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

{"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}

{"title":"Third-degree nasal tip burn in a preterm infant treated with amniotic membrane (Case report)","authors":"Paula Andrea Pérez Franco ,&nbsp;Sebastian Murcia Espino ,&nbsp;María Paula Ruiz Díaz ,&nbsp;Juan David Rodríguez Parra","doi":"10.1016/j.burnso.2025.100393","DOIUrl":"10.1016/j.burnso.2025.100393","url":null,"abstract":"<div><h3>Introduction</h3><div>Non-fatal burns are a global health issue with a considerable impact on morbidity as well as aesthetic and functional sequelae. Facial burns in neonates are rare and often occur in hospital settings due to medical devices. Due to its regenerative potential, the amniotic membrane has been used as an alternative treatment for superficial and partial-thickness burns. This report documents the successful use of the amniotic membrane in treating a third-degree burn on the nasal tip of a preterm newborn.</div></div><div><h3>Case presentation and results</h3><div>A male newborn at 33 weeks of gestation was admitted to the neonatal care unit and presented with a third degree burn on the tip, right ala, and columella of the nose, secondary to the use of malfunction on the temperature modulator of a ventilation mask. Initially, the use of hydrogel and dressings with Fitostimoline applied on the injury helped to partially eliminate the necrotic tissue, and then an amniotic membrane was placed on the injury. The 8-month follow-up showed adequate epithelialization without nasal collapse and a satisfactory aesthetic outcome were observed, although there was a slight loss of nasal tip projection.</div></div><div><h3>Discussion</h3><div>This case report demonstrates the effectiveness of the amniotic membrane in the healing process of nasal burns in neonates by improving wound healing and contributing to fibrosis reduction, due to its richness in growth factors and cytokines. Its anti-inflammatory and bacteriostatic effects contribute to pain control and reduce microbial proliferation, optimizing aesthetic outcomes. In combination with other dressings, the amniotic membrane promotes neovascularization and epithelialization preventing significant deformities.</div></div><div><h3>Conclusion</h3><div>The amniotic membrane is an effective alternative for treating neonatal facial burns, minimizing tissue damage and preserving nasal anatomy. This case report results highlight the importance of a multidisciplinary approach in treating facial burns, integrating surgical techniques and advanced wound care technologies to achieve adequate functional and aesthetic outcomes. However, long-term follow-up will establish the need for additional procedures and the evolution of the nasal anatomy.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"10 ","pages":"Article 100393"},"PeriodicalIF":0.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143129750","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 non-invasive treatment in deep burned patients who do not have consent to surgery","authors":"Seyed Hassan Tavoosi ,&nbsp;Ali Ahmadabadi ,&nbsp;Omid Yazarlou ,&nbsp;Hossain Safari ,&nbsp;Mahdi Kouhi Noghondar ,&nbsp;Elaheh Emadi ,&nbsp;Daryoush Hamidi Alamdari","doi":"10.1016/j.burnso.2024.100392","DOIUrl":"10.1016/j.burnso.2024.100392","url":null,"abstract":"<div><div>One of the common traumatic injuries is burns. In deep burns, the standard of care (SOC) is surgical excision and skin grafting, still, some patients do not have consent to do the surgical procedure because of operation fear, comorbidity disorder, or contraindications for anesthesia. This study applied a novel repairing gel, also called SUPRAZ, to treat patients with deep burns to achieve outcomes similar to those of SOC. This gel was made from approved biochemical components involved in wound healing mechanisms. Over 18 months, from 2022 to 2024, this controlled single-arm clinical trial including 22 patients aged 4–80 years with deep partial or/and full thickness burns covering 0.5–12 % of their total body surface area was conducted. Despite the emphasis on surgery, these patients did not consent to do surgery. Therefore, repairing gel was applied topically on the burn area. Repairing gel time to heal the area of burns was 24.9 ± 8.5 (mean ± SD; days). The pain subsided after 10–15 min of use. During the 3–12 months follow-up of the patients, there were no signs of hypertrophic scars and keloids. The repairing gel was safe and can be used for patients who do not consent to surgery. Multicenter clinical trials are needed to substantiate the efficacy of repairing gel and achieving comparable long-term results to SOC in deep-burned patients. Trial registration: IRCT20191228045924N6.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"10 ","pages":"Article 100392"},"PeriodicalIF":0.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143129053","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":"Burns injury characteristics and outcomes at lautoka hospital, fiji","authors":"Rahul Krishna Reddy ,&nbsp;Arun Murari ,&nbsp;Akhtar Ali ,&nbsp;Ronal Kumar ,&nbsp;Livai Lutunaika ,&nbsp;Abhay Choudhari ,&nbsp;Swastika Devi ,&nbsp;Famiza Kulsum","doi":"10.1016/j.burnso.2024.100384","DOIUrl":"10.1016/j.burnso.2024.100384","url":null,"abstract":"<div><h3>Background</h3><div>Burns injury are a global public health problem and one of the leading causes of morbidity and mortality. However, there is no published literature available from Lautoka Hospital in Fiji that assessed the characteristics and outcomes of burn patients.</div></div><div><h3>Objective</h3><div>The aim of this study was to explore sociodemographic and clinical characteristics, medical care and outcomes of burn injury patient at Lautoka Hospital in order to gain deeper insights into burns related issues and improve burns care at the hospital.</div></div><div><h3>Method</h3><div>A retrospective cross-sectional study was conducted between January 1st 2020 and June 30th 2024 at Lautoka Hospital in Fiji. Data were analysed using SPSS version 25. The association between independent variables and outcomes was assessed using Chi-square test.</div></div><div><h3>Results</h3><div>Study population included 267 patients predominately male (57 %). Majority of the patients (59 %) were aged below 10 years. Most of the burns occurred at home (92 %). A significant proportion of patients (64 %) had burns affecting multiple regions with the lower extremities being the most commonly affected area. Partial thickness burns were observed in 87.5 % of patients. The majority of patients (55 %) had a total body surface area (TBSA) &lt; 10 % affected by burns. Normal saline (39 %) and Paracetamol (93 %) were most commonly used intravenous fluid and analgesic respectively. Most patients (93.5 %) underwent daily hydrotherapy while 26 % required surgical interventions. The median length of hospitalisation was 7.4 days. Wound infection occurred in 25 % of patients and the mortality rate was 10 %.</div></div><div><h3>Conclusion</h3><div>This study provides deeper insights into burn related issues in order to reduce the incidence and morbidity of burn injury, and improve care. This study is single centred and conducted retrospectively thus limiting exploration of additional associations. A multicentred prospective study is recommended.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"9 ","pages":"Article 100384"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143155890","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 perspective on the current state of smartphone-based mobile applications for scar assessment","authors":"Peter Moortgat ,&nbsp;Jill Meirte ,&nbsp;Mieke Anthonissen ,&nbsp;Koen Maertens ,&nbsp;Thibau Demarbaix ,&nbsp;Ulrike Van Daele","doi":"10.1016/j.burnso.2024.100389","DOIUrl":"10.1016/j.burnso.2024.100389","url":null,"abstract":"<div><div>Scars can have a significant impact on the physical and psychosocial well-being, so the assessment of scars is crucial for accurate diagnosis, monitoring, and treatment. Traditionally, these assessments required specialized, bulky equipment that needed a wired connection to computers, making these assessment tools less accessible and efficient. The increasing omnipresence of smartphones, equipped with high-resolution cameras and advanced sensors, presents an opportunity to address this gap by developing smartphone-based assessment tools. By providing an overview of the state of smartphone-based scar evaluation tools, this paper will highlight areas for future research and development.</div><div>After a comprehensive review and synthesis of existing literature on smartphone-based tools for scar assessment, the authors identified 11 devices which met the inclusion- and exclusion-criteria. Among the 11 devices, four assessed skin color, two focused on hydration, one measured elasticity, two evaluated texture, three measured temperature, and one assessed thickness. Nine devices were tested on human skin, and only two on scarred skin. Seven tools were evaluated for both validity and reliability, while four were only tested for validity. Five devices required an add-on or clip-on, while six utilized the smartphone’s built-in features. All devices demonstrated moderate to high feasibility for use in various settings and required specialized software for analysis.</div><div>The development of smartphone-based tools for scar assessment represents a significant advancement, offering accessible and portable solutions for both patients and clinicians. While only two scar-specific smartphone tools currently exist, applications, such as skin hydration and color measurement show promise for future integration. These tools have proven effective in assessing general skin characteristics but require further investigation of validity and reliability in a specific scar population. Moving forward, standardized protocols and enhanced imaging technologies, such as raw image formats, will be crucial for improving reliability.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"9 ","pages":"Article 100389"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143155441","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":"Increasing experience in the use of papaya for burn injuries in an African context, potential and limitations","authors":"Helena W.C. Hofland ,&nbsp;Edris W. Kalanzi ,&nbsp;Emmie Viyuyi ,&nbsp;Tilinde Chokotho ,&nbsp;Titus M. Opegu ,&nbsp;Eduard E. Zijlstra","doi":"10.1016/j.burnso.2024.100385","DOIUrl":"10.1016/j.burnso.2024.100385","url":null,"abstract":"<div><div>World-wide, burns are most common in low resource settings (LRS) with high mortality. Human resources, equipment and affordable, effective and safe treatments all influence outcome. Treatment of full thickness burns is particularly challenging and associated with high risk of complications. The presence of an eschar, infection and hypergranulation are important factors that delay wound closure. Tropical fruits are used for treatment of wounds and burns with excellent results. These fruits are usually available throughout the year and essentially inexpensive. The efficacy of papaya and pineapple is based on enzymes that have proteolytic activity and other compounds that have antimicrobial action. In the context of reverse technology, this enzymatic therapy has formed the basis of Nexobrid™ (based on enzymes derived from pineapple) that is now standard of care in high income countries. However, it is painful and very expensive. In LRS the use of papaya paste seems an alternative attractive option; however, evidence-based studies are needed on efficacy, safety, including standardization of the product used and treatment regimens.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"9 ","pages":"Article 100385"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143155844","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}