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

{"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":"2025-07-01","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":"Burden and associated factors of unintentional household burn injuries in South Asia: A systematic review","authors":"Ahmer Adnan ,&nbsp;Salman Muhammad Soomar ,&nbsp;Asaad Nafees ,&nbsp;Wafa Aftab ,&nbsp;Zafar Fatmi","doi":"10.1016/j.burnso.2025.100411","DOIUrl":"10.1016/j.burnso.2025.100411","url":null,"abstract":"<div><h3>Background</h3><div>Burn injuries account for almost 0.3 million deaths annually worldwide. Household burn injury is one of the common causes of burn injuries. This issue in South Asia is concerning and is an important epidemiological problem that needs to be explored and reported. This study aimed to estimate the current burden, types, and severity of unintentional household burn injuries and identify the associated factors of unintentional household burn injuries.</div></div><div><h3>Methods</h3><div>We reviewed all available studies (qualitative or quantitative) on unintentional household injuries in South Asia. All studies on household burn injuries from 2000 to 2020, including all the relevant published information as described in the inclusion criteria.</div></div><div><h3>Results</h3><div>The findings of the study revealed that in South Asian regions the low socio-economic status, and poor prevention and treatment policies for the burden of burn injuries are the predominant factors and that the associated risk factors play a role in unintentional burn injury incidents with lack of education and awareness effecting mainly women and children to have accidents at households suffering from burn injuries, morbidity, and mortality. No data is available for the Maldives and Bhutan.</div></div><div><h3>Conclusion</h3><div>Unintentional burn injuries cause morbidity and mortality, primarily among women and children. With the lack of financial resources and inadequate policies for burn care, prevention, and treatment in South Asian countries, it is essential to reduce the burden.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"11 ","pages":"Article 100411"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480409","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":"Optimizing the user-experience (UX) and −interface (UI) of a mHealth application to aid recovery from burn injury (BurnCORE) through a user-centered design approach","authors":"Barclay T. Stewart ,&nbsp;Kyler Menge ,&nbsp;T.Varugis Kurien ,&nbsp;Caitlin Orton ,&nbsp;Rebecca Estrada ,&nbsp;Gretchen Carrougher ,&nbsp;Callie Thompson ,&nbsp;Gary Hsieh ,&nbsp;Tam N. Pham","doi":"10.1016/j.burnso.2025.100409","DOIUrl":"10.1016/j.burnso.2025.100409","url":null,"abstract":"<div><div>Anticipatory guidance delivered via a mobile application (app) can support people with burn injury during the early recovery period. We sought to create a prototype app (Burn Connect and Recover – BurnCORE) to complement care provided at burn centers and serve as a transition to the burn survivorship community. We employed a user-centered design (UCD) approach in collaboration with a diverse group of burn care and technology stakeholders (e.g., patients, carers, clinicians, software engineers) to determine key content, functions, and interface preferences. UCD is an iterative design process where a multi-disciplinary team of application designers receive feedback from future end-users to improve understanding of user requirements, optimal features of user experience (UX), and user-app interface considerations (UI). We performed UCD according to its phases: Phase I--community advisory for foundational inspiration; Phase II--cognitive interviews with patients, their carers, and clinicians to determine key content and features; and Phase III--iterative co-design with stakeholders using low-fidelity prototypes. Participants in Phase I suggested that we focus on key gaps in knowledge of the timeline and domains of burn recovery, strategies to promote self-agency and motivation, eliminating barriers to using burn-specific resources, and select issues that aimed to improve UX. Stakeholders recommended several major application features: understanding the initial burn experience, visualizing recovery, and habituation of daily/weekly tasks. Examples of iterative stakeholder feedback include addition of recovery performance tracking, monitored community chat functions, and better ways to visualize recovery over time. UCD allowed us to confirm important burn recovery domains, define valuable features, and elicit from stakeholders key UX/UI features to optimize app engagement.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"11 ","pages":"Article 100409"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144502835","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":"Meningitis as a rare cause of delirium in burn patient: Case report","authors":"Sarah Sabur,&nbsp;Amine El harti,&nbsp;Chaymaa Benyamna,&nbsp;Sara Karti,&nbsp;Ahlam El Youssoufi,&nbsp;Marouane Habla,&nbsp;Mounia Diouri","doi":"10.1016/j.burnso.2025.100415","DOIUrl":"10.1016/j.burnso.2025.100415","url":null,"abstract":"<div><div>Delirium is an acutely disturbed state of mind or consciousness frequent in patients with extensive burns. The causes are multiple but CNS (central nervous system) infection is among the rare and severe causes of delirium with high fever in burn patients and with the lack of fast and correct diagnosis and adequate treatment, the prognosis is mostly severe. Even with the presence of other causes of delirium in burn patients, the CNS infection must be excluded first, especially when we have a massive bacteremia.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"11 ","pages":"Article 100415"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144312590","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":"Unmasking the silent threat: deep tissue impacts of chemical burns – a case report","authors":"Satbir S.G. ,&nbsp;Fatimah Mat Johar ,&nbsp;Ahmad Sukari Halim ,&nbsp;Wan Azman Wan Sulaiman","doi":"10.1016/j.burnso.2025.100412","DOIUrl":"10.1016/j.burnso.2025.100412","url":null,"abstract":"<div><div>Chemical burns, often caused by corrosive substances like sulfuric acid, can result in severe physical and psychological harm. These injuries are challenging to manage due to difficulties in assessing burn depth and ongoing tissue damage beneath the eschar. This case report details a 21-year-old female with 9 % total body surface area full-thickness chemical burns from a battery acid assault affecting her face, chest, limbs, and eyes. Initial treatment included irrigation and pH monitoring, followed by early tangential excision, hydrosurgery, and skin allograft application. While surface eschar pH normalized after irrigation, subeschar tissue remained acidic, indicating deeper damage. The patient developed hypertrophic scarring, reflecting ongoing tissue damage beyond the visible eschar. Persistent subeschar acidity suggests that current treatment protocols may not sufficiently address the penetration of corrosive substances, leading to prolonged inflammatory processes and unfavorable scarring outcomes. This underscores the need for improved strategies to prevent prolonged inflammation and unfavorable outcomes in chemical burn management.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"11 ","pages":"Article 100412"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480411","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":"Fourth-degree frostbite complicated by necrotizing fasciitis in an indigenous Mexican patient: bilateral below-knee amputation and ethical challenges in tissue salvage a case report","authors":"Norman Alejandro Rendon Mejia ,&nbsp;Luisa Fernanda Cuervo Ollervides ,&nbsp;Laura Elizabeth Piñon Gaytan ,&nbsp;Jose Francisco De la Torre Ramos ,&nbsp;Alejandra Aguirre Aguilar ,&nbsp;Carlos Alan Benitez Membrila","doi":"10.1016/j.burnso.2025.100414","DOIUrl":"10.1016/j.burnso.2025.100414","url":null,"abstract":"<div><div>Frostbite, a debilitating injury caused by freezing temperatures, disproportionately affects marginalized populations, yet data from non-circumpolar regions remain critically underrepresented. We present the first documented case in Mexico of severe frostbite requiring bilateral below-knee amputation in a 26-year-old Indigenous man discovered unconscious with alcohol intoxication in subfreezing conditions. Clinical assessment revealed fourth-degree frostbite manifesting as dry necrosis, absent distal pulses, and purulent vesicles. Computed tomography angiography demonstrated popliteal artery occlusion and subfascial gas, confirming concurrent necrotizing fasciitis. Emergency bilateral amputation with fasciocutaneous flap reconstruction resulted in an uncomplicated recovery, enabling discharge on postoperative day 6 for multidisciplinary rehabilitation. This case underscores the ethical complexity of prioritizing limb salvage versus infection mitigation in resource-limited settings and advocates for context-specific, dynamic frostbite management guidelines. Furthermore, frostbite emerges as a sentinel of systemic inequity, reflecting social determinants such as inadequate access to cold-weather protection, alcohol misuse, and healthcare disparities. Culturally tailored prevention strategies—including multilingual community education and equitable healthcare infrastructure—are imperative. As climate change intensifies extreme weather events, frostbite management must evolve beyond acute interventions to address structural vulnerabilities, integrating public health and policy reforms.</div></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"11 ","pages":"Article 100414"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480410","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":"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":"2025-07-01","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":"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":"2025-04-01","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":"2025-04-01","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":"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":"2025-04-01","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}