{"title":"Breast Burns Scar Reconstruction: A Systematic Review of Management Considerations and Recommendations.","authors":"Q Y Sing, T-M Borg, S Shahid, O Abbassi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Breast burns scar reconstruction presents a unique challenge to the plastic surgeon. The consensus view and evidence base for the optimum reconstructive approach to take is not yet established in the literature. This study aims to review the literature to ascertain evidence-based principles for management of this patient cohort. A literature search of Medline was performed using the mesh terms: \"breast burns\", \"chest burns\", \"reconstruction\" and \"surgery\". Screening was performed by two independent assessors, with a senior assessor to resolve discrepancies. Expert articles, reviews, individual case reports and letters were excluded. Literature search generated 1,385 publications. Of these, 22 were deemed eligible for inclusion in this review. These encompassed 483 patients. We present the operative considerations, surgical technique used and outcomes. The recommendations from included literature were summarised to guide the surgeon when approaching breast burns. These include tangential excision, breast bud preservation, scar release at onset of thelarche, and reconstruction only once breast development has completed. Reconstructive approaches and their indications vary with burn severity, status of abdominal and back tissue, and unilateral or bilateral burn injury. The literature on breast burns reconstruction defines certain key steps for management. There is limited quantitative data on the various reconstructive options and lack of long term follow up data. Further work is needed to establish if a particular surgical approach leads to superior results when compared with others.</p>","PeriodicalId":93873,"journal":{"name":"Annals of burns and fire disasters","volume":"38 2","pages":"166-171"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531610","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}
A F Mahir, S R Laidding, A A Zainuddin, N Mariana, S Syarif, A A Islam, M N Massi, M H Cangara, W Warsinggih, I Dososaputro, F Josh, A Bukhari, M Faruk
{"title":"Comparison of EGF and FGF2 Serum Levels with Epithelization and Fibroblast Histopathology on the Acceleration of Deep Dermal Burn Injury Healing using the Combination of PRP and SVF in Wistar Rats.","authors":"A F Mahir, S R Laidding, A A Zainuddin, N Mariana, S Syarif, A A Islam, M N Massi, M H Cangara, W Warsinggih, I Dososaputro, F Josh, A Bukhari, M Faruk","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Burn injuries cause a considerable number of fatalities in Indonesia annually. Platelet-rich plasma (PRP) in combination with stromal vascular fraction (SVF) is a stem cell-related treatment modality for deep dermal burn wound healing that utilizes growth factors such as the epidermal growth factor (EGF) and basic fibroblast growth factor (FGF2). This study aimed to assess the relationship between serum EGF and FGF2 levels and their impact on re-epithelialization and fibroblast histopathology during deep dermal burn wound healing using PRP and SVF. Wistar rats (n=64) were categorized into the following groups: PRP+SVF injection (Group A), topical PRP+SVF application (Group B), topical Vaseline application (Group C), or control (Group D). Treatments were evaluated on days 1, 4, 7, 10 and 14 post-treatment for the treatment groups and day 0 for the control group. The software SPSS 22 was used for the statistical analysis, along with the Shapiro-Wilk, independent t-test, Mann-Whitney, Kruskal-Wallis, one-way ANOVA, and Kendall's Tau-B tests. The results showed that Group A exhibited the highest FGF2 and EGF levels (6.62 and 8.10 ng/ml, respectively), closely followed by Group B (6.40 and 7.09 ng/ml, respectively). Group C had lower FGF2 levels than Group D and similar EGF levels. The PRP+SVF injection group displayed faster re-epithelialization and fibroblast proliferation. The PRP+SVF injections outperformed the topical application and Vaseline, with greater re-epithelialization and higher EGF levels. Although the injections showed comparable healing to the topical application, Vaseline produced proliferation differences during deep dermal burn wound recovery.</p>","PeriodicalId":93873,"journal":{"name":"Annals of burns and fire disasters","volume":"38 2","pages":"136-150"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531611","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 and Late Application of Skin Homograft in Management of Major Burn Patients: A Comparative Study.","authors":"M A Megahed, H R A Elkhouly","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Our objective is to compare the effect of early and late application of skin homograft regarding complications and mortality rate. Burn is a type of physical trauma to skin or tissue. Burn can lead to loss of skin, resulting in deep, widespread skin wounds or even death. This prospective comparative study was done at the Plastic and Reconstructive Surgery Department of Menoufia University Hospitals from December 2017 to July 2020. It was conducted on 31 patients with major burns, classified into two main groups: the early homograft group (8 patients) and the late homograft group (23 patients). All studied patients and donors were subjected to a full history, general and local examination, and investigations such as complete blood counts (CBC), blood glucose level, kidney and liver function tests, electrolytes, and coagulation profile. Additionally, pre-operative preparation along with intra-operative and post-operative care were done. There was a significant decrease in temperature, HR, RR, SIRS score, TLC and K measurements, along with a decrease in rejection % and LOS (length of hospital stay) in the early homograft group compared to the late homograft group (p < 0.05 respectively). Additionally, there was a significant increase in albumin and Na measurements (p < 0.05, respectively). The use of homograft in major burn patients improved their overall condition by improving laboratory and respiratory data post-operatively. However, early usage of the homograft, especially in the first three days, improved laboratory data, SIRS score, percentage of rejection, and length of hospital stay.</p>","PeriodicalId":93873,"journal":{"name":"Annals of burns and fire disasters","volume":"38 2","pages":"158-165"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531613","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}
P A Saraswati, I D Saputro, A D W Widodo, A S Budi, P B D Permana
{"title":"Factors Associated with Clinical Outcomes of Bloodstream Infections at a Burn Unit in Indonesia: A Three-Year Analysis.","authors":"P A Saraswati, I D Saputro, A D W Widodo, A S Budi, P B D Permana","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Burn injuries have a relatively high prevalence in Indonesia, and infection, as one of the serious complications, can significantly increase the risk of morbidity and mortality in patients. This study aimed to investigate the bacteriological profile, antimicrobial susceptibility pattern, and clinical outcomes of burn patients with bloodstream infection (BSI) in Indonesia. A retrospective cohort design was employed from January 2019 to December 2021 using secondary data from the patients' medical records. Factors associated with length of stay (LoS) and in-hospital mortality were evaluated through Mann-Whitney/Kruskal-Wallis test and chi square/Fisher's exact test, respectively. A total of 43 burn patients with culture-proven bloodstream infections were included in the analysis. Gram negative bacteria were the most commonly isolated pathogens (61.9%), with <i>Acinetobacter baumannii</i> being the primary species (34.9%). Coagulase-negative Staphylococci (CoNS) was the second most common species (26.9%), accounting for the majority of gram-positive bacteria. Carbapenem non-susceptibility was remarkably high in gram-negative bacteria, with piperacillin-tazobactam, amikacin, and tetracycline offering higher activity. The presence of other coinfections apart from BSI was significantly associated with prolonged LoS (p=0.039). Factors associated with in-hospital mortality include flame burns (p=0.041), TBSA ≥40% (p=0.003), and early BSI of <7 days (p=0.046). However, no difference in LoS or mortality was demonstrated in patients with <i>A. baumanniii</i> infection compared to CoNS. Prolonged length of stay and increased risk of mortality necessitates clinicians to further improve infection control within the burn unit and evaluate prudent use of antibiotics for patients.</p>","PeriodicalId":93873,"journal":{"name":"Annals of burns and fire disasters","volume":"38 2","pages":"124-135"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531615","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 Acute Kidney Injury in Adult Burn Patients: Outcome and Risk Factors.","authors":"T D Hung, N N Lam, T T D Hien, N T Hung","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The objective of this study was to investigate the characteristics and risk factors for early acute kidney injury (AKI) amongst adult patients with severe burns. KDIGO criteria was used to determine and classify the stage of AKI. Early AKI was defined if occurring within 3 days after burn. The results showed that of amongst 241 enrolled patients, early AKI developed in 25.3% of cases. Of them, AKI stage I was 60.7%, followed by stage II (26.2%) and stage III. Mortality rate of patients who developed early AKI was significantly higher than in the non-AKI group (54.1% vs. 15.6%; p = .001). Compared with the non early-AKI group, patients who developed early AKI were significantly older, suffered larger burn extent and deep burn area, and higher rate of inhalation injury (p <.005). In addition, prevalance of required mechanical ventilation, and concentrations of hematocrit and arterial blood lactate level on admission were significantly higher in the early AKI group (p <.001). Admission pH value, levels of protein and albumin were remarkably lower than in the group with early AKI (p <0.01). Multivariate analysis showed that deep burn area, arterial blood lactate level and mechanical ventilation on admission were independently associated with AKI. The incidence of early AKI increases along with number of independent risk factors. This was 19.7% with 1 risk factor, then it increased to 24.6% with 2 factors and up to 36.1% with 3 risk factors (p <.001).</p>","PeriodicalId":93873,"journal":{"name":"Annals of burns and fire disasters","volume":"38 2","pages":"151-157"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531612","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":"First Skin Bank of Coastal Karnataka: Our Journey so Far.","authors":"C B Pereira, J Thomas, S C Pillai","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In India around 7 million people suffer from burn injuries each year, with 140,000 deaths and 240,000 people having some form of residual disability. Human skin allograft is the gold standard for the treatment of burn wounds, hence having an in-house skin bank at a Burn Unit would be ideal. This article presents the efforts to introduce the concept of skin donation after death to the population of Udupi and Mangalore District, the response to this venture, and how our in-house skin bank helps in the management of patients in our burns centre. This study is a descriptive study done at our skin bank at Kasturba Medical College Hospital Manipal. All donor and recipient records of cadaveric allografts from MAHE Skin Bank from inception on 21-8-2021 to date were analysed. From inauguration to date, a total of 23 skin donation calls have been attended and a total of 56,560 sq. cm of skin harvested, with an average of 2570 sq. cm of skin harvested from the back and the bilateral lower limbs. A total of 20 inpatients in our burns unit received 28,475 sq. cm of cadaveric skin from our skin bank, with 3 patients dying due to sepsis (mortality rate - 15.00%). It is feasible to create a skin bank in a community with no concept of cadaveric skin donation, as demonstrated by the successful establishment of Coastal Karnataka's first skin bank at KMC Manipal Hospital.</p>","PeriodicalId":93873,"journal":{"name":"Annals of burns and fire disasters","volume":"38 2","pages":"100-107"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531616","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}
N Bano, H Ali, M Pervez Khan, B Rizvi, B Zulfiqar, A Awan
{"title":"Nano Fat Therapy and Platelet Rich Plasma Versus Nano Fat Therapy Alone on Burn Scar.","authors":"N Bano, H Ali, M Pervez Khan, B Rizvi, B Zulfiqar, A Awan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The aim of the study was to identify the efficacy of platelet rich plasma plus nano fat therapy in comparison to nano fat therapy alone on burn scars. The study was conducted at the Department of Plastic & Reconstructive Surgery Dr. Ruth KM Pfau, Civil Hospital Karachi, Dow University of Health Sciences Pakistan from March 2021 to February 2022. Sixty-four patients with mature burn scar of both genders aged eighteen and above were included and randomly distributed in 2 groups: one group received treatment with nano fat therapy whereas the other group received treatment with nano fat therapy and platelet rich plasma. Vancouver scar scale (VSS) score was used to assess the scar at baseline, 1 month, 3 months and finally after 6 months. For both groups, the highest mean total VSS score values were observed at baseline and lowest at 6 months. All mean values at various points for the PRP + nano fat group were lower than mean values for the nano fat group. However, the mean difference between the two groups for scores after 6 months was insignificant. It was concluded that results of both treatments are equivocal.</p>","PeriodicalId":93873,"journal":{"name":"Annals of burns and fire disasters","volume":"38 2","pages":"119-123"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531618","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":"Electrical Burn Injuries in Colombia, South America: A Major Source of Morbidity and Mortality.","authors":"N Navarrete, J T Schulz","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In Colombia, electrical injuries account for most burn-related deaths. Mitigation of the risks of electrical injury depends on adequate and reliable epidemiologic data, but to date there is no literature describing the epidemiology of electrical injury in Colombia. In this retrospective study, we aim to begin such a literature. A descriptive, cohort study was conducted in the BICU of Simon Bolivar Hospital in Bogota, Colombia. The study enrolled all adult patients with electrical injuries (including lightning), admitted between January 2011 and December 2013. A detailed assessment of hospitalized patients within the first 48 hours after electrical injury was made in order to determine the severity of injury and outcome. 1.470 adult patients were admitted during this time. Of these patients, 357 patients (24.3%) had electrical injury: 84.3% with high-voltage injuries. The mean age was 35.1 years (SD 13.2). The mean total cutaneous burn surface area (TBSA) was 9.4% (SD: 13.1%); 51 patients (14.5%) had TBSA >20%; 289 patients presented within the first 48 hours after injury, for whom 235 charts were available for analysis. Creatine phosphokinase (CPK) was evaluated in 230 patients. 115 patients (50.0%) had rhabdomyolysis. Eleven patients (4.7%) required segmental amputation, and 14 patients (6.0%) developed early acute kidney injury. In this hospital-based study, 14.5% suffered burns >20% TSBA, and 16.1% showed CPK values >10,000 UI/L. In order to decrease morbidity and mortality from electrical burns in Colombia, it is necessary to establish preventive measures at workplaces and homes, where these injuries occur.</p>","PeriodicalId":93873,"journal":{"name":"Annals of burns and fire disasters","volume":"38 2","pages":"108-118"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531614","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":"Hemodynamic Monitoring in Burn Resuscitation: Current Status.","authors":"B J Halgas, G W Britton, L C Cancio","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The science and treatment of burn shock has continued to evolve in tandem with emerging technologies. Burn resuscitation attempts to deliver the appropriate amount of fluid to counteract the detrimental effects of shock, but advances in data collection, processing and analysis have failed to significantly move the needle. This is because there is little consensus about which markers accurately and dynamically predict the body's intravascular volume, a knowledge gap which only widens as each new technology generates more usable data. Here we review the lessons learned.</p>","PeriodicalId":93873,"journal":{"name":"Annals of burns and fire disasters","volume":"38 2","pages":"91-99"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531617","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}
N M Putri, A Wardhana, C L Sukasah, N Sandora, Rahyussalim, A R Harahap, N C Siregar, H Soedjana, J Prihartono
{"title":"A novel use of amniotic bilayer dressing co-cultured with keratinocytes and stem cell as skin substitute in adult burn patients.","authors":"N M Putri, A Wardhana, C L Sukasah, N Sandora, Rahyussalim, A R Harahap, N C Siregar, H Soedjana, J Prihartono","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Survival outcome of burn patients is increasingly higher with early excision and grafting. The problem after excisional debridement is the need for a skin graft or a temporary dressing. By using an amniotic membrane, which is a biological waste, we can limit the use of auto-skin grafts. A preliminary prospective study was conducted on adult patients with no other comorbidities admitted to dr. Cipto Mangunkusumo Hospital Jakarta Burn Unit between 2021-2022. Patients were divided into three groups, treated with early excision and skin grafting, the amnion bilayer dressing or amniotic bilayer dressings co-cultured with keratinocytes and human amniotic epithelial stem cells (hAESC). The patients were then followed up for two weeks and the resulting epithelization in each group was analyzed, including a skin biopsy for confirmation of the epidermal layer thickness. A total of six patients, two in each group, were included in the study. The amniotic bilayer dressings co-cultured with keratinocytes and stem cell group has a rapid rate of epithelization (10% / day) compared to the early excision and skin grafting and amnion bilayer group (7.14% / day). It also has the thickest epidermal layer (95.7μm - range: 67.4-124.02 μm) and the highest histological score (7.00) at two weeks follow-up. This preliminary study concluded that amniotic bilayer dressings co-cultured with keratinocytes and stem cells had an overall better outcome regarding epithelization rate, suggesting that further study is necessary to evaluate amniotic bilayer dressings co-cultured with keratinocytes and stem cell use in burn patients.</p>","PeriodicalId":93873,"journal":{"name":"Annals of burns and fire disasters","volume":"38 1","pages":"46-52"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144879","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}