Burns最新文献

{"title":"Does the dressing matter in pediatric partial-thickness burns: a systematic review and meta-analysis","authors":"Milly S van de Warenburg ,&nbsp;Bente Teeuwen ,&nbsp;Stefan Hummelink ,&nbsp;Dietmar JO Ulrich ,&nbsp;Mariëlle LAW Vehmeijer-Heeman","doi":"10.1016/j.burns.2025.107428","DOIUrl":"10.1016/j.burns.2025.107428","url":null,"abstract":"<div><div>Superficial partial thickness burns typically receive nonoperative treatment, whereas deep partial thickness burns, which are prone to hypertrophic scarring, are usually managed through debridement followed by autologous split-thickness skin grafting. Various therapies have been developed to prevent wound infection and to enhance wound healing in pediatric partial-thickness burns. However, the choice of dressing by the surgeon can be influenced by various factors. It is worth noting that there is no standardized approach across all burn centers, leading to variations in care practices. To optimize pediatric patient care, a systematic review was conducted following PRISMA guidelines to review existing treatment options for partial thickness burns in children. Outcomes of interest were wound healing time, dressing changes, length of hospital stay, wound infections, need for grafting despite treatment, and hypertrophic scarring. A total of 68 studies with 8199 patients were included. The mean age of the included patients was 3.1 years, and the mean total body surface area of the burns was 15.6 %. Treatment groups included topical agents, bandages, skin analogues, or unclassified. Considering all treatment outcomes evaluated in this systematic review of the literature, non-silver dressings and skin analogues may have some benefit over topical agents in terms of wound healing time, length of hospital stay, hypertrophic scarring, pain management, and cost saving. Dressing changes, wound infections, and need for grafting did not significantly change between various treatments.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 4","pages":"Article 107428"},"PeriodicalIF":3.2,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143619301","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 use of silk dressings in the treatment of skin injuries: A systematic review","authors":"Leen Vermoesen ,&nbsp;Ignace De Decker ,&nbsp;Jozef Verbelen ,&nbsp;Henk Hoeksema ,&nbsp;Kimberly De Mey ,&nbsp;Petra De Coninck ,&nbsp;Julie van Durme ,&nbsp;Nathalie Roche ,&nbsp;Stan Monstrey ,&nbsp;Karel E.Y. Claes","doi":"10.1016/j.burns.2025.107426","DOIUrl":"10.1016/j.burns.2025.107426","url":null,"abstract":"<div><h3>Background</h3><div>Skin injuries like superficial burns and skin graft donor sites are currently managed using various dressings. Frequent challenges include discomfort and trauma during dressing changes, suboptimal healing and significant scarring. Silk dressings show promise by reducing the need for frequent changes, allowing wound evaluation due to its transparency, exerting antibacterial properties, and minimizing scarring. However, silk is not yet widely adopted in clinical settings.</div></div><div><h3>Methods</h3><div>A systematic review was conducted. A search through 3 databases (PubMed, Embase, Cochrane Library) according to the PRISMA guidelines was performed. Only RCTs, cohort studies, case-control studies and case series were included. Appropriate quality tests were performed.</div></div><div><h3>Results</h3><div>1373 search results were identified. After deduplication, 979 were screened by title and abstract, of which 20 full-text articles remained and ultimately, 9 articles were included. Parameters examined were: healing duration, pain, subjective and objective skin measurements, adverse events, infection rates, transparency and price.</div></div><div><h3>Conclusion</h3><div>Silk dressings demonstrate comparable efficacy to existing dressings concerning transparency, healing time, pain, erythema, pigmentation, water loss normalization, firmness, visco-elasticity recovery, microcirculation, adverse events and infection rates. They are an economically interesting alternative for managing superficial partial-thickness skin burns and skin graft donor sites. Nonetheless, larger high-quality studies are needed to confirm these findings.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 4","pages":"Article 107426"},"PeriodicalIF":3.2,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143480591","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":"Do allografts present a risk to burn patients? Allografts and HLA-sensitization","authors":"Joshua Tsai ,&nbsp;Luka Kim ,&nbsp;Isabel Jones ,&nbsp;Samuel Culbert ,&nbsp;Tuna Ozyurekoglu","doi":"10.1016/j.burns.2025.107424","DOIUrl":"10.1016/j.burns.2025.107424","url":null,"abstract":"<div><h3>Objective</h3><div>This meta-analysis aimed to quantify sensitization rates following allograft usage and determine whether allografts have an increased risk of long-term sensitization compared to alternative therapies in burn patients.</div></div><div><h3>Methods</h3><div>Systematic review, meta-analysis and meta-regression of post-operative sensitization in burn patients were performed following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidance (Prospero registration: CRD42024497137). Database searches were conducted on MEDLINE, Embase, CENTRAL using ProQuest Dialog.</div><div>We included all studies reporting post-operative sensitization in burn patients that were not case series or singular case reports. Meta-analysis was used to compare the risk of sensitization for allograft versus alternative therapies.</div></div><div><h3>Results</h3><div>Six studies (Allograft Patients: 71; Non-Allograft Patients: 95) were included (n = 166). Overall, 73 % (CI: 39 %-92 %) of burn patients were sensitized following allograft. Patients receiving allograft were at a significantly increased risk of sensitization (OR 13.14 [95 % CI: 1.32–131.00]). However, on sub-group analysis, when directly comparing patients who received allograft and transfusion versus those who received transfusion alone, there was not a significantly increased risk of sensitization (OR 7.68 [95 % CI:.61–95.86]).</div></div><div><h3>Conclusion</h3><div>Allograft is associated with a significantly increased risk of sensitization in burn patients. However, it is not clear whether burn patients already receiving transfusion will have an increased risk of sensitization from adding allograft. Further studies are required to demonstrate the multifactorial causes of sensitization within the burned population to explain the significance of the contribution from allograft and/or transfusion reported within the literature. Clinicians must carefully weigh the immediate benefits of allografts against the potential long-term challenges of sensitization, especially where alternative wound therapies are possible.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 4","pages":"Article 107424"},"PeriodicalIF":3.2,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143685656","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":"Continuous renal replacement therapy fluid for burn resuscitation: A solution during nationwide fluid shortages","authors":"MAJ Lucas Bryant,&nbsp;LTC Scott Sullivan,&nbsp;LTC Alicia Williams","doi":"10.1016/j.burns.2025.107400","DOIUrl":"10.1016/j.burns.2025.107400","url":null,"abstract":"","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 4","pages":"Article 107400"},"PeriodicalIF":3.2,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143628612","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":"Corrigendum to “Th1/Th2 cytokine levels: A potential diagnostic tool for patients with necrotizing fasciitis” [Burns 49 (2023) 200–208]","authors":"Xiang-Wei Ling ,&nbsp;Ting-Ting Zhang ,&nbsp;Meng-Meng Ling ,&nbsp;Wei-Hao Chen ,&nbsp;Chun-Hui Huang ,&nbsp;Guo-Liang Shen","doi":"10.1016/j.burns.2024.107371","DOIUrl":"10.1016/j.burns.2024.107371","url":null,"abstract":"","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 3","pages":"Article 107371"},"PeriodicalIF":3.2,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143350212","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":"Assessing the efficacy and safety of calcium gluconate soaking as a treatment modality for hydrofluoric acid burns","authors":"Chi-Syuan Pan ,&nbsp;Chi-Chan Lee ,&nbsp;Jiun-Hao Yu ,&nbsp;Han-Wei Mu ,&nbsp;Dong-Zong Hung ,&nbsp;Chun-Hung Chen","doi":"10.1016/j.burns.2025.107422","DOIUrl":"10.1016/j.burns.2025.107422","url":null,"abstract":"<div><h3>Introduction</h3><div>Hydrofluoric acid is extremely toxic and can corrode tissues while reacting with calcium and magnesium, leading to severe tissue damage. The antidote, calcium gluconate, is effective for treating mild to moderate burns. However, our hospital lacks registered calcium gluconate gel, making treatment challenging. We investigated alternative soaking methods due to scant literature on this approach.</div></div><div><h3>Methods</h3><div>This retrospective case series study reviews hydrofluoric acid burn cases at China Medical University Hospital from 2004 and 2020, focusing on the effectiveness of calcium gluconate soaking. Among 29 patients treated for hydrofluoric acid burns in our emergency department, treatments included nail removal and debridement, but all received calcium gluconate soaks without requiring calcium injections.</div></div><div><h3>Results</h3><div>In our emergency department, 29 patients with hydrofluoric acid burns were treated; 8 required hospitalization and one was admitted to the intensive care unit. Burns varied widely in acid concentration (0.03 %-49 %) and size (1.60 ± 2.93 % body surface area). Treatments included nail removal for one patient and debridement for four. All patients underwent calcium gluconate soaking; none received intra-arterial or subcutaneous injections. There were no fatalities or significant electrolyte imbalances.</div></div><div><h3>Discussion</h3><div>Calcium gluconate soaking is effective for treating mild HF burns in the absence of gel. However, the lack of a control group limits the ability to compare its efficacy to other treatments.</div></div><div><h3>Conclusion</h3><div>Calcium gluconate soaking may serve as a practical alternative for treating minor HF burns.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 4","pages":"Article 107422"},"PeriodicalIF":3.2,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143619303","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":"Can seeing the photos of patients' faces before burns affect nurses' quality of care?","authors":"Mohammad Ali Majdoddin,&nbsp;Masoud Yavari,&nbsp;Samad Karkhah,&nbsp;Mostafa Saeedinia","doi":"10.1016/j.burns.2025.107423","DOIUrl":"10.1016/j.burns.2025.107423","url":null,"abstract":"","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 4","pages":"Article 107423"},"PeriodicalIF":3.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143579485","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":"Open label randomized controlled trial of the efficacy and safety of NexoBrid compared to standard of care in children with burns","authors":"Yaron Shoham ,&nbsp;Lior Rosenberg ,&nbsp;RP Narayan ,&nbsp;Raphael Staubach ,&nbsp;Ruzsena Bene ,&nbsp;Mohan Kakola ,&nbsp;Stan J. Monstrey ,&nbsp;Yvonne Wilson ,&nbsp;Manoj Jha ,&nbsp;Giavonni M. Lewis ,&nbsp;Shawn Larson ,&nbsp;Adam J. Singer","doi":"10.1016/j.burns.2025.107417","DOIUrl":"10.1016/j.burns.2025.107417","url":null,"abstract":"<div><h3>Objectives</h3><div>This study evaluated the safety and efficacy of an enzymatic bromelain-based debridement (BBD) agent (NexoBrid®) in children with deep thermal burns.</div></div><div><h3>Methods</h3><div>We conducted a multicenter, open-label, parallel design, randomized controlled trial at 36 burn centers in Europe, US, Israel and India. Main eligibility criteria included children 0–18 years old, suffering from deep thermal burns covering 1–30 % of their total body surface area. Patients were randomized to either BBD or standard of care (SOC) eschar removal methods. Primary endpoints included time to complete eschar removal (superiority), percentage of wound area surgically excised (superiority) and blinded 12 months follow-up assessment of cosmesis and function using the Modified Vancouver Scar Scale (MVSS, non-inferiority).</div></div><div><h3>Results</h3><div>One hundred and forty-five children were enrolled between 2015 and 2020 (last patient completed 12-month follow-up on April 2021); 72 were randomized to BBD and 73 to SOC. All three primary endpoints of the study were met. The median time to complete eschar removal was significantly lower in the BBD arm (1 vs. 6 days, <em>P</em> &lt; 0.001). The mean [SD] percentage of wound area surgically excised was also significantly lower in the BBD arm (1.5 % [12.1 %] vs. 48.1 % [46.6 %], <em>P</em> &lt; 0.001). Mean [SD] 12-month MVSS scores were 3.8 [2.9] and 4.9 [3.3] in the BBD and SOC arms, respectively (non-inferiority demonstrated at P &lt; 0.001). The incidence of adverse events was similar between the groups, and there were no significant safety issues or deaths during the trial.</div></div><div><h3>Conclusions</h3><div>BBD was demonstrated to be safe and effective in children. Its use lead to a shorter time to complete eschar removal, a reduction in excisional surgery and non-inferior cosmesis and function results as compared to SOC eschar removal methods.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 4","pages":"Article 107417"},"PeriodicalIF":3.2,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674196","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":"Identification and validation of immune-related biomarkers and polarization types of macrophages in keloid based on bulk RNA-seq and single-cell RNA-seq analysis","authors":"Yuzhu Zhang ,&nbsp;Chenglong Fang ,&nbsp;Lizhong Zhang ,&nbsp;Fengyu Ma ,&nbsp;Meihong Sun ,&nbsp;Ning Zhang ,&nbsp;Nan Bai ,&nbsp;Jun Wu","doi":"10.1016/j.burns.2025.107413","DOIUrl":"10.1016/j.burns.2025.107413","url":null,"abstract":"<div><h3>Introduction</h3><div>Keloids are a common complication that occurs after injury. The pathogenesis of this disease remains unknown. Therefore, identifying immune-related biomarkers and macrophage polarization types in keloids can provide new insights into their treatment.</div></div><div><h3>Methods</h3><div>In this study, keloid-related bulk RNA-seq data (GSE83286, GSE212954, GSE92566, and GSE90051) were obtained from the Gene Expression Omnibus (GEO) database. The datasets GSE83286, GSE212964, and GSE92566 were combined to form a training set, while GSE90051 was utilized as an external validation set. Differentially expressed genes (DEGs) were detected by comparing keloid and normal samples within the training set. Differentially expressed immune-related genes (DIRGs) were then determined by intersecting the DEGs with immune-related genes (IRGs). Based on the protein-protein interaction (PPI) network, the top 40 DIRGs were selected for further analyses. Weighted Gene Co-expression Network Analysis (WGCNA), in conjunction with three machine learning techniques - least absolute shrinkage and selection operator (LASSO), support vector machine-recursive feature elimination (SVM-RFE), and random forest (RF) - employed to identify biomarkers. Subsequently, a nomogram model was constructed and validated. Single-cell RNA (scRNA) analysis was used to examine the expression of biomarkers at the cell-type level. Furthermore, since keloid is a chronic inflammatory disease and the abnormal polarization of macrophages is essential for the occurrence of this kind of disease, in this study we also endeavor to elucidate the state of macrophage polarization dysregulation within keloid, with the anticipation of generating novel concepts for the treatment of keloid. Finally, western blot (WB) and immunofluorescence (IF) analyses were carried out to confirm the expression levels of the biomarkers.</div></div><div><h3>Results</h3><div>A total of 740 DEGs were identified in the training set, comprising 331 up-regulated genes and 409 down-regulated genes. After intersecting with the IRGs, 73 DIRGs were obtained. Subsequently, the top 40 DIRGs were chosen for further analysis. Eventually, two biomarkers, namely BMP1 and IL1R1, were identified through WGCNA and the three machine learning methods. Their expression levels were then verified by single-cell analysis, WB, and IF analysis. Additionally, it was found that the number of M2 macrophages significantly increased, while the number of M1 macrophages decreased in keloids compared to normal samples.</div></div><div><h3>Conclusion</h3><div>BMP1 and IL1R1 might function as novel biomarkers and potential therapeutic targets for keloid treatment. Moreover, upregulating M1 macrophages and downregulating M2 macrophages could represent a promising approach for the treatment of keloids.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 3","pages":"Article 107413"},"PeriodicalIF":3.2,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143372480","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":"Impact of pre-existing cancer diagnoses on burn injury survival and morbidity","authors":"Phillip Keys ,&nbsp;Kassandra Corona ,&nbsp;Sheldon McCown ,&nbsp;Lyndon Huang ,&nbsp;Elvia Villarreal ,&nbsp;Jasmine Chaij ,&nbsp;Giovanna De La Tejera ,&nbsp;Douglas S. Tyler ,&nbsp;George Golovko ,&nbsp;Amina El Ayadi ,&nbsp;Juquan Song ,&nbsp;Steven E. Wolf","doi":"10.1016/j.burns.2025.107414","DOIUrl":"10.1016/j.burns.2025.107414","url":null,"abstract":"<div><h3>Objectives</h3><div>Severe burns place patients in a compromised state, especially those with pre-existing chronic diseases such as malignancy. Due to improvements in detection and treatment, cancer mortality has declined significantly, leaving a growing population of cancer survivors. Therefore, we wondered whether pre-existing cancer diagnoses influence patient outcomes following burn injury.</div></div><div><h3>Methods</h3><div>46,275 patients with a neoplasm diagnosis prior to experiencing a burn injury were identified using the TriNetX research network. Two control groups were organized: 1) cancer patients without burns and 2) burn patients with no history of cancer. The test group included patients with a pre-existing cancer diagnosis who received a subsequent burn injury. Outcomes included death, sepsis, nutritional deficiency, eating disorder, immunodeficiency, and depression. Odds ratios were calculated with 95 % confidence intervals.</div></div><div><h3>Results</h3><div>Of the nearly 10 million cancer patients, 0.45 % experienced a burn injury after diagnosis. Compared to propensity-matched burned patients without cancer, burned patients with a previous cancer diagnosis had increased odds of developing sepsis (2.013, 1.895–2.138), nutritional deficiency (1.874, 1.58–2.221), immunodeficiency (5.584, 4.85–7.06), eating disorder (2.384, 1.947–2.918), and depression (1.772, 1.695–1.853). The odds ratios of sepsis (1.718, 1.612–1.83), nutritional deficiency (1.963, 1.593–2.418), immunodeficiency (1.265, 1.098–1.459), eating disorder (2.569, 2.077–3.177), and depression (1.538, 1.468–1.611) were increased when compared to cancer patients without burn injury. Burned patients with a previous neoplasm of hematologic origin fared worse in the odds of developing the mentioned outcomes compared to those with solid neoplasms. Lastly, burned patients with any previous neoplasm who later received chemotherapy and/or radiation suffered worse outcomes than those who never received such treatment.</div></div><div><h3>Conclusion</h3><div>Patients who developed neoplasms before receiving a burn injury demonstrated considerable increases in odds of poor outcomes. Increased odds of developing poor outcomes were greater in those with hematologic neoplasms and those who received chemotherapy or radiation treatment.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 3","pages":"Article 107414"},"PeriodicalIF":3.2,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143377848","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}