Burns最新文献

{"title":"Targeted Cx43 therapeutics reduce NLRP3 inflammasome activation in rat burn injury","authors":"Moogaambikai Thangaveloo ,&nbsp;Jiajun Feng ,&nbsp;Anthony RJ. Phillips ,&nbsp;David L. Becker","doi":"10.1016/j.burns.2024.107358","DOIUrl":"10.1016/j.burns.2024.107358","url":null,"abstract":"<div><div>Burns are dynamic injuries characterized by an initial zone of necrosis that progresses to compromise surrounding tissue. Acute inflammation and cell death are two main factors contributing to burn progression. These processes are modulated by Connexin43 (Cx43) hemichannels and gap junctions in burns and chronic wounds. Particularly, Cx43-mediated ATP release may interact with the P2X7 receptor to activate the NLRP3 inflammasome pathway. This study used a deep partial thickness rat burn model to evaluate the effect of Cx43 antisense oligodeoxynucleotides (Cx43asODN) or the Cx43 hemichannel blocker Tonabersat for the inhibition of inflammasome activation and their use as potential treatments for burn injury. Using immunofluorescence analysis, our data showed that Cx43asODN or Tonabersat reduced Cx43 hemichannel and gap junction expression. Concomitantly, they marginally and transiently reduced P2X7 expression and inflammasome complex assembly and inflammation. Quantitative analysis using H&amp;E, Masson's trichrome &amp; Picrosirus Red revealed reduced epidermal thickness and improved collagen preservation in treated burn wounds. Collectively, our findings suggest a possible involvement of the Cx43-mediated NLRP3 inflammasome pathway via P2X7 activation in early burn wound healing. This indicates that targeting Cx43 may have a potential therapeutic effect to improve healing outcomes.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 2","pages":"Article 107358"},"PeriodicalIF":3.2,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973137","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":"Trends and hotspots in burns-related pain research: A bibliometric analysis","authors":"Xin-xin Gao,&nbsp;Xiu-Hang Zhang,&nbsp;Jia-Ao Yu","doi":"10.1016/j.burns.2024.107345","DOIUrl":"10.1016/j.burns.2024.107345","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this investigation was to conduct a thorough synthesis of the extant scholarly discourse and to delineate the prevailing global trends in the domain of burn pain, employing a bibliometric analysis.</div></div><div><h3>Methods</h3><div>A bibliometric analysis was performed utilizing the Web of Science Core Collection database. Articles were selected based on titles or abstracts containing keywords associated with burns and pain. Both quantitative and qualitative methodologies were applied to examine the retrieved data, encompassing an analysis of publication trends, research themes, and collaboration networks.</div></div><div><h3>Results</h3><div>The number of articles on this topic has been increasing, averaging an annual growth rate of 6.9 % from 1997 to 2023. Contributions have come from 645 institutions across 53 countries, resulting in 446 papers that span areas such as nursing, anesthesia, and immunology. Key journals include <em>Burns</em>, <em>Journal of Burn Care &amp; Research</em>, and <em>Pain</em>. The United States has demonstrated a significant research output in this field, with active international collaboration, notably with Washington University leading in contributions. Patterson DR was the most prolific author in terms of published papers, while Choiniere M was the most frequently co-cited author. The focus of research has shifted from symptom management to exploring pain mechanisms. Current research priorities in burn pain include \"quality of life,\" \"music therapy,\" and \"psychological state.\" Recent analysis has highlighted key areas in neuropathic pain mechanisms, novel analgesic therapies, and specific groups such as pediatric burn patients. Influential studies have advanced our understanding of pathophysiology, while psychological interventions and inflammation are increasingly receiving attention. Emerging topics include non-pharmacological interventions, psychological support, technology in pain assessment and management, quality of life, and personalized pain management.</div></div><div><h3>Conclusion</h3><div>Research on burn pain is advancing rapidly; however, collaboration among countries and institutions remains limited. Increased cooperation and communication across these entities could significantly advance the field in the future. Future research should prioritize placebo-controlled trials of targeted therapeutic drugs and innovative pain management approaches, with a strong emphasis on patient outcomes and quality of life.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 2","pages":"Article 107345"},"PeriodicalIF":3.2,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967117","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":"Ethnicity does not change burn resuscitation and time to first excision","authors":"Janie Faris ,&nbsp;Kareem R. Abdelfattah ,&nbsp;Audra T. Clark ,&nbsp;Benjamin Levi ,&nbsp;Rebecca Coffey PhD MSN CBRN","doi":"10.1016/j.burns.2024.107360","DOIUrl":"10.1016/j.burns.2024.107360","url":null,"abstract":"<div><div>Health and racial disparities can limit access to preventative, trauma, and chronic disease care but have not been addressed in burn resuscitation. Over- and under-resuscitation contribute to increased overall hospital costs, and morbidity and mortality rates. The primary objective of this study was to identify potential racial disparities that may exist during the initial fluid resuscitation after burn injury. This was a retrospective review of all burn patients &gt; 14 years of age admitted between January 1, 2020 and December 31, 2022 to a county safety net hospital. Patients were excluded if they transitioned to comfort care within 24 hours of admission. Data collected included baseline demographics, relevant burn injury information, and laboratory parameters. Outcomes included hospital and ICU length of stay, duration of mechanical ventilation, payor status, and mortality. Patients were divided into white (59 %) vs. African American-Hispanic (AA-HIS) (41 %) and included 105 patients. The median age (IQR) was 44.5(30) for whites vs 34(36) for AA-HIS. There were no statistically significant differences in severity of burn injury, cause of burn injury, rates of inhalation injury, or ICU or hospital lengths of stay. In both groups 55 % of the patients required mechanical ventilation while 18 % required renal replacement therapy. Overall mortality was not higher in the AA-HIS group at 32.6 % vs 17.7 % (<em>p</em> = 0.081). There were no differences in amount of fluid administered, urine output, laboratory values during resuscitation, or patient outcomes between the groups. The use of protocols for burn resuscitation can be instrumental in protecting against racial and ethnic disparities.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 2","pages":"Article 107360"},"PeriodicalIF":3.2,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900040","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":"pH is not a ‘litmus test’ in chemical burns","authors":"Jasmine Crane,&nbsp;Sirous Golchinheydari,&nbsp;Fatma Shariff,&nbsp;Timothy Burge","doi":"10.1016/j.burns.2024.107362","DOIUrl":"10.1016/j.burns.2024.107362","url":null,"abstract":"","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 2","pages":"Article 107362"},"PeriodicalIF":3.2,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142966604","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":"Electronic and paper delivery of parent proxy and children’s report of two scar-specific patient-reported outcome measures (Brisbane Burn Scar Impact Profile and Patient and Observer Scar Assessment Scale): An equivalence study","authors":"Brandon Meikle ,&nbsp;Megan Simons ,&nbsp;Jill Meirte ,&nbsp;Kate Miller ,&nbsp;Roy Kimble ,&nbsp;Zephanie Tyack","doi":"10.1016/j.burns.2024.107359","DOIUrl":"10.1016/j.burns.2024.107359","url":null,"abstract":"<div><h3>Introduction</h3><div>The Brisbane Burn Scar Impact Profile (BBSIP) and the Patient and Observer Scar Assessment Scale (POSAS) are used in burn scar assessment to quantify patient health-related quality of life (HR-QoL). These questionnaires were developed using pen-and-paper delivery methods; however, there is a push towards electronic delivery of these questionnaires in both clinical practice and research. Equivalence testing is required to ensure that validity of these paper questionnaires is maintained electronically.</div></div><div><h3>Methods</h3><div>Participants were presented with a survey containing the BBSIP and POSAS, which was completed twice during a single outpatient appointment using either pen-and-paper or a tablet. Completion order was randomised to: 1) paper-paper; 2) paper-tablet; 3) tablet-paper; and 4) tablet-tablet. Comparison of intraclass correlation coefficients (ICCs), calculated for each BBSIP and POSAS subscale, was conducted with the ICC of the paper-paper group.</div></div><div><h3>Results</h3><div>Participants (n = 104) included 55 caregiver proxies of children aged 8 years or less, 26 caregiver proxies of children aged 8–18 years, and 23 children aged 8–18 years. The majority but not all BBSIP (61 %) and POSAS (81 %) subscales were equivalent. The acceptability of electronic delivery was supported.</div></div><div><h3>Conclusion</h3><div>Findings generally support electronic delivery of the BBSIP and POSAS, likely supporting their use in outpatient clinics, telehealth clinics, and remote monitoring. Additional testing is required for subscales that did not demonstrate equivalence.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 2","pages":"Article 107359"},"PeriodicalIF":3.2,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899966","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":"Quality of life and return to work rates in the first two years following major burn injury","authors":"Lincoln M. Tracy ,&nbsp;Peter A. Cameron ,&nbsp;Heather J. Cleland ,&nbsp;Lara Kimmel ,&nbsp;Warwick J. Teague ,&nbsp;Belinda J. Gabbe","doi":"10.1016/j.burns.2024.107355","DOIUrl":"10.1016/j.burns.2024.107355","url":null,"abstract":"<div><h3>Background</h3><div>A better understanding of how major burns patients recover following injury is vital in assessing trauma care and informing healthcare and rehabilitation provision. We aimed to describe the longer-term health and return to work status of major burns patients and identify factors associated with positive outcomes i.e., reporting no problems with health-related quality of life, returning to work).</div></div><div><h3>Methods</h3><div>This registry-based cohort study included adult (≥ 16 years) patients with a burn injury affecting ≥ 20 % total body surface area registered by the Victorian State Trauma Registry with a date of injury from July 1 2009 to June 30 2022. Patients were followed-up at six, 12, and 24 months post-injury, completing the 3-level or 5-level EuroQoL 5 dimensions questionnaire (depending on their date of injury) and return to work-related questions at each time point. Mixed effect regression models were used to predict factors associated with quality of life outcomes. Modified binary Poisson models were used to model the probability of experiencing no problems in each of the quality of life domains, and mixed effects linear regression was used to model the overall utility score.</div></div><div><h3>Results</h3><div>Two hundred and eighty-seven patients were included; 63 (21.9 %) did not die but were completely lost to follow-up. The prevalence of reporting no problems at 24 months post-injury was 70.2 % for mobility, 77.8 % for self-care, 48.0 % for usual activities, 49.7 % for pain or discomfort, and 51.5 % for anxiety or depression. The predicted probability of reporting no problems in each of the EQ-5D health states was lowest at six-months and increased over time.</div></div><div><h3>Conclusions</h3><div>The prevalence of ongoing problems – particularly with usual activities, pain, and anxiety/depression – at 24 months post-injury is high, confirming that major burns are often an ongoing disorder. Greater investment in interventions designed to reduce these problems is needed.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 3","pages":"Article 107355"},"PeriodicalIF":3.2,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029809","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":"Effect of prehospital topical application of water and other agents on outcome in burn injured patients: A prospective study","authors":"O.A. Olawoye ,&nbsp;C.P. Isamah ,&nbsp;S.A. Ademola ,&nbsp;A.O. Iyun ,&nbsp;A.I. Michael ,&nbsp;R.O. Aderibigbe ,&nbsp;O.M. Oluwatosin","doi":"10.1016/j.burns.2024.107357","DOIUrl":"10.1016/j.burns.2024.107357","url":null,"abstract":"<div><h3>Introduction</h3><div>Topical agents applied to the burn wound as first aid measures have been noted to impact outcomes. The application of cool running water is effective when administered for at least 20 min within 3 h of burn as recommended by the Australian and New Zealand Burn Association. However, the American Burn Association recommends running water for 5 min, and only in minor burns. In Nigeria, there are no guidelines for duration of water application. Other agents are often applied in the prehospital setting despite education against such practices. This study was carried out to determine the practice of prehospital first aid and its impact on outcome of burn injuries.</div></div><div><h3>Method</h3><div>This was a prospective observational study of all burn injured patients admitted to our burn unit between February 2013 and March 2020.</div></div><div><h3>Result</h3><div>A total of 335 burn injury patients were included in this study, with a median age of 22 years. Males constituted 54.3 % of the patients. Flame injuries accounted for 60 % of cases, and median TBSA was 20.5 %. Majority of the patients received first aid (80.2 %), with 78.9 % receiving first aid within 30 min of injury. Water was applied for first aid in 53.2 % of patients. Application of water for a period of 5 min was associated with reduced rate of infection(<em>P = 0.023)</em>, hospital length of stay (<em>P = 0.012</em>, and mortality(<em>P = 0.001)</em> compared with water application for 10 min, 20 min or just to extinguish flame. The use of running tap and water from a clean container were associated with reduced rate of infection <em>(P = 0.041)</em> and reduced mortality rate <em>(P = 0.006)</em> compared with other sources of water<em>.</em> Other agents applied were raw pap (a local custard) over the wound, honey, and raw egg, amongst others. These other agents were used either singly or in combination for a combined total of 205 times in 126 patients. These other topical agents had no statistically significant impact on outcome compared with those who did not receive these agents as first aid.</div></div><div><h3>Conclusion</h3><div>The application of water for approximately 5 min and the use of running tap water or water from a clean container were associated with improved burn injury outcomes. The use of non-water agents had no statistically significant impact on the outcome measures.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 2","pages":"Article 107357"},"PeriodicalIF":3.2,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967444","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":"Mixed grafting of small auto- and cryopreserved allo-skin for residual wound repair in severe burn patients: A retrospective study","authors":"Chao Ji ,&nbsp;Yuxiang Wang ,&nbsp;Tiansheng Chen ,&nbsp;Xiaoyan Hu,&nbsp;He Fang,&nbsp;Zhenzhen Yan,&nbsp;Yicheng Ma,&nbsp;Xiaowan Fang,&nbsp;Linhui Li,&nbsp;Dayuan Xu,&nbsp;Shizhao Ji,&nbsp;Pengfei Luo,&nbsp;Yongjun Zheng,&nbsp;Shichu Xiao","doi":"10.1016/j.burns.2024.107356","DOIUrl":"10.1016/j.burns.2024.107356","url":null,"abstract":"<div><h3>Background</h3><div>The wound repair process for extensively deep burn patients is a recurring and highly challenging endeavor. A prolonged healing time beyond 3 weeks after injury often leads to compromised healing outcomes. The limited availability of autologous skin grafts remains the primary obstacle in achieving timely wound repair. This study aimed to investigate an approach that minimizes the reliance on autologous skin grafts for repairing residual wounds in severe burn patients.</div></div><div><h3>Methods</h3><div>This was a retrospective review of 74 burn patients with large residual wounds in the middle- and late-stages of treatment who were admitted to the Burn Center of the First Affiliated Hospital of Naval Medical University between 2012 and 2022. Mixed grafting of small auto- and cryopreserved allo-skin was used in 32 patients with an expansion ratio of 1:9–16. Routine microskin grafting was applied in 17 cases with an expansion ratio of 1:10–15. Meek grafting was employed in 25 patients with an expansion ratio of 1:4–6. The main outcomes of this study were the wound healing rate and scar formation.</div></div><div><h3>Results</h3><div>The wound healing rate in the mixed grafting group was significantly greater than that in the microskin and Meek grafting groups (89 ± 5.8 % <em>vs.</em> 66.5 ± 6.9 % and 75.4 ± 5.1 %, respectively; <em>P</em> &lt; 0.001). Multiple linear regression analysis showed that under the same conditions, the wound healing rate of microskin grafting and Meek grafting decreased by 24.6 % and 16.8 % compared with mixed grafting respectively. Follow-up studies of 43 of total 74 burn patients over 1–2 years revealed that the mean VSS scores for pigmentation, pliability, scar height, and vascularity in the mixed grafting group (n = 23) were significantly lower (total score 4.23 ± 2.17) than those in the microskin grafting group (n = 12; 6.02 ± 2.73, <em>P</em> = 0.03), and not significantly different from those in the Meek grafting group (n = 18; 4.37 ± 2.13, <em>P</em> = 0.74).</div></div><div><h3>Conclusions</h3><div>Mixed grafting of small auto- and allo-skin minimizes the reliance on limited autologous skin resources while achieving superior healing rates and lower scar formation for repairing deep burn wounds. Compared with the microskin and Meek grafting methods, the mixed grafting approach significantly enhances wound healing rates and outcomes in patients with extensive deep burns. Our findings suggest that mixed grafting is a viable and effective strategy for improving wound repair and functional outcomes in severely burned patients.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 2","pages":"Article 107356"},"PeriodicalIF":3.2,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973136","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 Mepilex Ag glove: A novel burn dressing for hands","authors":"T.C. Ball,&nbsp;K.A. Toy,&nbsp;D.S. Seoighe","doi":"10.1016/j.burns.2024.107354","DOIUrl":"10.1016/j.burns.2024.107354","url":null,"abstract":"","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 2","pages":"Article 107354"},"PeriodicalIF":3.2,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900051","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":"LINC00525 promotes cell proliferation and collagen expression through feedforward regulation of TGF-β signaling in hypertrophic scar fibroblasts","authors":"Ling Chen ,&nbsp;Yiliang Yin ,&nbsp;Jingyun Li ,&nbsp;Qian Li ,&nbsp;Zezhang Zhu ,&nbsp;Jun Li","doi":"10.1016/j.burns.2024.107353","DOIUrl":"10.1016/j.burns.2024.107353","url":null,"abstract":"<div><div>The etiology of hypertrophic scar formation continues to elude researchers, despite advancements in the understanding of skin scarring. Several long non-coding RNAs (lncRNAs) have been implicated in the pathogenesis of hypertrophic scars, yet the role and molecular mechanisms of LINC00525 in this process remain unclear. This study demonstrates that LINC00525 enhances cell proliferation and collagen expression through knockdown and overexpression techniques. Further analysis, including nuclear and cytoplasmic localization studies, RNA pull-down assays, bioinformatics predictions, and PCR validation, reveals that LINC00525 interacts with miR-29a-5p. The downregulation of LINC00525 enhances the expression of miR-29a-5p and suppresses the TGF-β/Smad signaling pathway. Additionally, TGF-β1 induces the upregulation of LINC00525. Collectively, these findings indicate that LINC00525 operates through a feedforward mechanism to regulate TGF-β signaling in hypertrophic scar fibroblasts. This research offers novel insights for the prevention and treatment of scars.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"51 2","pages":"Article 107353"},"PeriodicalIF":3.2,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911075","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}