Scars, burns & healing最新文献

{"title":"A rare scrotal burn from post-circumcision cetrimide-chlorhexidine (savlon) dressing: Case report and literature review.","authors":"Mahamudu Ayamba Ali, Mawuenyo Attawa Oyortey, Frank Obeng, Kekeli Kodjo Adanu, William Rehoboth Nyanator","doi":"10.1177/20595131251347495","DOIUrl":"10.1177/20595131251347495","url":null,"abstract":"<p><strong>Introduction: </strong>Scrotal burns resulting from wound care are a rare but preventable injury compared to the wide spectrum of post-circumcisions related complications documented. We report an inadvertent cetrimide-chlorhexidine antiseptic scrotal burns due to post-circumcision dressing and review the literature on genital chemical burns.</p><p><strong>Case presentation: </strong>A 6-week-old baby presented with a 3-days history of worsening scrotal burns following smearing of undiluted cetrimide-chlorhexidine as dressing post-circumcision. Examination revealed a healthy baby with non-tender non-specific multiple ulcers and pan-erythematous scrotum. Wound swab isolated Klebsiella and Pseudomonas spp.</p><p><strong>Discussions: </strong>Although there was no clinical complication during procedure, the wrongful post-operative care resulted in scrotal burns. The isolated uropathogens did not result in sepsis or Fournier's gangrene, we believe this preventable burn was eventually reported due to the worsening progression over the period, albeit with minor adverse effects.</p><p><strong>Conclusion: </strong>Post-circumcision instruction for cetrimide-chlorhexidine use by caregiver must be understood to avoid scrotal burns.</p><p><strong>Lay summary: </strong>Scrotal skin burns from chemical agent: Isolated scrotal skin burns are not common and even rarer when they are caused by prescribed medical solution. A neonate was brought in by the parents with complain of developing watery containing swellings on the scrotum that later bust and leads to peeling of the scrotal skin. The mother noticed this after applying dressing solution as part of the measures to prevent circumcision wound infection. Even though the child looked well, the large scrotal surface without skin cover could become a common point for bacteria entry into the body and its consequences. Even though our test isolated 2 different types of disease-causing bacteria from the scrotal wound, this child was managed well and the wounds healed without any further problem. The lessons: 1. circumcision is the commonest surgical procedure performed. 2. This incidence may only be the tip of the iceberg. 3. The parents brought him because it was getting worse. 4. It is a preventable injury by just using the agent in accordance with recommendations.</p>","PeriodicalId":94205,"journal":{"name":"Scars, burns & healing","volume":"11 ","pages":"20595131251347495"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268297","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":"Trends in patients aged 80 years or older with burns requiring hospitalization.","authors":"Tomofumi Ogoshi, Takahiro Ueda, Noriko Matsuo, Yusuke Okawara, Masato Homma","doi":"10.1177/20595131251347496","DOIUrl":"10.1177/20595131251347496","url":null,"abstract":"<p><strong>Purpose: </strong>The average life expectancy in Japan is 81.47 years for males and 87.57 years for females, which is expected to increase, and this has led to an increase in the number of patients aged ≥80 years with burns requiring hospitalization. Herein, we investigated the factors that affect the survival and length of hospital stay of patients aged ≥80 years with burns requiring hospitalization.</p><p><strong>Major findings: </strong>The participants were patients admitted to our facility between 1 January 2008, and 31 December 2018. Deceased patients had significantly higher burn index, prognostic burn index, total body surface area, and revised Baux score, indicating the severity of burns; moreover, they had a lower Barthel index at admission and higher rates of inhalation injury and dementia. Regarding the length of hospital stay, patients with a higher burn index, prognostic body index, total body surface area, and rBaux scores took a longer period from admission to reach sitting and standing positions, and those who had buttock burns had significantly longer hospital stays.</p><p><strong>Conclusions: </strong>In patients aged ≥80 years, higher mortality rates were associated with more severe burns, lower activities of daily living at admission, inhalation injury, and dementia. The length of hospital stay was longer in patients with severe burns, buttock burns, and inability to achieve early mobilization.</p><p><strong>Lay summary: </strong>We investigated the factors influencing the survival rate and hospital stay duration among patients aged 80 years and older who required hospitalization for burns. We compared the records of surviving and deceased patients admitted to our hospital between 2008 and 2018. Our findings revealed that deceased patients experienced more severe burns, reduced activities of daily living at admission, and higher rates of inhalation injury and dementia. Furthermore, patients with severe burns had longer hospital stays, a longer period from admission to sitting and standing, and more frequently had buttock burns. These results indicate that burn severity, activities of daily living, inhalation injury, and dementia are critical factors in the treatment of burns in older patients.</p>","PeriodicalId":94205,"journal":{"name":"Scars, burns & healing","volume":"11 ","pages":"20595131251347496"},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12120278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182680","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":"Frequency of keloid recurrence post-surgical excision and radiation therapy on a 2-year follow-up: A single center cohort study.","authors":"Ceemal Khan, Nida Zahid, Fizzah Arif, Asim Hafiz, Omair Shaikh, Mohammad Fazlur Rahman","doi":"10.1177/20595131251321766","DOIUrl":"10.1177/20595131251321766","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Keloids are elevated, painful scars that extend beyond the original wound's boundaries and can cause significant emotional distress for patients. While combining surgical excision with radiation therapy has shown potential in treating these scars, its effectiveness in local populations remains unclear.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods and methodology: &lt;/strong&gt;The study was conducted from January 2015 to December 2019 in the Plastic Surgery Department at a tertiary care hospital in Karachi, Pakistan. Twenty-five patients who were treated at the hospital were recruited, while 17 out of 25 fulfilling the inclusion criteria were selected. Patients were treated according to a defined treatment protocol and evaluated after a 2-year follow-up. A survey questionnaire was administered after obtaining consent from the patients via telephonic interviews at a 2-year follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Result: &lt;/strong&gt;Out of 25 patients, 17 (68%) met eligibility criteria, eight (32%) were excluded due to lack of follow-up. The patients that presented with keloids, were seven (41%) males and 10 (59%) females. Six (35%) had a family history of keloids. Etiological factors included injury/trauma (n=9, 53%), spontaneous growth (n=6, 35%), and wound site growth (n=2, 12%). Recurrence post-surgery and radiation therapy occurred in 11 (65%) cases, while seven (35%) remained recurrence-free over 24 months. Recurrence frequency was noted in six (55%) patients within six months, three (27%) within 12 months, and two (18%) within 24 months.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Keloid management is a complex field requiring ongoing research to optimize treatment strategies, reduce recurrence rates, and improve patient outcomes through evidence-based protocols in the Pakistani population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Lay summary: &lt;/strong&gt;In a recent study conducted at a tertiary care hospital in Karachi, Pakistan researchers investigated the frequency of keloid recurrence following surgical removal and radiation therapy over a period of two years.Keloids are a type of raised scar that can form after an injury or surgery, often causing discomfort and aesthetic concerns for patients.The study aimed to understand how often keloids come back after treatment, particularly when surgery and radiation therapy are combined. This approach is commonly used to manage keloids, but its effectiveness in preventing recurrence over the long term is not fully understood.Over the two-year follow-up period, the researchers tracked a group of patients who had undergone surgical excision (removal) of their keloids followed by radiation therapy. They observed how many of these patients experienced the return of keloids at the site of the original scar.By analyzing the data, the researchers were able to determine the frequency of keloid recurrence in this specific group of patients. This information is important for healthcare providers and patients considering treatment options for keloids, as it h","PeriodicalId":94205,"journal":{"name":"Scars, burns & healing","volume":"11 ","pages":"20595131251321766"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11960156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143766158","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":"Maggot debridement therapy for burns surgery avoidance in an elderly and comorbid patient: A case report.","authors":"Alyss Vaughan Robinson, Hester Lacey, Baljit Dheansa","doi":"10.1177/20595131241279076","DOIUrl":"10.1177/20595131241279076","url":null,"abstract":"<p><strong>Introduction: </strong>Maggot debridement therapy is an effective and widely used biodebridement method in chronic or non-healing wounds but is infrequently documented in burn injuries. Many burn patients wish to avoid surgical intervention, and in an ageing population with increasing comorbidities surgery may not always be preferable. Here we describe its successful use in an elderly and comorbid patient.</p><p><strong>Methods: </strong>The larvae were applied to a 0.5% full thickness burn wound on the thigh using two treatments of BioMonde Biobags, and he achieved healing within eight weeks.</p><p><strong>Discussion: </strong>Maggot debridement therapy has been documented to shorten healing time, increase the likelihood of healing, and reduce antibiotics use in other chronic wounds. Maggots may be more selective in debriding wounds than sharp surgical debridement, preserving more healthy tissue. There is evidence to suggest that maggots clear biofilms created by <i>Staphylococcus aureus</i> and <i>Pseudomonas aeruginosa</i>, which are common organisms cultured in burn wounds. The patient was enthusiastic about the therapy and would recommend it to other patients.</p><p><strong>Conclusions: </strong>More formal evidence is required to compare outcomes between maggot debridement therapy and surgical intervention in such patient subgroups, as this may become a workhorse therapy for successful burns debridement and treatment.</p><p><strong>Lay summary: </strong>Burn injuries are common and increasingly so in the elderly. Full-thickness injuries are those which involve all the layers of skin and are at risk of becoming long-term wounds if left to heal on their own. These types of wounds will often develop a hard covering layer, called eschar, which protects the regenerating skin underneath but can slow down how fast the wound heals. Often patients with full thickness injuries will need the eschar removed, the wound surgically cleaned (known as debriding) and a skin graft to reduce the healing time. However, in elderly patients with medical issues such as diabetes and heart problems (as in this case), surgery may not be advisable due to the risks of having anaesthetics, as well as the medical problems possibly impacting on how well the skin graft will work. Maggots are immature green-bottle fly larvae which feed on dead tissue and release enzymes to break it down to digest. They have been used in wound care for centuries but are less frequently considered an option for burns. In this case report, an elderly and comorbid patient sustained a deep burn injury to his thigh. He declined surgery and maggots were used instead, which were highly safe and effective. He did not require skin grafting. We suggest more studies are required to compare how effective this treatment is within the elderly population as means of avoiding surgery.</p>","PeriodicalId":94205,"journal":{"name":"Scars, burns & healing","volume":"11 ","pages":"20595131241279076"},"PeriodicalIF":0.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143695040","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":"Treatment outcome and associated factors of burn injury in Ethiopian hospitals: A systematic review and meta-analysis.","authors":"Asnake Gashaw Belayneh, Ousman Adal, Sosina Tamrie Mamo, Alamirew Enyew Belay, Yeshimebet Tamir Tsehay, Henok Biresaw Netsere, Sileshi Mulatu, Gebrehiwot Berie Mekonnen, Wubet Tazeb Wondie, Tiruye Azene Demile, Gebremeskel Kibret Abebe, Mengistu Abebe Messelu","doi":"10.1177/20595131251321772","DOIUrl":"https://doi.org/10.1177/20595131251321772","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Burn injuries impose a substantial burden globally, particularly in low- and middle-income countries like Ethiopia, where the impact is pronounced. Despite existing studies on individual patient data, there 's a lack of synthesized evidence on burn injury mortality in Ethiopia. This study aimed to evaluate the combined prevalence of burn-related mortality and its determinants in Ethiopian hospitals.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A systematic search of various databases yielded 11 relevant studies, which were included in the analysis. Data extraction and quality assessment were conducted using Microsoft Excel 2021 and the Newcastle-Ottawa Scale, respectively. Statistical analyses were performed using STATA version 17 software.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Result: &lt;/strong&gt;The pooled mortality rate among burn patients in Ethiopian hospitals was determined to be 6.99% (95% CI: 4.8, 9.41). Factors significantly associated with mortality included inadequate resuscitation (Adjusted Odds Ratio (AOR) 3.73, 95% CI: 1.31, 10.58), pre-existing illness (AOR: 5.26, 95% CI: 2.12, 13.07), age &lt;5 or &gt;60 (AOR: 2.22, 95% CI: 1.45, 3.40), and burn injury &gt;20% total body surface area (AOR: 5.17, 95% CI: 2.47, 10.80).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The findings underscore a notably high prevalence of burn-related mortality in Ethiopia, with inadequate fluid resuscitation, pre-existing illness, extreme age, and the extent of injury identified as key determinants. Collaboration among healthcare stakeholders and policymakers is imperative to improve burn care services and mitigate the impact of these injuries. This study was registered with PROSPERO (CRD42023494159), providing a comprehensive overview of burn injury mortality in Ethiopia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Lay summary: &lt;/strong&gt;Burn injuries are a significant health concern globally, particularly in low- and middle-income countries like Ethiopia. Despite the existing studies on burn injuries, there's a lack of synthesized evidence on burn injury mortality in Ethiopia. This study aimed to evaluate the combined prevalence of burn-related mortality and its determinants in Ethiopian hospitals.The study systematically reviewed 11 relevant studies and conducted a meta-analysis to determine the prevalence of burn injury mortality and associated factors. The pooled mortality rate among burn patients in Ethiopian hospitals was found to be 6.99%. Factors significantly associated with mortality included inadequate resuscitation, pre-existing illness, age &lt;5 or &gt;60, and burn injury &gt;20% total body surface area.The findings underscore a notably high prevalence of burn-related mortality in Ethiopia, highlighting the need for comprehensive and effective treatment approaches. Inadequate fluid resuscitation, pre-existing illness, extreme age, and the extent of injury were identified as key determinants of mortality. Addressing these factors is crucial for improving burn care outcomes and reducing the burden of burn ","PeriodicalId":94205,"journal":{"name":"Scars, burns & healing","volume":"11 ","pages":"20595131251321772"},"PeriodicalIF":0.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652922","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":"Evaluation of wound healing activity of the crude extract and solvent fractions of <i>Rumex nervosus</i> Vahl (Polygonaceae) leaves in mice.","authors":"Abel Andualem, Kefyalew Ayalew Getahun, Bahiru Tenaw Goshu, Yaschilal Muche Belayneh","doi":"10.1177/20595131251316791","DOIUrl":"10.1177/20595131251316791","url":null,"abstract":"<p><strong>Background: </strong>In Ethiopian traditional medicine, <i>Rumex nervosus</i> Vahl leaves are used to treat wounds. However, despite traditional claims and supportive in vitro findings, no scientific study has been conducted to evaluate the in vivo wound healing activity of <i>R. nervosus</i> Vahl leaves.</p><p><strong>Aim of the study: </strong>To evaluate the wound healing activity of crude extract of the leaves of <i>R. nervosus</i> Vahl and its solvent fractions in mice.</p><p><strong>Methods: </strong><i>R. nervosus</i> Vahl leaves were extracted with 80% methanol, and then the crude extract was fractionated using ethyl acetate, chloroform, and water. Ointments at 5% and 10% strengths were formulated from the crude extract and its fractions. The healing activity of the crude extract was evaluated using linear incision, circular excision, and burn wound models in mice. Additionally, the activity of solvent fractions was assessed using circular excision wounds in mice.</p><p><strong>Results: </strong>Treatment of wounds with ointments containing 5% and 10% crude extract showed significantly increased wound contraction rate, shorter epithelialization period, and higher skin-breaking strength (P < 0.05) compared with the negative control. Both 5% and 10% formulations of the aqueous and ethyl acetate fractions significantly increased wound contraction and decreased the period of epithelialization in the excision wound model (p < 0.05), however, the chloroform fraction showed no significant wound healing effect compared with the negative control.</p><p><strong>Conclusion: </strong>The 80% methanol crude extract as well as the aqueous and ethyl acetate fractions of <i>R. nervosus</i> Vahl leaves possess wound healing activity as evidenced by improved wound contraction rate and tensile strength and decreased epithelialization period.</p>","PeriodicalId":94205,"journal":{"name":"Scars, burns & healing","volume":"11 ","pages":"20595131251316791"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082847","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":"Examining the role of post-traumatic stress disorder, chronic pain and opioid use in burn patients: A multi-cohort analysis.","authors":"Joshua Lewis, Lornee C Pride, Shawn Lee, Ogechukwu Anwaegbu, Nangah N Tabukumm, Manav M Patel, Wei-Chen Lee","doi":"10.1177/20595131241288298","DOIUrl":"10.1177/20595131241288298","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Burns are associated with a high risk of developing comorbidities, including psychiatric disorders such as Post-Traumatic Stress Disorder (PTSD). This study aimed to evaluate the association between PTSD and opioid use, chronic pain syndrome, and other outcomes following burn injuries.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective case-control analysis was conducted using the TriNetX database, a federated, de-identified national health research network with 92 healthcare organizations across the United States. Burn patients with and without PTSD were identified and matched based on demographics and injury severity. The likelihood of opioid use and other outcomes, including chronic pain, depression, anxiety, and emergency department visits, were compared between cohorts. Our study examined eight cohorts based on the percentage of total body surface area burned (TBSA%) and the presence or absence of PTSD. These cohorts were stratified as follows: patients with or without PTSD with TBSA, 1-19%, 20-39%, 40-59%, and 60+%. This stratification enabled a detailed comparison of outcomes across different levels of burn severity and the presence of PTSD, providing a comprehensive context for the results.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The mean age of patients with PTSD was slightly higher (46 ± 16 years) than that of those without PTSD (43 ± 23 years). Incidence of PTSD ranged from 4.96 to 12.26%, differing by percentage of total body surface area burned (TBSA%). Significant differences in various complications and comorbidities were observed between patients with and without PTSD within each burn severity cohort. Compared to the patients without PTSD, patients with PTSD had a significantly higher risk of opioid use in all cohorts: TBSA 1-19%, 20-39%, 40-59%, and 60+%.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;PTSD is associated with a significant increased likelihood of adverse outcomes following severe burns, particularly opioid use, chronic pain, psychological disorders, and higher healthcare utilization. These findings underscore the importance of identifying PTSD in burn patient management and highlight the need for further research into postoperative pain management strategies for this vulnerable population. Psychological assessments and cognitive behavioral therapy may be particularly useful.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Lay summary: &lt;/strong&gt;Burn injuries can cause serious problems like infections and organ failure, and they sometimes lead to death. Severe burns affect about 4.4% of all burn cases and can be deadly in nearly 18% of those cases. They cause inflammation that can lead to long-term heart, metabolism, and thinking problems. These injuries can also cause mental health issues like PTSD (Post-Traumatic Stress Disorder).PTSD means people might relive their trauma through bad memories or nightmares, avoid thinking about it, and feel different emotions for at least a month after it happens. People who survive burns often get PTS","PeriodicalId":94205,"journal":{"name":"Scars, burns & healing","volume":"10 ","pages":"20595131241288298"},"PeriodicalIF":0.0,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815291","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 extracorporeal membranous oxygenation and burn excision in severe burn and inhalation injury.","authors":"Andrew P Bain, Isabel Garcia, Matthew Leveno, Chiaka Akarichi","doi":"10.1177/20595131241302942","DOIUrl":"10.1177/20595131241302942","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Extracorporeal membranous oxygenation (ECMO) as a salvage therapy for patients with severe acute respiratory distress syndrome (ARDS) has been described but experience is limited in burn cases. Few case reports detail the use of ECMO the setting of burn excision.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Case: &lt;/strong&gt;Here, we describe a 40-year-old female found down in a house fire who presented with 30% total body surface area burns and severe inhalation injury resulting in ARDS. Veno-venous ECMO was initiated 12 h after injury, with a total ECMO run of 523 h. In that time, she underwent three tangential excisions with significant intraoperative and postoperative bleeding complications requiring in total 37 units of packed red blood cells, 8 pools of platelets, 24 units of fresh frozen plasma, and 1 unit of cryoprecipitate. The patient was successfully weaned from veno-venous ECMO. She required six subsequent excisions after her ECMO decannulation for both infection control and complete excision of her full-thickness burns. She was ultimately discharged to an inpatient rehabilitation facility.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;This report serves as the first detailed description of perioperative resuscitation on ECMO during burn excision and adds to the body of literature regarding ECMO support in the burned patient. This case specifically highlights the multidisciplinary care and resource demands of performing burn excision during ECMO as well as the associated bleeding complications of doing so. Further study is needed to define optimal timing, patient selection, and strategy for coagulopathy management and surgical care of the burn patient with ARDS treated with ECMO.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Lay summary: &lt;/strong&gt;Patients with severe burn injuries can have associated injuries to their lungs from both smoke and as a response to the stress a severe burn puts on the body. The injuries can be so severe that supportive machines can be needed that do the work of the lungs by adding oxygen to the blood, called extracorporeal membranous oxygenation (ECMO). These extreme measures are critical to supporting severe respiratory problems and have been incorporated into caring for burn patients with severely injured lungs. ECMO requires significant resources and has risks, including bleeding and clotting issues. Severely burned patients also need surgery to remove burned skin and decrease the stress placed on the body. Only a handful of cases have been described where burn surgery has been performed while a patient was on ECMO support. In our experience caring for a severely burned patient and performing multiple surgeries on ECMO, we encountered multiple bleeding complications secondary to the use of ECMO, resulting in large amounts of transfusion products needed. After one month, the patient's lungs recovered and ECMO was not needed. The patient survived to discharge from the hospital after completion of additional necessary burn surgeries. This report is","PeriodicalId":94205,"journal":{"name":"Scars, burns & healing","volume":"10 ","pages":"20595131241302942"},"PeriodicalIF":0.0,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815288","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":"Possible benefits of food supplementation or diet in scar management: A scoping review.","authors":"Thibau Demarbaix, Ulrike Van Daele, Jill Meirte, Mieke Anthonissen, Koen Maertens, Peter Moortgat","doi":"10.1177/20595131241282105","DOIUrl":"10.1177/20595131241282105","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;The evidence regarding a potential role of food supplementation as an adjunct therapy in scar aftercare is limited. In this scoping review we aim to provide an overview of the possible beneficial role of supplementations in aftercare settings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;After formulating the research question and accompanying key words, a comprehensive search for relevant publications was performed using PubMed and Web of Science. Two authors independently identified and checked each study against the inclusion criteria. All data was collected and summarized for further discussion.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;After screening, 11 studies were included in the qualitative synthesis. Four studies including human subjects showed a promising connection between scar improvement and supplementation of vitamin D, omega-3 fatty-acids or a Solanaceae-free diet and lower omega-6 fatty-acid intake. Most of the studies were performed on in-vitro models. Preliminary evidence confirmed the beneficial role of vitamin D. Curcumin- and quercetin-supplementation were linked to decreased fibroblast proliferation. Vitamin C enhanced collagen production in healthy as well as keloidal dermal fibroblasts. Chitin stimulated cell-proliferation in human fibroblasts and keratinocytes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The findings suggest early potential benefits of additional food supplementation in scar management for scars but provide no clear evidence. To establish guidelines or gather more evidence on food supplementation, studies involving human subjects (in vivo) are essential. The intricacies associated with nutritional studies in vivo present multifaceted challenges. It should be emphasized that substantial additional evidence is required before aspects such as timing and dosage of supplementation could be addressed for clinical application.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Lay summary: &lt;/strong&gt;&lt;b&gt;Aim:&lt;/b&gt; This scoping review looks at whether taking food supplements might help with scar care alongside standard scar management following burn injury. Little information is thought to be available on this subject. An up-to-date review of the literature was undertaken to assimilate the body of evidence and determine if a consensus could be drawn.&lt;b&gt;Method:&lt;/b&gt; A specific research question was designed and search conducted in scientific databases like PubMed and Web of Science. Two of our team members carefully selected and reviewed each study to determine which studies met the inclusion or exclusion criteria. All studies that met the inclusion criteria were then reviewed and the information collated to enable conclusions to be drawn.&lt;b&gt;Results:&lt;/b&gt; Eleven studies met the inclusion criteria and were used to formulate the conclusions drawn. Four studies showed that taking vitamin D, omega-3 fatty acids, a diet without certain vegetables (Solanaceae), and eating less omega-6 fatty acids might help improve scars. It is important to note that most studies (sev","PeriodicalId":94205,"journal":{"name":"Scars, burns & healing","volume":"10 ","pages":"20595131241282105"},"PeriodicalIF":0.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11402062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305232","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":"Use of 'stacked' dermal template: Biodegradable temporising matrix to close a large myelomeningocele defect in a newborn.","authors":"Saiidy Hasham, Ciaran O'Boyle, Skaria Alexander","doi":"10.1177/20595131241270220","DOIUrl":"10.1177/20595131241270220","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Myelomeningocele is a severe and complex congenital malformation of the central nervous system. Failure of neural tube closure at around four weeks of gestation results in an open communication between the neural placode and the external environment with varied functional impairment. Surgery is usually required.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;The primary goals of surgical management are to preserve neural function and minimise infection. Reconstruction is dependent upon the site and size of the defect as well as the quality of the surrounding soft tissues. Surgeons may employ a range of reconstructive techniques in order to achieve closure. Skin substitutes, also known as dermal regeneration templates, have also been utilised.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;In our unit, we use NovoSorb Biodegradable Temporising Matrix to reconstruct full-thickness skin and soft tissue defects. It is a synthetic, biodegradable, dermal regeneration template, composed of polyurethane foam bonded to a transparent sealing membrane and typically requires a two stage reconstruction. Integration and vascularisation take approximately three weeks. After this time, the recipient wound bed is suitable for split thickness skin grafting. A further benefit of dermal regeneration templates is the possibility of 'stacking' layers, which serves to increase the thickness of the final construct and to minimise overall contour defects. The authors present the case of a one-day-old full-term neonate with a large lumbosacral myelomeningocele that was successfully managed with staged, stacked NovoSorb Biodegradable Temporising Matrix and split thickness skin grafting. The authors believe this is the first case in which a 'stacked' dermal regeneration templates has been used to achieve healing of a primary myelomeningocele defect.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Lay summary: &lt;/strong&gt;&lt;b&gt;Background:&lt;/b&gt; NovoSorb Biodegradable Temporising Matrix (BTM) is a dermal regeneration template (DRT) and is used to reconstruct wounds following full-thickness skin and soft tissue loss resulting from burn injury, trauma, infection or surgery. It is composed of 2-millimetre thick, synthetic, biodegradable polyurethane foam bonded to a transparent (non-biodegradable) sealing membrane. Like all DRTs, it acts as a scaffold for cellular integration and vascularisation to eventually form a 'neo-dermis'. This is usually apparent from around three weeks. A second stage procedure can then be performed, with removal of the outer sealing membrane and split thickness skin grafting of the vascularised layer.&lt;b&gt;Objectives:&lt;/b&gt; Myelomeningocele is a severe and complex congenital malformation of the central nervous system and forms the group of anomalies commonly referred to as neural tube defects (NTDs). Neural tube closure usually occurs at around four weeks of gestation and failure to do so, results in an open communication between the neural placode and the external environment. The degree ","PeriodicalId":94205,"journal":{"name":"Scars, burns & healing","volume":"10 ","pages":"20595131241270220"},"PeriodicalIF":0.0,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134969","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}