J Burn Care Res [JOURNAL]
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200 papers
A Statewide Multi-Source Analysis of Supplemental Oxygen-Related Fires and Burn Injuries.
Klas KS, Zorkot D, White M … +1 more , Pitogo A
J Burn Care Res · 2026 Apr · PMID 41968346 · Publisher ↗
UNLABELLED: Despite the increasing prevalence of home oxygen therapy, its associated injury risks remain underrecognized. This study analyzed the statewide incidence of oxygen therapy-related fires, burns, and deaths to...
UNLABELLED: Despite the increasing prevalence of home oxygen therapy, its associated injury risks remain underrecognized. This study analyzed the statewide incidence of oxygen therapy-related fires, burns, and deaths to identify systemic barriers for data capture, outline improved surveillance pathways, and inform prevention strategies. METHODS: Retrospective, multi-source analysis of statewide data (2020-2023) from death certificates, hospital admissions, registries, and fire incident reports. Liaisons performed free-text field searches. Data reported in de-identified aggregate counts and analyzed descriptively for comparison. RESULTS: Reporting was highly inconsistent across all data systems, without specific ICD-10-CM injury codes (top utilized: flammable material, uncontrolled fire). State National Fire Incident Reporting System data revealed a total of only 2 oxygen therapy fires deaths (mean 3.5 fires/year). In sharp contrast, death certificates and fire inspectors reported a mean 9.8 - 10.3 deaths/year with 97% linked to smoking, confirming home oxygen therapy deaths are underreported by a factor of twenty in state fire incident data. Four hospitals reported mean 17.9/year (range 13-31) oxygen therapy admissions each, with combined 4-year total of 285 (range 51-124). This represents 33% of all home oxygen therapy patients compared to published national burn center data. CONCLUSION: Home oxygen burns and deaths are underreported in state and national datasets. Most incidents are preventable, with smoking as primary ignition source. Lack of dedicated injury codes, gaps in trauma / EMS variable data, and data suppression thresholds that prevent reporting of low-frequency events. Establishing specific ICD-10-CM codes and cohesive prevention strategies are necessary to reduce this injury burden.
Underweight adult burn survivors report significantly worse physical function and social participation: A Burn Model System Database Study.
Wang S, Choe D, Saito A … +7 more , Humbert A, Kowalske K, Oh J, Winnek K, Schneider JC, Ryan CM, Yenikomshian HA
J Burn Care Res · 2026 Apr · PMID 41968343 · Publisher ↗
Burns can cause serious physical injury and psychosocial distress. Extremes of body weight can also impair physical recovery and exacerbate emotional distress. However, the impact of body mass index (BMI) on longitudinal...
Burns can cause serious physical injury and psychosocial distress. Extremes of body weight can also impair physical recovery and exacerbate emotional distress. However, the impact of body mass index (BMI) on longitudinal self-reported outcomes is not well understood. We aimed to compare self-reported psychosocial and functional outcomes among adult burn survivors who were obese, normal weight, and underweight at discharge. Adult burn survivors participating in the Burn Model System (BMS) national database between 2010 - 2020 were included. Participants were divided into three groups: those who were obese (BMI ≥ 30), normal weight (BMI 18.5 - 29.9), and underweight (BMI < 18.5) at discharge. Survey responses using the PROMIS scales (Pain Interference, Anxiety, Depression, Fatigue, Ability to Participate in Social Roles, and Physical Function); PTSD Checklist for DSM-5; and Satisfaction with Life scale at 6-, 12-, and 24 months post-burn injury were analyzed. A total of 920 participants met inclusion criteria, of which 306 were obese, 579 normal weight, and 35 underweight. There were no significant differences across all self-reported outcomes between normal weight and obese participants. However, underweight participants reported significantly worse physical function (-4.2 pts, p = 0.005) and social participation (-3.49 pts, p = 0.041) compared to those with normal BMI. These findings indicate that underweight burn survivors may experience significantly worse physical function and social integration post-burn compared to normal weight survivors long-term. Our study suggests that low BMI status should be considered when discussing long-term physical and psychosocial recovery among adults living with burn injuries.
Electrical Burn Injuries in the United States: Recent Demographic, Clinical, and Regional Patterns from the BCQP Registry.
Brown NH, Rivera-Barbosa M, Leonardi C
J Burn Care Res · 2026 Apr · PMID 41966997 · Publisher ↗
Electrical injuries represent a small proportion of burn admissions but are associated with substantial morbidity. Prior studies suggest demographic and regional disparities in burn injury incidence and outcomes. This st...
Electrical injuries represent a small proportion of burn admissions but are associated with substantial morbidity. Prior studies suggest demographic and regional disparities in burn injury incidence and outcomes. This study aimed to compare electrical versus non-electrical burn injuries and assess regional differences in patient and burn characteristics, and outcomes using the American Burn Association's Burn Care Quality Platform (BCQP). We conducted a retrospective cohort study using adult admissions from 2020 to 2022 to compare electrical to other types of burns. Outcomes included length of stay, mortality, discharge disposition, and insurance status. Regional analyses were based on the five ABA regions in the USA. Statistical comparisons used multivariate analyses, including propensity score matching. . Of a total of 63,269 patients, 2,042 (3.3%) sustained electrical injuries. These patients were younger (average age 40), predominantly male (92.2%), more likely to be injured at work (61.9%) and disproportionately Hispanic/Latino (21.9%). In the Southern region, electrical injuries resulted in significantly shorter median hospital stays than non-electrical injuries (2 vs. 3 days, p < 0.0001) shorter ICU stays (3 vs. 4 days, p ≤ 0.001). Mortality was consistently lower among electrical injury patients (2.2% vs. 3.7%, p ≤ 0.012). 52.7% of patients in the sample were treated in the Southern region, which also had the highest rate of electrical injuries in the country.The ABA Southern region bears a disproportionate burden, particularly among Hispanic/Latino and uninsured patients. These findings highlight the need for region-specific prevention, improved safety training, and equitable access to care.
Hypoalbuminemia during the first 24 hours is not an independent risk factor for mortality in major burns.
Ils C, Zingg T, Berger MM … +6 more , Rouvé JD, Montoro L, de Buys Roessingh A, Al-Dourobi K, Harder Y, Pantet O
J Burn Care Res · 2026 Apr · PMID 41966986 · Publisher ↗
Major burn injuries commonly present with hypoalbuminemia within the first 24 hours. This study aimed to determine whether early hypoalbuminemia independently predicts mortality in severe burns. This single-center, retro...
Major burn injuries commonly present with hypoalbuminemia within the first 24 hours. This study aimed to determine whether early hypoalbuminemia independently predicts mortality in severe burns. This single-center, retrospective cohort study included patients aged 14 years and older with burns covering at least 20% of their body surface area, admitted between January 2006 and December 2023 in a university teaching hospital. Exclusion criteria were admission more than 8 hours post-injury or transfer to another unit within the first week. Albumin levels within the first 24 hours were recorded. The primary outcome was 28-day mortality. 161 patients were included with a median burn area of 38% (IQR 25-65) and an Abbreviated Burn Severity Index score of 9 (IQR 7-11.5). Mortality was 33% (53/161). While univariate analysis showed that lower albumin was associated with increased mortality (OR 0.91, 95% CI 0.86-0.96, p=0.001), this association was not significant after adjustment for burn severity (OR 0.99, 95% CI 0.93-1.06, p=0.87). The predictive value of minimum serum albumin for mortality was low with an area under the curve of 0.68. The optimal albumin threshold for predicting mortality was 24 g/L (sensitivity 81.0%, specificity 49.5%). Albumin levels below this threshold were not significantly associated with higher mortality in a time-to-event analysis (HR 1.72, 95% CI 0.79-3.73, p=0.169). Hypoalbuminemia in the first 24 hours was not found to be an independent risk factor for 28-day mortality in this cohort, suggesting it as a marker of burn severity rather than an independent predictor.
Correction to: Empowering Emergency Responders to Treat on Scene Alleviates Hospital Strain During Disaster Events.
J Burn Care Res · 2026 Apr · PMID 41947370 · Publisher ↗
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Healing of radiation-induced skin injury with a biosynthetic matrix: A case report.
Greenhalgh DG, Banerjee P, Moss A … +6 more , Moote J, Moote J, Woodroof I, Moss M, Woodroof E, Woodroof A
J Burn Care Res · 2026 Mar · PMID 41885538 · Publisher ↗
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A comparison of various skin graft expansion models: Beyond coverage and toward improved healing.
Khan MA, Poyarekar S, Puri V
J Burn Care Res · 2026 Mar · PMID 41870514 · Publisher ↗
Skin graft expansion techniques have demonstrated efficacy in treating large burns when the donor skin supply is insufficient. Currently, the pursuit of skin expansion extends beyond merely covering a large area; it also...
Skin graft expansion techniques have demonstrated efficacy in treating large burns when the donor skin supply is insufficient. Currently, the pursuit of skin expansion extends beyond merely covering a large area; it also aims to achieve a large perimeter gain, a smaller interpatch distance, and a shorter healing period. However, clinicians and surgeons appear to overlook the significance of inter-patch distance and perimeter gain on expansion ratio and healing period. Moreover, the interrelationships among these critical parameters remain unknown to this day. This study revisits the fundamental principles of various graft expansion techniques (meshing, micrografting, and punching) to describe the interrelationship between these parameters. The analysis indicates that increasing the expansion ratio always delays the wound closure, regardless of the graft expansion technique. The recommendation provided for clinicians/surgeons to select the best surgical parameters or commercially available skin graft expansion device to improve wound healing. Furthermore, a criterion was presented to surgeons to objectively compare the two different skin graft expansion methods without bias. Furthermore, a comprehensive understanding of the interrelationships among inter-patch distance, perimeter gain, wound-healing period, and expansion ratio will ultimately lead to the development of novel therapeutic methods to promote large wound coverage and rapid wound healing.
Posttraumatic Growth in Families Following Burn Injury: Prevalence and Discrepancy in Patient-Caregiver Pairs.
Zhao S, Yu Y, Dayton LI … +4 more , Caffrey J, Frey KP, Wegener ST, Castillo RC
J Burn Care Res · 2026 Mar · PMID 41863626 · Publisher ↗
Burn injuries cause physical and psychological trauma to patients and impose caregiving and emotional burdens on their families. Despite these challenges, both patients and caregivers may experience posttraumatic growth...
Burn injuries cause physical and psychological trauma to patients and impose caregiving and emotional burdens on their families. Despite these challenges, both patients and caregivers may experience posttraumatic growth (PTG). Using baseline cross-sectional data from 234 patient-family caregiver pairs recruited from burn units across 10 hospitals in China, this study provides a dyad-informed characterization of PTG at the family level, including PTG in patient-caregiver pairs and within-dyad PTG discrepancy. Participants completed assessments of PTG, psychological distress, PTSD symptoms, and perceived social support. Patients and caregivers reported comparable PTG levels (53.2 vs. 51.2). Social support, injury characteristics, and surgery were associated with PTG in both groups; patient income and caregiver distress were group-specific correlates. Within-dyad PTG differences related to social support, time since injury, appearance concerns, and caregiver stress. Findings underscore the prevalence and both shared and distinct characteristics of PTG in burn patients and family caregivers, and suggest that strengthening social support may promote positive change in both members of the dyad. These first time dyad-informed findings provide descriptive evidence and hypothesis-generating signals to inform future longitudinal and dyadic modeling.
Impact of Thrombolytic Treatment on Functional Rehabilitation in Severe Frostbite Patients.
Kindt L, Fisher B, Vang C … +9 more , Patricia White, Zemek S, Almendinger J, Nelson L, Alem RA, Colonna E, Schmitz K, Lumbard D, Nygaard RM
J Burn Care Res · 2026 Mar · PMID 41863599 · Publisher ↗
Thrombolytics improve limb and digit salvage following severe frostbite injury, however disability following thrombolytics therapy is largely undescribed. Our aim was to evaluate functional status, pain, and disability i...
Thrombolytics improve limb and digit salvage following severe frostbite injury, however disability following thrombolytics therapy is largely undescribed. Our aim was to evaluate functional status, pain, and disability in a large cohort of severe frostbite patients treated with and without thrombolytics, hypothesizing no significant differences between the two groups. Longitudinal cohort study of severe frostbite injured patients over the winters of 2013-20. Therapy and clinic notes were reviewed at discharge and follow-up. Outcomes were categorized including requiring assistance or modifications for activities of daily living (ADLs), grip, ambulation status (independent, assist-device, non-ambulatory), presence of pain, edema, numbness, throbbing, and hyperesthesia. The cohort included 182 patients, 75.8% received thrombolytics. Over a third of patients required assistance with ADLs (32.6% no thrombolytics vs 46.7% thrombolytics, p=0.115). Return to work status as same prior to injury were equal between the two treatment groups. Reports of neurologic pain, edema, and numbness were all higher in the thrombolytics treated group, while throbbing was higher in the non-thrombolytics group, but none reached significance. Significantly more non-thrombolytics treated patients required amputation. Of those with at least 1 clinic follow-up (n=133), 98 were treated with thrombolytics. Higher proportions of thrombolytics patients were independently ambulating at follow-up. No significant differences in reported pain, edema, swelling, hyperesthesia, or throbbing between the treatment groups were observed at follow-up. When examining those treated with or without thrombolytics that did not require amputation, the results mirrored the cohort. When assessing outcomes based on extremity impacted by frostbite, only independent ambulation was significantly higher in those with lower extremity injury treated with thrombolytics. This is the first long-term evaluation of functional outcomes of thrombolytics-treated severe frostbite patients. Future research is needed to incorporate the systematic documentation of functional outcomes using validated performance and patient-reported outcomes measures. Thrombolytics is a valuable intervention in preventing amputation following severe frostbite injury and functional recovery of salvaged limbs and digits warrant additional study.
Epidemiology of Burns in Eastern Slovakia (2014-2024).
Demcak T, Gazdova M, Lengyel P … +2 more , Branski LK, Gazda J
J Burn Care Res · 2026 Mar · PMID 41852331 · Publisher ↗
Burn injuries remain a major global health issue, and despite multidisciplinary advances, mortality among patients with major burns remains substantial. Preventive measures have reduced incidence worldwide; however, demo...
Burn injuries remain a major global health issue, and despite multidisciplinary advances, mortality among patients with major burns remains substantial. Preventive measures have reduced incidence worldwide; however, demographic and societal changes over recent decades warrant reassessment. We therefore analyzed recent trends in burn incidence requiring tertiary-care hospitalization between 2014 and 2024. A retrospective observational study was conducted including all acute burn patients admitted to the sole tertiary burn center serving Eastern Slovakia between 2014 and 2024. Annual incidence rates per 100,000 inhabitants were calculated using census-based regional population data and stratified by age and sex. A total of 2,346 patients were hospitalized (62% male; median age 25 years, IQR 2-55). Scalds predominated (55%), followed by flame burns (25%). Median burn size was 9% TBSA; inhalation injury occurred in 4.1%, and 3.9% were work-related. The median annual incidence was 12.95 per 100,000 (IQR 11.78-13.85), increasing from 9.41 in 2014 to 15.42 in 2024 (IRR 1.64, 95% CI 1.34-2.01). Male annual incidence remained higher than female (median 16.3 vs 9.4 per 100,000). Infants (0-1 year) comprised 22% of admissions, with the highest annual incidence among all age groups (median 119 per 100,000). The incidence of burn injuries requiring tertiary-care admission in Eastern Slovakia increased over the past decade, particularly among males and infants. These findings highlight the need for targeted preventive strategies focusing on domestic scald injuries and early childhood safety.
A single-armed pilot study to evaluate a psychosocial intervention for young people who have experienced a burn injury: The Wellbeing Study.
Paciente R, Hanna N, van Rensburg EJ … +8 more , McGivern L, Milroy H, Martin L, Wood F, Lombardi K, Ohan JL, English MCW, Woolard A
J Burn Care Res · 2026 Mar · PMID 41810870 · Publisher ↗
BACKGROUND: Children with serious burns often suffer psychosocial consequences. This study evaluated the pilot of a six-session psychoeducational intervention newly designed to support the wellbeing of children who exper...
BACKGROUND: Children with serious burns often suffer psychosocial consequences. This study evaluated the pilot of a six-session psychoeducational intervention newly designed to support the wellbeing of children who experienced burns. Each one-hour session was delivered online to individuals at times deemed convenient to participants, by trained facilitators (mental health researchers and other allied health professionals). METHODS: The pilot was single-arm, with psychosocial screening administered at baseline, immediately post-intervention, and at 6- and 12- month follow-ups. Eligible participants were 6-17 years, 6-weeks to 2-years post-burn, the burn must be non-intentional, without cognitive disability or existing mental health concerns in themselves or their parents. Interviews post-intervention explored acceptability. RESULTS: Overall, 27 young people were recruited; 12 started and completed the intervention, but 8 young people were lost to follow-up by the end of the follow-up period. Results from the problem and syndrome subscales of the Youth Self-Report (YSR) and the Child Behavioural Checklist showed that group medians did not significantly change over the post-intervention follow-up period. The individual-based characteristics showed that some young people improved on one to three YSR subscales (n=3), stagnated (n=3), and two young people started within clinical ranges while showing deterioration throughout the follow-up period. Qualitative data (n = 2) showed that the content was applicable to the needs of the young people. CONCLUSION: The results indicate some benefit to the young people but further investigation is required to ascertain the Wellbeing Program's effectiveness in improving the psychosocial outcomes of young people who have sustained a burn injury.
Primary Care Attachment and Long-Term Mortality in Burn Survivors: A Population-Based Cohort Study.
Little D, Yee EK, Haas B … +5 more , Rosella L, Postill G, Zagorski B, Jaakkimainen L, Mason S
J Burn Care Res · 2026 Mar · PMID 41810862 · Publisher ↗
Burn survivors are at greater risk of mortality due to cancer and chronic disease than the general population, which may be preventable with regular primary care. This study aimed to determine the association between pri...
Burn survivors are at greater risk of mortality due to cancer and chronic disease than the general population, which may be preventable with regular primary care. This study aimed to determine the association between primary care provider (PCP) attachment and long-term mortality in burn survivors. We conducted a retrospective population-based cohort study including all adults in Ontario who survived hospitalization for a major burn injury between 2010-2022. PCP attachment (as a marker of regular primary care) was categorized as attached or uncertainly attached. The primary outcome was five-year all-cause mortality, with follow-up until death or March 31, 2023. Kaplan-Meier curves were used to estimate cumulative mortality. Cox proportional hazards (CPH) models assessed the association between PCP attachment and mortality after adjusting for age, sex, comorbidity, rurality, immigration status, and socioeconomic characteristics. Among 1,968 burn survivors (median age 47 years, 73% male), 86% were attached to a PCP. PCP-attached individuals had a greater burden of medical comorbidities but similar burn injury severity. Five-year mortality was 11% in PCP-attached and 9% in uncertainly attached burn survivors. Time-stratified CPH models did not demonstrate a significant association between PCP attachment and mortality post-discharge either within (HR: 0.77, 95% CI: 0.41, 1.43) or beyond two years (HR: 0.77, 95% CI: 0.38, 1.57) after discharge. PCP attachment was common among burn survivors, though not significantly associated with long-term survival. Attachment to primary care, in isolation, may not represent meaningful or regular primary care use that would reduce the chronic disease burden in burn survivors.
Community-Level Disparities in the Inhalation Injury Patient Population.
Fedor CJ, Kaulakis MG, Liu HY … +7 more , Arellano JA, Tepe S, Elias GA, Corcos AC, Siedsma MP, Ziembicki JA, Egro FM
J Burn Care Res · 2026 May · PMID 41800561 · Publisher ↗
Low-income neighborhoods face higher fire risk due to overcrowding, substandard housing, and limited access to safety devices, contributing to greater burn severity among affected residents. Inhalation injury, a frequent...
Low-income neighborhoods face higher fire risk due to overcrowding, substandard housing, and limited access to safety devices, contributing to greater burn severity among affected residents. Inhalation injury, a frequent consequence, often necessitates early intubation and transfer to burn centers. Given the high degree of coordination required, this study examines how management strategies and outcomes vary across levels of social vulnerability and urbanicity, 2 community-level proxies for access to care. We retrospectively reviewed inhalation injuries diagnosed by bronchoscopy at a single ABA-certified burn center (2012-2024), limited to structure fires. Community vulnerability was estimated using the Social Vulnerability Index (SVI; low <0.5, moderate 0.5-0.74, and high ≥0.75) and urbanicity using Rural-Urban Commuting Area (RUCA) codes (<4 = urban). Clinical outcomes were compared across SVI and RUCA groups using univariate and multivariate analyses. Among 184 patients, higher social vulnerability was associated with a greater proportion of Black individuals and higher asthma prevalence. Clinical characteristics, burn severity, timing of intubation, intensive care unit/hospital length of stay, ventilator days, and surgical interventions did not differ significantly across SVI or rural-urban groups. Transfer from outside hospitals was more common among rural residents (51.4% vs 30.1%), who were also more likely to be intubated at the scene (35% vs 30%). In multivariable analyses, high social vulnerability independently predicted increased mortality risk, although it was not associated with pneumonia, acute respiratory distress syndrome, or ventilator duration. Most patients with inhalation injuries come from socially vulnerable communities, yet higher SVI did not convincingly affect clinical outcomes, suggesting equitable acute care delivery when resources are available.
Negative pressure wound therapy improves the survival rate of Meek skin grafting in burn patients: A prospective randomized controlled study in a single centre.
Zhang P, Luo J, Yuan LL … +2 more , Huang YS, Xiang F
J Burn Care Res · 2026 Mar · PMID 41800546 · Publisher ↗
This study aimed to determine whether negative pressure wound therapy (NPWT) improved the survival rate of Meek skin grafting compared to that of traditional dressing in burn patients. Thirteen burn patients with similar...
This study aimed to determine whether negative pressure wound therapy (NPWT) improved the survival rate of Meek skin grafting compared to that of traditional dressing in burn patients. Thirteen burn patients with similar depths on both limbs were admitted, the limbs were divided into the NPWT+Meek group and the Meek group. The polyamide gauze adherence rate, the wound secretion culture result and the skin survival rate between the two groups were compared. The polyamide gauze adherence rate and the skin survival rate in the NPWT+Meek group were higher than those in the Meek group. Therefore, replacing traditional dressing with NPWT for bandaging after Meek skin grafting can improve the skin survival rate.
Retrospective Review of Self-Adhesive Elastic Wrapping in Patients with Facial Burns.
Warthman R, Nedelec B, Murray D … +4 more , Martinez A, Islas C, Richey K, Foster KN
J Burn Care Res · 2026 Mar · PMID 41795952 · Publisher ↗
The management of the burn-injured face poses unique challenges for therapy intervention. Standard compression techniques require an intimate fit and are traditionally implemented after wound closure when the patient has...
The management of the burn-injured face poses unique challenges for therapy intervention. Standard compression techniques require an intimate fit and are traditionally implemented after wound closure when the patient has minimal or no dressings. Our center developed a method of self-adhesive facial wrapping that can be initiated early in care to provide custom contoured compression, decrease edema, and help maintain definition of facial features. The study aimed to characterize our experience with self-adhesive wrap in adult and pediatric patients with facial burn injuries. We conducted a retrospective chart review of patients treated with self-adhesive elastic facial wrapping at a single center between 2019 and 2023. Thirty patients were identified over this 5-year period who received self-adhesive elastic wrapping to the face. Mean age was 32.2 years, 57% of the subjects were male, median TBSA burned was 35%, and length of stay was 51 days. Self-adhesive wrap was initiated at a median of 18.5 days post-admission and was used for a median duration of 8.0 days. All patients with documented limitations in oral (n=3) or ocular (n=10) closure demonstrated improvements after wrap application. There was no significant association between the use of self-adhesive wrap use and skin breakdown (p=0.743) or graft loss (p=0.726) when the wrap was applied by therapists. No complications were identified that necessitated discontinuation of the intervention. This readily available technique may be implemented early in the course of care to provide compression when other typical options are not yet appropriate or may be cost-prohibitive.
Predictors of Survival and Length of Stay in Steven Johnson syndrome and toxic epidermal necrolysis: A single centre retrospective study of 111 patients.
Stewart T, Farrell J, Cook D … +1 more , Frew J
J Burn Care Res · 2026 Mar · PMID 41786616 · Publisher ↗
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) comprise a spectrum of severe mucocutaneous drug reactions associated with significant morbidity and mortality. Current prognostication of survival and...
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) comprise a spectrum of severe mucocutaneous drug reactions associated with significant morbidity and mortality. Current prognostication of survival and length of stay is imprecise and unreliable across different populations. We assessed and quantified patient, disease and management factors associated with survival and length of stay in an Australian cohort of adults with SJS/TEN. We reviewed 16 years of Stevens Johnson syndrome and toxic epidermal necrolysis cases at a large tertiary referral centre in Australia. Collated variables were demographics, comorbidities, disease-specific, laboratory results, treatments, complications, and mortality. 111 cases of Stevens Johnson syndrome or toxic epidermal necrolysis were included. Older age (p<0.01), delayed presentation (p=0.012), higher SCORTEN (p<0.01), heart rate above 120 beats per minute (p<0.01), septicemia (p<0.01), urogenital involvement (p=0.013) and intensive care admission (p<0.01) were predictive of non-survival, with only more than one culprit drug (p=0.02) retaining its significance on covariate analysis. Ocular (p<0.01), oral (p=0.014) and urogenital mucosal involvement (p<0.01), as well as chronic pain (p<0.01) were predictive of longer length of stay on univariate analysis, whilst a central line (p=0.017), parenteral analgesia (p=0.024) and neutropenia (p=0.02) were predictive on covariate analysis. Intravenous immunoglobulin was shown to reduce length of stay (p=0.046). Study limitations included retrospective design, data from a single referral centre, as well as sampling and recall bias. Our study identified several well-established, less explored, and novel predictors of survival and length of stay in adults with SJS/TEN, which may serve to inform future prognostication tools and research.
Value of LDH/ALB ratio in prediction of short-term mortality in patients with severe burns.
Yi W, Yan Y, Zhu L … +5 more , Zhang L, Sun N, Gu Z, Han D, Wu G
J Burn Care Res · 2026 Mar · PMID 41766621 · Publisher ↗
The predictive value of Lactate dehydrogenase (LDH)/ Albumin (ALB) ratio (LAR) in patients with severe burns has not been explored. The aim of the study was to investigate the correlation between LAR at admission and sho...
The predictive value of Lactate dehydrogenase (LDH)/ Albumin (ALB) ratio (LAR) in patients with severe burns has not been explored. The aim of the study was to investigate the correlation between LAR at admission and short-term mortality in severe burned patients. Patients with a primary diagnosis of severe burns, defined as 30% Total Body Surface Area (TBSA) or more, admitted to the burn center of Changhai Hospital were screened, and 324 patients were ultimately enrolled in this study. Binary logistic regression, univariate and multivariate analyses, Least Absolute Shrinkage and Selection Operator (LASSO) regression, Receiver Operating Characteristic (ROC) analysis, Kaplan-Meier curve and nomogram were used to analyze and present the relationship between admission LAR and short-term mortality. Patients with high admission LAR were more likely to die than low LAR. Age, LAR, TBSA, tracheostomy and heart disease were used to establish the nomogram with LAR having the highest area under the curve (AUC) value. We utilized nomograms to visually express data analysis results. This nomogram incorporates the lymphocyte-to-albumin ratio (LAR), a robust and readily accessible prognostic marker, to aid in the identification of patients with severe burns who are at high risk for short-term mortality. Therefore, it is well-suited for early risk stratification, from initial patient assessment after admission to the early inpatient phase, particularly in mass-casualty incidents like forest fires and explosions.
A Patient's Irreconcilable Voices: Considering Another Type of "Refusal" in Burn Care.
Goff AD, Huberman BJ
J Burn Care Res · 2026 Feb · PMID 41761762 · Publisher ↗
In general, literature on treatment refusals in burn care has largely centered on decisional capacity in the acute phases of burn treatment and an individual's "right to die" rather than endure treatment or its consequen...
In general, literature on treatment refusals in burn care has largely centered on decisional capacity in the acute phases of burn treatment and an individual's "right to die" rather than endure treatment or its consequences. However, burn providers frequently encounter in the moment refusals in which patients who very much want to survive attempt to delay or otherwise avoid treatment for various reasons, including trauma response, anticipatory anxiety, pain, desire for control, and ambivalence. In this paper, we consider a case inspired by our shared experience as clinical ethicists in which a burn patient readily expressed a desire to live and agreed to necessary treatment yet would often demonstrate significant distress in anticipation of and during even the most basic of care. We explore the utility and shortcomings of existing frameworks of decisional capacity in this context and detail a multidisciplinary team, patient-centered approach to care.
Predictors for Remission versus Refractory Disease Following Wide Local Excision Surgery for Hidradenitis Suppurativa: A Single-Center Case-Control Analysis.
Garg KS, Le TD, Pinto D … +4 more , Moffatt LT, Shupp JW, Dalia Y, Carney BC
J Burn Care Res · 2026 Feb · PMID 41757478 · Publisher ↗
Hidradenitis suppurativa (HS) is a chronic skin disease with a significant psychosocial burden. Skin of color (SOC) populations remain underrepresented in HS literature. Surgical excision is often pursued after failed me...
Hidradenitis suppurativa (HS) is a chronic skin disease with a significant psychosocial burden. Skin of color (SOC) populations remain underrepresented in HS literature. Surgical excision is often pursued after failed medical management, but predictors of post-surgical disease recurrence are not well characterized. This study aimed to identify non-surgical risk factors associated with persistent, refractory HS despite medical and surgical intervention in a predominantly SOC patient population. A retrospective chart review was conducted on 31 adult HS patients with prior excision surgery. Patients were categorized into remission (n=15) or refractory (n=16) cohorts. Demographic, clinical, and surgical data were extracted from the electronic medical record. There was no association between surgical closure technique and refractory disease (p=0.5936). Patients with refractory disease were more likely to be active smokers at the time of surgery (68.8% vs. 33.3%, p=0.0486), have groin or perineal involvement (p=0.0059; p=0.0185), and have psychiatric comorbidities (75% vs. 33.3%, p=0.0198). Female patients with gynecological comorbidities or evidence of female hormone dysregulation were significantly more likely to achieve remission after excision surgery (p=0.0024). Active cigarette smoking and groin/perineal involvement are significant predictors of refractory disease despite surgical intervention. While all HS patients should be screened for psychosocial burden of disease, patients with refractory disease may be at higher risk of comorbid psychiatric illness. Further research is needed to illicit the role of female hormone level dysregulation in HS pathophysiology and post-operative outcomes. Limitations include a small sample size and single-institution, retrospective nature of the study.
Clinical Competencies for the Burn Speech-Language Pathologist: A Multidisciplinary Development and Delphi Consensus Study.
Clayton NA, Regal H, Mohr T … +15 more , Arguello L, Kerr K, Busch D, Shemyakin Y, Cappel H, Silverberg E, Webler K, Jabbour N, Ratner A, Carisse D, Nedelec B, Dwertman MN, Parry I, Forbes L, Godleski M
J Burn Care Res · 2026 May · PMID 41744065 · Full text
Clinical competency guidelines promote optimal, safe standard of care. While nationally established clinical competencies exist for burn occupational therapists and physiotherapists, no equivalent frameworks exist for bu...
Clinical competency guidelines promote optimal, safe standard of care. While nationally established clinical competencies exist for burn occupational therapists and physiotherapists, no equivalent frameworks exist for burn speech-language pathologists (SLPs). To address this gap, we developed a burn-specific SLP competency tool. Led by the American Burn Association (ABA) Rehabilitation Committee, an expert panel of burn SLPs, Burn Therapists-Certified (BT-C) clinicians, and a physiatrist implemented a staged process. Current national and international practice guidelines were synthesized through modified Delphi methodology, with expert consensus meetings to create and refine a burn SLP competency tool. The ABA Burn Rehabilitation Therapists Competency Tool served as the model framework. Eighteen multidisciplinary burn clinicians representing 14 burn centers, across 3 countries, refined the burn SLP competency tool. A steering group (5 SLPs, 1 burn physiatrist) identified 103 competency statements spanning 15 core clinical domains. These were presented across 2 rounds of Delphi survey and consensus meetings. The tool was refined with each survey resulting in a final tool comprising 81 knowledge and application competency statements covering 17 domains, tailored to the burn SLP across the continuum of care for adult and pediatric populations. The tool is structured into 2 tiered levels of expertise: level 1: minimum level of specialist skill required to manage a patient with burn injury; level 2: expert level of specialist skill and recognized resource to other SLPs. This initiative has produced the first internationally developed and consensus-based competency tool for burn SLPs. It establishes a standardized reference for SLPs to deliver specialized burn care throughout the acute and rehabilitative continuum.
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