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Alcalá-Cerrillo M, González-Sánchez J, González-Bernal JJ, Santamaría-Peláez M, Fernández-Solana J, Sánchez Gómez SM, Gómez-Martín A. Retrospective Study of the Epidemiological-Clinical Characteristics of Burns Treated in a Hospital Emergency Service (2018-2022). NURSING REPORTS 2024; 14:1987-1997. [PMID: 39189278 PMCID: PMC11348191 DOI: 10.3390/nursrep14030148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Revised: 08/09/2024] [Accepted: 08/13/2024] [Indexed: 08/28/2024] Open
Abstract
BACKGROUND Burns are a common and severe medical emergency requiring immediate specialized care to minimize damage and prevent complications. Burn severity depends on depth, extent, and location, with more complex care needed for burns on critical areas or extensive burns. Nursing is essential in burn management, providing immediate care, adapting treatments, managing pain, preventing infections, and offering emotional support for recovery. The study aims to analyse the epidemiological and clinical characteristics of burns treated at the Hospital Emergency Department of the Hospital Complex of Cáceres (Spain) from January 2018 to December 2022. It looks at factors like gender, age, hospital stay duration, emergency type (paediatric or adult), main diagnosis, skin thickness, burn degree, affected body areas, percentage of body surface area burned, and treatment types. It also investigates how treatment varies by gender, age, skin thickness, and burn severity. The relevance of this research lies in the fact that periodic epidemiological studies are essential to monitor changes in diseases, evaluate the effectiveness of interventions, detect outbreaks quickly, update knowledge on risk factors, and guide health policy decisions. This ensures an adapted and effective response to the needs of the population. METHODS Retrospective, observational study that analysed burn cases treated at the Hospital Complex of Cáceres (Spain) 2018-2022. Inclusion criteria were based on ICD-10 codes for burns, excluding severe cases not treated in this service. Data were analysed using descriptive statistics, Student's t-tests, Chi-square tests, and ANOVA. RESULTS 220 patients surveyed, with a mean age of 47 years and 60.9% male. Most burns (95.5%) affected the external body surface, with a mean hospital stay of 7.86 days. Medical treatment was provided to 75.5% of patients, and 24.5% required surgical intervention. Significant differences in treatment procedures were observed according to age, skin thickness, and burn degree. Older patients had more procedures and longer hospital stays. Excision and transfer procedures were more common in full-thickness and severe burns. CONCLUSIONS The findings align with previous research on burn demographics and treatment approaches. Treatment differences by age and burn severity highlight the need for tailored interventions. The study underscores the importance of comprehensive burn management, including psychological support for improved long-term outcomes. Further research could explore the impact of socio-economic factors on burn incidence and treatment. This study was not registered.
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Affiliation(s)
- María Alcalá-Cerrillo
- Social Impact and Innovation in Health, Faculty of Nursing and Occupational Therapy, University of Extremadura, Avda. de la Universidad s/n, 10003 Cáceres, Spain;
| | - Josefa González-Sánchez
- Health Science Department, Faculty of Health Science, University of Burgos, Paseo de los Comendadores s/n, 09001 Burgos, Spain; (J.G.-S.); (J.J.G.-B.); (J.F.-S.)
| | - Jerónimo J. González-Bernal
- Health Science Department, Faculty of Health Science, University of Burgos, Paseo de los Comendadores s/n, 09001 Burgos, Spain; (J.G.-S.); (J.J.G.-B.); (J.F.-S.)
| | - Mirian Santamaría-Peláez
- Health Science Department, Faculty of Health Science, University of Burgos, Paseo de los Comendadores s/n, 09001 Burgos, Spain; (J.G.-S.); (J.J.G.-B.); (J.F.-S.)
| | - Jessica Fernández-Solana
- Health Science Department, Faculty of Health Science, University of Burgos, Paseo de los Comendadores s/n, 09001 Burgos, Spain; (J.G.-S.); (J.J.G.-B.); (J.F.-S.)
| | - Sara M. Sánchez Gómez
- Nursing Department, Faculty of Nursing and Occupational Therapy, University of Extremadura, Avda. de la Universidad s/n, 10003 Cáceres, Spain; (S.M.S.G.); (A.G.-M.)
| | - Ana Gómez-Martín
- Nursing Department, Faculty of Nursing and Occupational Therapy, University of Extremadura, Avda. de la Universidad s/n, 10003 Cáceres, Spain; (S.M.S.G.); (A.G.-M.)
- Extremadura Institute of Biosanitary Research (Instituto de Investigación Biosanitaria de Extremadura—INUBE), 1003 Cáceres, Spain
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Greenhalgh DG, Hill DM, Burmeister DM, Gus EI, Cleland H, Padiglione A, Holden D, Huss F, Chew MS, Kubasiak JC, Burrell A, Manzanares W, Gómez MC, Yoshimura Y, Sjöberg F, Xie WG, Egipto P, Lavrentieva A, Jain A, Miranda-Altamirano A, Raby E, Aramendi I, Sen S, Chung KK, Alvarez RJQ, Han C, Matsushima A, Elmasry M, Liu Y, Donoso CS, Bolgiani A, Johnson LS, Vana LPM, de Romero RVD, Allorto N, Abesamis G, Luna VN, Gragnani A, González CB, Basilico H, Wood F, Jeng J, Li A, Singer M, Luo G, Palmieri T, Kahn S, Joe V, Cartotto R. Surviving Sepsis After Burn Campaign. Burns 2023; 49:1487-1524. [PMID: 37839919 DOI: 10.1016/j.burns.2023.05.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 05/02/2023] [Indexed: 10/17/2023]
Abstract
INTRODUCTION The Surviving Sepsis Campaign was developed to improve outcomes for all patients with sepsis. Despite sepsis being the primary cause of death after thermal injury, burns have always been excluded from the Surviving Sepsis efforts. To improve sepsis outcomes in burn patients, an international group of burn experts developed the Surviving Sepsis After Burn Campaign (SSABC) as a testable guideline to improve burn sepsis outcomes. METHODS The International Society for Burn Injuries (ISBI) reached out to regional or national burn organizations to recommend members to participate in the program. Two members of the ISBI developed specific "patient/population, intervention, comparison and outcome" (PICO) questions that paralleled the 2021 Surviving Sepsis Campaign [1]. SSABC participants were asked to search the current literature and rate its quality for each topic. At the Congress of the ISBI, in Guadalajara, Mexico, August 28, 2022, a majority of the participants met to create "statements" based on the literature. The "summary statements" were then sent to all members for comment with the hope of developing an 80% consensus. After four reviews, a consensus statement for each topic was created or "no consensus" was reported. RESULTS The committee developed sixty statements within fourteen topics that provide guidance for the early treatment of sepsis in burn patients. These statements should be used to improve the care of sepsis in burn patients. The statements should not be considered as "static" comments but should rather be used as guidelines for future testing of the best treatments for sepsis in burn patients. They should be updated on a regular basis. CONCLUSION Members of the burn community from the around the world have developed the Surviving Sepsis After Burn Campaign guidelines with the goal of improving the outcome of sepsis in burn patients.
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Affiliation(s)
- David G Greenhalgh
- Department of Burns, Shriners Children's Northern California and Department of Surgery, University of California, Davis, Sacramento, CA, USA.
| | - David M Hill
- Department of Clinical Pharmacy & Translational Scre have been several studies that have evaluatedience, College of Pharmacy, University of Tennessee, Health Science Center; Memphis, TN, USA
| | - David M Burmeister
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Eduardo I Gus
- Division of Plastic & Reconstructive Surgery, The Hospital for Sick Children; Department of Surgery, University of Toronto, Toronto, Canada
| | - Heather Cleland
- Department of Surgery, Monash University and Alfred Hospital, Melbourne, Australia
| | - Alex Padiglione
- Department of Surgery, Monash University and Alfred Hospital, Melbourne, Australia
| | - Dane Holden
- Department of Surgery, Monash University and Alfred Hospital, Melbourne, Australia
| | - Fredrik Huss
- Department of Surgical Sciences, Plastic Surgery, Uppsala University/Burn Center, Department of Plastic and Maxillofacial Surgery, Uppsala University Hospital, Uppsala, Sweden
| | - Michelle S Chew
- Department of Anaesthesia and Intensive Care, Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - John C Kubasiak
- Department of Surgery, Loyola University Medical Center, Maywood, IL, USA
| | - Aidan Burrell
- Department of Epidemiology and Preventative Medicine, Monash University and Alfred Hospital, Intensive Care Research Center (ANZIC-RC), Melbourne, Australia
| | - William Manzanares
- Department of Critical Care Medicine, Universidad de la República (UdelaR), Montevideo, Uruguay
| | - María Chacón Gómez
- Division of Intensive Care and Critical Medicine, Centro Nacional de Investigacion y Atencion de Quemados (CENIAQ), National Rehabilitation Institute, LGII, Mexico
| | - Yuya Yoshimura
- Department of Emergency and Critical Care Medicine, Hachinohe City Hospital, Hachinohe, Japan
| | - Folke Sjöberg
- Department of Anaesthesia and Intensive Care, Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Wei-Guo Xie
- Institute of Burns, Tongren Hospital of Wuhan University (Wuhan Third Hospital), Wuhan, China
| | - Paula Egipto
- Centro Hospitalar e Universitário São João - Burn Unit, Porto, Portugal
| | | | | | | | - Ed Raby
- Infectious Diseases Department, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | | | - Soman Sen
- Department of Burns, Shriners Children's Northern California and Department of Surgery, University of California, Davis, Sacramento, CA, USA
| | - Kevin K Chung
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | | | - Chunmao Han
- Department of Burn and Wound Repair, Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, China
| | - Asako Matsushima
- Department of Emergency and Critical Care, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Moustafa Elmasry
- Department of Hand, Plastic Surgery and Burns, Linköping University, Linköping, Sweden
| | - Yan Liu
- Department of Burn, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Carlos Segovia Donoso
- Intensive Care Unit for Major Burns, Mutual Security Clinical Hospital, Santiago, Chile
| | - Alberto Bolgiani
- Department of Surgery, Deutsches Hospital, Buenos Aires, Argentina
| | - Laura S Johnson
- Department of Surgery, Emory University School of Medicine and Grady Health System, Georgia
| | - Luiz Philipe Molina Vana
- Disciplina de Cirurgia Plastica da Escola Paulista de Medicina da Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | | | - Nikki Allorto
- Grey's Hospital Pietermaritzburg Metropolitan Burn Service, University of KwaZulu Natal, Pietermaritzburg, South Africa
| | - Gerald Abesamis
- Alfredo T. Ramirez Burn Center, Division of Burns, Department of Surgery, University of Philippines Manila - Philippine General Hospital, Manila, Philippines
| | - Virginia Nuñez Luna
- Unidad Michou y Mau Xochimilco for Burnt Children, Secretaria Salud Ciudad de México, Mexico
| | - Alfredo Gragnani
- Disciplina de Cirurgia Plastica da Escola Paulista de Medicina da Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Carolina Bonilla González
- Department of Pediatrics and Intensive Care, Pediatric Burn Unit, Clinical Studies and Clinical Epidemiology Division, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Hugo Basilico
- Intensive Care Area - Burn Unit - Pediatric Hospital "Prof. Dr. Juan P. Garrahan", Buenos Aires, Argentina
| | - Fiona Wood
- Department of Surgery, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | - James Jeng
- Department of Surgery, University of California, Irvine, CA, USA
| | - Andrew Li
- Department of Surgery, Monash University and Alfred Hospital, Melbourne, Australia
| | - Mervyn Singer
- Department of Intensive Care Medicine, University College London, London, United Kingdom
| | - Gaoxing Luo
- Institute of Burn Research, Southwest Hospital, Army (Third Military) Medical University, Chongqing, China
| | - Tina Palmieri
- Department of Burns, Shriners Children's Northern California and Department of Surgery, University of California, Davis, Sacramento, CA, USA
| | - Steven Kahn
- The South Carolina Burn Center, Department of Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Victor Joe
- Department of Surgery, University of California, Irvine, CA, USA
| | - Robert Cartotto
- Department of Surgery, Sunnybrook Medical Center, Toronto, Ontario, Canada
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Sabeti S, Ochtli CR, Tay-Lasso E, Whelton M, Burton K, Bernal NO, Joe VC, Chin TL. The Effects of the COVID-19 Pandemic on Burn Clinic. J Burn Care Res 2022; 43:766-771. [PMID: 35488371 PMCID: PMC9047216 DOI: 10.1093/jbcr/irac041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
The COVID-19 pandemic has led to anxiety and fears for the general public. It is unclear how the behavior of people with acute burns and the services available to them has changed during the pandemic. The aim of our observational study was to evaluate our clinic’s experience with patients presenting with burns during the first ten months of the COVID-19 pandemic and determine if delays in presentation and healthcare delivery exist within our burn population. Patients referred to our clinic from March 1, 2020 to Dec 15, 2020 were reviewed for time of presentation after injury. We defined a true delay in presentation of >5 days from date of injury to date of referral for patients who were not inpatients at our facility or received initial care elsewhere prior to referral. Of the 246 patients who were referred to our clinic, during this time period, 199 patients (80.89%) attended their appointments. Our in-person clinic volume from referrals increased in July 2020 with a sharp decrease in August 2020. Our total clinic volume decreased in 2020 from 2019 by about 14%. Referrals to our clinic decreased in 2020 from 2019 by about 34%. Video telehealth visits did not account for the decrease in visits. There was low incidence of delays in presentation to our clinic during the pandemic. Additional investigation is necessary to see if the incidence of burn injury decreased. Despite the pandemic, our clinic remained ready and open to serve the burn population.
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Affiliation(s)
- Sara Sabeti
- Department of Surgery, University of California at Irvine, USA
| | - Ché R Ochtli
- Department of Surgery, University of California at Irvine, USA
| | - Erika Tay-Lasso
- Department of Surgery, University of California at Irvine, USA
| | - Melissa Whelton
- Department of Surgery, University of California at Irvine, USA
| | - Kimberly Burton
- Department of Surgery, University of California at Irvine, USA
| | - Nicole O Bernal
- Department of Surgery, University of California at Irvine, USA
| | - Victor C Joe
- Department of Surgery, University of California at Irvine, USA
| | - Theresa L Chin
- Department of Surgery, University of California at Irvine, USA
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Arnaudet I, Montassier E, Javaudin F, Naux E, Le Bastard Q. Prise en charge des brûlures en préhospitalier et aux urgences. ANNALES FRANCAISES DE MEDECINE D URGENCE 2021. [DOI: 10.3166/afmu-2021-0360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Une brûlure est une lésion de la peau ou d’un autre tissu organique principalement causée par la chaleur ou les rayonnements, la radioactivité, l’électricité, la friction ou le contact avec des produits chimiques. Les plus fréquentes, les brûlures thermiques (dues à la chaleur), surviennent lorsque certaines cellules ou toutes les cellules de la peau ou d’autres tissus sont détruites par des liquides bouillants, des solides chauds (brûlures de contact), ou des flammes. En France, l’incidence des brûlures prises en charge à l’hôpital est environ de 13 pour 100 000 habitants. La prise en charge en urgence du brûlé grave par lésion thermique est bien décrite, une recommandation de pratique professionnelle a été publiée en 2019 par la Société française d’anesthésie et de réanimation, en association avec la Société francophone de brûlologie, la Société française de médecine d’urgence et l’Association des anesthésistes-réanimateurs pédiatriques d’expression française. Pourtant, l’urgentiste va être confronté à de nombreuses brûlures de gravité et de nature différentes. Nous faisons ici une mise au point sur les données connues en termes d’épidémiologie, de manifestations cliniques et des différentes thérapeutiques qui peuvent être proposées dans la prise en charge des brûlures. Nous faisons aussi le point sur les localisations à risque particulier que l’urgentiste doit connaître, ainsi que sur les intoxications qui peuvent être associées aux brûlures. Nous détaillons aussi certains contaminants qui sont à connaître.
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Milazzo M, Gallone G, Marcello E, Mariniello MD, Bruschini L, Roy I, Danti S. Biodegradable Polymeric Micro/Nano-Structures with Intrinsic Antifouling/Antimicrobial Properties: Relevance in Damaged Skin and Other Biomedical Applications. J Funct Biomater 2020; 11:jfb11030060. [PMID: 32825113 PMCID: PMC7563177 DOI: 10.3390/jfb11030060] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 08/07/2020] [Accepted: 08/12/2020] [Indexed: 12/16/2022] Open
Abstract
Bacterial colonization of implanted biomedical devices is the main cause of healthcare-associated infections, estimated to be 8.8 million per year in Europe. Many infections originate from damaged skin, which lets microorganisms exploit injuries and surgical accesses as passageways to reach the implant site and inner organs. Therefore, an effective treatment of skin damage is highly desirable for the success of many biomaterial-related surgical procedures. Due to gained resistance to antibiotics, new antibacterial treatments are becoming vital to control nosocomial infections arising as surgical and post-surgical complications. Surface coatings can avoid biofouling and bacterial colonization thanks to biomaterial inherent properties (e.g., super hydrophobicity), specifically without using drugs, which may cause bacterial resistance. The focus of this review is to highlight the emerging role of degradable polymeric micro- and nano-structures that show intrinsic antifouling and antimicrobial properties, with a special outlook towards biomedical applications dealing with skin and skin damage. The intrinsic properties owned by the biomaterials encompass three main categories: (1) physical–mechanical, (2) chemical, and (3) electrostatic. Clinical relevance in ear prostheses and breast implants is reported. Collecting and discussing the updated outcomes in this field would help the development of better performing biomaterial-based antimicrobial strategies, which are useful to prevent infections.
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Affiliation(s)
- Mario Milazzo
- Department of Civil and Environmental Engineering, Massachusetts Institute of Technology, Cambridge, MA 02142, USA
- Correspondence: (M.M.); (S.D.)
| | - Giuseppe Gallone
- Department of Civil and Industrial Engineering, University of Pisa, 56126 Pisa, Italy;
| | - Elena Marcello
- School of Life Sciences, University of Westminster, London W1W 6UW, UK;
| | - Maria Donatella Mariniello
- Doctoral School in Clinical and Translational Sciences, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, via Savi 10, 56126 Pisa, Italy;
| | - Luca Bruschini
- Department of Surgical, Medical, Molecular Pathology and Emergency Medicine, University of Pisa, via Savi 10, 56126 Pisa, Italy;
| | - Ipsita Roy
- Department of Materials Science and Engineering, Faculty of Engineering, University of Sheffield, Sheffield S1 3JD, UK;
| | - Serena Danti
- Department of Civil and Environmental Engineering, Massachusetts Institute of Technology, Cambridge, MA 02142, USA
- Department of Civil and Industrial Engineering, University of Pisa, 56126 Pisa, Italy;
- Doctoral School in Clinical and Translational Sciences, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, via Savi 10, 56126 Pisa, Italy;
- Correspondence: (M.M.); (S.D.)
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Yao P, OuYang J, Liu C, Wang S, Wang X, Sun S. Improving burn surgery education for medical students in China. Burns 2019; 46:647-651. [PMID: 31629615 DOI: 10.1016/j.burns.2019.09.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 09/15/2019] [Accepted: 09/20/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION In China, although burn treatment develops rapidly, and ranks in the forefront of the world, there is a relative shortage of burn specialists, which limits the development of burn education. In traditional curriculum of surgery education, burn surgery education accounts for few proportions, which results in the indifference to the burn surgery among medical students. To date, few research reported the application of Clinical pathway- Problem based Learning (CP-PBL) in burn surgery education. The objective of the study is to explore the teaching effect of this novel teaching method in burn surgery education. METHODS A pilot study was performed. One hundred and six students were randomly divided into a Lecture based Learning (LBL) only group (control group) and a LBL combined Clinical pathway- Problem based Learning group (observation group). A set of test was designed as evaluation criteria based on questions of burn surgery in National Medical Licensing Examination (NMLE) from 2011 to 2018. RESULTS The students with Clinical pathway- Problem based Learning had better academic performances in profession theory. Type A2 and Type A3/A4 scores in the observation group were higher than those in the control group (p < 0.05). The scores of the observation group were higher than those of control group in the domains of understanding and application (p < 0.05). They also have higher favorable impressions of learning experience. CONCLUSIONS More active approaches yield more learning and are viewed more favorable, which provides a vital message for the evolution of curriculum in Chinese medical schools.
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Affiliation(s)
- Pin Yao
- Shengjing Hospital of China Medical University, No.36 Sanhao Street, Heping District, Shenyang, 110004, China.
| | - Jing OuYang
- Humanity and Management College of Shaanxi University of Chinese Medicine, China, Xixian Big Road, Xixian New District, Shanxi Province, 712046, China.
| | - Chunping Liu
- Administration School, Hainan Medical University, China, No. 3 Xueyuan Road, Longhua Area, Haikou, Hainan Province, 571199, China.
| | - Siyu Wang
- College of the Humanities and Social Sciences, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122, China.
| | - Xin Wang
- College of the Humanities and Social Sciences, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122, China.
| | - Shu Sun
- Department of Burns, The First Affiliated Hospital of China Medical University, No.155 Nanjing Road, Heping District, Shenyang, Liaoning Province, 110001, China.
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Chadwick P, Ousey K. Bacterial-binding dressings in the management of wound healing and infection prevention: a narrative review. J Wound Care 2019; 28:370-382. [DOI: 10.12968/jowc.2019.28.6.370] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The aim of this review was to present the clinical data on the use of the family of bacterial-binding dressings (Sorbact; dialkylcarbamoyl chloride-coated) in the treatment of a variety of acute and chronic wounds. The findings are discussed in terms of the effectiveness of the bacterial-binding dressings on bacterial bioburden reduction, infection prevention, initiation/progression of wound healing and cost-effectiveness. The evidence in support of the bacterial-binding dressings is strongest in the area of infection prevention in surgical wounds, with several controlled trials showing the prophylactic benefit of the dressing in these wounds. Wound bioburden management in chronic wounds is supported by a number of clinical studies. In total, 29 published clinical studies (with a total of 4044 patients) were included in this review.
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Affiliation(s)
- Paul Chadwick
- Clinical Director, The College of Podiatry, Quartz House, 207 Providence Square, Mill Street, London, SE1 2EW
| | - Karen Ousey
- Professor of Skin Integrity, Professor and Director of the Institute of Skin Integrity and Infection Prevention, Department of Nursing and Midwifery, University of Huddersfield
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Yucel B, Coruh A, Deniz K. Salvaging the Zone of Stasis in Burns by Pentoxifylline: An Experimental Study in Rats. J Burn Care Res 2019; 40:211-219. [DOI: 10.1093/jbcr/irz005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Bora Yucel
- Department of Plastic Reconstructive and Aesthetic Surgery, Ministry of Health, Elmali State Hospital, Elmali/Antalya, Turkey
| | - Atilla Coruh
- Medical Faculty, Department of Plastic Surgery, Erciyes University, Kayseri, Turkey
| | - Kemal Deniz
- Medical Faculty, Department of Pathology, Erciyes University, Kayseri, Turkey
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Zhao F, Liu W, Yu Y, Liu X, Yin H, Liu L, Yi G. Effect of small molecular weight soybean protein-derived peptide supplementation on attenuating burn injury-induced inflammation and accelerating wound healing in a rat model. RSC Adv 2019; 9:1247-1259. [PMID: 35518054 PMCID: PMC9059567 DOI: 10.1039/c8ra09036j] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 12/19/2018] [Indexed: 12/18/2022] Open
Abstract
The populations most afflicted by burn injuries have limited abilities to support the significant specialized requirements and costs for acute and long-term burn injury care. This article describes the results of optimizing the use of readily absorbed small molecular weight soybean protein enzymolysis-derived peptide to attenuate rat burn injury-induced inflammation and accelerate wound healing. A major full-thickness 30% total body surface area burn-injury rat model was utilized and the systemic white blood cell (WBC) counts, the relative level of stimulation index of respiratory burst, and the inflammatory markers procalcitonin (PCT), tumor necrosis factor-α (TNF-α), chemokine (C–C motif) ligand 3 (CCL-3), chemokine (C–C motif) ligand 11 (CCL-11) and interleukin-10 (IL-10) were assessed. The burn injury-induced neutrophil and macrophage immune cell infiltration of the cutaneous tissues was detected by immunohistochemical analysis of the protein markers myeloperoxidase (MPO) and cluster of differentiation 68 (CD-68). The local induction of the burn injury-induced toll-like receptor 4/nuclear factor kappa-light-chain-enhancer of activated B (TLR4/NF-κB) signaling pathway in the effected cutaneous tissues was determined by the quantification of the protein expression of TLR4 and phosphorylated NF-κB/p65 using Western blots. In addition, burn wound size and healing rate were assessed biweekly for 8 weeks by imaging and measuring the burn wound surface area, and the angiogenesis protein marker of cluster of differentiation 31 (CD-31) expression in cutaneous tissues was also detected by immunohistochemical analysis. The results showed that nutrient supplementation with optimized readily absorbed small molecular weight soybean protein-derived peptide resulted in a dramatic anti-inflammatory effect as evidenced by the significant increase in the burn injury-induced systemic white blood cell counts and their relative level of stimulation index of respiratory burst, reduction in the burn injury-induced activation of NF-κB transcriptional signaling pathways, significant reduction in the local burn injury-induced cutaneous infiltration of neutrophils and macrophages at all measured time points, reduction in wound size and improved rate of burn injury wound healing with increased CD-31 protein expression. These results indicated that dietary supplementation with small molecular weight soybean-derived peptides could be used as an adjunct therapy in burn injury management to reduce inflammation and improve overall patient outcomes. The populations most afflicted by burn injuries have limited abilities to support the significant specialized requirements and costs for acute and long-term burn injury care.![]()
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Affiliation(s)
- Fen Zhao
- Beijing Advanced Innovation Center for Food Nutrition and Human Health
- Beijing Engineering and Technology Research Center of Food Additives
- Beijing Technology and Business University
- Beijing 100048
- China
| | - Wei Liu
- Burn Institute
- The First Affiliated Hospital of PLA General Hospital
- Beijing 100048
- China
| | - Yonghui Yu
- Beijing Advanced Innovation Center for Food Nutrition and Human Health
- Beijing Engineering and Technology Research Center of Food Additives
- Beijing Technology and Business University
- Beijing 100048
- China
| | - Xinqi Liu
- Beijing Advanced Innovation Center for Food Nutrition and Human Health
- Beijing Engineering and Technology Research Center of Food Additives
- Beijing Technology and Business University
- Beijing 100048
- China
| | - Huinan Yin
- Burn Institute
- The First Affiliated Hospital of PLA General Hospital
- Beijing 100048
- China
| | - Lingying Liu
- Burn Institute
- The First Affiliated Hospital of PLA General Hospital
- Beijing 100048
- China
| | - Guofu Yi
- Beijing Advanced Innovation Center for Food Nutrition and Human Health
- Beijing Engineering and Technology Research Center of Food Additives
- Beijing Technology and Business University
- Beijing 100048
- China
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Sorooshian P, Holden J, Stewart CJ, Colville RJ. Wound management in acute medicine. J Plast Reconstr Aesthet Surg 2018; 72:513-527. [PMID: 30585153 DOI: 10.1016/j.bjps.2018.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 12/09/2018] [Indexed: 10/27/2022]
Affiliation(s)
- Parviz Sorooshian
- Department of Plastic and Reconstructive Surgery, St George's University Hospital, London SW17 0QT, UK.
| | - Jane Holden
- Department of Plastic and Reconstructive Surgery, St George's University Hospital, London SW17 0QT, UK
| | - Camilla J Stewart
- Department of Plastic and Reconstructive Surgery, St George's University Hospital, London SW17 0QT, UK
| | - R James Colville
- Department of Plastic and Reconstructive Surgery, St George's University Hospital, London SW17 0QT, UK
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11
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Baldwin AJ. National Burns Awareness Day 2018, but how aware are British medical students? Burns 2018; 44:2107-2108. [PMID: 30262423 DOI: 10.1016/j.burns.2018.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Accepted: 09/09/2018] [Indexed: 10/28/2022]
Affiliation(s)
- Alexander J Baldwin
- College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom.
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12
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Goodarzi P, Falahzadeh K, Nematizadeh M, Farazandeh P, Payab M, Larijani B, Tayanloo Beik A, Arjmand B. Tissue Engineered Skin Substitutes. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1107:143-188. [PMID: 29855826 DOI: 10.1007/5584_2018_226] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The fundamental skin role is to supply a supportive barrier to protect body against harmful agents and injuries. Three layers of skin including epidermis, dermis and hypodermis form a sophisticated tissue composed of extracellular matrix (ECM) mainly made of collagens and glycosaminoglycans (GAGs) as a scaffold, different cell types such as keratinocytes, fibroblasts and functional cells embedded in the ECM. When the skin is injured, depends on its severity, the majority of mentioned components are recruited to wound regeneration. Additionally, different growth factors like fibroblast growth factor (FGF), epidermal growth factor (EGF), vascular endothelial growth factor (VEGF) are needed to orchestrated wound healing process. In case of large surface area wounds, natural wound repair seems inefficient. Inspired by nature, scientists in tissue engineering field attempt to engineered constructs mimicking natural healing process to promote skin restoration in untreatable injuries. There are three main types of commercially available engineered skin substitutes including epidermal, dermal, and dermoepidermal. Each of them could be composed of scaffold, desired cell types or growth factors. These substitutes could have autologous, allogeneic, or xenogeneic origin. Moreover, they may be cellular or acellular. They are used to accelerate wound healing and recover normal skin functions with pain relief. Although there are a wide variety of commercially available skin substitutes, almost none of them considered as an ideal equivalents required for proper wound healing.
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Affiliation(s)
- Parisa Goodarzi
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Khadijeh Falahzadeh
- Metabolomics and Genomics Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehran Nematizadeh
- Metabolomics and Genomics Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Parham Farazandeh
- Metabolomics and Genomics Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Moloud Payab
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Akram Tayanloo Beik
- Cell Therapy and Regenerative Medicine Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Babak Arjmand
- Cell Therapy and Regenerative Medicine Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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13
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Ramos G, Cornistein W, Cerino GT, Nacif G. Systemic antimicrobial prophylaxis in burn patients: systematic review. J Hosp Infect 2017. [DOI: 10.1016/j.jhin.2017.06.015] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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14
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Bourdon RT, Nelson-Cheeseman BB, Abraham JP. Review of the initial treatment and avoidance of scald injuries. World J Dermatol 2017; 6:17-26. [DOI: 10.5314/wjd.v6.i2.17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 02/13/2017] [Indexed: 02/06/2023] Open
Abstract
Scald injuries, which describe burns to living tissue from hot liquids, are a very common injury that occur across geographical, social, economic, and national boundaries. Despite their ubiquitous nature, a complete understanding of the conditions which are required to cause scald burns is not yet available. In addition, clear guidance to medical practitioners is available through various guidelines however in actual situations, the extent of the burn is not fully known and this lack of knowledge complicates care. Here, a comprehensive review is made of the available knowledge of temperatures and scald durations which lead to skin-burn injuries. The range of volumes and liquid temperatures are typical of those found in heated consumer beverages. This review can help medical practitioners design initial treatment protocols and can be used by manufacturers of hot-liquid products to avoid the most severe burns. Next, within the context of this ability to quantify burn depths, a review of current burn treatment guidelines is given. Included in this review is a visual recognition of the extent of burns into the dermal layer as well as decision guidelines for selection of patients which would benefit from referral to a dedicated burn center. It is hoped that by bringing together both the quantified burn-depth information and current treatment guidelines, this review can be used as a resource for persons in the medical, manufacturing, beverage service, and other industries to reduce the human impact of scald injuries.
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15
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Jopke K, Sanders H, White-Traut R. Use of Essential Oils Following Traumatic Burn Injury: A Case Study. J Pediatr Nurs 2017; 34:72-77. [PMID: 28089405 DOI: 10.1016/j.pedn.2016.12.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 12/27/2016] [Accepted: 12/29/2016] [Indexed: 10/20/2022]
Abstract
Hospital admissions related to burn injury reach 40,000 annually. Patients who experience extensive burns require longer hospital stays and are at increased risk for infection and hospital acquired conditions. This comparative case study is a two patient matched case control design that follows the hospital course of two children who experienced burn injuries. For one of these patients, with the consent of the child's parents, the grandmother treated her granddaughter with essential oils. Essential oils have the potential to inhibit microbial growth, support treatment of wounds, and facilitate healing. However, there have been no large scale studies on essential oils. Data for the two cases were retrieved from the electronic medical record at a Midwestern Pediatric Hospital. Retrieved data included burn site description, treatment for burns, number of days on the ventilator, white blood cell count, length of hospital stay, number of ICU days, infections diagnosed by positive culture and pain ratings. While the goals for treatment were the same for both children, the child who received only standard care was diagnosed with two blood stream infections and four hospital acquired conditions while the child who received supplemental treatment with essential oils did not develop any blood stream infections, was diagnosed with one hospital acquired condition, was in the PICU one day less, and had a four day shorter length of hospital stay. While these case findings are intriguing, research is needed to expand understanding of the role of essential oils in the treatment of burns.
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Affiliation(s)
| | | | - Rosemary White-Traut
- Children's Hospital of Wisconsin, United States; University of Illinois at Chicago, Department of Women, Children, and Family Health Science, United States.
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16
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Tevlin R, Dillon L, Clover AJP. Education in burns: Lessons from the past and objectives for the future. Burns 2017; 43:1141-1148. [PMID: 28408146 DOI: 10.1016/j.burns.2017.03.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Revised: 01/26/2017] [Accepted: 03/08/2017] [Indexed: 11/28/2022]
Abstract
Burns are devastating to the individual and society, representing a huge biomedical burden. Improved education in burns has however ignited a revolution in high-income countries-burn mortality is reducing. Education in burns is far-reaching. For the purpose of this concise review, we focus on four categories: education of both (1) emergency and (2) specialist physicians, and the general population, both at a (3) societal and (4) individual level. Tragically, the global burns picture is bleak with burns representing a neglected but solvable health crisis. Ninety-five percent of burns occur in low-income countries, causing enormous suffering, death and disability. Here, we examine the literature detailing burn education with a focus on past lessons, current trends and future objectives. We have identified key educational objectives to revolutionise burn care on a global perspective. Now is the time to build on promising educational strides to reduce the global burns burden.
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Affiliation(s)
- Ruth Tevlin
- Department of Plastic and Reconstructive Surgery, Cork University Hospital, Cork, Ireland
| | - Luke Dillon
- Department of Public Health and Primary Care, School of Medicine, Trinity College, Dublin, Ireland
| | - A James P Clover
- Department of Plastic and Reconstructive Surgery, Cork University Hospital, Cork, Ireland.
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17
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Zinchenko R, Perry FM, Dheansa BS. Burns teaching in UK medical schools: Is it enough? Burns 2016; 42:178-183. [DOI: 10.1016/j.burns.2015.10.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 09/17/2015] [Accepted: 10/01/2015] [Indexed: 10/22/2022]
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18
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Chemical burns from topical use of traditional Chinese medicine. EUROPEAN JOURNAL OF PLASTIC SURGERY 2015. [DOI: 10.1007/s00238-015-1066-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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19
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Zhanzeng F, Yurong Z, Chuangang Y, Yunyun J, Xingang W, Zhaofan X, Chunmao H. Basic investigation into the present burn care system in China: Burn units, doctors, nurses, beds and special treatment equipment. Burns 2015; 41:279-88. [DOI: 10.1016/j.burns.2014.06.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2013] [Revised: 06/06/2014] [Accepted: 06/09/2014] [Indexed: 12/18/2022]
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20
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Cerqueira MT, da Silva LP, Santos TC, Pirraco RP, Correlo VM, Marques AP, Reis RL. Human skin cell fractions fail to self-organize within a gellan gum/hyaluronic acid matrix but positively influence early wound healing. Tissue Eng Part A 2014; 20:1369-78. [PMID: 24299468 DOI: 10.1089/ten.tea.2013.0460] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Split-thickness autografts still are the current gold standard to treat skin, upon severe injuries. Nonetheless, autografts are dependent on donor site availability and often associated to poor quality neoskin. The generation of dermal-epidermal substitutes by tissue engineering is seen as a promising strategy to overcome this problematic. However, solutions that can be safely and conveniently transplanted in one single surgical intervention are still very challenging as their production normally requires long culture time, and graft survival is many times compromised by delayed vascularization upon transplantation. This work intended to propose a strategy that circumvents the prolonged and laborious preparation period of skin substitutes and allows skin cells self-organization toward improved healing. Human dermal/epidermal cell fractions were entrapped directly from isolation within a gellan gum/hyaluronic acid (GG-HA) spongy-like hydrogel formed from an off-the-shelf dried polymeric network. Upon transplantation into full-thickness mice wounds, the proposed constructs accelerated the wound closure rate and re-epithelialization, as well as tissue neovascularization. A synergistic effect of the GG-HA matrix and the transplanted cells over those processes was demonstrated at early time points. Despite the human-derived and chimeric blood vessels found, the proposed matrix did not succeed in prolonging cells residence time and in sustaining the self-organization of transplanted human cells possibly due to primitive degradation. Despite this, the herein proposed approach open the opportunity to tackle wound healing at early stages contributing to re-epithelialization and neovascularization.
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Affiliation(s)
- Mariana T Cerqueira
- 1 3B's Research Group-Biomaterials, Biodegradables and Biomimetics, University of Minho , Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Guimarães, Portugal
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21
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In Vivo Evaluation of Wound Bed Reaction and Graft Performance After Cold Skin Graft Storage. J Burn Care Res 2014; 35:e187-96. [DOI: 10.1097/bcr.0b013e3182a226df] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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22
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23
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24
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Chadwick SL, Yip C, Ferguson MWJ, Shah M. Repigmentation of cutaneous scars depends on original wound type. J Anat 2013; 223:74-82. [PMID: 23668313 DOI: 10.1111/joa.12052] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2013] [Indexed: 02/02/2023] Open
Abstract
Cutaneous scarring is currently an inevitable outcome following skin injury. Abnormal pigmentation within scars makes them more noticeable, causing distress for patients, particularly as there is no reliable and effective treatment available to date. The Duroc pig, known to scar badly, was used to investigate repigmentation of scars resulting from three different wound types: incisional, partial thickness excisional and full thickness excisional. Wounds were created on the backs of Duroc pigs and the resulting scars harvested at days 35, 56, 70 and 90 days post-injury. Scars were processed for histology and immunohistochemistry, quantitatively analysed using image analysis software and subjected to statistical analysis. Photographs of the macroscopic appearance of scars were scored for pigmentation using a visual analogue scale. Results demonstrated temporal and spatial differences in melanocyte repopulation and function within scars from different wound types. The microscopic pigment deposition did not correlate with macroscopic appearances in mature scars. Pigmentation of scars is dependent on the width and depth of wounds. This study has provided important information on which we can base future studies to investigate factors controlling the repigmentation of scars.
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Affiliation(s)
- Sarah L Chadwick
- Faculty of Life Sciences, University of Manchester, Manchester, UK.
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25
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Vujanovic S, Vujanovic J. Bioresources in the pharmacotherapy and healing of burns: A mini-review. Burns 2013; 39:1031-8. [PMID: 23642293 DOI: 10.1016/j.burns.2013.03.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2012] [Revised: 09/07/2012] [Accepted: 03/27/2013] [Indexed: 12/11/2022]
Abstract
The present mini-review actualizes the pharmacy of botanical, animal, and fungal sources of potential value in the management of burns wounds. It also highlights the importance of applying contemporary imaged-based sciences such as radiology in the assessment and prognosis of wounds and burns.
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Affiliation(s)
- Silva Vujanovic
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Canada.
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26
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Abstract
Burns commonly occur in children and their first aid remains inadequate despite burn prevention programmes. While scald injuries predominate, contact and flame burns remain common. Although typically less severe injuries overall than those in adults, hypertrophic scarring complicating both the burn wound and even donor sites occur more frequently in children. The heterogeneous nature of burn wounds, coupled with the difficulties associated with the early clinical assessment of burn depth, has stimulated the application of novel technologies to predict burn wound outcome. This review explores current best practice in the management of paediatric burns, with a focus on prevention, optimal first aid, resuscitation, burn wound prediction and wound management strategies.
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Affiliation(s)
- Leo K P Kim
- The Children's Hospital at Westmead Burns Research Institute, Sydney Medical School, The University of Sydney, New South Wales, Australia
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27
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Zanni GR. Thermal burns and scalds: clinical complications in the elderly. THE CONSULTANT PHARMACIST : THE JOURNAL OF THE AMERICAN SOCIETY OF CONSULTANT PHARMACISTS 2012; 27:16-22. [PMID: 22231994 DOI: 10.4140/tcp.n.2012.16] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Burns are categorized as superficial, superficial partial thickness, deep partial thickness, and full thickness. Superficial burns heal spontaneously; more serious burns require treatment. Elders are disproportionately affected, and advanced age is associated with poorer outcomes, partially because of thin skin and preexisting conditions. Clinical complications are common in elderly burn victims. Treatment's two stages, acute care and follow-up care, are discussed. Severe burns can result in significant scarring and painful contractures, and victims are at increased risk for depression and related psychiatric problems. The majority of elders suffering from severe burns are transferred to long-term care and rehabilitation facilities for follow-up care. Most burns are preventable, and burns occurring in long-term care facilities require investigation.
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28
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Yavuz A, Ayse A, Abdullah Y, Belkiz A. Clinical and demographic features of pediatric burns in the eastern provinces of Turkey. Scand J Trauma Resusc Emerg Med 2011; 19:6. [PMID: 21244683 PMCID: PMC3032719 DOI: 10.1186/1757-7241-19-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2010] [Accepted: 01/18/2011] [Indexed: 12/02/2022] Open
Abstract
Background The aim of this study is to perform a retrospective analysis of the causes of burns observed in children in the eastern provinces of Turkey. Method In this study, patients were studied retrospectively with regard to their age, sex, cause of burns, seasonal variations, social and economic factors, length of hospital stay, burned body surface area, medical history, site of injury, and mortality. Results A total of 125 patients undergoing inpatient treatment were male, (53.2%) and 110 were female (46.8%). The most common causes of burns in patients treated on an inpatient basis were scald burns (65.5%) and tandir burns (15.7%). The mean total body surface area of all the patients was 12.17+9.86%. When the patients were grouped according to tandir, cauldron, and others burn causes, a significant difference was seen between the in burn percentages caused by tandir and cauldron burns and other causes (p < 0.001). Higher burn percentages were seen for cauldron burns than for tandir burns (p < 0.05). The average length of hospital stay was 17.67+13.64 days. When the patients were grouped according to burn causes (tandir, cauldron, and others), a significant difference was determined between the hospitalization periods of patients with tandir burns and other burn causes (p = 0.001) The most commonly proliferating microorganism in burned areas was Pseudomonas aeruginosa (20.4%). Of the 235 patients, 61 were treated in operating rooms. During the 24-month period of the study, 2 of the 235 patients died (0.85%). Conclusion Pediatric burns in the eastern part of Turkey are different from those in other parts of Turkey, as well as in other countries. Due to the lifestyle of the region, tandir and cauldron burns, which cause extensive burn areas and high morbidity, are frequently seen in children. Therefore, precautions and educational programs related to the use of tandirs and cauldrons are needed in this region.
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Affiliation(s)
- Albayrak Yavuz
- Department of General Surgery and Burn Unit, Erzurum Region Education and Research Hospital, Erzurum, Turkey.
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29
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Findlay JM, Shaw A. Emergency management of burns. Br J Hosp Med (Lond) 2010; 71:M162-6. [PMID: 21063246 DOI: 10.12968/hmed.2010.71.sup11.79670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- John M Findlay
- Department of General Surgery, Royal Berkshire Hospital, Reading
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30
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Gandhi M, Thomson C, Lord D, Enoch S. Management of pain in children with burns. Int J Pediatr 2010; 2010:825657. [PMID: 20885937 PMCID: PMC2946605 DOI: 10.1155/2010/825657] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2010] [Accepted: 06/23/2010] [Indexed: 01/03/2023] Open
Abstract
Burn injuries are common in children under 10 years of age. Thermal injury is the most common mechanism of injury and scalds account for >60% of such injuries. All children with burns will experience pain, regardless of the cause, size, or burn depth. Undertreated pain can result in noncompliance with treatment and, consequently, prolonged healing. It is acknowledged that the monitoring and reporting of pain in children with burns has generally been poor. Due to the adverse physiological and emotional effects secondary to pain, adequate pain control is an integral and requisite component in the management of children with burns. A multidisciplinary approach is frequently necessary to achieve a robust pain relief. Key to successful treatment is the continuous and accurate assessment of pain and the response to therapy. This clinical review article discusses the essential aspects of the pathophysiology of burns in children provides an overview of pain assessment, the salient principles in managing pain, and the essential pharmacodynamics of commonly used drugs in children with burn injuries. Both pharmacological and nonpharmacological treatment options are discussed, although a detailed review of the latter is beyond the scope and remit of this article.
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Affiliation(s)
- M. Gandhi
- Central Manchester and Manchester University Children's Hospitals NHS Trust, Manchester, UK
| | - C. Thomson
- Central Manchester and Manchester University Children's Hospitals NHS Trust, Manchester, UK
| | - D. Lord
- Central Manchester and Manchester University Children's Hospitals NHS Trust, Manchester, UK
| | - S. Enoch
- University Hospitals of South and Central Manchester, Manchester, UK
- Royal Manchester Children's Hospital, Oxford Road, Manchester M13 9WL, UK
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31
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Avni T, Levcovich A, Ad-El DD, Leibovici L, Paul M. Prophylactic antibiotics for burns patients: systematic review and meta-analysis. BMJ 2010; 340:c241. [PMID: 20156911 PMCID: PMC2822136 DOI: 10.1136/bmj.c241] [Citation(s) in RCA: 123] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess the evidence for prophylactic treatment with systemic antibiotics in burns patients. DESIGN Systematic review and meta-analysis of randomised or quasi-randomised controlled trials recruiting burns inpatients that compared antibiotic prophylaxis (systemic, non-absorbable, or topical) with placebo or no treatment. DATA SOURCES PubMed, Cochrane Library, LILACS, Embase, conference proceedings, and bibliographies. No language, date, or publication status restrictions were imposed. Review methods Two reviewers independently extracted data. The primary outcome was all cause mortality. Risk or rate ratios with 95% confidence intervals were pooled with a fixed effect model if no heterogeneity was present. RESULTS 17 trials were included. Trials that assessed systemic antibiotic prophylaxis given for 4-14 days after admission showed a significant reduction in all cause mortality (risk ratio 0.54, 95% confidence interval 0.34 to 0.87, five trials). The corresponding number needed to treat was 8 (5 to 33), with a control event rate of 26%. Perioperative non-absorbable or topical antibiotics alone did not significantly affect mortality. There was a reduction in pneumonia with systemic prophylaxis and a reduction in wound infections with perioperative prophylaxis. Staphylococcus aureus infection or colonisation was reduced with anti-staphylococcal antibiotics. In three trials, resistance to the antibiotic used for prophylaxis significantly increased (rate ratio 2.84, 1.38 to 5.83). The overall methodological quality of the trials was poor. CONCLUSIONS Prophylaxis with systemic antibiotics has a beneficial effect in burns patients, but the methodological quality of the data is weak. As such prophylaxis is currently not recommended for patients with severe burns other than perioperatively, there is a need for randomised controlled trials to assess its use.
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Affiliation(s)
- Tomer Avni
- Department of Medicine E, Rabin Medical Center, Beilinson Hospital, Sackler Faculty of Medicine, Tel-Aviv University, Israel
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32
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Böttcher-Haberzeth S, Biedermann T, Reichmann E. Tissue engineering of skin. Burns 2009; 36:450-60. [PMID: 20022702 DOI: 10.1016/j.burns.2009.08.016] [Citation(s) in RCA: 217] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2009] [Accepted: 08/14/2009] [Indexed: 01/27/2023]
Abstract
The engineering of skin substitutes and their application on human patients has become a reality. However, cell biologists, biochemists, technical engineers, and surgeons are still struggling with the generation of complex skin substitutes that can readily be transplanted in large quantities, possibly in only one surgical intervention and without significant scarring. Constructing a dermo-epidermal substitute that rapidly vascularizes, optimally supports a stratifying epidermal graft on a biodegradable matrix, and that can be conveniently handled by the surgeon, is now the ambitious goal. After all, this goal has to be reached coping with strict safety requirements and the harsh rules of the economic market.
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Affiliation(s)
- Sophie Böttcher-Haberzeth
- Tissue Biology Research Unit, Department of Surgery, University Children's Hospital Zurich, Steinwiesstrasse 75, CH-8032 Zurich, Switzerland
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