Capacity building in burns and mental health care
Publication date: Available online 18 February 2019Source: BurnsAuthor(s): Michelle Cleary, Sancia West, Josef Haik, Melanie Greenwood, Therese Toohey, Rachel KornhaberAbstractDelivery of safe quality care in health is augmented by better research capacity building. This can include financial investment in research and system development, and, mostly notably, human capacity to undertake research. Establishing capacity to undertake research warrants attention to a range of activities to build and sustain health professions’ impact on health outcomes. This editorial reflects on burns and mental health care to identify ...
Source: Burns - February 19, 2019 Category: Dermatology Source Type: research

In hot water: The impact of burn injuries from hot water bottles — Experience of a UK burns unit and review of the literature
ConclusionsThere are a significant proportion of patients presenting with HWB burns that could be prevented, with significant impact on patient morbidity and resource burden on the NHS. Targeted public awareness campaigns are needed to ameliorate these injuries. (Source: Burns)
Source: Burns - February 12, 2019 Category: Dermatology Source Type: research

Partial thickness wound: Does mechanism of injury influence healing?
This study examines whether the mechanism of injury influences healing of wounds of similar depth. Burn and excisional wounds were created on the back of Hampshire pigs and harvested at 7, 14, 28, 44, 57 and 70 days after injury and processed for histology and immunohistochemistry. Quantitative analysis of re-epithelialisation, inflammatory response and thickness of the scar and semi-quantitative analyses of the architecture of the resultant scar were performed and subjected to statistical analysis. Results demonstrated a higher number of neutrophils, macrophages and lymphocytes present in the burn on day 7 compared t...
Source: Burns - February 8, 2019 Category: Dermatology Source Type: research

Head and neck burns are associated with long-term patient-reported dissatisfaction with appearance: A Burn Model System National Database study
This study evaluates the effect of H&N burns on long-term patient reported outcomes compared to patients who sustained burns to other areas.MethodsData from the National Institute on Disability, Independent Living, and Rehabilitation Research Burn Model System National Database collected between 1996 and 2015 were used to investigate differences in outcomes between those with and without H&N burns. Demographic and clinical characteristics for adult burn survivors with and without H&N burns were compared. The following patient-reported outcome measures, collected at 6, 12, and 24 months after injury, were examin...
Source: Burns - February 5, 2019 Category: Dermatology Source Type: research

Work-related burn injuries and claims for post-traumatic stress disorder in Korea
ConclusionsWe analyzed the characteristics of the psychiatric disorders due to work-related burn injury for which compensation was received from 2005 to 2014 according to the approved results. To gain a long-term understanding of the management of workers’ compensation status for psychiatric disorders due to work-related burn injuries, we should gather accurate information on the risk factors involved in order to achieve the needed systematic improvements. (Source: Burns)
Source: Burns - February 2, 2019 Category: Dermatology Source Type: research

The scourge of burn contractures: Who will bell the cat?
ConclusionsAttempt has been made to identify the factors affecting the prevalence of burn scar contractures. Authors recommend that efforts be made for improving the knowledge of the treating doctors. Also, efforts should be made to increase awareness of burn prevention and emergent management. (Source: Burns)
Source: Burns - January 29, 2019 Category: Dermatology Source Type: research

Dysphagia in the burn patient: Experience in a National Burn Reference Centre
Conclusion27.78% of burn patients presented dysphagia, with differences in the degree of severity. Presence and duration of orotracheal intubation stands out as a condition of interest. The SLP inclusion in the burn team is presented as a valuable input in order to minimize risks associated with swallowing impairment. (Source: Burns)
Source: Burns - January 26, 2019 Category: Dermatology Source Type: research

Candidemia in major burn patients and its possible risk factors: A 6-year period retrospective study at a burn ICU
ConclusionCandidemia has a high incidence and mortality in major burn patients. The changes in etiology and drug sensitivity may make new challenges for the management of candidemia in burn ICUs. (Source: Burns)
Source: Burns - January 25, 2019 Category: Dermatology Source Type: research

Hospitalisations with burns in children younger than five years in Portugal, 2011–2015
DiscussionThis Portuguese nation-wide study on hospitalisations with burns highlights that 90% of all burns were due to hot liquid or object and a major impact of patients younger than 2 years old in this age group. Urban vs rural difference in hospitalization rate should also be considered for further health inequalities’ studies. As conclusion, ongoing attention needs to be dedicated to paediatric burn prevention and safety cost-effective strategies, particularly in relation to scalds, to further reduce the incidence of burn hospitalisations in children and the associated hospital costs. (Source: Burns)
Source: Burns - January 25, 2019 Category: Dermatology Source Type: research

New fluid therapy protocol in acute burn from a tertiary burn care centre
This study has been carried out to compare the use of Ringer lactate (RL) alone and combination of RL with Dextrose Normal Saline (DNS) as fluid replacement therapy in acute burn.ObjectiveTo assess the biochemical parameters with the use of DNS as maintenance fluid in combination with Ringer lactate as resuscitation fluid in acute burns resuscitation.MethodA prospective randomized control study has been carried out by enrolling 200 patients into 2 groups, treated in ICU and resuscitated by using Modification of Brooke’s formula (2 mL/kg/% TBSA for resuscitation plus 2500 mL maintenance). Group A received RL...
Source: Burns - January 25, 2019 Category: Dermatology Source Type: research

Opioid creep in burn center discharge regimens: Doubled amounts and complexity of narcotic prescriptions over seven years
We examined discharge narcotic prescriptions at a single burn center in the Midwest United States and found that patients discharged in 2015 received nearly twice the amount of narcotics (mean = 600 morphine equivalents [ME]) than those discharged in 2008 (mean = 350 ME), with a significantly increased likelihood of a more complex narcotic discharge regimen. The increase in ME remained significant even after controlling for age, burn size, intensive care unit stay, discharge day, substance abuse, comorbidity status, insurance, language, race, and ethnicity. The data do not clearly explain such a signifi...
Source: Burns - January 25, 2019 Category: Dermatology Source Type: research

The association of patient and burn characteristics with itching and pain severity
ConclusionPain and itch after burn injuries are predicted by slightly different variables, presumably secondary to different underlying mechanisms. We conclude that age, sex (female), extent of burn injuries (total body surface area %), and injuries to the face/neck predict itching of greater severity. Patients with burn injuries that match these parameters would require greater care and closer follow up to reduce itching after healing. (Source: Burns)
Source: Burns - January 25, 2019 Category: Dermatology Source Type: research

Red blood cell distribution width is an independent risk factor in the prediction of acute respiratory distress syndrome after severe burns
ConclusionsThe findings of this study suggest that an elevated RDW is associated with an increased risk of ARDS and RDW is an independent risk factor in the prediction of ARDS after severe burns. (Source: Burns)
Source: Burns - January 25, 2019 Category: Dermatology Source Type: research

Platelet-rich fibrin as an alternative adjunct to tendon-exposed wound healing: A randomized controlled clinical trial
Publication date: Available online 25 January 2019Source: BurnsAuthor(s): Shuang Zhang, DongSheng Cao, Juan Xie, HongHong Li, ZengHong Chen, Qiong BaoAbstractBackgroundThe use of platelet-rich fibrin (PRF) has attracted great interest in the treatment of oral and maxillofacial procedures, gingival recessions, and bone healing. However, PRF has been reported hardly to prepare wound bed before skin grafting. This randomized clinical study sought to identify the effect of PRF as an alternative adjunct to tendon-exposed wound healing.MethodsThirty-six patients with tendon-exposed wounds were treated by applying Integra or PRF ...
Source: Burns - January 25, 2019 Category: Dermatology Source Type: research

Tissue expanders; review of indications, results and outcome during 15 years’ experience
ConclusionOur patients were satisfied with the results. In 12% cases we have done re-expansion. Re-expansion is possible as long as you have enough thickness of dermis in the skin. More than 50% of our patients were optimistic for 2nd or 3rd session of re-expansion. (Source: Burns)
Source: Burns - January 24, 2019 Category: Dermatology Source Type: research

The role of recruited minced skin grafting in improving the quality of healing at the donor site of split-thickness skin graft—A comparative study
ConclusionIn this study we conclude that, recruited minced skin grafting to the donor site of split skin graft leads to better quality of healing in terms of early epithelialisation, better quality of scar, better pigmentation, less pain and pruritus, thus leading to improved quality of healing. (Source: Burns)
Source: Burns - January 18, 2019 Category: Dermatology Source Type: research

Social support and posttraumatic growth in Iranian burn survivors: The mediating role of spirituality
ConclusionThe mediating role of spirituality should provide new visions for the augmentation of PTG in burn survivors. (Source: Burns)
Source: Burns - January 15, 2019 Category: Dermatology Source Type: research

Reply to comments on “comparison of efficacy and safety of intralesional triamcinolone and combination of triamcinolone with 5-fluorouracil in the treatment of keloids and hypertrophic scars: Randomised control trial”
Publication date: Available online 14 January 2019Source: BurnsAuthor(s): Farrukh Aslam Khalid, Muhammad Younas Mehrose, Muhammad Saleem, Muhammad Amin, Abdul Malik Mujahid, Saif Ur Rehman, Sania AhmAd, Moazzam Nazeer Tarar (Source: Burns)
Source: Burns - January 15, 2019 Category: Dermatology Source Type: research

Burn camps for burns survivors—Realising the benefits for early adjustment: A systematic review
ConclusionFurther research is required to understand the lack on congruence between qualitative and quantitative data. Qualitative data suggests burn camps are beneficial for children with burn injuries. (Source: Burns)
Source: Burns - January 10, 2019 Category: Dermatology Source Type: research

Infant burns: A single institution retrospective review
Publication date: Available online 9 January 2019Source: BurnsAuthor(s): C. Brink, Q. Isaacs, M.F. Scriba, M.E.H. Nathire, H. Rode, R. MartinezAbstractThermal injuries amongst infants are common and a cause of significant mortality and morbidity in South Africa. This has been attributed to the lack of an enabling environment (poverty-related lack of safe living conditions) and the cognitive and physical developmental immaturity of infants, who depend on their surroundings and adults to keep them safe. This is a retrospective observational study of 548 infant admissions over 48 months. Infant was defined as children below 1...
Source: Burns - January 10, 2019 Category: Dermatology Source Type: research

Survey of national and local practice of compression therapy timing for burn patients in the United States
ConclusionsThe current study identified that although the national reporting of time to garment application is estimated to be between 2–6 weeks at the majority of burn centers including our own, we found our center to be well in excess of 17 weeks. The findings offer an opportunity for local improvement, and raise the possibility of similar incongruity between goals and practice at other centers. (Source: Burns)
Source: Burns - January 8, 2019 Category: Dermatology Source Type: research

Editorial Board
Publication date: February 2019Source: Burns, Volume 45, Issue 1Author(s): (Source: Burns)
Source: Burns - January 8, 2019 Category: Dermatology Source Type: research

Acknowledgement to Reviewers 2018
Publication date: February 2019Source: Burns, Volume 45, Issue 1Author(s): (Source: Burns)
Source: Burns - January 8, 2019 Category: Dermatology Source Type: research

From traditional biochemical signals to molecular markers for detection of sepsis after burn injuries
Publication date: February 2019Source: Burns, Volume 45, Issue 1Author(s): Balam Muñoz, Rocío Suárez-Sánchez, Oscar Hernández-Hernández, Rafael Franco-Cendejas, Hernán Cortés, Jonathan J. MagañaAbstractSepsis is a life-threatening organ-dysfunction condition caused by a dysregulated response to an infectious condition that can cause complications in patients with major trauma. Burns are one of the most destructive forms of trauma; despite the improvements in medical care, infections remain an important cause of burn injury-related mortality and morbidity, and c...
Source: Burns - January 8, 2019 Category: Dermatology Source Type: research

Vitamin D in burn-injured patients
Publication date: February 2019Source: Burns, Volume 45, Issue 1Author(s): Megan A. Rech, Daniel Colon Hidalgo, Jennifer Larson, Sarah Zavala, Michael MosierAbstractRecently, many studies have demonstrated pleotropic effects of vitamin D, including immune modulation and cardiovascular system activity. Sufficient vitamin D concentrations and supplementation of vitamin D may be of benefit in burn-injured patients. Low 25(OH)D has been observed in nearly all pediatric and most adult burn patients. Vitamin D has primarily been studied in pediatric burn patients, focusing on bone marker measurements and the incidence of fractur...
Source: Burns - January 8, 2019 Category: Dermatology Source Type: research

“An improvement on burn care” — A full audit cycle on accuracy & appropriateness of burn injury referrals from an Emergency Department through a Burns Network
Publication date: Available online 5 January 2019Source: BurnsAuthor(s): Stephen Frost, Paul Malone, Claire Porter, Reena Agarwal (Source: Burns)
Source: Burns - January 5, 2019 Category: Dermatology Source Type: research

Is the burns research community committed to filling in the gaps in the evidence? An analysis of the burns section of the Cochrane Database of Systematic Reviews
Publication date: Available online 3 January 2019Source: BurnsAuthor(s): Juan Enrique Berner, Simon Booth, Baljit Dheansa (Source: Burns)
Source: Burns - January 4, 2019 Category: Dermatology Source Type: research

Epidemiology and outcomes of burn injuries at a tertiary burn care center in Bangladesh
This study was conducted at the National Institute of Burn and Plastic Surgery in Dhaka, Bangladesh in June of 2016. Data included conducting surveys of hospitalized burn patients (N = 66) and a chart review of deceased burn patients (N = 88). In addition to reporting on the demographic profile of patients, information was also obtained on clinical measures during hospitalization. For non-fatal burns, high risk groups included young adult males (early 30s) of lower socioeconomic status. Among children, the most vulnerable group was found to be children less than eight years old. The most common non-fata...
Source: Burns - January 4, 2019 Category: Dermatology Source Type: research

Use of the burn intervention score to calculate the charges of the care of burns
ConclusionOur intervention-based estimate of charges has proved to be a valid tool that is sensitive to the procedures that drive the costs of the care of burns such as large TBSA%, intensive care, and operations. The burn score system could be reproduced easily in other burn centres worldwide and facilitate the comparison regardless of the differences in the currency and the economic circumstances. (Source: Burns)
Source: Burns - January 4, 2019 Category: Dermatology Source Type: research

Stem cells in burn wound healing: A systematic review of the literature
ConclusionStem cell therapy appears to exert a positive effect in burn wound healing. There is, therefore, justification for continued efforts to evaluate the use of stem cells as an adjunct to first-line therapies in burns. (Source: Burns)
Source: Burns - January 3, 2019 Category: Dermatology Source Type: research

Epidemiological characteristics of burn injuries in Iraq: A burn hospital-based study
In conclusion, young adults and children, males, and low educated patients represent the majority of admitted burn cases in Iraq. Flame and scalds were the most important causes of burn. More than one tenth of patients died mostly due to septicemia and multi-organ failure. (Source: Burns)
Source: Burns - December 30, 2018 Category: Dermatology Source Type: research

(-)-Epigallocatechin-3-gallate, reduces corneal damage secondary from experimental grade II alkali burns in mice
ConclusionThis work constitutes the first evidence for the use of EGCG in the acute phase of a corneal alkali burn, representing a possible novel alternative to improve patient outcomes as an add-on therapy. (Source: Burns)
Source: Burns - December 30, 2018 Category: Dermatology Source Type: research

Comment on “Incidence of risk factors for bloodstream infections in patients with major burns receiving intensive care: A retrospective single-center cohort study”
Publication date: Available online 28 December 2018Source: BurnsAuthor(s): Swenn Maxence Krähenbühl, Olivier Pantet, Mette M. Berger, Wassim Raffoul, Pietro Giovanni di Summa (Source: Burns)
Source: Burns - December 29, 2018 Category: Dermatology Source Type: research

Toxic epidermal necrolysis therapeutic standardization: A holistic approach
Publication date: Available online 28 December 2018Source: BurnsAuthor(s): Alberto Sánchez-García, Enrique Salmerón-González, Jose-Maria García-Sánchez, Nieves Vanaclocha-Sáiz (Source: Burns)
Source: Burns - December 29, 2018 Category: Dermatology Source Type: research

Beyond surge: Coping with mass burn casualty in the closest hospital to the Formosa Fun Coast Dust Explosion
ConclusionIn the hospital closest to the FFCDE disaster scene, it caused an overwhelming demand in an already crowded, beyond-nominal-capacity ED. This study describes how the hospital mobilized and reconfigured response capacity to cope with overload, uncertainty, and time pressure. These findings support improving disaster planning and preparedness for all healthcare entities through organizational support for adaptation and routine practice coping with unexpected scenarios. (Source: Burns)
Source: Burns - December 29, 2018 Category: Dermatology Source Type: research

Common hydrotherapy practices and the prevalence of burn wound bacterial colonisation at the University Teaching Hospital in Lusaka, Zambia
ConclusionHydrotherapy as currently practiced at the University Teaching Hospital does contribute significantly to cross-infection among burn patients with widely resistant organisms. The main ones are S. aureus and K. pneumoniae. Switching care to a shower mechanism might help eliminate this problem as the study demonstrates that no bacteria were found in the water samples. (Source: Burns)
Source: Burns - December 28, 2018 Category: Dermatology Source Type: research

Investigating the interrater reliability of a novel functional outcome measure for use in the burns intensive care unit: The Functional Assessment for Burns — Critical Care (FAB-CC)
Publication date: Available online 27 December 2018Source: BurnsAuthor(s): J.H. Eagan, G. Ramdharry, S.T. SmailesAbstractIntroductionIntensive Care Unit Acquired Weakness challenges the clinical care of critically ill patients. Despite a surge in validated ICU functional outcome measures following the publication of Clinical Guideline 83 ‘Rehabilitation After Critical Illness’ by the National Institute for Health and Care Excellence (2009), there are none composed specifically for use in the Burns ICU. We therefore developed and tested the inter-rater reliability of a burn specific novel functional outcome meas...
Source: Burns - December 28, 2018 Category: Dermatology Source Type: research

Genetic influence on scar height and pliability after burn injury in individuals of European ancestry: A prospective cohort study
This study aimed to identify genetic variants associated with scar height and pliability after burn injury. An exome-wide array association study and gene pathway analysis were performed on a prospective cohort of 665 patients treated for burn injury. Outcomes were scar height (SH) and scar pliability (SP) sub-scores of the modified Vancouver Scar Scale (mVSS). DNA was genotyped using the Infinium® HumanCoreExome-24 BeadChip. Associations between genetic variants (single nucleotide polymorphisms) and SH and SP were estimated using an additive genetic model adjusting for age, sex, number of surgical procedures and % tot...
Source: Burns - December 28, 2018 Category: Dermatology Source Type: research

Frailty and more: Age-related outcome factors in burns
Publication date: Available online 27 December 2018Source: BurnsAuthor(s): Elisabeth Hofmann, Sebastian P. Nischwitz, Daniel Popp, Petra Kotzbeck, Lars-Peter Kamolz (Source: Burns)
Source: Burns - December 28, 2018 Category: Dermatology Source Type: research

Nano-silver modified porcine small intestinal submucosa for the treatment of infected partial-thickness burn wounds
ConclusionsNano-silver modified porcine small intestinal submucosa (NS-PSIS) can be used as a biological derivative dressing for the treatment of infected partial-thickness burn wounds. (Source: Burns)
Source: Burns - December 28, 2018 Category: Dermatology Source Type: research

Dakin’s Solution: “One of the most important and far-reaching contributions to the armamentarium of the surgeons”
Publication date: Available online 24 December 2018Source: BurnsAuthor(s): Jeremias Georgiadis, Vanessa B. Nascimento, Catherine Donat, Ikenna Okereke, Mohammadali M. ShojaAbstractHenry Drysdale Dakin is a notable person in the history of surgery, wound care, military medicine and infectious disease control. Dakin is an exemplar scientist who in the midst of war forged an international collaboration with scientists in multiple fields to create and universalize an antiseptic utopia, which saved thousands lives during World War I, remarkably diminished functional disabilities from wounds and continues to be a “far-reac...
Source: Burns - December 25, 2018 Category: Dermatology Source Type: research

The role of psychological flexibility in appearance anxiety in people who have experienced a visible burn injury
This study aimed to investigate whether psychological flexibility, a key element underpinning acceptance and commitment therapy (ACT), was associated with appearance anxiety. It was hypothesised that reduced psychological flexibility (lower acceptance, cognitive defusion, mindfulness, and committed action) would be related to increased appearance anxiety. The role of psychological flexibility in the maintenance of appearance anxiety was investigated using a cross-sectional quantitative questionnaire study.MethodSeventy-eight burns patients (47 female, 31 male; M age = 45.2 years) completed the Derriford Appe...
Source: Burns - December 25, 2018 Category: Dermatology Source Type: research

Re: Comment on “Incidence of risk factors for bloodstream infections in patients with major burns receiving intensive care: A retrospective single-center cohort study”
Publication date: Available online 24 December 2018Source: BurnsAuthor(s): Alexandra Fochtmann-Frana, Christian Freystätter, Vera Vorstandlechner, André Barth, Michael Bolliger, Elisabeth Presterl, Gerald Ihra, Gabriela Muschitz, Martina Mittlboeck, Athanasios Makristathis, Thomas Rath, Christine Radtke, Christina Forstner (Source: Burns)
Source: Burns - December 25, 2018 Category: Dermatology Source Type: research

Investigating the potential to assess severe lung inhalation injuries using computed tomography
ConclusionA lung CT scan is able to reflect the early-stage lung injuries of rabbits with different levels of severe inhalation injury. (Source: Burns)
Source: Burns - December 22, 2018 Category: Dermatology Source Type: research

Can systemic inflammatory response syndrome score at admission predict clinical outcome in patients with severe burns?
ConclusionsThe model with the variables age, percentage full-thickness burns, and inhalation injury provided excellent prediction of poor outcomes in patients with severe burns, while SIRS score has limited use for prognostic determinations. (Source: Burns)
Source: Burns - December 22, 2018 Category: Dermatology Source Type: research

Effectiveness of an educational program on decreasing burns and injuries in Persian festival of fire: A burden of diseases approach
In this study we tried to find effectiveness of Chaharshanbeh souri educational campaign on decreasing burden of injuries due to fireworks of this day.In this before–after study, an educational campaign was done for 2017 focusing on children and students. Data of a registry which was designed for gathering information of injuries and mortalities of this festival was used to show effectiveness of the program. Disability adjusted life years was calculated and compared before and after intervention.The results of this study showed that mean age of injuries was increased from 27.75 to 32.65 years and DALY decreased signi...
Source: Burns - December 22, 2018 Category: Dermatology Source Type: research

Demonstration of the safety and effectiveness of the RECELL® System combined with split-thickness meshed autografts for the reduction of donor skin to treat mixed-depth burn injuries
Publication date: Available online 19 December 2018Source: BurnsAuthor(s): J.H. Holmes, J.A. Molnar, J.W. Shupp, W.L. Hickerson, B.T. King, K.N. Foster, B.A. Cairns, J.E. CarterAbstractIntroductionSplit-thickness skin grafts (STSG) are the standard of care (SOC) for burns undergoing autografting but are associated with donor skin site morbidity and limited by the availability of uninjured skin. The RECELL® Autologous Skin Harvesting Device (RECELL® System, or RECELL) was developed for point-of-care preparation and application of a suspension of non-cultured, disaggregated, autologous skin cells, using 1 cm2 of...
Source: Burns - December 19, 2018 Category: Dermatology Source Type: research

Epidemiological analysis of pediatric burns in the Dominican Republic reveals a demographic profile at significant risk for electrical burns
ConclusionThis investigation identifies a demographical profile where electrical burns account for a significant percentage of the burn population. This provides a basis for concentrating preventative efforts in vulnerable populations. (Source: Burns)
Source: Burns - December 18, 2018 Category: Dermatology Source Type: research

Implementation of a checklist to enhance operation note quality at a UK burns centre
Publication date: Available online 15 December 2018Source: BurnsAuthor(s): Ankur Khajuria, Walton Charles, Andrew Williams, Jorge Leon-Villapalos, Joanne Atkins, Isabel Jones, Sarah Bache, Declan CollinsAbstractIntroductionOperation notes are fundamental for clinical, academic and medico-legal purposes. Good Surgical Practice (2014) provides guidelines to assist note completion but the literature suggests poor adherence to these. The aim of this study was to evaluate and improve operation note quality at a UK burns centre through implementation of a burns surgery-specific checklist.MethodsA 22-component burns surgery-speci...
Source: Burns - December 16, 2018 Category: Dermatology Source Type: research

Impact of burn contractures of chest wall and their surgical release on pulmonary function
ConclusionLong standing chest wall contractures and contractures involving>75% of the chest circumference are likely to cause a restrictive pattern on PFT. Any significant improvement of pulmonary function after surgical release of the contracture is unlikely. (Source: Burns)
Source: Burns - December 16, 2018 Category: Dermatology Source Type: research