BurnsPub Date : 2025-08-05DOI: 10.1016/j.burns.2025.107647
Chao-Ming Wu
{"title":"Impact of hospital procedure volume on inpatient outcomes of burns covering 20–50 % of the total body surface receiving skin allograft: An analysis of the US Nationwide Inpatient Sample 2005–2020","authors":"Chao-Ming Wu","doi":"10.1016/j.burns.2025.107647","DOIUrl":"10.1016/j.burns.2025.107647","url":null,"abstract":"<div><h3>Objective</h3><div>This study examined how hospital procedure volume influences outcomes of burn patients receiving skin allografts.</div></div><div><h3>Methods</h3><div>Data of adults ≥ 18 years with burns of 20–50 % of the total body surface area who received skin allografts were extracted from the US Nationwide Inpatient Sample (NIS) database 2005–2020. Hospitals were categorized into low- and high-volume based on an annual number of skin allograft procedures, and patients were categorized by type of hospital at which they received treatment. Outcomes include mortality, complications, length of hospital stay, and safety indicators. Propensity score matching (PSM) ensured balanced comparisons.</div></div><div><h3>Results</h3><div>Following PSM, data from 1044 patients (representing 5118 persons in the US) were analyzed. Multivariable analysis revealed that high hospital volume was significantly associated with a lower risk of unfavorable discharge (adjusted odds ratio [aOR] = 0.74, 95 % confidence interval [CI]: 0.57, 0.97) and lower total hospital costs (adjusted beta = −129.44, 95 % CI: −142.93, −115.96 thousand USD). Stratified associations revealed that high hospital volume was associated with decreased risk of in-hospital mortality (aOR = 0.60, 95 % CI: 0.38, 0.95, p = 0.027) in patients ≥ 60 years old, and reduced risk of patient safety indicator (PSI) presence (aOR = 0.71, 95 % CI: 0.54, 0.92, p = 0.010) in the subgroup without comorbidities.</div></div><div><h3>Conclusions</h3><div>Older patients with major burns treated with allografts at high-volume hospitals have lower costs, decreased risk of unfavorable discharge, lower in-hospital mortality rates, and reduced safety risks for those without comorbidities.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 8","pages":"Article 107647"},"PeriodicalIF":2.9,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144866200","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}
BurnsPub Date : 2025-07-30DOI: 10.1016/j.burns.2025.107631
APBS Campelo , ER Holanda , DV Pinto , FA Santos , BO Reinado , MWS Campelo , PL de Vasconcelos
{"title":"Nutraceutical effects of omega 9, 6, and 3-enriched milk in rats submitted to thermal burning by direct conduct","authors":"APBS Campelo , ER Holanda , DV Pinto , FA Santos , BO Reinado , MWS Campelo , PL de Vasconcelos","doi":"10.1016/j.burns.2025.107631","DOIUrl":"10.1016/j.burns.2025.107631","url":null,"abstract":"<div><div>In burns, the balance of dietary lipids can influence the inflammatory response through the interaction between different types of polyunsaturated fatty acids in the diet. The present study used mixtures of oils in nutraceutical concentrations with antioxidant and anti-inflammatory properties. This study examined the effects of milk enriched with ω9, ω6, and ω3 (modified milk) oils in a thermal burn model. Forty-eight rats were allocated into four groups: water (W), burned + water (B+W), burned + milk (B+M), and burned + modified milk (B+ω). After burns induction, water, and altered milk were administered to the respective groups for twenty-one consecutive days, ad libitum. The evolution of body mass, fluid intake, feed intake, burned area involution, reepitheliazed epidermis thickness, collagen type, NF-κB expression, malondialdehyde (TBARS), catalase, reduced glutathione (GSH), and glutathione peroxidase (GPx) were evaluated. On the third and the twenty-first days, the animals were anesthetized, and photographs of the lesions and skin samples were collected for analysis. Lower macroscopic lesions, epidermal thickness, and a higher proportion of collagen type I/III were found in the B+ ω group than in the other burned groups. In addition, TBARS concentrations in the B+ ω group showed no difference compared to the W group and were lower than in other groups. GSH concentrations and activity of GPx and catalase were higher in the B+ ω group than B+W or B+M groups. The omega-9, 6, and 3 oil mixes decrease healing time with better collagen, inhibiting NF-κB and reducing oxidative stress.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 8","pages":"Article 107631"},"PeriodicalIF":2.9,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144866145","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}
BurnsPub Date : 2025-07-30DOI: 10.1016/j.burns.2025.107632
Zachary H. Zamore , Jeffrey Khong , Rachana Suresh , Kitae Eric Park , Keon Niknejad , Tara McCaffrey , Keith T. Kuo , Sami Tuffaha , Sheera F. Lerman , Julie A. Caffrey
{"title":"Antimuscarinics for burn patients: Helpful or harmful for sensation recovery?","authors":"Zachary H. Zamore , Jeffrey Khong , Rachana Suresh , Kitae Eric Park , Keon Niknejad , Tara McCaffrey , Keith T. Kuo , Sami Tuffaha , Sheera F. Lerman , Julie A. Caffrey","doi":"10.1016/j.burns.2025.107632","DOIUrl":"10.1016/j.burns.2025.107632","url":null,"abstract":"<div><h3>Background</h3><div>Burn injuries are a major cause of morbidity and mortality, often resulting in nerve damage that causes pain or numbness. Loss of protective sensation increases the risk of future injury. Enhancing nerve regeneration after burns is critical. Antimuscarinic drugs, used to treat overactive bladder, have shown potential in promoting peripheral nerve growth by supporting cytoskeletal development and mitochondrial trafficking. This study investigates whether antimuscarinic use at the time of burn injury is associated with increased nerve regeneration.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis using the TriNetX Research Database. Burn patients were identified using ICD-10-CM codes by anatomical area and total burn surface area (TBSA). The experimental group included patients taking one of seven antimuscarinic drugs (darifenacin, fesoterodine, oxybutynin, propiverine, solifenacin, tolterodine, or trospium) at the time of injury. Controls were burn patients not on these medications. Patients with preexisting sensory disturbances were excluded. Propensity score matching was performed by age, sex, diabetes status, and either burn location or TBSA. Paresthesia 3–24 months post-injury was used as a proxy for nerve regeneration.</div></div><div><h3>Results</h3><div>Among 362,224 patients with burns coded by anatomical area, 9266 antimuscarinic users were matched to 9266 controls. Users were over twice as likely to develop paresthesia (RR: 2.19, CI: [1.85, 2.60]) and had higher analgesic use (52.4 % vs. 30.3 %, p < 0.001). For 168,164 patients with burns coded by TBSA, 3294 matched pairs showed similar findings: increased paresthesia (RR: 2.95, CI: [2.06, 4.23]) and analgesic use (50.1 % vs. 25.3 %, p < 0.001).</div></div><div><h3>Conclusion</h3><div>Burn patients on antimuscarinic therapy were more likely to develop paresthesia, possibly indicating nerve regeneration. While this may reflect sensory recovery, it could also lead to abnormal or painful sensations that negatively impact quality of life. Further research is needed to assess functional outcomes.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 8","pages":"Article 107632"},"PeriodicalIF":2.9,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144866201","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}
BurnsPub Date : 2025-07-30DOI: 10.1016/j.burns.2025.107629
Tanja Klotz , Hollie Moran , Peter Vu , Guy Maddern , Marcus Wagstaff
{"title":"Commonly recommended moisturising products: effect on transepidermal water loss and hydration in a scar model","authors":"Tanja Klotz , Hollie Moran , Peter Vu , Guy Maddern , Marcus Wagstaff","doi":"10.1016/j.burns.2025.107629","DOIUrl":"10.1016/j.burns.2025.107629","url":null,"abstract":"<div><h3>Background</h3><div>Moisturizing is a widely recommended and accessible approach to scar management, yet objective evidence supporting the efficacy of commonly used products remains limited. Research suggests that moisturizers may reduce hypertrophic scar activity by normalising transepidermal water loss (TEWL) and enhancing skin hydration.</div></div><div><h3>Aim</h3><div>This study aimed to provide insights into the effect of generic moisturizers on TEWL and hydration in a scar model, helping clinicians make informed recommendations for scar treatment.</div></div><div><h3>Methods</h3><div>The performance of eight moisturizing products were evaluated using a tape-stripping method on normal skin to simulate the elevated TEWL conditions observed in active scars. Thirty participants were recruited based on power calculations, with TEWL and hydration measurements recorded at baseline and hourly for four hours. Untreated tape-stripped areas served as controls for each participant.</div></div><div><h3>Results</h3><div>Eucerin demonstrated the highest efficacy, significantly increasing hydration and normalising TEWL. Sorbolene ranked second, showing notable improvements in both hydration and TEWL regulation. Alhydran produced mixed results, effectively normalizing TEWL but reducing hydration. QV Lotion increased hydration but had minimal impact on TEWL. Aqueous Cream exhibited a non-significant trend toward TEWL normalisation.</div><div>The silicone gel sheet provided high hydration levels but caused elevated TEWL after removal due to rapid evaporation of retained moisture. Liquid silicone (Strataderm) and BioOil performed poorly, with negligible effects on hydration and TEWL.</div></div><div><h3>Conclusion</h3><div>These findings reveal significant variability in the effectiveness of common scar management products, emphasising the limited utility of liquid silicones compared to basic moisturizers. Products with balanced formulations of humectants, emollients, and occlusives showed objective evidence to indicate efficacy in managing hypertrophic scars during their active phase. This study offers evidence-based guidance for clinicians and highlights the need for further research to optimise formulations for scar management.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 8","pages":"Article 107629"},"PeriodicalIF":2.9,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144904253","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}
BurnsPub Date : 2025-07-25DOI: 10.1016/j.burns.2025.107630
Jingjing Ruan , Ting Huo , Yao Zhang , Qiongfang Ruan , Maomao Xi , Tianfeng Ru , Shuhua Liu
{"title":"Effect of Acceptance and Commitment Therapy on psychological wellbeing and physical function in rehabilitation patients after burns: A randomized controlled trial","authors":"Jingjing Ruan , Ting Huo , Yao Zhang , Qiongfang Ruan , Maomao Xi , Tianfeng Ru , Shuhua Liu","doi":"10.1016/j.burns.2025.107630","DOIUrl":"10.1016/j.burns.2025.107630","url":null,"abstract":"<div><h3>Objectives</h3><div>Burns cause significant physical harm and complex psychological issues. The dual influence of physical and psychological factors can contribute to difficulties in rehabilitation of patients. Consequently, it is crucial to identify a treatment approach that simultaneously promotes mental health and functional recovery. Acceptance and Commitment Therapy (ACT) has garnered significant attention for its beneficial effects on both the physical and psychological wellbeing of individuals. This study aims to investigate the influence of integrating ACT with traditional burn rehabilitation methods on the psychological wellbeing and physical function of patients with burns during their recovery process.</div></div><div><h3>Methods</h3><div>This study was a randomized controlled trial. Fifty-four patients with moderate to severe burns at the Burn Rehabilitation Center of Wuhan Third Hospital participated in the study from October 2022 to April 2024. They were randomly assigned to the ACT group and the Standard of Care (SOC) group. Patients in the SOC group began a conventional burn rehabilitation program, while those in the ACT group received ACT treatment alongside the traditional program. At the start of the trial and after 12 weeks, patients were assessed for anxiety, depression, sleep quality, activity of daily living (ADL), and upper and lower limb function, using the appropriate scales: Self-Rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS), the Assens Insomnia scale (AIS), the modified Barthel index, and the Fugl-Meyer motor function scale.</div></div><div><h3>Results</h3><div>Before the trial, no significant differences were found between the two groups in anxiety, depression, sleep quality, ADL, or motor function (P > 0.05). After 12 weeks, the scores of anxiety, depression, and sleep quality in the ACT group were better than those in the SOC group (P < 0.05). After 12 weeks, there were no significant differences between the two groups in Fugl-Meyer motor function scores or activities of daily living scores (P > 0.05), indicating that ACT combined with conventional rehabilitation improved mental health but had no additional benefits for physical function.</div></div><div><h3>Conclusion</h3><div>Combining ACT with routine rehabilitation training in moderate to severe burn patients can improve their anxiety, depression, and sleep quality.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 8","pages":"Article 107630"},"PeriodicalIF":2.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144866150","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}
BurnsPub Date : 2025-07-23DOI: 10.1016/j.burns.2025.107628
Enrico Cocchi, Davide Melandri
{"title":"Response to Drs. Wang, Huan and Chen: Comments and recommendations on the role of skin grafting in preventing infection in children with deep burns","authors":"Enrico Cocchi, Davide Melandri","doi":"10.1016/j.burns.2025.107628","DOIUrl":"10.1016/j.burns.2025.107628","url":null,"abstract":"","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 8","pages":"Article 107628"},"PeriodicalIF":2.9,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144866214","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}
BurnsPub Date : 2025-07-22DOI: 10.1016/j.burns.2025.107627
Seçil Sayın , Sabri Demir , Emine Gülşah Torun , İbrahim Ece , Emrah Şenel
{"title":"Optimized fluid management in pediatric burn patients by transthoracic echocardiography","authors":"Seçil Sayın , Sabri Demir , Emine Gülşah Torun , İbrahim Ece , Emrah Şenel","doi":"10.1016/j.burns.2025.107627","DOIUrl":"10.1016/j.burns.2025.107627","url":null,"abstract":"<div><h3>Background</h3><div>Accurate assessment of intravascular volume status is crucial for managing fluid resuscitation in pediatric burn patients. Conventional methods, such as clinical signs and urine output, may be insufficient. This study aimed to evaluate the effectiveness of transthoracic echocardiography (TTE) in guiding fluid therapy for severely burned children.</div></div><div><h3>Materials and methods</h3><div>This retrospective study included 40 pediatric patients with burns covering ≥ 20 % of total body surface area (TBSA), admitted within 24 h of injury to the pediatric burn center between 2019 and 2022. Patients were divided into two groups: TTE group (n = 20) and control group (n = 20). The TTE group received fluid therapy guided by TTE parameters, particularly the inferior vena cava to aorta (IVC/Ao) ratio. The control group was managed using conventional methods. Demographic data, clinical characteristics, fluid management, and outcomes were compared between the groups.</div></div><div><h3>Results</h3><div>There were no significant differences in age, gender, TBSA burned, or burn type between groups. In the TTE group, fluid therapy was modified in 80 % of patients based on echocardiographic findings. The TTE group required less diuretic treatment (10 % vs 60 %, p < 0.05) compared to the control group. Although the TTE group had higher rates of initial intubation (55 % vs 20 %, p < 0.05) and inotropic support (35 % vs 5 %, p < 0.05), there was no significant difference in mortality between groups. A negative, moderate linear relationship was found between urine output and descending aorta diameter in the TTE group (correlation coefficient: −0.47, p = 0.04).</div></div><div><h3>Conclusion</h3><div>The addition of TTE to conventional methods for managing fluid resuscitation in pediatric burn patients may help reduce unnecessary fluid administration and diuretic use. TTE, particularly the IVC/Ao ratio, appears to be a valuable tool for assessing intravascular volume status in this population. While further prospective studies are needed to establish standardized reference values for TTE parameters in pediatric burn patients, this non-invasive method shows promise in improving fluid management and potentially reducing complications associated with over- or under-resuscitation.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 8","pages":"Article 107627"},"PeriodicalIF":2.9,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144866301","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}
BurnsPub Date : 2025-07-21DOI: 10.1016/j.burns.2025.107625
Enrico Cocchi, Davide Melandri
{"title":"Response to Dr. Wang and Dr. Bao: Beyond the Scalpel: Unpacking grafting’s role in pediatric burn infection prevention","authors":"Enrico Cocchi, Davide Melandri","doi":"10.1016/j.burns.2025.107625","DOIUrl":"10.1016/j.burns.2025.107625","url":null,"abstract":"","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 8","pages":"Article 107625"},"PeriodicalIF":2.9,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144866212","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}
BurnsPub Date : 2025-07-21DOI: 10.1016/j.burns.2025.107626
Jiwon Kim , Sung Gon Park , Jaechul Yoon , Yong Suk Cho , Dohern Kym , Jun Hur , Ohseong Kwon , Sung Tae Cho , Young Goo Lee , Sahyun Pak
{"title":"Lower urinary tract symptoms following perineal burns: Clinical characteristics and predictors of symptom persistence","authors":"Jiwon Kim , Sung Gon Park , Jaechul Yoon , Yong Suk Cho , Dohern Kym , Jun Hur , Ohseong Kwon , Sung Tae Cho , Young Goo Lee , Sahyun Pak","doi":"10.1016/j.burns.2025.107626","DOIUrl":"10.1016/j.burns.2025.107626","url":null,"abstract":"<div><h3>Introduction</h3><div>Lower urinary tract symptoms (LUTS) are frequently observed following perineal burn injuries, but their long-term clinical implications and predictors of prognosis remain poorly understood. This study aimed to investigate the clinical characteristics of newly developed LUTS in patients with perineal burns and to identify factors associated with persistent symptoms.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 172 patients who were admitted to a burn center with perineal burns and subsequently referred to the urology department for evaluation of new-onset LUTS between August 2010 and December 2023. LUTS were evaluated at the time of urologic referral using available clinical data. Patients were categorized into transient and persistent symptom groups based on whether pharmacologic treatment was required beyond 3 months. Multivariate logistic regression was used to identify independent predictors.</div></div><div><h3>Results</h3><div>The most common LUTS were urinary frequency (44.2 %), nocturia (28.5 %), and incomplete bladder emptying (25.6 %). Storage symptoms were observed in 64.5 % of patients, while voiding symptoms were noted in 58.1 %. Most patients showed symptom resolution with short-term standard treatment. However, 30 % experienced persistent LUTS beyond 3 months, requiring continued pharmacologic therapy. Eleven patients (6.4 %) ultimately needed catheter-based management. Among burn-related factors, electrical burns were independently associated with persistent LUTS (OR 7.7, 95 % CI 2.3–26.0, <em>p</em> = 0.001), whereas other variables were not statistically significant.</div></div><div><h3>Conclusion</h3><div>LUTS following perineal burns generally resolve with short-term treatment, but a substantial proportion of patients experience persistent symptoms requiring long-term care. Early identification and management are particularly important in patients with electrical burns.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 8","pages":"Article 107626"},"PeriodicalIF":2.9,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144866302","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}
BurnsPub Date : 2025-07-19DOI: 10.1016/j.burns.2025.107623
Jiaqi Lou , Ziyi Xiang , Jiliang Li , Shengyong Cui , Neng Huang , Guoying Jin , Xin Le , Youfen Fan , Qionghui Sun
{"title":"The beneficial impact of virtual reality in the burn wound care of pediatric patients: An updated systematic review and meta-analysis","authors":"Jiaqi Lou , Ziyi Xiang , Jiliang Li , Shengyong Cui , Neng Huang , Guoying Jin , Xin Le , Youfen Fan , Qionghui Sun","doi":"10.1016/j.burns.2025.107623","DOIUrl":"10.1016/j.burns.2025.107623","url":null,"abstract":"<div><h3>Objective</h3><div>This systematic review and meta-analysis assesses the efficacy of virtual reality (VR) interventions in managing pain, anxiety, and physiological parameters in pediatric patients undergoing burn wound care.</div></div><div><h3>Methods</h3><div>We conducted a comprehensive literature search across PubMed, Embase, the Cochrane Library, and Web of Science to identify randomized controlled trials (RCTs) comparing VR interventions with standard care or non-VR alternatives in pediatric burn patients. Methodological quality was assessed using the Cochrane Risk of Bias tool. Primary outcomes included pain scores, anxiety levels, time spent thinking about pain, pleasure scores, heart rate, and oxygen saturation. Data were pooled using random-effects models to calculate standardized mean differences (SMD) and 95 % confidence intervals (CI). Analyses included funnel plots, Egger’s regression tests, and sensitivity analyses to evaluate publication bias and robustness.</div></div><div><h3>Results</h3><div>Fifteen RCTs involving 622 pediatric burn patients were included. Meta-analysis indicated that VR was associated with reduced pain scores (SMD = −1.44, 95 % CI: −2.03 to −0.85; P < 0.001, I² = 81.1 %) and anxiety scores (SMD = −0.61, 95 % CI: −0.93 to −0.29; P < 0.001, I² = 77.1 %). VR interventions also appeared to decrease the time patients spent thinking about pain (SMD = −0.72, 95 % CI: −1.21 to −0.21; P < 0.001, I² = 85.2 %). Pleasure scores were numerically higher in the VR group (SMD = 0.47, 95 % CI: 0.23–0.71; P = 0.940, I² = 0.00 %), though this difference did not reach statistical significance. Furthermore, VR was associated with lower heart rate (SMD = −1.60, 95 % CI: −2.72 to −0.48; P = 0.007, I² = 86.4 %) without affecting oxygen saturation (SMD = 0.00, 95 % CI: −0.35–0.35; P = 0.651, I² = 86.4 %). Sensitivity analyses suggested relative stability of effect sizes, and funnel plots indicated limited evidence of publication bias.</div></div><div><h3>Conclusion</h3><div>These findings suggest VR interventions may offer benefits in reducing pain and anxiety in pediatric burn patients during wound care. The evidence supports exploring VR as an adjunctive approach in burn care settings. Future research is needed to focus on optimizing VR content, delivery systems, and long-term outcomes to better understand its clinical utility.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 8","pages":"Article 107623"},"PeriodicalIF":2.9,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144771790","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}