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

{"title":"Total burn mortalities in Brazil: 10 years study","authors":"Luiz Philipe Molina Vana ,&nbsp;Derek Chaves Lopes ,&nbsp;André Vinícius Martignago ,&nbsp;Laura Pompermaier ,&nbsp;Jose Adorno ,&nbsp;Mauricio José Lopes Pereima ,&nbsp;Fábio Ferreira Amorim ,&nbsp;Edgar Merchán-Hamann ,&nbsp;Sérgio Eduardo Soares Fernandes","doi":"10.1016/j.burnso.2025.100437","DOIUrl":"10.1016/j.burnso.2025.100437","url":null,"abstract":"<div><h3>Background</h3><div>Brazil is a large country with a high incidence of burn injuries and socio-economic disparities among its states that affect access to burn care. However, Brazil does not have a national burn database, and most of the research on burns analyzes local burn units’ registries. This study aimed to assess burn-related pre- and in-hospital mortality in Brazil between 2010 and 2019 and to investigate its relationship with sociodemographic aspects.</div></div><div><h3>Methods</h3><div>We have performed a cross-sectional study using publicly available data. Two information systems were compared for data qualification, the Mortality Information System (SIM) and the Hospital Information System (SIH).</div></div><div><h3>Results</h3><div>Pre-hospital mortality depends on burn etiology, with a relative risk of an out-of-hospital death from electrical burns compared to thermal burns of 1.59 (95 % CI: 1.55–1.63). Among all burn deaths, 76.2 % occurred in males, with a statistical significance for all age groups (p &lt; 0.001). Regions with the lowest demographic density in the country had areas with high mortality, with a difference of mean from 2.21 inhab/Km² (median: 2.19) in municipalities with mortality ≥4/100,000inhab to 127 inhab/Km² (median 27.8) in municipalities with mortality &lt;4/100,000inhab (p &lt; 0.001). The association between mortality and the socioeconomic variables studied was exactly the opposite between thermal and electrical causes. A mean difference of 0.61 (95 % CI: 0.55–0.68) in in-hospital mortality due to general burns per 100,000 inhabitants was observed between the SIM database (mean: 0.64/100,000 inhabitants) and the SIH database (mean: 0.03/100,000 inhabitants; p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Our findings demonstrate that studies related to burns must analyze thermal and electrical etiologies separately since they present different correlations with sociodemographic aspects. Also, SIH should not be used to estimate burn incidence or mortality, since it underreports data.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"13 ","pages":"Article 100437"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145738035","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":"Correlation of O2C-device with cutometer and scar scales in evaluation of burn scars: a retrospective cohort study of scar elasticity and perfusion","authors":"Virginia Galati ,&nbsp;Tobias Kisch ,&nbsp;Felix Stang ,&nbsp;Reinhard Vonthein ,&nbsp;Alexander Hoenning","doi":"10.1016/j.burnso.2025.100427","DOIUrl":"10.1016/j.burnso.2025.100427","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;The O2C device (LEA Medizintechnik GmbH, Giessen, Germany), approved in 2002, provides non-invasive monitoring of microcirculatory parameters in tissues and organs. The measurement principle is a combination of laser Doppler spectroscopy to determine blood flow and velocity with white light spectroscopy to determine oxygen saturation and hemoglobin amount. Blood flow, one of the four microcirculatory parameters measured by the O2C device, has been used to assess burn scars und has been found to be higher in hypertrophic scars. However, limited research exists on the O2C device’s role in evaluating burn scars.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;The purpose of this secondary analysis is to quantify and investigate the correlation between the measurements with O2C-Device and those with Cutometer and scar scale scores in the evaluation of burn scars.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We conducted a secondary analysis of the patient cohort described in our previous retrospective clinical study. This study examined the elasticity and perfusion of burn scars after autologous split-thickness skin grafting or the application of the temporary wound dressing Suprathel at least one year after treatment. A total of 80 patients (72.3% male) with a mean age of 47.6 (+- 16.3) years, treated between 2013 and 2018, were enrolled between March and December 2019. Pearson’s correlation coefficient, canonical correlations, and stepwise regression analysis were used to assess relationships between measurements with O2C-Device and those with Cutometer and scar scale scores.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Statistical analysis revealed a lack of correlation between measurements obtained with the O2C device and those from the Cutometer and scar scale scores in the evaluation of burn scars, with a maximum Pearson’s correlation coefficient of r = 0.43. Among the microcirculatory parameters, only weak correlations were found, with the exception of blood flow and velocity. Sensitivity analyses confirmed that the observed correlations were not influenced by age, sex, scar location, or smoking.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Our analysis showed a lack of correlation between measurements obtained with the O2C device and those from the Cutometer and scar scale scores in the evaluation of burn scars. The O2C device provides objective, reproducible measurements of microcirculation and perfusion in burn scars, offering valuable data for evaluating scar healing and functionality. The O2C device may potentially serve as an additional tool to provide more information in the assessment of burn scars. However, the clinical relevance of this information needs to be investigated in future research projects.&lt;/div&gt;&lt;div&gt;Abbreviations: AU, Arbitrary units (chosen arbitrarily by the developer of the device); Fig., Figure; LDI, Laser Doppler perfusion imaging; LSPI, Laser speckle perfusion imaging; log, Natural logarithm; logit, logit transformat","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"12 ","pages":"Article 100427"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145324686","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":"Outcomes in patients with thermal injury treated with cefiderocol","authors":"Heidi Michaels ,&nbsp;Evelyn Coile ,&nbsp;Samuel P. Mandell ,&nbsp;Janie Faris","doi":"10.1016/j.burnso.2025.100418","DOIUrl":"10.1016/j.burnso.2025.100418","url":null,"abstract":"<div><div>Gram-negative infections in burn patients remain a challenge due to increasing antibiotic breakpoints and developing resistance of <em>Pseudomonas</em> species<em>, Enterobacter</em> species<em>,</em> and <em>Stenotrophomonas maltophilia.</em> Unfortunately, established breakpoints are lacking for newer antibiotic products in resistant Gram-negative bacteria; resulting in a significant obstacle when managing difficult to treat pathogens. Our goal was to determine if cefiderocol is efficacious in treating burn patients with Gram-negative bacterial infections.</div></div><div><h3>Methods</h3><div>We present 7 patients treated with cefiderocol for multidrug-resistant (MDR) and extensively drug-resistant (XDR) infections. Ages ranged from 7 to 64 years old, with burn size 8–97.9 % total body surface area. Six patients had flame burn injuries while one had an electrical injury. Four patients sustained inhalation injury and five required continuous renal replacement therapy during their hospital stay. The median ABSI was 13, and the modified Baux score was 123. A median of 9 different antibiotic classes were used per patient prior to cefiderocol. Therapy with cefiderocol ranged from 7 to 80 days with aggressive dosing up to 2 g every 6 h to ensure adequate tissue concentration. Five patients survived and achieved clinical cure. Of the two patients who died, one demonstrated microbiological clearance. Both patients likely died from superinfection with invasive mold. Only one patient demonstrated subsequent cultures resistant to cefiderocol (osteomyelitis) which was cured with amputation. No adverse events were attributed to the cefiderocol regimens. Six of the seven patients showed microbiological clearance for Gram-negative bacteria. Additional studies in patients with large thermal injuries are needed to determine optimal dosing regimens for these hypermetabolic patients.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"12 ","pages":"Article 100418"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687055","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":"Life-threatening drug-induced type B lactic acidosis & serotonin syndrome occurring simultaneously in a major burn patient: a case report","authors":"Radwan Safa,&nbsp;Simon Myers","doi":"10.1016/j.burnso.2025.100430","DOIUrl":"10.1016/j.burnso.2025.100430","url":null,"abstract":"<div><div>We present a unique case of hyperthermia and lactic acidosis in a patient with massive burn injury occurring after the administration of Linezolid. These acute and rapidly progressive symptoms were attributed to separate; rare adverse effects associated with linezolid. Treatment focused on aggressive cooling measures, discontinuation of offending agents, and hemodynamic and respiratory support. Hyperthermia and lactic acidosis resolved quickly after initiation of therapy. Unfortunately, the patient never recovered normal mental status for the remainder of his prolonged ICU stay. He underwent surgical tracheostomy and remained bedbound with minimal movement or interactions and was discharged to a long term facility.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"12 ","pages":"Article 100430"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145465644","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":"Correlation between cardiac index and mean arterial pressure during burn wound excision and skin grafting in patients with severe burns","authors":"Duc Tien Nguyen ,&nbsp;Quynh Van Nguyen ,&nbsp;Thach Ngoc Nguyen","doi":"10.1016/j.burnso.2025.100431","DOIUrl":"10.1016/j.burnso.2025.100431","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate the correlation between cardiac index (CI) and mean arterial pressure (MAP) at different intraoperative time points in patients undergoing burn wound excision and skin grafting.</div></div><div><h3>Methods</h3><div>This prospective observational study included 45 adult patients (≥16 years old) with severe burns, admitted to the Le Huu Trac National Burn Hospital. CI was measured using the ultrasound cardiac output monitor (USCOM), and MAP was recorded via invasive arterial catheterization. Hemodynamic data were collected at seven standardized perioperative time points: T₀ (immediately after premedication); T₁ (immediately after induction of anesthesia); T₂ (prior to burn wound excision); T₃ (at the start of excision); T₄ (at the end of excision); T₅ (at the end of skin grafting); and T₆ (upon regaining consciousness). Simple linear regression was applied at each time point to evaluate the correlation between CI and MAP. Multivariable regression was performed with CI as the dependent variable, and MAP and timepoint as independent variables.</div></div><div><h3>Results</h3><div>Across all time points, the correlation between CI and MAP was weak and not statistically significant. The highest R² value was observed at T₃ (R² = 0.086), indicating a slight positive trend. In the multivariable model, MAP and timepoint did not significantly predict CI (P &gt; 0.05). CI and MAP values fluctuated during surgery but remained within acceptable clinical ranges.</div></div><div><h3>Conclusion</h3><div>No significant correlation was found between CI and MAP during burn wound excision and skin grafting. These findings suggest that cardiac index (CI) and mean arterial pressure (MAP) reflect distinct aspects of cardiovascular function and should be monitored concurrently during intraoperative care in patients with severe burns.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"12 ","pages":"Article 100431"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145528422","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":"Corrigendum to “Initial fluid resuscitation guided by the Parkland formula leads to high fluid volumes in the first 72 h, increasing mortality and the risk for kidney injury” [Burns Open 7(3) (2023) 51–58]","authors":"Laura Lindahl ,&nbsp;Tuomas Oksanen ,&nbsp;Andrew Lindford ,&nbsp;Tero Varpula","doi":"10.1016/j.burnso.2025.100421","DOIUrl":"10.1016/j.burnso.2025.100421","url":null,"abstract":"","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"12 ","pages":"Article 100421"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145623302","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":"The Dutch burn care protocol − Reflections on data from the Dutch Burn Registry","authors":"Folke Sjoberg ,&nbsp;Ingrid Steinvall ,&nbsp;Ahmed T. El-Serafi ,&nbsp;Matilda Karlsson ,&nbsp;Islam Abdelrahman ,&nbsp;Pia Olofsson ,&nbsp;Moustafa Elmasry","doi":"10.1016/j.burnso.2025.100423","DOIUrl":"10.1016/j.burnso.2025.100423","url":null,"abstract":"","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"12 ","pages":"Article 100423"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145623303","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":"A case of delayed encephalopathy after acute carbon monoxide poisoning in a burn patient","authors":"Patrick J. Kennedy ,&nbsp;Allison Chowdhury ,&nbsp;Chinaemelum Akpunonu ,&nbsp;Ariel Rodgers ,&nbsp;Nicole Bernal ,&nbsp;John Loftus","doi":"10.1016/j.burnso.2025.100424","DOIUrl":"10.1016/j.burnso.2025.100424","url":null,"abstract":"<div><div>Delayed encephalopathy after acute carbon monoxide poisoning (DEACMP) is a rare complication of carbon monoxide poisoning, presenting with waxing and waning of neuropsychiatric symptoms days to weeks after initial carbon monoxide poisoning.</div><div>In this case report, we present a case of delayed neuropsychiatric sequelae and demise in a 48-year-old male who suffered 22 % total body surface area burns in a house fire. Initial management included intubation, administration of hydroxocobalamin, and Parkland resuscitation protocol. Despite initial recovery, his neurological status fluctuated, developing hepatic and renal failure, and septic shock. He underwent multiple surgeries and procedures, including tracheostomy, debridement, and grafting, but remained unresponsive with waxing and waning neurological symptoms. A later brain MRI revealed abnormalities in the basal ganglia and thalami, suggestive of DEACMP. Based on the clinical presentation and radiologic findings, an attending neurologist at our institution agreed with this diagnosis before the patient’s demise.</div><div>This case emphasizes the need for vigilant monitoring of burn patients for carbon monoxide poisoning and delayed neuropsychiatric sequelae. There are emerging therapies that may assist in the recovery of neuropsychiatric functioning, but further studies are necessary to guide treatment strategies for DEACMP.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"12 ","pages":"Article 100424"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144892067","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":"Partnering with consumers and multidisciplinary team to understand challenges when conducting clinical trials in the burns ambulatory clinical environment: A qualitative research study","authors":"Beau Scaddan ,&nbsp;Rohan Kumar ,&nbsp;Suzanne Rea ,&nbsp;Fiona M. Wood ,&nbsp;Dale W. Edgar","doi":"10.1016/j.burnso.2025.100428","DOIUrl":"10.1016/j.burnso.2025.100428","url":null,"abstract":"<div><h3>Purpose</h3><div>Patient and staff participation is a key factor influencing the feasibility, implementation and conduct of clinical trials within an acute burn multidisciplinary service environment. Thus, the aim of the project was to better understand the barriers to participation in outcome survey research conducted in the ambulatory clinic environment, from the perspective of patients and staff.</div></div><div><h3>Methods</h3><div>Patient and clinician qualitative responses were collected through semi-structured interviews and summarized.</div></div><div><h3>Results</h3><div>A total of 11 patients and 8 staff participants completed the interviews. The lack of quarantined time available in clinic for research tasks, was the most consistently identified barrier. Competing demands on patients impeded their ability to complete survey packages during their daily clinic journey; and for researchers, the lack of dedicated time to customize project design and access study resources to efficiently recruit patients were the primary challenges identified.</div></div><div><h3>Conclusion</h3><div>This study confirmed that while common challenges exist for burn researchers in the burn clinic, there were multiple, flexible and practical actions to mitigate barriers to completing clinical research in the ambulatory environment.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"12 ","pages":"Article 100428"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145415082","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":"Comfort with burn injury management among healthcare providers in a rural and remote region: a cross-sectional survey","authors":"Darby Little ,&nbsp;George Ho ,&nbsp;Emily Pynn ,&nbsp;Shahriar Shahrokhi ,&nbsp;Margarita Elloso","doi":"10.1016/j.burnso.2025.100425","DOIUrl":"10.1016/j.burnso.2025.100425","url":null,"abstract":"<div><h3>Background</h3><div>Rural and remote communities often rely on primary care providers to complete the initial management and referral of burn injuries. This study aimed to assess frontline providers’ comfort with the initial assessment and management of burn injuries in a rural and remote setting.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was distributed to primary and wound care providers across 10 healthcare facilities in Northwestern Ontario between August and December 2024. Self-reported comfort levels with 15 aspects of burn care were assessed using a five-point Likert scale. Wilcoxon rank-sum tests were used to compare survey responses across practice characteristics.</div></div><div><h3>Results</h3><div>Fifty-nine providers participated, including family physicians (44 %), nurse practitioners (20 %), emergency physicians (10 %), and others. While 90 % saw at least one burn injury per year, only 42 % saw more than five. Most respondents reported comfort with tetanus prophylaxis (72 %) and burn first aid (66 %). However, fewer felt comfortable assessing burn size (31 %) or depth (27 %), initiating fluid resuscitation (27 %), or applying the American Burn Association guidelines for burn center transfer (24 %). Providers managing five or more burns annually reported significantly greater comfort across multiple domains (p &lt; 0.05). No significant differences were found between early- and late-career providers.</div></div><div><h3>Conclusion</h3><div>This study demonstrates that providers working in a rural and remote region reported limited comfort with burn size and depth assessment, initiating fluid resuscitation, and applying burn center referral guidelines – important skills for initial injury management and referral. These findings highlight a need for system-level supports and educational resources for providers in regions remote from specialized burn centers.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"12 ","pages":"Article 100425"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145264997","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}