Burns最新文献

{"title":"Human platelet lysate–loaded collagen–poloxamer foam dressing for the management of deep partial-thickness burns","authors":"Marc A. Thompson ,&nbsp;David Larson ,&nbsp;Kim Brown ,&nbsp;Donald Brown ,&nbsp;Kristo Nuutila","doi":"10.1016/j.burns.2025.107825","DOIUrl":"10.1016/j.burns.2025.107825","url":null,"abstract":"<div><h3>Background</h3><div>Burn injuries remain a significant public health concern worldwide, leading to substantial morbidity, mortality, and healthcare costs. They are also common in military conflicts and have been a major concern in the ongoing war in Ukraine, often necessitating rapid evacuation and specialized medical care. There is a pressing need for effective burn management strategies that promote healing, reduce the risk of infection, and improve patient outcomes. In this study, we introduce a human platelet lysate (HPL)-containing poloxamer–collagen matrix, named AlloPLEX™️, for use in burn care.</div></div><div><h3>Methods</h3><div>AlloPLEX™ degradation, growth factor release, and bioactivity were characterized <em>in vitro</em>. <em>In vivo</em>, deep partial-thickness burns were induced on anesthetized pigs, with four treatment groups 1) high HPL (7.3 g) AlloPLEX™ (HHA), 2) low HPL (3.65 g) AlloPLEX™ (LHA), (3) no HPL AlloPLEX™ (Vehicle control, VC), and 4) Silverlon (SoC). Analgesia was provided prior to all surgical procedures. Punch biopsies were harvested on days 0 and 3; after euthanasia on day 28, the burns were excised for histologic analyses. Non-invasive imaging was utilized to assess burns macroscopically.</div></div><div><h3>Results</h3><div><em>In vitro</em>, it was shown that the foam is biodegradable, epidermal growth factor (EGF) and platelet derived growth factor (PDGF) release efficiently from the matrix, and it improves human mesenchymal stem cell (hMSC) proliferation. In vivo, the LHA group mitigated burn wound progression when compared to the SoC group. In terms of wound healing and quality of healing no differences were seen.</div></div><div><h3>Conclusions</h3><div>AlloPLEX™ is a novel bioactive and biodegradable foam dressing. It is lightweight and easy-to-use. The results demonstrated its potential as a burn care dressing.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"52 1","pages":"Article 107825"},"PeriodicalIF":2.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145726689","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 enzymatic debridement reduce the occurrence of hypertrophic scarring in intermediate depth burns?","authors":"Kimberly De Mey ,&nbsp;Julie van Durme ,&nbsp;Jozef Verbelen ,&nbsp;Ignace De Decker ,&nbsp;Henk Hoeksema ,&nbsp;Tine Nuyttens ,&nbsp;Petra De Coninck ,&nbsp;Nathalie Roche ,&nbsp;Stan Monstrey ,&nbsp;Karel E.Y. Claes","doi":"10.1016/j.burns.2025.107819","DOIUrl":"10.1016/j.burns.2025.107819","url":null,"abstract":"<div><h3>Background</h3><div>Hypertrophic scarring (HTS) is a major concern after burns. While conservative therapy is standard for superficial partial thickness burns and debridement for deep burns, the optimal treatment for intermediate depth burns remains unclear. This retrospective study assesses whether enzymatic debridement with Nexobrid® (EDNX) can reduce HTS in intermediate depth burns.</div></div><div><h3>Methods</h3><div>Patients with intermediate depth burns (healing potential (HP) 14–21 days), assessed by laser Doppler imaging (LDI), were retrospectively analysed for HTS following conservative therapy or EDNX. Regions of interest (ROIs) were analysed for flux values, surface area, and wound closure time. HTS within ROIs was evaluated at 3–6, 6–12, and 12–24 months post-injury, independently by two burn specialists.</div></div><div><h3>Results</h3><div>In total, 87 ROIs were analyzed in 62 patients, with 44 ROIs treated conservatively and 43 ROIs treated with EDNX. HTS was still present after 12 months in 13.6 % (6/44) of ROIs in the conservative group and 9.3 % (4/43) in the EDNX group, showing no statistically significant difference between the two groups (p = 0.186). The conservative group and EDNX group were comparable, with no statistically significant difference in flux values (346.41 ± 22.90 vs. 340.19 ± 20.75, p = 0.275) or wound closure time (22.70 ± 7.90 vs. 23.42 ± 7.47, p = 0.862). A statistically significant correlation was found between HTS formation and wound closure time (p = 0.001); however, no significant correlation was observed between HTS formation and flux values (p = 0.262).</div></div><div><h3>Conclusion</h3><div>The overall incidence of HTS after scar maturation was low in both the conservative group (13.6 %) and in the EDNX group (9.3 %). A small, but in significant difference was observed in HTS prevalence between intermediate depth burns treated conservatively and those treated with EDNX. These findings support conservative management through local wound care as the preferred approach for intermediate depth burns.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"52 1","pages":"Article 107819"},"PeriodicalIF":2.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736159","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":"Factors associated with prolonged mechanical ventilation in the burn patient","authors":"Sofía Kohn,&nbsp;Alejandra Stolovas,&nbsp;Florencia Urrestarazu,&nbsp;Eliana Robatto,&nbsp;Juan Silva,&nbsp;Ignacio Aramendi","doi":"10.1016/j.burns.2025.107813","DOIUrl":"10.1016/j.burns.2025.107813","url":null,"abstract":"<div><h3>Introduction</h3><div>We evaluated the incidence of short-term mechanical ventilation (STMV) in patients admitted to our national burn centre (CENAQUE) and clinical findings (CF) associated with prolonged mechanical ventilation (PMV).</div></div><div><h3>Methods</h3><div>Retrospective review of all burn adults admitted to CENAQUE with endotracheal intubation (EI) between 2010 and 2023. Data included demographics, injury characteristics, and CF at intubation. Patients were categorised as ≤ 2 days ventilation (STMV) or &gt; 2 days (PMV). Multivariable logistic regression analysed associations between CF and PMV. Sensitivity (SE), specificity (SP), positive predictive value (PPV), and negative predictive value (NPV) were calculated for each CF.</div></div><div><h3>Results</h3><div>Among 973 patients, STMV incidence was 42.3 % (n = 412). PMV was significantly associated with total body surface area burn (TBSA) (OR 1.094; 1.076–1.113; p &lt; 0.001), age (OR 1.031; 1.022–1.040; p &lt; 0.001), full-thickness facial burn (FTFB) (OR 2.152; 1.131–4.096; p = 0.020), shock (OR 10.662; 3.623–31.375; p &lt; 0.001), and oral oedema (OR 0.590; 0.368–0.944; p = 0.028). Shock (SE 21.2 %, SP 99.0 %) and FTFB (SE 24.6 %, SP 95.4 %) were the most sensitive and specific CF for detecting PMV, with high PPV (96.7 % and 87.8 %) but low NPV (48.1 % and 48.3 %), respectively. In patients with TBSA &lt; 20 %, NPV increased to 60.6 % for shock and 61.2 % for FTFB.</div></div><div><h3>Conclusions</h3><div>STMV for prophylactic reasons is frequent in burn patients in our country and may represent potentially unnecessary intubations. PMV was associated with higher TBSA, age, FTFB, and shock. FTFB and shock showed the best overall diagnostic performance for detecting PMV, with moderate NPV in patients with TBSA &lt; 20 %. New protocols should be established in our region for airway management of burn patients.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"52 1","pages":"Article 107813"},"PeriodicalIF":2.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736247","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":"Comments on: “Effect of Acceptance and Commitment Therapy on psychological wellbeing and physical function in rehabilitation patients after burns: A randomized controlled trial”","authors":"Danni Huang,&nbsp;Linping Zhu","doi":"10.1016/j.burns.2025.107812","DOIUrl":"10.1016/j.burns.2025.107812","url":null,"abstract":"","PeriodicalId":50717,"journal":{"name":"Burns","volume":"52 1","pages":"Article 107812"},"PeriodicalIF":2.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736248","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 lethal triad in patients with severe burns","authors":"Elisha Purcell ,&nbsp;Samara Rosenblum ,&nbsp;Biswadev Mitra ,&nbsp;Marc Schnekenburger","doi":"10.1016/j.burns.2025.107827","DOIUrl":"10.1016/j.burns.2025.107827","url":null,"abstract":"<div><h3>Background</h3><div>The lethal triad of trauma (acidemia, coagulopathy, and hypothermia) is associated with substantial morbidity and mortality. Patients with severe burn injuries, defined as &gt; 20 % total body surface area (TBSA), are one group of trauma patients at risk of developing this triad. However, there is currently limited evidence on how the lethal triad affects this cohort of patients.</div></div><div><h3>Objectives</h3><div>To describe the prevalence of the lethal triad in patients with severe burns on arrival to an adult burns service hospital. The secondary aim was to investigate potential factors associated with presence of the lethal triad.</div></div><div><h3>Methods</h3><div>Adult patients (&gt; 18 years of age) with severe burns (&gt; 20 %TBSA) admitted to a Victorian Adult Burns Service (VABS) tertiary hospital between January 1, 2019 and 31 December, 2023, were included in the study.</div></div><div><h3>Results</h3><div>From 158 patients identified through the VABS registry, 142 patients met inclusion criteria. Among 106 patients with available data, the lethal triad was present on arrival to hospital in 6 patients (5.7 %; 95 %CI: 2.1–11.9 %). Acidemia was present in 58 of 116 (50.0 %; 95 %CI: 40.6–59.4), coagulopathy in 18 of 125 (14.4 %; 95 %CI: 8.8–21.8) and hypothermia in 53 of 140 (37.9 %; 95 %CI: 29.8–46.4). Among patients with the lethal triad, all 6 patients (100 %) died, compared to 27 patients (27.0 %) without the lethal triad (odds ratio 21.0; 95 %CI: 2.91-&gt;99.9).</div></div><div><h3>Conclusions</h3><div>A small proportion of patients with severe burns presented to hospital with all three components of the lethal triad of trauma. Acidemia and hypothermia were more commonly observed when compared to coagulopathy. Recognition, prevention, and early management may result in improved outcomes.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"52 1","pages":"Article 107827"},"PeriodicalIF":2.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736254","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 we predict mortality, length of stay, and time taken to heal at the point of admission in burn patients?","authors":"Olivia Antoinette Smith ,&nbsp;Ascanio Tridente ,&nbsp;Sankhya Kapil Sen","doi":"10.1016/j.burns.2025.107779","DOIUrl":"10.1016/j.burns.2025.107779","url":null,"abstract":"<div><h3>Background</h3><div>Burn injuries may be complex, life-changing and life-threatening. Knowing the factors that contribute to unfavourable outcomes, particularly mortality, is crucial so that they can be assessed and addressed. Well-recognised contributors to adverse outcomes in burn patients include age, burn size, revised Baux score, and inhalation injury. Less well described, but increasingly reported, is frailty status. Here we aim to expand the current literature by adjusting for confounders not previously investigated. This is important particularly with an increasing emphasis on frailty assessment in acute care.</div></div><div><h3>Methods</h3><div>A retrospective analysis of adult burn patients who required admission was conducted at a single burns unit in the United Kingdom from 2019 to 2024. The Rockwood Clinical Frailty Scale (CFS) was used to assess an individual’s frailty on a scale of 1 (very fit) to 9 (terminally ill). Univariate and multi-variate linear and logistic regression analyses assessed associations between various predictors, including revised Baux score and frailty (as a potential prognostic factor), and hospital mortality, length of stay, and time taken to heal.</div></div><div><h3>Results</h3><div>Our study included 1451 adult patients. Adjusting for age, sex, burn size, inhalation injury, and revised Baux score, frailty was significantly associated with increased mortality (OR 3, CI 1.84 – 4.88, p &lt; 0.001), length of hospital stay (LOS, <em>b</em> 2.03, 95 % CI 1.27 – 2.78, p &lt; 0.001), and time taken to heal (<em>b</em> 4.5, 95 % CI 1.75 – 7.3, p = 0.001). Other significant predictors of mortality were %TBSA (OR per % increase 1.06, 95 % CI 1.03–1.1, p &lt; 0.001) and revised Baux (OR per 1 point increase 1.06, 95 % CI 1.03 – 1.1, p = 0.001). Burn %TBSA was also predictive of LOS (β per 1 % increase 0.35, 95 % CI 0.24 – 0.47, p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Our findings suggest that 1) age, %TBSA, revised Baux score, and frailty are independently associated with mortality in burn injured patients; 2) frailty score and the % TBSA are independent predictors of increased length of hospital stay; and 3) frailty is an independent predictor of prolonged burn wound healing time. Further validation in more severe burn cohorts and multi-centre populations is needed before strong clinical recommendations can be made.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"52 1","pages":"Article 107779"},"PeriodicalIF":2.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670566","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":"Comments on: \"Burn injury in obesity: Examination of the Burn Care Quality Platform’s (BCQP) available data on obese patients to determine burn-related outcomes\"","authors":"Mahta Moghaddam Ahmadi,&nbsp;Moein Moghaddam Ahmadi","doi":"10.1016/j.burns.2025.107801","DOIUrl":"10.1016/j.burns.2025.107801","url":null,"abstract":"","PeriodicalId":50717,"journal":{"name":"Burns","volume":"52 1","pages":"Article 107801"},"PeriodicalIF":2.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617716","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 burn repair molecule? Evaluating FGF-21 in thermal injury – A systematic review","authors":"Tobias Niederegger ,&nbsp;Thomas Schaschinger ,&nbsp;Jule Brandt ,&nbsp;Leonard Knoedler ,&nbsp;Samuel Knoedler ,&nbsp;Alen Palackic ,&nbsp;Felix J. Klimitz ,&nbsp;Dorothea Noll ,&nbsp;Patrick Most ,&nbsp;Julia Ritterhoff ,&nbsp;Adriana C. Panayi ,&nbsp;Gabriel Hundeshagen","doi":"10.1016/j.burns.2025.107785","DOIUrl":"10.1016/j.burns.2025.107785","url":null,"abstract":"<div><div>Severe burns induce a hypermetabolic and inflammatory state, impairing wound healing and contributing to long-term morbidity. Fibroblast growth factor 21 (FGF-21), a metabolic hormone regulating lipid oxidation, glucose uptake, and mitochondrial homeostasis, has emerged as a potential biomarker and therapeutic modulator in critical illness.</div><div>This systematic review followed PRISMA 2020 guidelines and assessed seven studies (2015–2024) published until April 2025. Clinical, in vivo, and in vitro investigations were included. Methodological quality was evaluated using the Level of Evidence, Newcastle-Ottawa Scale, and the SYRCLE Risk of Bias tool.</div><div>In our study, FGF-21 was commonly upregulated following burn injury and was associated with hypermetabolism, adipose tissue browning, mitochondrial stress, and systemic inflammation. Nutritional interventions, including hydrolyzed collagen and omega-3 fatty acids, reduced FGF-21 levels, improved wound healing, and attenuated inflammatory responses. Preclinical models demonstrated that administration of exogenous FGF-21 enhanced re-epithelialization, angiogenesis, mitochondrial function, and anti-inflammatory signaling pathways. Conversely, chronically elevated endogenous FGF-21 levels were consistently linked to metabolic exhaustion, liver dysfunction, and impaired recovery.</div><div>Overall, FGF-21 may be a promising diagnostic and therapeutic target in burn care. Its clinical relevance and long-term effects require further investigation for successful integration into clinical practice.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"52 1","pages":"Article 107785"},"PeriodicalIF":2.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617718","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":"Advancements in burn size assessment: A systematic review of emerging technologies","authors":"Amy Woods ,&nbsp;Poh Tan,&nbsp;Tamara Mertz,&nbsp;Christopher J. Lewis","doi":"10.1016/j.burns.2025.107782","DOIUrl":"10.1016/j.burns.2025.107782","url":null,"abstract":"<div><h3>Background</h3><div>Accurate and reproducible assessment of total body surface area (TBSA) in burns is vital for guiding fluid resuscitation, triage, referral decisions, and overall clinical management. Traditional methods are widely used but prone to significant inter-rater variability and diagnostic inaccuracies.</div></div><div><h3>Objective</h3><div>This systematic review evaluates emerging technologies developed to improve TBSA estimation, focusing on diagnostic accuracy and inter-rater reliability.</div></div><div><h3>Methods</h3><div>A comprehensive search of EMBASE, MEDLINE (OVID), Web of Science, Scopus, PubMed and Cochrane Library databases was conducted. Studies assessing technological tools for TBSA estimation in both human and artificial burns were included. Primary outcomes were accuracy and reliability, while secondary outcomes included speed and user feedback. Study quality was appraised using the QUADAS-2 tool.</div></div><div><h3>Results</h3><div>Thirty-six studies were included: 3D programs (n = 7), mobile applications (n = 11), 3D stereophotogrammetry (n = 8), and machine learning models (n = 10). 3D stereophotogrammetry showed the highest accuracy (mean ICC = 0.988) and excellent inter-rater reliability (ICC = 0.989). 3D programs demonstrated good diagnostic performance and reduced variability. Mobile applications improved accuracy and consistency, particularly among non-specialists, and offered practical benefits in prehospital settings. Machine learning, though largely in experimental phases, demonstrated promising accuracy, with some models outperforming clinician estimates.</div></div><div><h3>Conclusion</h3><div>3D stereophotogrammetry provided more consistent and reliable estimates of TBSA, while mobile applications offered practical and scalable solutions. Early machine learning approaches showed potential but remain largely experimental. Overall, most studies were of low quality and methodologically heterogeneous; therefore, definitive conclusions cannot yet be drawn. Further high-quality, real-world research is required to validate accuracy and establish clinical utility.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"52 1","pages":"Article 107782"},"PeriodicalIF":2.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617817","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":"Comments on: “Red blood cell transfusion risk factors and outcomes in burn patients: A retrospective cohort study”","authors":"Liying Jin,&nbsp;Xingyi Yang","doi":"10.1016/j.burns.2025.107814","DOIUrl":"10.1016/j.burns.2025.107814","url":null,"abstract":"","PeriodicalId":50717,"journal":{"name":"Burns","volume":"52 1","pages":"Article 107814"},"PeriodicalIF":2.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736250","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}