Burns open : an international open access journal for burn injuries最新文献

{"title":"Comprehensive management and recovery of reproductive function after testicular necrosis from scrotal burn: A case report","authors":"Yuya Miyoshi ,&nbsp;Takashi Hongo ,&nbsp;Takatoshi Moriwake ,&nbsp;Taisuke Kanno ,&nbsp;Kohei Tsukahara ,&nbsp;Tetsuya Yumoto ,&nbsp;Hiromichi Naito ,&nbsp;Atsunori Nakao","doi":"10.1016/j.burnso.2025.100404","DOIUrl":"10.1016/j.burnso.2025.100404","url":null,"abstract":"<div><div>Genital burns are uncommon injuries; however, they present significant concerns regarding reproductive function, particularly in younger populations. Despite this, the literature on the long-term follow-up of reproductive function after genital burns remains insufficient. A 20-year-old Japanese man suffered severe burns in his lower body including genital area following a motorcycle accident. Doppler ultrasonography revealed reduced blood flow to the right testis, which gradually atrophied. The patient underwent longitudinal monitoring through semen analysis, which revealed declining sperm function. Considering the adverse effects on the contralateral testis, right orchiectomy was performed six months after injury, and subsequent semen analysis showed normalization of sperm parameters. Genital burns with testicular necrosis can result in decreased testicular function, emphasizing the need for continuous monitoring through ultrasonography and semen analysis, and the potential necessity of orchiectomy.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"11 ","pages":"Article 100404"},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143761268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Our initial experience with rapid enzymatic debriding agent for burn eschar: Case series from an ABA verified burn center","authors":"Cole L. Bird ,&nbsp;Yair Saucedo ,&nbsp;Jessica Reynolds ,&nbsp;Dhaval Bhavsar","doi":"10.1016/j.burnso.2025.100403","DOIUrl":"10.1016/j.burnso.2025.100403","url":null,"abstract":"<div><div>We reviewed 14 consecutive patients at our ABA-verified burn center who received enzymatic debridement with anacaulase-bcdb (NexoBrid®) from January 2020 to May 2023. These patients, part of the NEXT study, had deep partial or full-thickness burns. We aimed to evaluate NexoBrid’s effect on eschar removal, wound healing, surgical needs, and scar quality.</div><div>Data included total body surface area (TBSA) burned, enzymatically treated area, amount of NexoBrid used, grafting details, time to healing, and scar characteristics. Analysis was descriptive, reporting medians, ranges, and percentages.</div><div>All 14 patients achieved ≥ 95 % eschar removal with a single NexoBrid application. Their ages ranged from 15–65 years, and mean burn size was 9.25 % TBSA. Eight patients required grafting, but these grafts covered only about 60 % of the treated area. Time to 95 % wound closure averaged 36 days. Scar assessment using the Vancouver Scar Scale showed improvement from a mean score of 3.8 at three months to 0.5 at twelve months. Despite this, four patients developed hypertrophic scars and one required intervention for a contracture.</div><div>In summary, NexoBrid facilitated rapid, consistent non-surgical eschar removal, timely wound closure, and favorable scar outcomes within one year. In nearly half of the patients, it eliminated the need for skin grafting. Among those who did require grafts, smaller graft areas were needed. These findings suggest that early eschar removal and dermal preservation contribute to improved outcomes. Further studies with larger cohorts will help confirm these results.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"10 ","pages":"Article 100403"},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating the probability of survival of hospitalized burn patients at a tertiary hospital in Ghana","authors":"Julius Kwabena Karikari ,&nbsp;Samuel Nana Forjuoh ,&nbsp;Emmanuel Konadu ,&nbsp;Ebenezer Otu Ayeboafo Ansah ,&nbsp;Nicholas Karikari Mensah ,&nbsp;Sulemana Baba Abdulai ,&nbsp;Jennifer Fordjour ,&nbsp;Lydia Oduro ,&nbsp;Emmanuel Kweku Nakua","doi":"10.1016/j.burnso.2025.100402","DOIUrl":"10.1016/j.burnso.2025.100402","url":null,"abstract":"<div><div>This retrospective study estimated the survival patterns and mortality predictors among burn patients admitted to Komfo Anokye Teaching Hospital in Ghana, where burn-related mortality remains high due to challenges in providing comprehensive care. Data from 457 burn patients admitted from January 2021 to December 2023 were extracted from the Lightwave Health Information Management System. Descriptive analyses were conducted for continuous and categorical variables. Survival probabilities were estimated using Lifetable and Kaplan-Meier analyses, while Cox proportional hazard regression model was used to identify mortality predictors. Hazard ratios (HR) were used to estimate mortality risk with 95 % confidence intervals (CI) and a p-value of 0.05 to express the association between significant predictors and the treatment outcome (mortality). Data analysis was performed in Stata/SE Version 17.0. Diagnoses of Systemic Inflammatory Response Syndrome (SIRS) and inhalation injury as well as mechanical ventilation usage were associated with lower survival probabilities. Mortality risk increased with larger total body surface area (TBSA) burned (adjusted hazard ratio [aHR] = 1.05, 95 % CI: 1.04–1.06), full-thickness burns (aHR = 4.86, 95 % CI: 2.70–8.74), and inhalation injury (aHR = 1.66, 95 % CI: 1.05–2.61). Conversely, hemo-transfusion (aHR = 0.50, 95 % CI: 0.31–0.79) and surgical intervention (aHR = 0.15, 95 % CI: 0.06–0.37) were associated with improved survival. TBSA burned, full-thickness burns, and inhalation injuries significantly predicted increased mortality risk, while hemo-transfusion and surgical interventions were associated with improved survival. The findings of this study suggest that early surgical intervention significantly improved survival outcomes.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"10 ","pages":"Article 100402"},"PeriodicalIF":0.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143563636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The addition of lactate to SOFA score improves the prediction of mortality in patients with severe burns–A retrospective cohort study","authors":"Martin Huss Knave ,&nbsp;Romans Elvihs ,&nbsp;Jyrki Tenhunen ,&nbsp;Fredrik Huss ,&nbsp;Filip Fredén ,&nbsp;Annelie Barrueta Tenhunen","doi":"10.1016/j.burnso.2025.100398","DOIUrl":"10.1016/j.burnso.2025.100398","url":null,"abstract":"<div><h3>Background</h3><div>Major burn injury is a serious condition associated with high morbidity and mortality. In addition to Baux and revised Baux scores, several scores for prediction of outcome have been employed during the years, including SOFA (Sequential Organ Failure Assessment) score and lactate on admission.</div></div><div><h3>Methods</h3><div>The goal of the present study was to investigate two early composite indexes, with the hypothesis that they would more accurately predict mortality. SOFALx was formulated by adding the highest blood lactate of day 1, 2 and 3 after admission to the SOFA score of the corresponding day. CCIrBS was defined as the sum of Charlson Comorbidity Index with revised Baux Score and SAPS-3 (Simplified Acute Physiology Score). We investigated the prognostic value of these composite indexes in patients admitted to the burn center at Uppsala University Hospital with major burn injury (≥ 20 % TBSA) between January 2017 and December 2022. Primary outcome was 180-day mortality.</div></div><div><h3>Results</h3><div>Among the 95 patients that were included, 38 were non-survivors and 57 were survivors. Both composite indexes had a proper prognostic value. The prognostic accuracy was best for SOFALx on day 2 (SOFAL2) with median value (IQR) of 8.3 (4.8) for survivors vs. 16.5 (7.9) for non-survivors (p &lt; 0.001) and the area under the ROC curve of 0.923. CCIrBS gave an area under the ROC curve of 0.916. The value of this composite index was 138 (63) in survivors vs. 212 (52) in non-survivors (p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Both SOFALx and CCIrBS are accurate prognostic indexes. Since SOFALx, in comparison to the more complex CCIrBS, is easy to use, this composite index is interesting for future studies.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"10 ","pages":"Article 100398"},"PeriodicalIF":0.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143548682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early opioid use in acute severe burn injuries and long-term pain and quality of life","authors":"Tessa Garside ,&nbsp;Lachlan Donaldson ,&nbsp;Emily Fitzgerald ,&nbsp;Bao Teng ,&nbsp;Anthony Delaney","doi":"10.1016/j.burnso.2025.100401","DOIUrl":"10.1016/j.burnso.2025.100401","url":null,"abstract":"<div><h3>Introduction</h3><div>Pain management in the intensive care unit (ICU) following severe burn injury, particularly the use of high dose opioid therapy, may contribute to the development of long-term pain and impact long term health-related quality of life. This study aims to describe the analgesic management and long-term self-rated health-related quality of life, including functional, psychological and pain outcomes, in patients admitted to ICU with a major burn injury.</div></div><div><h3>Methods</h3><div>This was a retrospective analysis of prospectively collected data. All patients who were admitted to a tertiary referral intensive care unit with burns ≥20 % of total body surface area (TBSA) and survived to hospital discharge were included. Data relating to the severity of injury and analgesia management were collected for each patient. Patients completed follow up with the EQ-5D-5L questionnaire at 6- and 12-months post burn injury.</div></div><div><h3>Results</h3><div>84 patients were included. Seventy eight percent of patients reported long term issues with pain at 12 month follow up. Seventy-four percent of patients reported issues at 12 months with usual activities and 78 % reported issues with anxiety and depression. The mean dose of opioids (oral morphine equivalent dosing) prescribed to patients who reported issues with pain was not significantly different to those who did not report issues with pain at long term follow up (5079 (SD 7006) mg vs 3599 (SD 3175) mg, p = 0.2).</div></div><div><h3>Conclusions</h3><div>Patients who suffer major burns requiring ICU admission have long term issues with pain/discomfort, mobility, usual activities, self-care, and anxiety and depression, that are greater than reported in the general burns population. The total dose of opioids given in the acute stage of injury do not seem to influence the prevalence of long-term pain/discomforts in burn patients.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"10 ","pages":"Article 100401"},"PeriodicalIF":0.0,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilization of Suprathel® in delayed surgical management of toxic epidermal necrolysis (TEN): A case report","authors":"Isabella Lipkin ,&nbsp;Michelle Hughes ,&nbsp;W.B. Hughes","doi":"10.1016/j.burnso.2025.100399","DOIUrl":"10.1016/j.burnso.2025.100399","url":null,"abstract":"<div><div>Given the lack of established practice guidelines for the management of cutaneous symptoms associated with toxic epidermal necrolysis, treatments range from various dressings to skin substitutes. The following report details a case of a 21-year-old male patient with this diagnosis who presented nine days after rash eruption from an outside hospital with no signs of healing. The patient was then successfully managed surgically eleven days after symptom onset with debridement of epidermal blisters and placement of Suprathel®. To our knowledge, this publication is the first to describe the potential of this synthetic skin substitute in promoting epidermal regeneration for delayed surgical management of toxic epidermal necrolysis.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"10 ","pages":"Article 100399"},"PeriodicalIF":0.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143487153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathophysiology and management of burn injury-induced pain","authors":"Zerong You ,&nbsp;Shubhika Jain ,&nbsp;Shiqian Shen ,&nbsp;Jianren Mao ,&nbsp;J.A. Jeevendra Martyn","doi":"10.1016/j.burnso.2025.100396","DOIUrl":"10.1016/j.burnso.2025.100396","url":null,"abstract":"<div><div>This review examines the pathophysiology and therapeutic management of burn injury-induced pain (BIP). Burn injury, occurring globally in about 11 million people, often induces the most intense pain, but its management remains suboptimal. The pain often persists even after complete wound healing and hospital discharge causing both long-term disability and neurological dysfunction. The fact that BIP persists well beyond the initial hospitalization is not well recognized and should be underscored as the pain involves even non-burned areas. The pathophysiology of the latter problem is poorly understood and needs further study. Opioids, the mainstay for moderate to severe pain relief after major burn injury, with time, have poor analgesic and serious side effects. Accurate assessment pain of BIP and its biology at different stages of treatment helps to provide effective treatments of the different etiological factors that cause BIP and their sequelae. Based on clinical and pre-clinical studies, we discuss the current knowledge on the underlying cellular and molecular mechanisms in the initiation and persistence of BIP during the acute phase and later phases of injury. Opioid receptor-mediated signaling changes <em>per se</em> and immune microglia responses in concert exaggerate nociceptive behavior. Both burn injury and opioids upregulate spinal NMDA receptor expression and microglia changes, which further exaggerate pain. BIP has inflammatory and neuropathic components. Pharmacological and non-pharmacological approaches currently available for management of BIP is discussed. Areas that need further study include the role of other central and peripheral factors in the exaggeration of pain well beyond wound healing. Novel non-opioid methods to rectify BIP is important to develop in view of the potential for opioid use disorder. The role of microbiome in chronic pain syndromes is an unexplored territory and its relevance to BIP needs further examination. Pruritus or itch, though very common and important in the pharmacotherapy of burns, the discussion of this topic is brief. Extensive review of this topic is beyond the scope of this review in view of the vast body of knowledge and varying and multiple treatment options.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"10 ","pages":"Article 100396"},"PeriodicalIF":0.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143509195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between burn area and severity and length of stay in burn patients treated at the leading referral burn Centre in West Java, Indonesia","authors":"Patricia Andini ,&nbsp;Arif Tri Prasetyo ,&nbsp;Lisa Y. Hasibuan ,&nbsp;Hardisiswo Soedjana ,&nbsp;Filla Reviyani Suryaningrat","doi":"10.1016/j.burnso.2025.100397","DOIUrl":"10.1016/j.burnso.2025.100397","url":null,"abstract":"<div><h3>Background</h3><div>Burns are severe injuries that require intensive medical care and have a significant impact on patients’ healing and rehabilitation processes. The outcome of burn treatment is largely influenced by the length of hospital stay, which is primarily determined by the surface area and severity of the burns. This study aims to examine the relationship between the extent (≥20 % TBSA) and severity of burns with prolonged hospitalization (≥14 days) in burn patients at the Burn Unit of Dr. Hasan Sadikin General Hospital, Bandung, from January 2021 to December 2023.</div></div><div><h3>Methods</h3><div>This research is an observational analytical correlational study using a cross-sectional approach. The subjects were burn patients hospitalized in the Burn Unit of Dr. Hasan Sadikin General Hospital during the same period, with data collected from their medical records. Out of 195 cases, only 82 were deemed suitable for evaluation. Statistical analysis of the categorical data was performed using the Chi-square test.</div></div><div><h3>Results</h3><div>The results indicated a significant relationship between the extent of burns and the length of hospital stay in patients who showed improvement, with a p-value of 0.003 and an Odds Ratio (OR) of 6.111. A significant relationship was also found between the severity of burns and the length of stay, with a p-value of 0.025 and an OR of 3.667. However, no significant relationship was observed between the extent of burns and the length of stay in patients who did not survive.</div></div><div><h3>Conclusion</h3><div>This study reveals a significant relationship between the extent and severity of burns and the length of hospital stay in patients who showed improvement in the Burn Unit of Dr. Hasan Sadikin General Hospital from January 2021 to December 2023.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"10 ","pages":"Article 100397"},"PeriodicalIF":0.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143465152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel approach to non-surgical management of deep second-degree perianal burn in an immobile patient using platelet-rich plasma: A case report","authors":"Martynas Tamulevicius,&nbsp;Peter M. Vogt,&nbsp;Vincent Maerz","doi":"10.1016/j.burnso.2025.100395","DOIUrl":"10.1016/j.burnso.2025.100395","url":null,"abstract":"<div><div>This case report presents a 24-year-old patient with severe mental and physical disabilities who sustained deep partial-thickness burns to the perianal and gluteal region. Conventional surgical interventions, such as skin grafting, were deemed unsuitable due to the high risk of infection and the patient’s non-compliance with specialized positioning. Instead, the innovative use of platelet-rich plasma (PRP) therapy was implemented, involving subdermal PRP injections and daily dressing changes. PRP, derived from the patient’s own blood, offers low immunogenicity and promotes wound healing by enhancing angiogenesis, modulating inflammation, and reducing oxidative stress. The patient showed significant wound healing and reepithelialization, avoiding the need for any surgery. This case highlights the efficacy of PRP in managing complex burn wounds and underscores the necessity for personalized treatment strategies, particularly for patients with significant comorbidities, where conventional methods may pose additional risks.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"10 ","pages":"Article 100395"},"PeriodicalIF":0.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143403422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful recovery of 85% TBSA burns in a resource-limited Nigerian hospital without a burns ward or intensive care unit: A case report","authors":"Innih Asuekome Kadiri ,&nbsp;Kolawole Olubunmi Ogundipe ,&nbsp;Deborah Aanuoluwapo Oluwatuyi","doi":"10.1016/j.burnso.2025.100394","DOIUrl":"10.1016/j.burnso.2025.100394","url":null,"abstract":"<div><div>Survival and death from major burns are important indicators of burn treatment quality. Most burn-related mortalities occur in low- and medium-income countries (LMICs), with Africa accounting for a significant portion. While advancements in burn management have resulted in improved survival rates in high-income countries (HICs), LMICs like Nigeria still face high mortality rates, with a lethal area (LA50) below 50% TBSA.</div><div>This case report presents the successful management of a patient with 85% TBSA burns at a resource-limited tertiary hospital in southwest Nigeria, which lacks a dedicated burns ward and an intensive care unit. It highlights the potential for favourable outcomes in resource-limited settings when the managing team is committed.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"10 ","pages":"Article 100394"},"PeriodicalIF":0.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143129749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}