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

{"title":"Characteristics of burn injuries in old and extremely old patients: A city-wide study","authors":"Takahiro Yamanaka,&nbsp;Ryo Yamamoto,&nbsp;Junichi Sasaki","doi":"10.1016/j.burnso.2025.100408","DOIUrl":"10.1016/j.burnso.2025.100408","url":null,"abstract":"<div><h3>Background</h3><div>The global population is aging rapidly. However, research on the characteristics of burn injuries in extremely old individuals remains limited. The current study aimed to identify the characteristics of burn injuries among elderly people by examining a city-wide burn database in Tokyo.</div></div><div><h3>Methods</h3><div>This observational study was conducted at 14 burn centers, and data from the Tokyo Burn Unit Association registry from 1999 to 2020 were used. Demographic characteristics, burn mechanisms and severity, and clinical outcomes were compared among three age groups: &gt;80 (very old), 65–79 (old), and 18–64 years.</div></div><div><h3>Results</h3><div>In total, 11,876 patients with burn, including 1,150 aged &gt; 80 years, 1,916 aged 65–79 years, and 8,810 aged 18–64 years, were analyzed. Older patients had a higher incidence of flame burns, burns in the closed space, and trunk, perineum, and lower extremity injuries. The older population had a greater injury severity, longer length of hospital stay, and higher in-hospital mortality rate. Similar trends were observed in the very old population.</div></div><div><h3>Conclusion</h3><div>This study elucidated the characteristics of burn injuries, which included injury mechanisms and anatomical burn sites, among elderly individuals.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"11 ","pages":"Article 100408"},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144084356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fusarium isolates in burn-injured patients: Clinical characteristics and susceptibility patterns","authors":"Robyn Stoianovici ,&nbsp;Sierra Young ,&nbsp;Jeremiah J. Duby ,&nbsp;Naomi Hauser ,&nbsp;Erin Louie","doi":"10.1016/j.burnso.2025.100407","DOIUrl":"10.1016/j.burnso.2025.100407","url":null,"abstract":"<div><h3>Introduction/Objective</h3><div><em>Fusarium</em> species are ubiquitous in the environment and can cause opportunistic infection in burn-injured patients. The purpose of this retrospective cohort observational study is to characterize <em>Fusarium</em> susceptibilities, antifungal and surgical management, and the effect on survival in this patient population.</div></div><div><h3>Methods</h3><div>All burn ICU patients with a positive <em>Fusarium</em> culture were retrospectively identified between November 2017 to June 2023 at a regional burn center. Demographic, clinical, and microbiologic susceptibility data was collected from the electronic medication record.</div></div><div><h3>Results</h3><div>Eighteen patients with positive <em>Fusarium</em> wound cultures were included. The median age was 35 (32–41) years and 28 % were female. The average %TBSA was 55 ± 23 % and r-Baux score of 93 ± 22. The most common mechanism of injury was thermal burn (17 patients, 94 %). This cohort experienced prolonged ICU [53 (46–95) days] and hospital [57 (48– 97) days] lengths of stay. The median time from burn injury to positive <em>Fusarium</em> cultures was 18 (14–24) days. Mechanical ventilation was common (94 %) and prolonged [42 (34–55) days]. Sixty percent of isolates resulted with a minimal inhibitory concentration (MIC) ≥ 16 mcg/ml for voriconazole and 93 % isolates resulted with an MIC &lt; 1 mcg/ml for amphotericin B. All patients underwent surgical debridement for source control. Ten of 18 patients (55 %) with <em>Fusarium-</em>positive infections survived to hospital discharge. Infection complicated by multisystem organ failure and sepsis was the most common attributable cause of death (88 %).</div></div><div><h3>Conclusion</h3><div>Patients infected with <em>Fusarium</em> were severely burned, critically ill, and exposed to prolonged mechanical ventilation and to central venous catheterization. The high mortality rate associated with <em>Fusarium</em> infection and prolonged time to antifungal susceptibility results emphasize the importance of appropriate empiric therapy.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"11 ","pages":"Article 100407"},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shifting dynamics of self-immolation in the capital of Iran? The rising trend among young, unmarried, less-educated men","authors":"MohammadAli Shokri ,&nbsp;SaeedehSadat Khalili ,&nbsp;Abdol-Hossein Vahabie ,&nbsp;Atefeh Ghanbari Jolfaei ,&nbsp;Amir-Abbas Keshavarz-Akhlaghi ,&nbsp;Mostafa Dehmardei ,&nbsp;Fatemeh Sadat Mirfazeli","doi":"10.1016/j.burnso.2025.100406","DOIUrl":"10.1016/j.burnso.2025.100406","url":null,"abstract":"<div><div>In our study, we aimed to explore the psychiatric disorders, risk factors, and predictors of self-immolation among individuals admitted to Shahid Motahari Hospital in Tehran from 2019 to 2020. This cross-sectional study examines 64 hospitalized patients who received psychiatric counseling following self-immolation incidents.</div><div>The rate of self-immolation varies significantly based on specific demographics. It is observed that in our population men had a higher rate of being unmarried (70.96 % vs 15.15 %), lower levels of education (70.96 % vs 63.63 % did not have a university degree), higher level of unemployment (54.83 % vs 30.30 %), younger age average with most men aging 15–24 (29.06 (SD = 9.33)) vs women 35–44 (35.27(SD = 10.27)) and higher prevalence of addiction (67.74 % vs 36.36 %) compared to women. On the other hand, women who attempted self-immolation mainly were married, involved in housekeeping, and tended to exhibit higher rates of depression (63.63 % vs 32.25 %) than men. Furthermore, these self-immolation incidents are often impulsive (64.1 %) and occur shortly (under an hour) after experiencing a stressor (39.1 %). Self-immolation accidents are frequently carried out using gasoline (50 %). Geographically, the majority of self-immolation cases of our study are concentrated in the central region of Iran (76.6 %), followed by the western region (15.6 %) this may be due to the proximity of these regions to our center while patients of other<!--> <!-->regions were hospitalized in their referral hospitals and were rarely transferred to the capital. To effectively address the issue of self-immolation and reduce its prevalence, it is essential to identify vulnerable populations and explore targeted preventive measures. Based on our findings, future pilot studies could investigate the feasibility of specific interventions, such as crisis hotlines to reduce impulsivity-related acts of self-immolation. Additionally, small-scale feasibility projects could explore the effectiveness of impulse control management or interpersonal skills training in high-risk populations, but further research is needed to assess their practicality and impact.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"11 ","pages":"Article 100406"},"PeriodicalIF":0.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143874874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"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}