, limited availability in extensive burn injuries, and hypertrophic scarring (HTS). Tissue engineering aims to address these drawbacks by developing optimal skin substitutes. This systematic review aims to provide an overview of the current applications of cultured cells in burn surgery, encompassing diverse approaches and addressing existing challenges to enhance burn wound management and improve patient outcomes. Following PRISMA guidelines, a comprehensive search was performed across three databases (PubMed, Embase, Cochrane Library) for articles on cultured cell use in burn treatment. Only clinical studies were included. Articles were screened by two independent reviewers. Quality assessment was performed. The search yielded 167 articles of which 14 met the eligibility criteria. The selection included 8 randomized controlled trials (RCT), 5 prospective cohort trials, and 1 retrospective cohort study. Various tissue-engineered skin substitutes, from cultured epidermal autografts (CEA) to dermal regeneration templates (DRT) seeded with cultured cells, showed promising outcomes. Several substitutes exhibited take rates comparable to STSG with improved scar quality. Results are promising, though standardization of cultured skin substitutes and robust clinical trials with larger populations and appropriate comparators are still lacking.","PeriodicalId":50717,"journal":{"name":"Burns","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142186268","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":"Wounds within: The hidden scars of violent care.","authors":"Xin Zhang, Xiu-Hang Zhang","doi":"10.1016/j.burns.2024.08.011","DOIUrl":"https://doi.org/10.1016/j.burns.2024.08.011","url":null,"abstract":"","PeriodicalId":50717,"journal":{"name":"Burns","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146785","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":"Risk factors besides lamotrigine associated Stevens-Johnson Syndrome and toxic epidermal necrolysis.","authors":"Kaveh Gharaei Nejad, Reyhaneh Ghadarjani","doi":"10.1016/j.burns.2024.08.007","DOIUrl":"https://doi.org/10.1016/j.burns.2024.08.007","url":null,"abstract":"","PeriodicalId":50717,"journal":{"name":"Burns","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134335","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":"Enhancing the evaluation of burn scar quality.","authors":"Hojat Eftekhari","doi":"10.1016/j.burns.2024.08.009","DOIUrl":"https://doi.org/10.1016/j.burns.2024.08.009","url":null,"abstract":"","PeriodicalId":50717,"journal":{"name":"Burns","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134333","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}