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

{"title":"Burn vs. Referral Physicians' TBSA Estimation Errors: A Cross-Sectional Study at the National Burn Center","authors":"Alejandro Angel Corona-Figueroa ,&nbsp;Mario Vélez-Palafox ,&nbsp;Erik Agustin Marquez-Gutierrez ,&nbsp;Erika Barlandas-Quintana ,&nbsp;Samuel Eloy Gutierrez-Barreto","doi":"10.1016/j.burnso.2024.100361","DOIUrl":"10.1016/j.burnso.2024.100361","url":null,"abstract":"<div><h3>Background</h3><p>The percentage of the total body surface area (TBSA) is a simplified way to address the magnitude and severity of a thermal injury. The burn care providers recognize the relationship between burn size, prognosis, and number of required interventions. This study aims to identify the prevalence and magnitude of TBSA estimation inconsistencies between referring hospitals and the National Burn Center in Mexico and introduce new telemedicine and mobile applications for effectively estimating burn areas for non-burn-trained personnel.</p></div><div><h3>Methods</h3><p>We included patients with any thermal injury at the National Rehabilitation Institute in Mexico City referred from any other hospital in the country. Data was collected from the referral email and our medical records, and the burn estimation error was calculated using the following formula: (TBSA referral Hospital – TBSA Burn Center) / TBSA Burn Center multiplied by 100.</p></div><div><h3>Results</h3><p>Seventy-eight patients were transferred to the institute; the mean age was 27 years, 55 were male. The mean %TBSA from the referring hospital was 36 %, and in our Burn Center was 28 %, with a mean difference of 8.8 %. There were 59 cases with overestimated %TBSA, and ten were underestimated; the rest were similar in percentage.</p></div><div><h3>Conclusions</h3><p>Our study highlights substantial discrepancies between the estimated %TBSA by referring hospitals and the actual %TBSA, consistently tending towards overestimation.</p></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"8 4","pages":"Article 100361"},"PeriodicalIF":0.0,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S246891222400049X/pdfft?md5=cdecf09df87b374863c335044dc20fc9&pid=1-s2.0-S246891222400049X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141843576","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":"Characteristics of pediatric burns complications in the main referral hospital of Mozambique","authors":"Luísa Huo ,&nbsp;Shannon Richardson ,&nbsp;Celma Issufo ,&nbsp;Valeria Chicamba ,&nbsp;Baltazar Chilundo ,&nbsp;Natércia Fernandes ,&nbsp;Vanda Amado","doi":"10.1016/j.burnso.2024.100362","DOIUrl":"10.1016/j.burnso.2024.100362","url":null,"abstract":"<div><h3>Background</h3><p>Burns remains a major preventable cause of injury in children worldwide with morbidity and mortality disproportionately affecting low- and middle-income countries. Complications following burn injuries in children are not well studied in Mozambique.</p></div><div><h3>Methods</h3><p>Children between 1 month and 14 years old hospitalized for burns between 2015 and 2017 at Hospital Central de Maputo were identified retrospectively. Child and burns characteristics were compiled with complications including wound infection, sepsis, anemia, hypoalbuminemia, hyperglycemia, and dehydration. The association of complications with demographic variables and burn characteristics were assessed through bivariate analysis.</p></div><div><h3>Results</h3><p>Of the 206 children, the most common cause of burns was hot liquids (66%), followed by fire (28%) and electrical current (6%). Children aged one to four years old were most frequently affected (54%). Of the 91 children with complications, 68% had severe burns with a significant relationship between lesion depth and complications. Among the complications, hypoalbuminemia (56%), hyperglycemia (51%), and wound infections (17%) were the most common. Children who had flame/fire burns and 2nd and 3rd degree burns were associate with a greater risk of having complications.</p></div><div><h3>Conclusions</h3><p>Pediatric burns in the early years are more frequent in Mozambique and hold a high burden of complications. Moreover, flame/fire burns and 2nd and 3rd degree burns were associated with increased odds of complications. Primary prevention measures within the family will be critical to minimize pediatric burns and additional research is warranted to better understand clinical interventions to prevent mortality and complications in low- and middle-income countries.</p></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"8 4","pages":"Article 100362"},"PeriodicalIF":0.0,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468912224000506/pdfft?md5=9995c153ba6c8c5a9718d96e98363ae8&pid=1-s2.0-S2468912224000506-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141838953","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":"Characteristics of patients with burn injuries managed at a tertiary care centre","authors":"Suntharamoorthy Iyer Thuraisamy Sarma,&nbsp;Sreekanthan Gobishangar,&nbsp;Suwaminathan Thiruvarangan,&nbsp;Nadarajah Hamsavakini,&nbsp;Paramanathan Shathana","doi":"10.1016/j.burnso.2024.100360","DOIUrl":"https://doi.org/10.1016/j.burnso.2024.100360","url":null,"abstract":"<div><h3>Introduction</h3><p>Burn injuries are becoming a growing burden, negatively impacting both individuals and society. They affect a person’s health and lead to psychosocial and economic problems. This study evaluates the prevalence, characteristics, and short-term outcomes of patients with burn injuries admitted to a tertiary care hospital in Northern Sri Lanka.</p></div><div><h3>Methods</h3><p>This prospective cross-sectional study was conducted on patients with burn injuries admitted to Tertiary care centre Jaffna over six months in 2023. Ethical clearance was obtained from the Ethics Review Committee of the Faculty of Medicine, University of Jaffna. Baseline characteristics and clinical features during hospitalisation were recorded. Categorical variables were compared using the Chi-square test, with post hoc Tukey tests conducted where applicable.</p></div><div><h3>Results</h3><p>This study included 57 patients aged 1 to 88 years, with a mean age of 35.19 ± 21.16 years. Most participants were female (53.4 %), and most had completed secondary education (62.1 %). Approximately 65.5 % were employed in unskilled jobs, with the remainder in skilled professions. Accidental burns were the most common cause (72.4 %), with 84.5 % of injuries occurring at home, though suicide-related burns accounted for 24.1 %. Flame-related burns constituted 50 % of injuries, with first-degree burns being the most common (44.8 %). The availability of first aid significantly influenced outcomes, with 74.1 % receiving assistance, primarily through removing clothing (43.8 %) and using running water (15.8 %). A combined approach of care was received by most patients (52.7 %), while 8.8 % were hospitalised in the plastic and reconstructive surgery department. Many patients had burns covering less than 10 % of their body surface area (46.6 %).</p></div><div><h3>Conclusion</h3><p>The findings of this study on patients with burn injuries underscore the importance of understanding the causes of burns, administering appropriate first aid, recognising different injury types and severities, assessing the total burn surface area, and tailoring patient treatment. These insights are crucial for informing prevention strategies and healthcare planning, aiming to mitigate the impact of burn injuries and improve patient outcomes.</p></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"8 4","pages":"Article 100360"},"PeriodicalIF":0.0,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468912224000488/pdfft?md5=a124304ab43abb497a38d80710e70b16&pid=1-s2.0-S2468912224000488-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141605597","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":"Too hot to handle − Microwaved drinkware: An emerging cause of contact burn injuries?","authors":"Tamara Mertz,&nbsp;Amr Elassy,&nbsp;Christopher Wearn","doi":"10.1016/j.burnso.2024.100359","DOIUrl":"https://doi.org/10.1016/j.burnso.2024.100359","url":null,"abstract":"<div><h3>Purpose of the study</h3><p>To investigate the local and national incidence of contact burns secondary to microwave-heated drinkware and specifically those with a metallic coating.</p></div><div><h3>Methods</h3><p>This retrospective analysis from November 2018 to December 2022 includes UK-wide data on burn mechanism, demographics, TBSA (total body surface area), depth and additionally, local data on injury details, management, complications, healing duration, return-to-work time, and follow-up duration within our service.</p></div><div><h3>Results</h3><p><em>National:</em> In the UK, 87 patients sustained burns related to microwave heating of drinkware. Median (IQR) burn size was 0.21% (+/−0.15) TBSA. Most burn injuries were superficial dermal (SD) (88.7%). All cases were treated conservatively.</p><p><em>Regional:</em> Contact burns from microwave-heated metallic coated drinkware were identified in 28 patients. The median (IQR) TBSA was 0.12% (+/−0). Most injuries were assessed as SD (90%, 45/50), however, 4/5 (80%) of the deeper burns were caused by metallic-coated drinkware. The median (IQR) follow-up was 6.04 days (+/−4.5). Median (IQR) healing time was 14.17 (+/−0) days and mean time to return to work was 7.57 (+/−3.5) days.</p></div><div><h3>Conclusions</h3><p>Microwave-heated drinkware burns, while constituting a small portion of referrals to UK burns services, may have a larger true population incidence. Due to their size, these injuries are probably treated locally without referral to a burns service. Regional data analysis highlighted that metallic coated drinkware related injuries were associated with longer healing times.</p></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"8 4","pages":"Article 100359"},"PeriodicalIF":0.0,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468912224000476/pdfft?md5=d77c48aea66bb87a41a84dc43abdc9d3&pid=1-s2.0-S2468912224000476-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141594571","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":"Prevalence and characteristics of paediatric burns at the National Reconstructive Plastic Surgery and Burns Centre, Korle Bu Teaching Hospital, Ghana","authors":"Alberta Amissah Rockson ,&nbsp;Natalie Benjamin-Damons ,&nbsp;Sonti Imogene Pilusa","doi":"10.1016/j.burnso.2024.100358","DOIUrl":"https://doi.org/10.1016/j.burnso.2024.100358","url":null,"abstract":"<div><h3>Introduction</h3><p>Burn injuries among children have emerged as a significant global public health concern, accounting for substantial morbidity and mortality worldwide. Low and Middle-Income Countries bear a significant burden of paediatric burn injuries. In Ghana, limited data exists on the prevalence, characteristics and outcomes of paediatric burns. This study provides vital data on the local burden and epidemiology of paediatric burns at Ghana’s main burns treatment center. The findings have significant value in informing prevention strategies, allocating resources, and improving quality of paediatric burn care.</p></div><div><h3>Study objective</h3><p>To establish the prevalence and characteristics of paediatric burns injuries in Ghana’s leading burn center.</p></div><div><h3>Methodology</h3><p>A retrospective cohort study analyzed data from 662 adult and paediatric patients who presented with burns from all over Ghana between 2020 and 2022. The study encompassed medical records of paediatric burn cases (aged 0–14 years) admitted to the center from January 2020 to December 2022. A purposive sampling technique was used to select cases based on the inclusion criteria and elimination of cases with 20 % missing data. A total of 335 paediatric records were reviewed.</p></div><div><h3>Data analytical methods</h3><p>Descriptive statistics, such as frequencies, mean, percentages were used to establish period prevalence and demographic characteristics of paediatric burns. Chi-square analysis and univariate logistic regression was utilized to explore associations between categorical variables, and predictors of burn outcome.</p></div><div><h3>Results</h3><p>The period prevalence of paediatric burns was found to be 50.6 %. Paediatric burn cases predominantly affected males (57.6 %). Majority of cases fell within the age range of 1 to 5 years (70.1 %). Hot water emerged as the leading cause (58.4 %), whiles superficial partial thickness burns (51.9 %) was the predominant type of burn. Most cases involved burns affecting less than 20 % Total Body Surface Area (59.0 %). Multi-part body injuries were common (87.2 %), with the lower limb being the most affected (25.36 %). The mortality rate was calculated to be 21.0 %. Higher TBSA was a significant predictor of mortality (p &lt; 0.001).</p></div><div><h3>Conclusion</h3><p>This study found a high prevalence of paediatric burns with hot water and foods being the predominant causes. Higher TBSA predicted lower chances of survival. The findings have scientific value in informing prevention strategies, allocating resources, and improving the quality of care.</p></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"8 4","pages":"Article 100358"},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468912224000464/pdfft?md5=738e7741addc028c0101f1d772465df3&pid=1-s2.0-S2468912224000464-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141541241","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":"Evaluating the long-term aesthetic outcomes of a customized nanofibrous temporary epidermal matrix in facial burn treatment","authors":"Alexandra Schulz,&nbsp;Carmo Kanho,&nbsp;Paul Christian Fuchs,&nbsp;Wolfram Heitzmann ,&nbsp;Jennifer Lynn Schiefer","doi":"10.1016/j.burnso.2024.06.004","DOIUrl":"https://doi.org/10.1016/j.burnso.2024.06.004","url":null,"abstract":"<div><h3>Introduction</h3><p>Facial burn injuries have a profound impact on patients’ lives due to the significant alterations in physical appearance. Recent advancements in medical technology aim to improve the healing process while minimizing scar formation. This study investigates the clinical outcomes of treating superficial to partial-thickness facial burns with a nanofibrous temporary epidermal matrix over a 12-month period, encompassing objective and subjective scar assessments.</p></div><div><h3>Methods</h3><p>A prospective cohort analysis was conducted involving ten patients with facial burns. The study assessed re-epithelialization time, complications, and long-term objective scar outcomes at the 8-month and 12-month marks.</p></div><div><h3>Results</h3><p>The study revealed a notable mean re-epithelialization time of 12.1 days (Standard Deviation: 3.78) without any complications. At the 8-month assessment, there were no discernible differences in objective scar outcomes between treated and intact areas. After a 12-month follow-up, a subtle reduction in skin quality was observed, which lacked clinical significance.</p></div><div><h3>Conclusion</h3><p>These findings emphasize the potential of nanofibrous temporary epidermal matrices as patient-friendly dressings for managing second-degree to partial-thickness facial burns. Their ability to address facial burns without increasing patient discomfort suggests the potential for a less traumatic healing experience, ultimately enhancing overall patient recovery.</p></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"8 3","pages":"Pages 245-252"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468912224000361/pdfft?md5=1745e654c7ce935aecb967875454f3a9&pid=1-s2.0-S2468912224000361-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141484579","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":"Assessment of the quality of life of moderate and severe burn patients in Saudi Arabia using the Burn Specific Health Scale-Brief","authors":"Ali M. Alkhathami ,&nbsp;Salah Aldekhayel","doi":"10.1016/j.burnso.2024.06.007","DOIUrl":"https://doi.org/10.1016/j.burnso.2024.06.007","url":null,"abstract":"<div><p>Improvements in the mortality rate for burn injuries has led to an increase in the number of major burn survivors. Burn injuries pose significant physical and psychological consequences that impact the quality of life of burn survivors. The current study assessed the quality of life of major burn survivors in Saudi Arabia using the Burn Specific Health Scale-Brief (Arabic version). A total of 48 major burn survivors completed a validated online survey. Additional data, including demographics, burn injury characteristics, and treatment strategies, were collected from electronic health records. The mean extent of the patients’ burn injuries was 32 % of total body surface area. The average number of surgical interventions was four (ranging between two to 15 procedures). Over 40 % of the patients experience significant difficulties in performing their jobs. About 94 % are bothered by the appearance of their burn scars. Exposure to sun and hot weather remains a significant burden for the majority. The mean scale score was 99 out of 148. The number of surgical interventions was found to be related to a lower quality of life score (<em>p-</em>value = 0.02). Gender, age, and total body surface area had no predictive value for lower quality of life after burn injury. Even several years after sustaining burn injuries, burn patients continue to exhibit long-term complications and limitations in their functional status and daily living. Furthermore, the number of surgical interventions burn survivors have undergone is a negative predictor for their quality of life.</p></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"8 3","pages":"Pages 241-244"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468912224000403/pdfft?md5=e640bca7daabab10309aff7c55ae517e&pid=1-s2.0-S2468912224000403-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141484578","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":"Double opposing five flaps as an easy way to correct post burn band contracture","authors":"Mahmoud Eloteify ,&nbsp;Mohamed Eloteify","doi":"10.1016/j.burnso.2024.100357","DOIUrl":"https://doi.org/10.1016/j.burnso.2024.100357","url":null,"abstract":"<div><p>Post burn contracture usually need interference mostly for functional or cosmetic correction. Release and skin graft is the first option in the reconstructive ladder; it has its drawbacks either re-contracture or pigmentation of the graft. Release and flap coverage when available is the best. Free flaps, at a time, was the best and last option in the reconstructive ladder. Still, it is the most expensive surgery that consumes a long time for flap raising, anastomosis of its vessels, in addition to donner site morbidity, the need for stages of defatening and the possibility of failure.</p><p>Local flaps if available is the easiest technique for all plastic surgeons even the beginners. Back to basic: advancement, transposition and rotation flap are easy for any plastic surgeon. Linear scaring or contracture usually can be corrected by Z plasty or multiple Z if long. Sometimes double opposing Z plasties (5 flaps release) is used if one side of the line is healthy and the other is scared.</p><p>Z plasty and its varieties are not enough to correct very broad band contracture since its release usually develops large defect. In that case even the free flap alone is not enough; split skin graft is mandatory to complete the defect coverage.</p><p>Our technique is only for band contracture that neither very broad nor linear, and is surrounded by healthy skin, that technique is double opposing 5 flap (DO5F) release.</p></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"8 4","pages":"Article 100357"},"PeriodicalIF":0.0,"publicationDate":"2024-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468912224000415/pdfft?md5=6920e511cf669aacd9e42697ace88812&pid=1-s2.0-S2468912224000415-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141541240","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":"Can viscoelastic haemostatic tests in burn patients help to predict outcome? – A case report and narrative review of the literature","authors":"Joeri Slob ,&nbsp;Stephan A. Loer ,&nbsp;Seppe S.H.A. Koopman ,&nbsp;Cornelis H. van der Vlies","doi":"10.1016/j.burnso.2024.06.005","DOIUrl":"10.1016/j.burnso.2024.06.005","url":null,"abstract":"<div><h3>Background</h3><p>Burn injuries can cause multiple burn-induced coagulopathies. Viscoelastic haemostatic tests received increasing attention in coagulation monitoring as a tool to evaluate the haemostatic function of whole blood. Their exact role in burn patients remains unclear. We wondered whether the results of viscoelastic haemostatic tests are correlated with patient outcome. We present a case report as well as the results of a literature review of studies addressing the relationship of viscoelastic haemostatic tests and patient outcome.</p></div><div><h3>Case</h3><p>We report the case of a 77 year old patient who had suffered flame burns to the chest, abdomen, neck and upper arms accounting for 16 % of the body surface area. One week after burn the patient underwent extensive burn surgery. Repeated perioperative viscoelastic coagulation testing with rotational thromboelastometry showed rapidly changing haemostatic states ranging from hyper- to hypocoagulability. Despite prophylactic use of anticoagulation, the patient developed pulmonary embolism on the second postoperative day. This case highlights the importance of close haemostatic monitoring of patients with burn-induced coagulopathies.</p></div><div><h3>Principal results</h3><p>We identified four studies addressing the relationship between viscoelastic tests and outcome in burn patients, two prospective observational studies and two retrospective cohort studies. Two studies generated prediction models identifying predictors of mortality or complications. Maximum amplitude during viscoelastic testing was found to be an independent outcome predictor in both prediction models. Two other studies suggest that fibrinolysis at 30 min during viscoelastic testing was associated with mortality.</p></div><div><h3>Conclusions</h3><p>Haemostatic management of patients with burn-induced coagulopathies remains challenging. We suggest that viscoelastic haemostatic tests can help to guide clinical decisions. Specific markers, such as maximal strength of the clot and lysis at 30 min after the time of maximal clot strength have been associated with increased mortality. Future research should explore the exact role of viscoelastic haemostatic testing in burn patients.</p></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"8 4","pages":"Article 100354"},"PeriodicalIF":0.0,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468912224000397/pdfft?md5=e0e2bf92a14167933483fef54f1dbf1e&pid=1-s2.0-S2468912224000397-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141401312","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":"Conservative therapy for extensive laryngotracheal stenosis after severe inhalation injury in a patient with severe intellectual disabilities: A case report","authors":"Tatsunori Nagamura ,&nbsp;Takero Terayama ,&nbsp;Hiroshi Kato ,&nbsp;Nobuaki Kiriu ,&nbsp;Masahiko Seki ,&nbsp;Kohei Yamada ,&nbsp;Soichiro Seno ,&nbsp;Yasumasa Sekine ,&nbsp;Kosuke Uno ,&nbsp;Koji Araki ,&nbsp;Tetsuro Kiyozumi","doi":"10.1016/j.burnso.2024.06.006","DOIUrl":"10.1016/j.burnso.2024.06.006","url":null,"abstract":"<div><h3>Introduction</h3><p>Laryngotracheal stenosis after inhalation injury can occur not only in the acute period but also in the late period. Stenosis usually develops in only one area and, in some cases, may require intubation or tracheostomy. However, selecting the treatment for extensive laryngotracheal stenosis in patients with severe mental retardation may be difficult.</p></div><div><h3>Case presentation</h3><p>A 20-year-old man with severe intellectual disabilities was admitted to our emergency department with burns on the face and lower limbs. Severe inhalation injury was suspected; therefore, intubation was performed. The patient was extubated on day 14; however, extensive laryngeal stenosis from the supraglottic area to the cricothyroid ligament area developed on day 37, resulting in carbon dioxide narcosis requiring cricothyrotomy. We believed that the risk of re-stenosis was high, and his mental retardation would make postoperative management difficult; therefore, we selected conservative therapy. Extensive stenosis persisted over 2 years after injury with a tracheostomy tube.</p></div><div><h3>Conclusion</h3><p>Given the risk of re-stenosis, conservative therapy or laryngotracheal reconstruction is preferred for the treatment of extensive laryngotracheal stenosis after inhalation injury. Conservative therapy is advisable when patients cannot comply with the rest required for the treatment.</p></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"8 3","pages":"Pages 237-240"},"PeriodicalIF":0.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468912224000385/pdfft?md5=26687c09721e3606e78e6a27d2e2d0c4&pid=1-s2.0-S2468912224000385-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141404730","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}