Impact of primary payer status on outcomes among patients with burn injury: A nationwide analysis
ConclusionsPrimary payer does not affect in-hospital mortality or treatment metrics among patients admitted for burn injury. However, compared with private insurance, Medicaid was associated with both higher morbidity and resource utilization, whereas uninsured patients had lower resource utilization. (Source: Burns)
Source: Burns - July 11, 2018 Category: Dermatology Source Type: research

Microbial cellulose dressing compared with silver sulphadiazine for the treatment of partial thickness burns: A prospective, randomised, clinical trial
Publication date: Available online 10 July 2018Source: BurnsAuthor(s): Ahmed Aboelnaga, Moustafa Elmasry, Osama A. Adly, Mohamed A. Elbadawy, Ashraf H. Abbas, Islam Abdelrahman, Omar Salah, Ingrid SteinvallAbstractBackgroundThe current treatment for partial thickness burns at the trial site is silver sulphadiazine, as it minimises bacterial colonisation of wounds. Its deleterious effect on wound healing, together with the need for repeated, often painful, procedures, has brought about the search for a better treatment. Microbial cellulose has shown promising results that avoid these disadvantages. The aim of this study was...
Source: Burns - July 11, 2018 Category: Dermatology Source Type: research

Care in patients with epidermal necrolysis in burn units. A nursing perspective
ConclusionsNursing care in patients with epidermal necrolysis varied between burn units in Spain. Differences and similarities were observed when compared with burn units in other countries. Genital and ocular care were outdated in all BU/SUs. Pain assessment documentation was suboptimal. Evidence-based nursing care guidelines were generally demanded by all participants to help reduce mortality and morbidity of this rare and often devastating disease. (Source: Burns)
Source: Burns - July 11, 2018 Category: Dermatology Source Type: research

Experience with NexoBrid® in enzymatic debridement of facial burns
Publication date: June 2018Source: Burns, Volume 44, Issue 4Author(s): J.M. Sampietro de Luis (Source: Burns)
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

Response to Letter to the Editor: ‘Experience with NexoBrid® in enzymatic debridement of facial burns’
Publication date: June 2018Source: Burns, Volume 44, Issue 4Author(s): A. Schulz, P.C. Fuchs, I. Rothermundt, A. Hoffmann, L. Rosenberg, Y. Shoham, H. Oberländer, J. Schiefer (Source: Burns)
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

Comments on “Diabetes mellitus after injury in burn and non-burned patients: A population based retrospective cohort study”
Publication date: June 2018Source: Burns, Volume 44, Issue 4Author(s): Saeid Safiri, Ahad Ashrafi-Asgarabad (Source: Burns)
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

Analysing longitudinal data
Publication date: June 2018Source: Burns, Volume 44, Issue 4Author(s): Janine M. Duke, Sean M. Randall, James H. Boyd (Source: Burns)
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

Comments on procalcitonin for the early diagnosis of sepsis in burn patients: A retrospective study
Publication date: June 2018Source: Burns, Volume 44, Issue 4Author(s): Saeid Safiri, Erfan Ayubi, Kamyar Mansori (Source: Burns)
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

Response to Letter to the Editor: ‘Comments on procalcitonin for the early diagnosis of sepsis in burn patients: A retrospective study’
Publication date: June 2018Source: Burns, Volume 44, Issue 4Author(s): Luís Cabral, Vera Afreixo, Filipe Santos, Luís Almeida, José Artur Paiva (Source: Burns)
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

Comment on “Accelerant-related burns and drug abuse: Challenging combination”
Publication date: June 2018Source: Burns, Volume 44, Issue 4Author(s): Manoochehr Karami, Salman Khazaei (Source: Burns)
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

High numbers of firework related injury referrals to the London Burns Service during the recent ‘Bonfire night’ period, is it time for new regulations?
Publication date: June 2018Source: Burns, Volume 44, Issue 4Author(s): P. Macneal, J. Torres-Grau, J. Atkins, G. Williams (Source: Burns)
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

Rapid microbial diagnosis in burns patients: Time for a change?
Publication date: June 2018Source: Burns, Volume 44, Issue 4Author(s): Peter Macneal, Shakeel Rahman, Luke Moore, Andrew McKean, Joanne Atkins (Source: Burns)
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

Chemical burn assaults: Is the media coverage representative?
Publication date: June 2018Source: Burns, Volume 44, Issue 4Author(s): Robert Miller, Sarah Pywell, Jorge Leon-Villapalos, Joanne Atkins (Source: Burns)
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

A survey of learning methods used by Plastic Surgery and Anaesthetics trainees in burn care
Publication date: June 2018Source: Burns, Volume 44, Issue 4Author(s): Salma Mohamed, Jonathan Dunne, Jeremy Rawlins (Source: Burns)
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

Editorial Board
Publication date: June 2018Source: Burns, Volume 44, Issue 4Author(s): (Source: Burns)
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

Resistance training for rehabilitation after burn injury: A systematic literature review & meta-analysis
ConclusionFurther research with robust methodology is recommended to assess the potential benefit suggested in this review. (Source: Burns)
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

Chemical burns: Diphoterine untangled
ConclusionsDiphoterine appears to be safe to use and is probably superior to other rinsing solutions.However, immediate decontamination is imperative and if Diphoterine is not available a different rinsing solution should be used.The methodology of the published literature for Diphoterine is generally poor and future publications should use the frameworks given as templates. (Source: Burns)
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

Epidemiology and socio-demographic risk factors of self-immolation: A systematic review and meta-analysis
ConclusionsOur study indicated that individuals who attempted self-immolation in Iran were mainly women, married and young adults.Graphical abstract (Source: Burns)
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

Hyperosmolar metabolic acidosis in burn patients exposed to glycol based topical antimicrobials—A systematic review
ConclusionThis first systematic review found very few cases of documented hyperosmolar metabolic acidosis, all within one study that had set to specifically explore this toxidrome. High index of suspicion with frequent osmolar gap monitoring may help identify future toxicities in a timely manner. (Source: Burns)
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

Incidence of risk factors for bloodstream infections in patients with major burns receiving intensive care: A retrospective single-center cohort study
The objective was primarily to identify risk factors for bloodstream infections (BSI) caused by different pathogens.MethodsA retrospective single-center cohort study was performed on 472 burn patients with an abbreviated burn severity index (ABSI) ≥ 3, a total burn surface area (TBSA) ≥ 10%, and an ICU stay of at least 24 h. Risk factors for different BSI pathogens were analyzed by competing risks regression model of Fine and Gray.ResultsA total of 114 burn patients developed 171 episodes of BSIs caused by gram-negative bacteria (n = 78;46%), gram-positive bacteria (n = 69...
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

Physical, functional, and psychosocial recovery from burn injury are related and their relationship changes over time: A Burn Model System study
ConclusionsRecovery from burn injury is complex and the most important facets of recovery change over time. Future research should focus on developing treatments to help patients adjust to post-burn appearance in the early post-discharge period, and mental health interventions may be effective as patients progress in recovery. (Source: Burns)
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

The role of preliminary hospitals in the management of a mass burn casualty disaster
ConclusionOur preliminary findings suggest that local hospitals are capable of providing high-quality acute care to mass casualty burn victims. Our results suggest that patients with suspected limb ischemia should be rapidly transferred to a regional burn center to ensure optimal care. Systemic pre-planning such as employing telemedicine and personnel collaboration, should be considered by the administration to maximize the function of preliminary hospitals in burn care. (Source: Burns)
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

Treatment of toxic epidermal necrolysis by a multidisciplinary team. A review of literature and treatment results
ConclusionsSJS and TEN are a spectrum of severe mucocutaneous reactions that have unclear treatment recommendations within the literature and within our Level 1 hospital. Information gleaned from this research will help educate physicians involved in the treatment and management of patients with these diagnoses and has resulted in development of treatment guidelines in our hospital. (Source: Burns)
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

Three-dimensional imaging is a novel and reliable technique to measure total body surface area
ConclusionThe inter-observer reliability of three-dimensional imaging was superior compared with the rule of nines and palm method. (Source: Burns)
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

Can live music therapy reduce distress and pain in children with burns after wound care procedures? A randomized controlled trial
ConclusionsLive music therapy was not found effective in reducing distress and pain in young children after burn wound care. Older children might be more responsive to this intervention. (Source: Burns)
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

Autonomic nerve activity indexed using 24-h heart rate variability in patients with burns
ConclusionWe hypothesized that HRV is a surrogate for autonomic nervous system dysfunction in patients with burns. The patients with burns were observed a sympathetic predominance during daytime and a decreased parasympathetic activity during nighttime. These results of patients with other major burns were more predominant compared with the results of patients with other groups. (Source: Burns)
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

Women’s recovery, negotiation of appearance, and social reintegration following a burn
In this study, narratives that emerged from in-depth interviews with seven women were examined. The narratives emphasized essential needs of these burn survivors for personal support, the complexities of negotiating intimate relationships, struggles with the humiliation from family and friends, in some instances strained relationships with children, the support found through religious beliefs and institutions, and often frustratingly slow psychological acceptance of scars. These difficulties faced by women survivors of burns have highlighted the need to include religion/spirituality, intimate male partners, and women&rsquo...
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

Parental presence or absence during paediatric burn wound care procedures
ConclusionFindings emphasize the distressing nature of wound care procedures. Despite the distress, parents expressed their preference to be present. The abilities to control their own emotions and to be responsive to the child’s needs were considered beneficial for both the child and the parent. Importantly, being present increased a sense of control in parents that helped them to cope with the situation. For parents not present, the professional was the intermediary to provide information about the healing process that helped parents to deal with the situation. In sum, the proposed model provides avenues for profes...
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

Mother, father and child traumatic stress reactions after paediatric burn: Within-family co-occurrence and parent-child discrepancies in appraisals of child stress
ConclusionsThe current study demonstrates the impact of pediatric burn injury on the family level, and shows simultaneous existence of within-family interrelatedness of traumatic stress and an influence of parents’ own symptoms on their perception of child symptoms. Findings highlight the need for trauma symptom screening in all family members and for considering informants’ symptoms to understand the child’s functioning in particular. (Source: Burns)
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

Skin banking at a regional burns centre—The way forward
Publication date: June 2018Source: Burns, Volume 44, Issue 4Author(s): Sunil Manohar Keswani, Mukesh Gopinath Mishra, Shilpa Karnik, Shruti Dutta, Mamata Mishra, Sangita Panda, Reshmi Varghese, Tanvi Virkar, Vaishna UpendranAbstractIn India approximately 1 million people get burnt every year and most of them are from the lower or middle income strata. Therefore it is obligatory to find out an economic way of treatment for the affected populace. Since use of human skin allograft is the gold standard for the treatment of burn wound, in-house skin banking for a burn unit hospital is prerequisite to make the treatment procedur...
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

Influence on clinical parameters of depressomassage (part I): The effects of depressomassage on color and transepidermal water loss rate in burn scars: A pilot comparative controlled study
ConclusionsIn practice, precise indications to begin depressomassage have to be kept in mind. Perhaps other scar abnormalities such as decreased elasticity, increased thickness, excessive pain or itching could be sufficient reasons to begin depressomassage and should be assessed. (Source: Burns)
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

Assessing the feasibility of implementing low-cost virtual reality therapy during routine burn care
The objective of this mixed-methods study was to evaluate key stakeholder (i.e., patients, providers) perceptions of feasibility, acceptability, and effectiveness for the use of low-cost VR technology during routine burn care with adult patients. Ten adult patients used VR during burn care dressing changes in an outpatient clinic setting, after which they completed a satisfaction survey and individual qualitative interview. Providers also completed a satisfaction/perception survey after each participant’s care. Quantitative and qualitative results from both patient and provider perspectives consistently supported the...
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

Development of a contaminated ischemic porcine wound model and the evaluation of bromelain based enzymatic debridement
ConclusionsOur model simulates the initial phase of chronic wounds characterized by a contaminated necrotic eschar allowing evaluation of wound debriding agents, and that a bromelain-based debriding agent completely debrides the contaminated necrotic eschars within one week in this model. (Source: Burns)
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

Usage of density analysis based on micro-CT for studying lung injury associated with burn–blast combined injury
Publication date: June 2018Source: Burns, Volume 44, Issue 4Author(s): Yang Chang, Dong-hai Zhang, Quan Hu, Ling-ying Liu, Yong-hui Yu, Jia-ke ChaiAbstractBackgroundBurn–blast combined injury is a kind of injury caused by heat and blast at the same time. The lung injury after burn–blast combined injuries is of primary importance, and investigation of lung injury is needed in the clinical care of patients. Computed tomography (CT) is one of the standard tools used to observe the anatomical basis and pathophysiology of acute lung injury.MethodsWe applied a method of fast 3D (three-dimensional) reconstruction to c...
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

Effect of skin graft thickness on scar development in a porcine burn model
In this study, scar development and maturation were assessed in a porcine full-thickness burn model with immediate excision and split-thickness autograft coverage. Red Duroc pigs were treated with split-thickness autografts of varying thickness: 0.026 in. (“thin”) or 0.058 in. (“thick”). Additionally, the thin skin grafts were meshed and expanded at 1:1.5 or 1:4 to evaluate the role of skin expansion in scar formation. Overall, the burn-excise-autograft model resulted in thick, raised scars. Treatment with thick split-thickness skin grafts resulted in less contraction and reduced scarring ...
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

Matrix metalloproteinase-2 and its correlation with basal membrane components laminin-5 and collagen type IV in paediatric burn patients measured with Surface Plasmon Resonance Imaging (SPRI) biosensors
ConclusionCurrent work is the first follow-up study regarding MMP-2 in burns. MMP-2, laminin-5 and collagen type IV levels were elevated early after burn injury in the plasma of studied patients, and were highest 12–16 h after the injury. MMP-2, laminin-5 and collagen type IV levels were not proportional to the severity of the burn. We believe in the possibility that the gradual decrease of MMP-2, collagen type IV and laminin-5 concentrations could be connected with the process of healing, but to prove it, more investigation is needed in this area. The SPR imaging biosensor is a good diagnostic tool for determin...
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

A population-based retrospective cohort study to assess the mental health of patients after a non-intentional burn compared with uninjured people
ConclusionsPatients hospitalised for unintentional burns had significantly higher MH admission rates after discharge than that observed for an uninjured cohort. Ongoing mental health support is clearly indicated for many burns patients for a prolonged period after discharge. (Source: Burns)
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

Pre-burn malnutrition increases operative mortality in burn patients who undergo early excision and grafting in a sub-Saharan African burn unit: Methodological issues
Publication date: Available online 6 June 2018Source: BurnsAuthor(s): Ahad Ashrafi-Asgarabad, Saeid Safiri (Source: Burns)
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

The abbreviated burn severity index as a predictor of acute respiratory distress syndrome in young individuals with severe flammable starch-based powder burn
Publication date: Available online 6 June 2018Source: BurnsAuthor(s): Kuan-Hsun Lin, Chi-Ming Chu, Yu-Kai Lin, Hao-Yu Chiao, Ta-Wei Pu, Yuan-Ming Tsai, Ying-Yi Chen, Hsu-Kai Huang, Hung Chang, Shih-Chun Lee, Tsai-Wang HuangAbstractHere, we investigated whether the abbreviated burn severity index (ABSI) scoring system predicts acute respiratory distress syndrome (ARDS) in a retrospective analysis of a severe flammable starch-based powder burn population. Demographics, total body surface area (TBSA) burn, the presence of mouth and nose burn, ABSI, inhalation injury, and clinical outcomes for each patient were analysed for as...
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

Changes in burn mortality in Bangladesh: Findings from Bangladesh Health and Injury Survey (BHIS) 2003 and 2016
ConclusionBurn death is an emerging cause of injury deaths in Bangladesh. Further researches are required to explore the epidemiology of electrocution deaths in Bangladesh and design effective interventions. (Source: Burns)
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

Toxic epidermal necrolysis data from the CELESTE multinational registry. Part I: Epidemiology and general microbiological characteristics
ConclusionThe published data were obtained from the unique registry of TEN patients in Central Europe. In the first part, we have succeeded in defining the basic epidemiological indicators in the group of patients anonymously included in this registry.The study clearly confirms that infectious complications currently play an essential role in TEN patients, often limiting the chances of survival. The study also shows a high prevalence of these complications in the period after 15 days from the start of hospitalization, when most patients already have completely regenerated skin cover. (Source: Burns)
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

Attribution bias underlying burns-induced anxiety symptoms
Publication date: Available online 7 June 2018Source: BurnsAuthor(s): Mena Farag, Edward J.R. Watson, Klára Nenadlová, Christian Asher, Sayed Al-Aidarous, Sundhiya Mandalia, Lisa M. Williams, Trudi L. Edginton, Declan Collins, Marcela P. VizcaychipiAbstractIntroductionBurn injuries are a debilitating cause of morbidity and mortality associated with the long-term impact of psychological factors on quality of life. Accurate assessment of the differential impact of burn sequelae and anxiety is often complicated by the overlap between psychological and somatic symptoms in burns patients. The Beck Anxiety Inventor...
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

Accurately identifying blast injuries in civilian burn practice
Publication date: Available online 7 June 2018Source: BurnsAuthor(s): Joseph A. Ward, Georgina Phillips, Niall A.J. Martin (Source: Burns)
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

Comparison of intralesional verapamil versus intralesional corticosteroids in treatment of keloids and hypertrophic scars: A randomized controlled trial
ConclusionOur results did not support verapamil’s capability in treatment of keloid nor hypertrophic scars. (Source: Burns)
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

The recovery of post-burn hypertrophic scar in a monitored pressure therapy intervention programme and the timing of intervention
This study aimed to examine the maturation trajectory of post-burn hypertrophic scars in a 6-month monitored pressure therapy intervention programme and investigate the difference in the trajectory between patients receiving early intervention and patients receiving late intervention.MethodsThirty-four patients with sixty-five post-burn hypertrophic scar samples were recruited for the study. All the subjects were treated with a 6-month pressure therapy programme with the pressure dosage regulated using a newly developed pressure therapy system, the Smart Pressure Monitored Suits. The selected scars were assessed with MiniS...
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

Burn wounds in the young versus the aged patient display differential immunological responses
ConclusionOur study has identified at least 2 well known cytokines, CCL5 (RANTES) and EGF, which are differentially regulated in response to burn injury by young versus aged burn victims. Evidence suggests that a proinflammatory environment can explain the high conversion rate from partial to full thickness burns. Our data suggest the need for future studies at the point of injury (cutaneous targets) that may be modulated by post burn release of cytokines/chemokines. (Source: Burns)
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

Effect of tadalafil on reduction of necrosis in the ischemic zone in a rat comb burn model
Publication date: Available online 9 June 2018Source: BurnsAuthor(s): Adam J. Singer, Henry Towery, Steve A. McClainAbstractObjectivesA major goal of burn management is to reduce the progression of necrosis in the zone of ischemia surrounding the central zone of necrosis. A rat comb burn model is often used to assess the progression of necrosis in the zone of ischemia. We compared various combinations of naproxen [NPX], N-acetyl cysteine [NAC], and tadalafil [TD] (a phosphodiesterase-5 inhibitor used as a vasodilator to treat erectile dysfunction) in a rat comb burn model to determine their effects on injury progression.Me...
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

Optimal skin regeneration after full thickness thermal burn injury in the spiny mouse, Acomys cahirinus
Publication date: Available online 11 June 2018Source: BurnsAuthor(s): Malcolm MadenAbstractThe spiny mouse, Acomys cahirinus, shows remarkable regenerative abilities after excisional skin wounding by regrowing hair, sebaceous glands, smooth muscle, skeletal muscle and dermis without scarring. We have asked here whether this same regeneration can be seen after full thickness thermal burn injuries. Using a brass rod thermal injury model we show that in contrast to the lab mouse, Mus musculus, which forms a thick scar covered by a hairless epidermis, the spiny mouse regenerates all the tissues injured — skeletal muscle...
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

Comparative study of Silver Sulfadiazine with other materials for healing and infection prevention in burns: A systematic review and meta-analysis
Publication date: Available online 11 June 2018Source: BurnsAuthor(s): Heloisa Helena Nímia, Viviane Fernandes Carvalho, Cesar Isaac, Francisley Ávila Souza, Rolf Gemperli, André Oliveira PaggiaroAbstractThe aim of this systematic review with meta-analysis was to compare the effect of Silver Sulfadiazine (SSD) with other new dressings, with or without silver, on healing and infection prevention in burns. The electronic search was carried out in the electronic databases of Pubmed, ScienceDirect, Lilacs and BVS. The articles included were randomized clinical trials about burn treatment with SSD, which ev...
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research

Toxic epidermal necrolysis data from the CELESTE multinational registry. Part II: Specific systemic and local risk factors for the development of infectious complications
ConclusionWe did not find any statistically significant correlation between the nature of immunosuppressive therapy and the risk of developing infectious complications. We failed to identify statistically significant risk factors for the development of BSI. Mechanical ventilation and tracheostomy increase the likelihood of developing LRTIs in patients with TEN. (Source: Burns)
Source: Burns - July 10, 2018 Category: Dermatology Source Type: research