Percutaneous mesh expansion
Publication date: Available online 25 June 2019Source: BurnsAuthor(s): J.J. Vandeput, M. Nelissen (Source: Burns)
Source: Burns - June 25, 2019 Category: Dermatology Source Type: research

Analgesia protocols for burns dressings: Challenges with implementation
Publication date: Available online 21 June 2019Source: BurnsAuthor(s): S.L. Wall, D.L. Clarke, N.L. AllortoAbstractBackgroundThe aim of this study is to compare doctors’ knowledge regarding analgesia in paediatric burns patients in a setting where analgesia protocols are provided but not reinforced to a setting where the same protocols are used but with constant re-enforcement from burns surgeons.MethodsWe reviewed questionnaires completed anonymously by doctors managing burns children in the Pietermaritzburg (PMB) Hospital Complex and the referral hospitals.ResultsThe questionnaire was completed by 43 doctors with 5...
Source: Burns - June 23, 2019 Category: Dermatology Source Type: research

Artificial intelligence and machine learning for predicting acute kidney injury in severely burned patients: A proof of concept
ConclusionsThe performance of UOP and creatinine for predicting AKI could be enhanced by with a ML algorithm using a k-NN approach when NGAL is not available. Additional studies are needed to verify performance of ML for burn-related AKI. (Source: Burns)
Source: Burns - June 23, 2019 Category: Dermatology Source Type: research

Superiority of silver-foam over porcine xenograft dressings for treatment of scalds in children: A prospective randomised controlled trial
ConclusionsWe compared two different treatments for children with partial-thickness scalds, and the data indicate that wound healing was faster, fewer dressing changes were needed, and dressing times were shorter in the silver-foam group. (Source: Burns)
Source: Burns - June 23, 2019 Category: Dermatology Source Type: research

Acid attacks: Broadening the multidisciplinary team to improve outcomes
Publication date: Available online 20 June 2019Source: BurnsAuthor(s): Marie Song, Alexander Armstrong, Alexandra MurrayAbstractA rise in the current trend of corrosive substance attacks have been reported in the UK, causing devastating effects on victims. The optimal management of these patients requires the specialist skills of the burn multidisciplinary team (MDT) to address the resulting physical and psychological trauma experienced. However, burn care must commence in the pre-hospital setting. The public and first responders are invaluable resources in helping to limit the adverse effects of burns.Challenges of burn c...
Source: Burns - June 22, 2019 Category: Dermatology Source Type: research

Interobserver reliability of laser speckle contrast imaging in the assessment of burns
ConclusionObservers can reliably identify the same ROI, which results in observer-independent perfusion measurements, irrespective of burn experience. Extensive burn experience did not further improve burn depth assessment. The LSCI recommendation was more accurate in all professional groups. Introducing LSCI measurements would be likely improve early assessment of burns. (Source: Burns)
Source: Burns - June 22, 2019 Category: Dermatology Source Type: research

“Smart” polymer enhances the efficacy of topical antimicrobial agents
Publication date: Available online 21 June 2019Source: BurnsAuthor(s): Chathuranga C. De Silva, Nikita Israni, Anand Zanwar, Amit Jagtap, Porakrit Leophairatana, Jeffrey T. Koberstein, Shanta M. ModakAbstractThe delivery of antimicrobial agents to surface wounds has been shown to be of central importance to the wound healing process. In this work, we prepared film forming wound care formulations containing 3 polymers (FTP) that provide broad-spectrum antimicrobial protection for prolonged periods. FTP formulations comprises of a smart gel matrix comprising of pH-degradable and temperature responsive polyacetals (smart poly...
Source: Burns - June 22, 2019 Category: Dermatology Source Type: research

Outpatient opioid use of burn patients: A retrospective review
ConclusionsWhereas opioids are widely prescribed upon discharge, most patients no longer use them 30 days later. Higher opiate utilization at discharge increases risk of long term use, as does pre-injury drug and alcohol use, but only temporarily. (Source: Burns)
Source: Burns - June 20, 2019 Category: Dermatology Source Type: research

Prospective observational study comparing burn surgeons’ estimations of wound healing after skin grafting to photo-assisted methods
ConclusionsBedside wound healing assessments show variability; photograph documentation of sequential wound progression could supplement active clinical management or studies for more reliable assessments. (Source: Burns)
Source: Burns - June 20, 2019 Category: Dermatology Source Type: research

Plasma protein C levels are directly associated with better outcomes in patients with severe burns
Publication date: Available online 18 June 2019Source: BurnsAuthor(s): Thomas Charles Lang, Ruilong Zhao, Albert Kim, Aruna Wijewardena, John Vandervord, Rachel McGrath, Siobhan Fitzpatrick, Gregory Fulcher, Christopher John JacksonAbstractProtein C circulates in human plasma to regulate inflammation and coagulation. It has shown a crucial role in wound healing in animals, and low plasma levels predict the presence of a wound in diabetic patients. However, no detailed study has measured protein C levels in patients with severe burns over the course of a hospital admission. A severe burn is associated with dysfunction of in...
Source: Burns - June 19, 2019 Category: Dermatology Source Type: research

Direct current electrical injuries: A systematic review of case reports and case series
ConclusionFrom the few available data and partly incomplete documentations of cases we could gather hints of DC medical consequences, however, it was not possible to identify well-defined medical consequences for various circumstances of DC electrical injuries in occupational and non-occupational settings. To achieve this goal, additional studies are required, each providing a comprehensive description of the medical consequences and the circumstances of the electrical injuries. (Source: Burns)
Source: Burns - June 16, 2019 Category: Dermatology Source Type: research

Incorporation of 3D stereophotogrammetry as a reliable method for assessing scar volume in standard clinical practice
Publication date: Available online 15 June 2019Source: BurnsAuthor(s): Mitchell Peake, Kristen Pan, R. Maxwell Rotatori, Heather Powell, Laura Fowler, Laura James, Elizabeth DaleAbstractSignificant disfigurement and dysfunction is caused by hypertrophic scarring, a prevalent complication of burn wounds. A lack of objective tools in the assessment of scar parameters makes evaluation of scar treatment modalities difficult. 3D stereophotogrammetry, obtaining measurements from 3D photographs, represents a method to quantitate scar volume, and a 3D camera may have use in clinical practice. To validate this method, scar models w...
Source: Burns - June 16, 2019 Category: Dermatology Source Type: research

Impact of “opening the lung” ventilatory strategy on burn patients with acute respiratory distress syndrome
The objective of this study was to investigate the feasibility and influence of opening the lung strategy ventilation on burned patients complicated with ARDS.MethodsA prospective study was carried out in 66 moderate to severe burned patients also presented with ARDS who were randomly divided into the control group (ventilated as ARDS net) and the study group (ventilated with open lung strategy). All patients were ventilated with volume control mode until weaning.ResultsOpening the lung procedure was safe in all patients with optimal PEEP of 14.8 ± 1.8 cmH2O. After 24 h of lung recruitmen...
Source: Burns - June 16, 2019 Category: Dermatology Source Type: research

The adaptation of the Burn Specific Health Scale-Revised (BSHS-R) into the Portuguese context
The objective of this study was the adaptation of the Burn Specific Health Scale-Revised (BSHS-R) into the Portuguese context. The authors of the original version of BSHS-R with 31 items are Blalock, Bunker and DeVellis and it was developed to evaluate the health status of burns victims.The Brazilian version of the BSHS-R was translated from Portuguese (Brazil) to Portuguese (Portugal), through a semantic adaptation process, by independent Portuguese-Brazilian specialists, followed by a verbal comprehension assessment of all items, with a heterogeneous group of people, in terms of age, education and occupation.After the su...
Source: Burns - June 14, 2019 Category: Dermatology Source Type: research

Changes in ventilator settings and ventilation–induced lung injury in burn patients—A systematic review
Publication date: Available online 12 June 2019Source: BurnsAuthor(s): Gerie J. Glas, Janneke Horn, Sophia M. van der Hoeven, Markus W. Hollmann, Berry Cleffken, Kirsten Colpaert, Nicole P. Juffermans, Paul Knape, Bert G. Loef, David P. Mackie, Manu Malbrain, Jan Muller, Auke C. Reidinga, Benedikt Preckel, Marcus J. SchultzAbstractObjectiveVentilation strategies aiming at prevention of ventilator–induced lung injury (VILI), including low tidal volumes (VT) and use of positive end–expiratory pressures (PEEP) are increasingly used in critically ill patients. It is uncertain whether ventilation practices changed i...
Source: Burns - June 13, 2019 Category: Dermatology Source Type: research

A study of Kurdish women’s tragic self-immolation in Iran: A qualitative study
Publication date: Available online 12 June 2019Source: BurnsAuthor(s): Javad Yoosefi lebni, Morteza Mansourian, Mohammad Hossain Taghdisi, Bahar Khosravi, Arash Ziapour, Gülcan Demir ÖzdenkAbstractSelf-immolation is one of the most painful methods of suicide which is widespread among women in Kurdish regions of Iran. The present study aimed to explore the causes and sociocultural groundwork of choosing self-immolation methods by women in Kurdish regions of Iran.This present study was conducted using a qualitative approach and conventional content analysis. The research population included women who self-immolated...
Source: Burns - June 13, 2019 Category: Dermatology Source Type: research

MRSA colonization and acquisition in the burn unit: A systematic review and meta-analysis
ConclusionOur study yielded that among burn victims, MRSA colonization prevalence on admission is not negligible and the risk of becoming MRSA colonized during hospitalization is higher when no decolonization protocols are implemented. Flame burns, admission to ICU, and inhalation injury were found to be associated with MRSA acquisition. (Source: Burns)
Source: Burns - June 13, 2019 Category: Dermatology Source Type: research

Implications of adipose derived stem cells (ASCs) in management of burns
Publication date: Available online 11 June 2019Source: BurnsAuthor(s): Fizzah Arif (Source: Burns)
Source: Burns - June 13, 2019 Category: Dermatology Source Type: research

Burns surgery antiseptic preparation: A UK national survey
Publication date: Available online 11 June 2019Source: BurnsAuthor(s): Mehul Thakkar, Christopher Wearn, Sarah Al-Himdani, Anthony Sack, Sankhya Sen, Catalina Estela (Source: Burns)
Source: Burns - June 13, 2019 Category: Dermatology Source Type: research

Editorial Board
Publication date: August 2019Source: Burns, Volume 45, Issue 5Author(s): (Source: Burns)
Source: Burns - June 11, 2019 Category: Dermatology Source Type: research

Trends and risk factors for mortality in elderly burns patients: A retrospective review
Publication date: Available online 7 June 2019Source: BurnsAuthor(s): Moti Harats, Hagit Ofir, Matan Segalovich, Denis Visentin, Adi Givon, Kobi Peleg, Rachel Kornhaber, Michelle Cleary, Josef HaikAbstractIntroductionThe elderly experience higher mortality rates and poorer outcomes compared to younger burn survivors with similar injuries.MethodsThis epidemiological study reviewed records of all admitted elderly burn patients collected from five burns facilities in Israel between 1997–2016. Collected data was limited to the population aged 20+, focused on the population aged 60+.ResultsMortality rates for elderly pati...
Source: Burns - June 8, 2019 Category: Dermatology Source Type: research

Alarming rise in fatal electrocutions in Bangladesh: Comparison of two national surveys
ConclusionElectrocution mortality rates have raisen alarmingly between 2002 and 2015. Working persons and males have a higher susceptibility to deaths from electrocution. Rural areas pose greater threats compared to urban Bangladesh. Being derived from a nationwide survey, these facts provide with useful direction to set priorities for prevention of this emerging unnatural cause of death in the country. (Source: Burns)
Source: Burns - June 6, 2019 Category: Dermatology Source Type: research

The experience of wearing compression garments after burn injury: “On the inside it is still me”
ConclusionsThe results highlighted a variety of influences that affected the individual experience of garment wear, highlighting the need for a patient centred approach by burn service providers. (Source: Burns)
Source: Burns - June 6, 2019 Category: Dermatology Source Type: research

Early and late-recorded predictors of health-related quality of life of burn patients on long-term follow-up
ConclusionTen years after the burn incident, the quality of life was on average comparable to the one in the general population. Multiple variables seem to influence the physical and mental long-term outcome. Herein presented data may support in adapting and designing follow-up strategies tailored to a patient’s burn-specific circumstances. (Source: Burns)
Source: Burns - June 6, 2019 Category: Dermatology Source Type: research

Patterns and predictors of burn scar outcome in the first 12 months after burn: The patient’s perspective
ConclusionThe POSAS patient total and individual item scores demonstrated a statistically significant improvement in the scar quality in the first 12 months after burn, except for the relief. Sex, age, depth of the wound, the percentage of TBSA and flame burns were predictors of various POSAS patient items at 3, 6 and 12 months after burn. (Source: Burns)
Source: Burns - June 6, 2019 Category: Dermatology Source Type: research

Electric arc path on lungs
Publication date: Available online 6 June 2019Source: BurnsAuthor(s): Alessandro De Cassai, Paolo Persona (Source: Burns)
Source: Burns - June 6, 2019 Category: Dermatology Source Type: research

Reply: The impact of skin allograft on inpatient outcomes in the treatment of major burns 20–50% total body surface area — A propensity score matched analysis using the nationwide inpatient sample
Publication date: Available online 6 June 2019Source: BurnsAuthor(s): Clifford C. Sheckter, Jeremy Goverman (Source: Burns)
Source: Burns - June 6, 2019 Category: Dermatology Source Type: research

Thermal fatalities in Pretoria: A 5-year retrospective review
ConclusionThe study is the first of its kind in South Africa to generate bimodal descriptive statistics for burn fatalities. Approximately 3% of unnatural deaths at the PTA-MLL were due to burns, occurring at a rate of ±1 death per week. The data provides a platform for funding, collaborative research, planning and development of public health programs. (Source: Burns)
Source: Burns - June 5, 2019 Category: Dermatology Source Type: research

Volunteering for burns moulage as a medical student
Publication date: Available online 4 June 2019Source: BurnsAuthor(s): Alexander J. Baldwin (Source: Burns)
Source: Burns - June 5, 2019 Category: Dermatology Source Type: research

Response to the article: “The impact of skin allograft on inpatient outcomes in the treatment of major burns 20–50% total body surface area — A propensity score matched analysis using the nationwide inpatient sample” by Sheckter et al. (Burns, 45, 2019)
Publication date: Available online 5 June 2019Source: BurnsAuthor(s): Michel H.E. Hermans (Source: Burns)
Source: Burns - June 5, 2019 Category: Dermatology Source Type: research

Health related quality of life 5–7 years after minor and severe burn injuries: a multicentre cross-sectional study
ConclusionsThe majority of patients experienced some problems with HRQL 5–7 years post burn. This emphasizes that burns can have a negative impact on an individual’s HRQL, particularly in more severely burned patients, that persists for years. The HRQL dimensions most frequently affected include pain/discomfort and anxiety/depression. Patients with a prolonged hospital stay, females and older patients are at higher risk of poor HRQL in the long-term. (Source: Burns)
Source: Burns - June 5, 2019 Category: Dermatology Source Type: research

Euphorbia honey and garlic: Biological activity and burn wound recovery
This study assays the antioxidant, synergistic antimicrobial and burn wound healing activities of Euphorbia honey and Allium sativum (garlic). The minimal inhibitory concentration (MIC) of each natural product was determined against microorganisms commonly found in wound infections. The synergistic antimicrobial effect was assessed by mixing different concentrations of honey and garlic extract below their relative MICs. Subsequently, the antioxidant activity, total phenolic (TPC) and flavonoid (TFC) contents of both natural products and a selected mixture of them were evaluated. Efficacy of that mixture was also evaluated ...
Source: Burns - June 3, 2019 Category: Dermatology Source Type: research

Insecure adult attachment style is associated with elevated psychological symptoms in early adjustment to severe burn: A cross-sectional study
Publication date: Available online 1 June 2019Source: BurnsAuthor(s): Rachael Holt, Rachel Kornhaber, Julia Kwiet, Vanessa Rogers, Joanne Shaw, Jeremy Law, Marie-Thérèse Proctor, John Vandervord, Jeffrey Streimer, Denis Visentin, Michelle Cleary, Loyola McLeanAbstractResearch into recovery and adjustment after burn injury has indicated a link between psychopathological symptoms including traumatic stress, distress, depression and anxiety, and worse psychosocial and physical outcomes. The severity of psychological symptoms does not always correlate with that of the burn injury, and symptoms can be ongoing in c...
Source: Burns - June 1, 2019 Category: Dermatology Source Type: research

The longitudinal validity, reproducibility and responsiveness of the Brisbane Burn Scar Impact Profile (caregiver report for young children version) for measuring health-related quality of life in children with burn scars
ConclusionThe psychometric properties tested support the use of the BBSIP0–8 as an evaluative measure of burn scar-related health-related quality of life for children aged below eight years in the early post-acute period of rehabilitation. Further investigation at longer time period after burn injury is indicated. (Source: Burns)
Source: Burns - May 29, 2019 Category: Dermatology Source Type: research

Cultural adaptation and validation of patient and observer Scar Assessment Scale for Turkish use: Methodological issues
Publication date: Available online 29 May 2019Source: BurnsAuthor(s): Mine Seyyah, Saadet Ufuk Yurdalan (Source: Burns)
Source: Burns - May 29, 2019 Category: Dermatology Source Type: research

How to improve compression garment wear after burns: Patient and therapist perspectives
ConclusionsThe reported patient and therapist perspectives highlight the need for further research into service improvement to enhance the patient experience of wearing compression garments after burns. (Source: Burns)
Source: Burns - May 26, 2019 Category: Dermatology Source Type: research

Analysis of factors impacting length of stay in thermal and inhalation injury
ConclusionsThere are multiple factors associated with the increased LOS seen in patients with thermal and inhalation injury. This study confirmed and identified novel factors not previously discussed in the literature that were significantly associated with LOS. Expansion of the data submitted to the National Burn Repository and the Burn Quality Improvement Program may be warranted. This study confirms claims from previous studies on inadequacy of current data submitted for benchmarking and under-reimbursement for the care of such a complex population. (Source: Burns)
Source: Burns - May 25, 2019 Category: Dermatology Source Type: research

Support needs of parents of hospitalised children with a burn injury: An integrative review
ConclusionFindings from this review describe parental feelings of distress, guilt and blame and parental needs of information and support. Further research is needed to facilitate the development of evidence-based support programmes for parents of burn injured children that address these parental needs. (Source: Burns)
Source: Burns - May 23, 2019 Category: Dermatology Source Type: research

The effects of Beeswax, Olive oil and Butter impregnated bandage on burn wound healing
ConclusionThis study demonstrated that beeswax–olive oil–butter mixture impregnated bandage treatment in a second-degree burn rat model improved burn wound healing and encouraged skin renewal via modulating tissue TGF-β1 and VEGF-α. (Source: Burns)
Source: Burns - May 22, 2019 Category: Dermatology Source Type: research

Treatment of burned children using dermal regeneration template with or without negative pressure
ConclusionNPWT associated with DRT offers a higher rate of success in the treatment of complex wounds caused by burns, promotes increased DRT take rate, reduces DRT maturation time and increases the take rate of the skin graft. (Source: Burns)
Source: Burns - May 19, 2019 Category: Dermatology Source Type: research

Editorial Board
Publication date: June 2019Source: Burns, Volume 45, Issue 4Author(s): (Source: Burns)
Source: Burns - May 16, 2019 Category: Dermatology Source Type: research

Incidence, severity and pattern of burns in children and adolescents: An epidemiological study among immigrant and Swiss patients in Switzerland
ConclusionThe study emphasizes the need for highly specific measures of burn prevention and indicates the necessity of focusing on certain target groups who are especially vulnerable to burns, such as immigrants from less developed countries. (Source: Burns)
Source: Burns - May 14, 2019 Category: Dermatology Source Type: research

The frailty tipping point: Determining which patients are targets for intervention in a burn population
ConclusionsIn our study population, patients with low admission frailty scores are at greatest risk for worsened frailty at discharge and should be targeted for the development of future frailty prevention programs. (Source: Burns)
Source: Burns - May 11, 2019 Category: Dermatology Source Type: research

Thromboprophylaxis in adult and paediatric burn patients: A survey of practice in the United Kingdom
Discussion and conclusionAlthough the true burden of VTE in burn patients is unknown, we recognise that they are a population at risk. In addition to changes in the inflammatory and clotting pathways associated with thermal injury, prolonged hospital stay, ventilatory support, multiple surgeries, numerous central venous cannulations and reduced mobility all multiply this risk.The risk associated with the administration of heparin (bleeding complications and heparin-induced thrombocytopaenia) is low and can be reduced even further to 0.1% by the use of LMWH. The risk of symptomatic VTE is far greater, therefore the benefits...
Source: Burns - May 11, 2019 Category: Dermatology Source Type: research

Crosstalk among adipose tissue, vitamin D level, and biomechanical properties of hypertrophic burn scars
Publication date: Available online 7 May 2019Source: BurnsAuthor(s): Yoon Soo Cho, Jongseok Lee, So Young Joo, Cheong Hoon SeoAbstractPurposeThis cross-sectional study aimed to investigate whether adipose tissue loss and reduced vitamin D levels following severe burn injury are associated with pathologic scar formation and biomechanical scar properties.MethodsA total of 492 male subjects with hypertrophic burn scars were enrolled from January 2014 to July 2018 and analyzed. Body fat content was measured using dual-energy X-ray absorptiometry. Values of melanin, erythema, and trans-epidermal water loss (TEWL) and the disten...
Source: Burns - May 8, 2019 Category: Dermatology Source Type: research

Cultural adaptation and validation of patient and observer Scar Assessment Scale for Turkish use: Methodological issues
Publication date: Available online 7 May 2019Source: BurnsAuthor(s): Ayse Kabuk, Ebru Erek Kazan (Source: Burns)
Source: Burns - May 8, 2019 Category: Dermatology Source Type: research

Skin wound repair: Results of a pre-clinical study to evaluate electropsun collagen–elastin–PCL scaffolds as dermal substitutes.
In this study, we have developed a triple-polymer scaffold made of collagen–elastin–polycaprolactone (CEP) composite, aiming to enhance the mechanical properties of the scaffold while retaining its biological properties in promoting cell attachment, proliferation and tissue regeneration. The inclusion of elastin was revealed to decrease the stiffness of the scaffold, while also decreasing hysteresis and increasing elasticity. In mice, electrospun collagen–elastin–PCL scaffolds promoted keratinocyte and fibroblast proliferation, tissue integration and accelerated early-stage angiogenesis. Only a mild...
Source: Burns - May 8, 2019 Category: Dermatology Source Type: research

Denatured acellular dermal matrix seeded with bone marrow mesenchymal stem cells for wound healing in mice
In this study, the preparation method of DADM was improved and DADM was seeded with BM-MSCs. Then BM-MSCs-seeded DADM (DADM/MSCs) was implanted into mice cutaneous wound, and the effect of DADM/MSCs dermal substitute was assessed on skin regeneration. As a result, BM-MSCs survived well and DADM/MSCs scaffolds significantly promoted wound healing in terms of angiogenesis, re-epithelialization and skin appendage regeneration. DADM/MSCs scaffold may represent an alternative promising therapy for wound healing in deep extensive burns. (Source: Burns)
Source: Burns - May 7, 2019 Category: Dermatology Source Type: research

Mental health liaison in a regional burns unit—Past, present and future
Publication date: Available online 4 May 2019Source: BurnsAuthor(s): Catherine Adams, Connell Locke, James WarnerAbstractObjectiveTo describe the epidemiology of patients assessed by a Psychiatric Liaison Team (PLT) on a Regional Burns Unit in London, UK.MethodA case note review of all patients assessed by the PLT over a 4-year period was carried out. Data were extracted regarding whether the burn was sustained intentionally or non-intentionally, ICD-10 psychiatric diagnosis, alcohol use at the time of injury and mechanism of injury. The independent t-test and chi-squared test were used for data analysis.ResultsThe PLT ass...
Source: Burns - May 5, 2019 Category: Dermatology Source Type: research

Rectal ketamine during paediatric burn wound dressing procedures: a randomised dose-finding study
Publication date: Available online 4 May 2019Source: BurnsAuthor(s): Benjamin Grossmann, Andreas Nilsson, Folke Sjöberg, Lena NilssonAbstractBackgroundWorldwide, ketamine is used during paediatric procedures, but no recommendations are available regarding a suitable dose for rectal administration during procedures involving high levels of pain and/or anxiety such as burn wound dressing change.MethodsWe evaluated three different single doses of rectally administered racemic ketamine mixed with a fixed dose of 0.5 mg/kg of midazolam. In total, 90 children – aged 6 months to 4 years – were randomised 1:1...
Source: Burns - May 5, 2019 Category: Dermatology Source Type: research