J Burn Care Res [JOURNAL]
Sun
200 papers
Fish skin (Kerecis Omega 3 Wound®) vs Suprathel® in deep dermal burns: An intraindividual comparison of long-term scar quality.
Heitzmann W, Enzmann J, von Kohout M … +5 more , Mattern MM, Akkan J, Fuchs PC, Lefering R, Schiefer JL
J Burn Care Res · 2026 Feb · PMID 41744053 · Publisher ↗
Deep dermal burns pose a high risk for long-term functional and aesthetic impairments. The choice of wound dressing following enzymatic debridement plays a critical role in modulating the healing response and scar format...
Deep dermal burns pose a high risk for long-term functional and aesthetic impairments. The choice of wound dressing following enzymatic debridement plays a critical role in modulating the healing response and scar formation. While both Kerecis® and Suprathel® have demonstrated clinical safety and efficacy, comparative long-term data remain limited. Kerecis®, being associated with accelerated wound healing in previous studies, was compared to Suprathel® in this study to evaluate functional and aesthetic scar outcomes using an intraindividual study design. This prospective, intraindividual study included 21 patients with deep dermal burns of the hands and feet, who underwent enzymatic debridement using Nexobrid®. Each patient received treatment with both Kerecis® and Suprathel® on comparable burn areas, ensuring consistency in the comparison. Scar outcomes were evaluated at 3-, 6-, and 12-months post-treatment. Objective parameters such as skin pigmentation, elasticity, transepidermal water loss, and oxygen saturation were measured. Additionally, subjective aesthetic, clinical, and functional parameters were assessed using the Patient and Observer Scar Assessment Scale (POSAS) and the Vancouver Scar Scale (VSS). At the 12-months follow-up, objective measurements demonstrated significant differences in erythema and gross elasticity, with Kerecis® exhibiting comparatively favorable outcomes. Subjective analyses indicated a significantly improved scar height and pliability for the Kerecis® group in the VSS and the POSAS Observer Scale. However, no significant differences were found in the POSAS Patient Scale. Both dressings provide satisfactory long-term scar outcomes in enzymatically debrided deep dermal burns, with Kerecis® showing trends toward more physiological scar characteristics in selected parameters, warranting further patient-centered research.
Extracorporeal Membrane Oxygenation Therapy in Toxic Epidermal Necrolysis-Related Respiratory Failure: A Case Report.
Stevens J, Jaraki J, Terasaki Y … +4 more , Baylor A, Dolman H, White MT, Isaacson A
J Burn Care Res · 2026 May · PMID 41732813 · Publisher ↗
Toxic epidermal necrolysis (TEN) is a rare and life-threatening cutaneous adverse reaction characterized by > 30% total body surface area desquamation and mucosal involvement. Although ocular, oral, and urogenital mucosa...
Toxic epidermal necrolysis (TEN) is a rare and life-threatening cutaneous adverse reaction characterized by > 30% total body surface area desquamation and mucosal involvement. Although ocular, oral, and urogenital mucosal involvements are well described, pulmonary mucosal injury is uncommon and associated with high mortality. We report a case of a 33-year-old woman with rapidly progressive TEN complicated by respiratory failure. Despite early multidisciplinary management including local wound care, immunomodulatory therapy, systemic corticosteroids, and lung-protective mechanical ventilation, she developed worsening hypoxemia and hypercarbia with radiographic findings consistent with acute respiratory distress syndrome. As respiratory failure progressed despite maximal conventional therapy, she was cannulated for venovenous extracorporeal membrane oxygenation (ECMO). Following ECMO therapy, her pulmonary infiltrates gradually resolved in parallel with cutaneous re-epithelialization. She underwent tracheostomy for prolonged ventilatory support, was successfully decannulated after 9 days of ECMO support, and survived to discharge. This case adds to the limited data supporting the feasibility of ECMO as a rescue therapy for TEN-associated severe respiratory failure. In carefully selected patients with TEN having refractory respiratory failure, ECMO may serve as an effective bridge to pulmonary recovery. Further studies are needed to better define patient selection, timing, and outcomes in this population.
The ENGAGE Protocol: Enzymatic Debridement With NexoBrid Followed by Grafting After Graded Early Excision-A Retrospective Cohort Study.
Lombardo GAG, Mollica M, Pepe S … +3 more , Melita D, Ranno R, Marchica P
J Burn Care Res · 2026 May · PMID 41717791 · Publisher ↗
Enzymatic debridement with NexoBrid has become a cornerstone of modern burn care due to its selective tissue-sparing properties. However, the optimal timing and strategy for surgical intervention following enzymatic trea...
Enzymatic debridement with NexoBrid has become a cornerstone of modern burn care due to its selective tissue-sparing properties. However, the optimal timing and strategy for surgical intervention following enzymatic treatment remain debated. We aimed to evaluate the clinical outcomes of the ENGAGE protocol (ENzymatic debridement with NexoBrid, followed by Grafting After Graded early Excision), a structured algorithm integrating enzymatic debridement with scheduled wound reassessment and selective early excision. This before-and-after observational study included adult patients with burn injuries treated with NexoBrid between January 2020 and October 2025 (2020-2022 received standard NexoBrid management; 2023-2025 received the ENGAGE protocol, featuring day-7 reassessment and selective excision). Endpoints included autologous grafting rate, length of hospital stay (LOS), mortality, and number of surgical procedures. Eighty-eight patients were analyzed (27 standard NexoBrid management, 61 ENGAGE). Baseline characteristics and burn etiologies were comparable. The ENGAGE group showed a significantly shorter LOS (mean ± SD: 24 ± 13.8 vs 32 ± 19.2 days, median: 23 vs 27 days, P = .03) with no increase in grafting rate (60.7% vs 59.3%, P = .54) or mortality (9.8% vs 7.4%, P > .5). The number of surgical procedures per patient was higher in the ENGAGE group (4.36 ± 3.82 vs 2.74 ± 3.82, P = .029), reflecting planned early reassessment and targeted intervention rather than increased morbidity. The ENGAGE protocol reduces hospital stay without compromising grafting or survival outcomes. By incorporating early, biologically guided excision after enzymatic debridement, it offers a structured and effective refinement of modern burn wound management.
Association of the CAGE Questionnaire for Alcohol and Substance Misuse With Burn Patient Demographics and Outcomes.
Dyamenahalli KU, Shepler LJ, Ryan CM … +8 more , Orton C, Yenikomshian HA, Trinh NH, Kazis LE, Slavin MD, McMullen K, Schneider JC, Goverman J
J Burn Care Res · 2026 May · PMID 41717777 · Full text
The burden of alcohol and substance use disorder is disproportionately high among patients with burn injuries and portends worse clinical outcomes. The Cut down, Annoyed, Guilty, and Eye-opener (CAGE) questionnaire is a...
The burden of alcohol and substance use disorder is disproportionately high among patients with burn injuries and portends worse clinical outcomes. The Cut down, Annoyed, Guilty, and Eye-opener (CAGE) questionnaire is a validated 4-question screen for alcohol and drug use. This study aimed to identify demographic and clinical variables that predict positive CAGE screens or negative-to-positive screen conversion in burn survivors and to examine psychosocial and functional outcomes. The Burn Model System database was used to assess characteristics of patients with burn injuries who completed a CAGE screen at discharge (1994-2023). The relationship between CAGE scores and Satisfaction with Life Scale (SWLS), PROMIS (Patient Reported Outcomes Measurement Information System)-Anxiety, -Depression, -Pain Interference, and -Physical Function were analyzed. Mean length of hospital stay was longer in patients with positive CAGE screens (34.0 vs 25.1 days, P < .001). Mean number of surgeries demonstrated a similar association (2.8 vs 2.2, P < .001). Significant differences were also observed by ethnicity, race, employment status, burn mechanism, marital status, and insurance type. Drug misuse at the time of injury was significantly higher in CAGE-positive patients (34.9% vs 6.6%, P < .001). Younger age (P = .004) and unemployment (P = .001) were significantly associated with transition to a positive CAGE screen within 24 months. At 12 months, a positive CAGE screen was associated with lower SWLS (P < .001) and higher (detrimental) PROMIS-Anxiety (P = .006) and -Depression (P = .019) scores. These data suggest significant associations between positive CAGE screens, as a surrogate for drug and alcohol misuse, and measures of burn severity (length of stay and number of surgeries), psychological stress (anxiety and depression), and social dysfunction (unemployment).
Burned at Sea During the World's Largest Maritime Exercise: Implications for Large-Scale Combat Operations.
Cancio JM, Carter JE, Wallace S … +5 more , de la Campa DF, Woods J, Cardin S, Tadlock MD, Cancio LC
J Burn Care Res · 2026 May · PMID 41717776 · Publisher ↗
Burns are among the most devastating forms of trauma, and both immediate and long-lasting physical, physiological, psychosocial, and functional effects have been well documented in the civilian burn literature. From a mi...
Burns are among the most devastating forms of trauma, and both immediate and long-lasting physical, physiological, psychosocial, and functional effects have been well documented in the civilian burn literature. From a military standpoint, burn injuries comprise approximately 5-10% of battlefield casualties during conventional (non-nuclear) conflict;3 the risk of thermal injury is particularly high during war at sea. Little data exist regarding the total costs of caring for those with battlefield burn injuries. These gaps in the literature impact our ability to plan medical support for combat operations and to develop effective strategies for returning burned servicemembers to duty and to community life. The purpose of this report is to describe the immediate and long-term resources utilized in the care of 2 coalition-nation Sailors severely burned on the Pacific Ocean and treated at the U.S. Army Burn Center, and to describe their long-term outcomes. Given the presence of burn injury on the modern battlefield, there is an urgent need to plan for the care of servicemembers who have sustained burn injury in future large scale combat operations, to include war at sea. It is imperative this plan be properly resourced and include an organized program of prehospital care, aeromedical evacuation, acute care, and long-term follow-up--addressing the complex, multi-domain, and chronic effects of severe thermal injury. These cases illustrate such a program.
The Presence and Presentation of Microstomia in Burn Survivors: A Burn Model System Study.
Yelvington ML, Nedelec B, Humbert A … +3 more , Mandell SP, Yenikomshian HA, Schneider JC
J Burn Care Res · 2026 May · PMID 41711076 · Full text
Microstomia, or small oral aperture, often results from facial burns. This condition appears as scars form within the oral tissue and at the oral commissures, narrowing the oral opening, and leading to mobility, speech,...
Microstomia, or small oral aperture, often results from facial burns. This condition appears as scars form within the oral tissue and at the oral commissures, narrowing the oral opening, and leading to mobility, speech, respiratory difficulties, emotional distress, and social interaction challenges. This study examines the presence of reported burn microstomia and its related clinical factors. Pediatric and adult data from a multicenter longitudinal database from 2003 to 2005 were analyzed to determine the frequency of microstomia at discharge. Summary statistics were used to describe clinical characteristics, demographics, and burn location in pediatric and adult burn survivors. Clinical and burn characteristics were then tested to determine if there was an association with the development of microstomia. Data revealed 4.7% (n = 10) of adult burn survivors (n = 214) and 11% (n = 10) of pediatric burn survivors (n = 91) presented with microstomia at hospital discharge. Those with microstomia had significantly larger TBSA burns, higher rate of inhalation injury, more days on ventilation, and higher rate of adjacent contractures. No differences were found when considering age, sex, race, ethnicity, etiology of burn, or discharge location. Burn size and length of time requiring ventilation were predictive of microstomia. Knowledge of these risk factors suggests that therapists should focus on early microstomia prevention, even during times of ventilation, especially in those with larger burn injuries. The high incidence of adjacent contractures demonstrates the impact of cutaneokinematic skin recruitment and suggests that areas beyond the perioral should be considered when developing a treatment and prevention program for microstomia following a burn injury.
Cannabis Intoxication Does Not Impact Nutritional Status in Patients With Small Burns.
Wang S, Stanton E, Emeh A … +6 more , Manasyan A, Wong S, Boudiab E, Baranco P, Johnson MB, Gillenwater TJ
J Burn Care Res · 2026 May · PMID 41700804 · Full text
Patients with burn injuries exhibit one of the most intense hypermetabolic responses among critically ill populations, making them highly susceptible to malnutrition-linked to prolonged hospital stays and delayed wound h...
Patients with burn injuries exhibit one of the most intense hypermetabolic responses among critically ill populations, making them highly susceptible to malnutrition-linked to prolonged hospital stays and delayed wound healing. While cannabis is recognized for its appetite-stimulating properties in acute settings, its association with the nutritional demands of burn injuries remains underexplored. A single-institution retrospective study was conducted on adult patients with burn injuries having < 20% TBSA who tested positive for cannabis on admission urine toxicology between 2015 and 2024. These patients were matched 1:1 with controls who tested negative for cannabis. The primary predictor variable was cannabis use, while outcomes included burn characteristics, prealbumin and albumin levels, overall outcomes, and complications. Significance was set at P < .05. We analyzed 76 cannabis-positive patients with burn injuries and 76 controls. No significant differences were found in demographics or outcomes. When controlling for body mass index, cannabis intoxication was not significantly associated with changes in admission prealbumin (18.8 vs 19.2, P = .804) or admission albumin (3.9 vs 4.0, P = .375) levels. There was also no significant variation in the number of days postadmission required to achieve peak prealbumin (3.8 vs 3.9, P = .876) and albumin level (0.3 vs 1.0, P = .088). Increased age was associated with a reduction in admission albumin (P < .001), and Caucasian patients had increased albumin compared to other races (P = .048). Cannabis intoxication had no significant association with preburn injury nutritional status. Further research with larger sample sizes is necessary to fully understand the complex relationship.
Hyperbaric Oxygen Therapy in Burn Care: A Systematic Review of Current Evidence.
Molina-Vega J, Pferdehirt RE, Vardanian AJ
J Burn Care Res · 2026 May · PMID 41700783 · Full text
Hyperbaric oxygen therapy (HBOT) involves inhaling 100% oxygen at pressures exceeding one atmosphere within a chamber. It is used across several specialties and has been proposed as an adjunct in burn management to enhan...
Hyperbaric oxygen therapy (HBOT) involves inhaling 100% oxygen at pressures exceeding one atmosphere within a chamber. It is used across several specialties and has been proposed as an adjunct in burn management to enhance healing and improve outcomes. Despite increasing interest, evidence supporting its efficacy in burn care remains inconsistent, with no clear consensus in practice. A literature search was conducted in September 2025 across PubMed, Cochrane Library, and Embase without date restrictions to identify studies evaluating HBOT for burn treatment. Inclusion criteria were human studies, English-language articles, and full-text availability. Study selection followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Two reviewers screened titles and abstracts, and a third resolved discrepancies. Eligible studies described HBOT as a burn treatment and reported clinical outcomes. Thirteen studies met inclusion criteria: 5 randomized controlled trials, 7 cohort studies, and 1 case-control study, evaluating 566 burn patients. Burn severity, HBOT protocols, and outcomes varied substantially. Several studies reported reduced need for surgery and shorter hospital stays with HBOT. Trends toward improved healing and lower infection risk were noted, while mortality benefits were inconsistent. Heterogeneity in design and treatment regimens limited synthesis via meta-analysis. Hyperbaric oxygen therapy shows promise as an adjunct in burn care, improving healing and reducing complications. However, variability and inconsistent outcomes limit definitive conclusions. Well-designed randomized trials are needed to establish standardized protocols and clarify their clinical role in burn management. Until then, burn centers may consider HBOT for acute injuries and threatened grafts.
Effectiveness of Early Compression Therapy in Acute Hand Burns: A Randomized Controlled Trial.
da Silva Mendes JP, Marques FCF, de Sousa AJF … +4 more , Miranda LLM, de Assunção JAF, Santos-Costa J, de Almeida Cabral JL
J Burn Care Res · 2026 May · PMID 41674156 · Publisher ↗
Hand burns pose significant rehabilitation challenges. While compression therapy is well-established for chronic scar management, evidence for its application during the acute phase remains limited. This study evaluated...
Hand burns pose significant rehabilitation challenges. While compression therapy is well-established for chronic scar management, evidence for its application during the acute phase remains limited. This study evaluated the effectiveness of early compression therapy on edema, passive range of motion (PROM), and grip strength in acute hand burns. A randomized controlled trial was conducted at a tertiary burn center between November 2023 and March 2025. Thirty-two adult patients (40 hands) with superficial and/or deep partial-thickness hand burns were randomly assigned to control (standard care; 16 patients, 20 hands) or intervention groups (standard care plus compression therapy at 8 mmHg; 16 patients, 20 hands). Outcomes measured at baseline and the end of the acute phase included hand edema, metacarpophalangeal joint PROM, and grip strength. Statistical analyses included paired and independent t-tests, analysis of covariance, and effect size calculations. Groups were homogeneous at baseline. The intervention group demonstrated significantly greater improvements: PROM increased 23.6 ± 12.8° vs 8.6 ± 16.7° (P = .003, Cohen's d = 1.00), grip strength improved 4.2 ± 5.9 kg vs declined 0.8 ± 5.0 kg (P = .006, d = 0.92), and edema reduced 4.2 ± 2.9 cm vs 2.3 ± 2.1 cm (P = .025, d = -0.74). Analysis of covariance confirmed significant effects after adjusting for baseline values (all P < .01). No adverse events occurred. Early compression therapy during acute hand burns significantly improves outcomes with large effect sizes. These findings support considering earlier initiation of compression therapy (48-72 h postinjury) as part of acute hand burn management protocols.
Physician-industry Payments in the Skin Substitute Market-Shedding Light from the Sunshine Act.
Smith M, Hinson C, Sheckter C
J Burn Care Res · 2026 Feb · PMID 41674140 · Publisher ↗
BACKGROUND: Skin substitutes are vital in burn care. While physician-industry partnerships drive innovation and access, they also raise concerns regarding bias and conflicts in product promotion. This study analyzes curr...
BACKGROUND: Skin substitutes are vital in burn care. While physician-industry partnerships drive innovation and access, they also raise concerns regarding bias and conflicts in product promotion. This study analyzes current trends in physician-company financial relationships within the skin substitute market related to burn treatment. METHODS: The Physician Payments Sunshine Act mandates transparency in reporting industry payments to physicians. Companies with the largest market share of skin substitutes and burn wound coverage products were evaluated. Physician payment records from 2017 to 2023 were extracted and analyzed by category, including consulting fees, speaker compensation for non-accredited education, food and beverage, and travel. RESULTS: Eight companies representing 28 products distributed nearly $45 million in direct payments to physicians over six years; company totals varied by up to $13.5 million. Annual per-physician payments ranged from $0.35 to $1,088,405.68 (median $47.17, IQR $21.44 to $130.57). The highest expenditure categories were non-accredited speaker compensation ($2,741,643.65/year), which declined during COVID-19, and consulting fees ($1,046,408.71/year), which remained stable. Excluding pandemic years (2020-2021), total annual payments ranged from $3,233.73 to $4,379,242.77 (median: $115,052.45). Only two companies, Kerecis and Avita, demonstrated consistent increases in payments over the past three years. CONCLUSION: Physician payments in the skin substitute market vary widely. The wide variability-from negligible sums to over a million dollars-questions the adequacy of blanket disclosure statements as a meaningful representation of physician involvement in research and product promotion. These findings suggest opportunity for greater transparency in disclosure statements.
Epidural Anesthesia for Pain Relief in Patients With Severe Burns.
Silverstein ML, Dhanani U, Chua P … +2 more , Sheckter CC, Karanas Y
J Burn Care Res · 2026 May · PMID 41674138 · Publisher ↗
Patients with severe burn injuries endure intense pain, which is amplified by serial operations, daily dressing changes, and regular physical therapy. While peripheral nerve blocks have become increasingly popular in the...
Patients with severe burn injuries endure intense pain, which is amplified by serial operations, daily dressing changes, and regular physical therapy. While peripheral nerve blocks have become increasingly popular in the management of isolated burns to the extremities, there have been few reports on the use of neuraxial anesthesia to treat burn pain. Here, we describe the inclusion of epidural anesthesia in our algorithm for management of burns to the lower trunk, bilateral lower extremities, buttocks, and perineum. We hypothesized that epidural anesthesia would be associated with reduced opioid use and improved pain scores. We performed a retrospective review of all patients admitted to a verified burn center who underwent epidural catheter placement between 2018 and 2024. Visual analog scale pain scores and opioid consumption (standardized in morphine milligram equivalents [MMEs]) were extracted for several days before and after placement of each patient's first epidural catheter. During the study period, 11 patients underwent epidural catheterization in our burn unit. An average of 1.8 (SD 1.3) catheters were placed per patient, for a total of 20 catheters. All patients experienced significant reductions in daily opioid consumption (92.5 MMEs/day pre-epidural to 58.1 MMEs/day postepidural, P = .008) and average pain scores (6.25 pre-epidural to 2.45 postepidural; P = .008). Minor complications including nausea/vomiting and pruritus occurred in 4 patients. There were no major complications or infections. We conclude that epidural anesthesia is safe and effective for relieving pain and decreasing opioid consumption in patients with burn injuries.
Regional Socioeconomic Deprivation Predicts In-Hospital Burn Mortality in Texas-New Mexico Cohort: A Retrospective Analysis of Social Determinants of Health.
Miller CL, Edwards IT, Baechle J … +1 more , Santos A
J Burn Care Res · 2026 May · PMID 41674136 · Publisher ↗
Social determinants of health (SDOH) have been shown to contribute to disparities in burn outcomes. This study leverages patient data from a regional burn center serving Texas and New Mexico to evaluate whether national...
Social determinants of health (SDOH) have been shown to contribute to disparities in burn outcomes. This study leverages patient data from a regional burn center serving Texas and New Mexico to evaluate whether national indices of social vulnerability accurately predict in-hospital mortality among patients with burn injuries from underserved areas. We conducted a retrospective cohort study of 1841 patients treated for burn injuries over a 5-year period (2019-2024). Sixteen ZIP code-level SDOH metrics including Social Vulnerability Index and socioeconomic status (SES) were quantified. Univariate and multivariable logistic regression analyses were performed to assess the impact of SDOH on mortality. Patients were stratified into quartiles to explore dose-response relationships. In univariate analysis, higher SES scores (indicating greater deprivation) were the strongest SDOH metric associated with mortality (odds ratio [OR] = 6.28, P = .0018). In multivariable analysis, patients in the most deprived SES quartile (Q4) had more than double the odds of mortality compared to the least deprived (Q1) (OR = 2.20, P = .0199). Significant clinical predictors included age, second- and third-degree TBSA, alcohol use disorder, chronic obstructive pulmonary disease, and obesity. Social Vulnerability Index was not independently associated with mortality after adjustment. Socioeconomic status was an independent predictor of in-hospital burn mortality in this regional cohort after adjusting for clinical factors. Other aggregate scores poorly predicted mortality after controlling for clinical variables. This is potentially due to the influence of urban demographics of these indices. Further research should investigate metrics to better capture rural SDOH to improve rural burn care.
FGF2 in Burn Wound Healing: From Molecular Function to Clinical Application-A Systematic Review.
Niederegger T, Schaschinger T, Brandt J … +7 more , Munzinger R, Karakas E, Knoedler L, Knoedler S, Palackic A, Panayi A, Hundeshagen G
J Burn Care Res · 2026 May · PMID 41665267 · Publisher ↗
Burn injuries trigger complex inflammatory and metabolic cascades that impair wound healing and increase morbidity. Fibroblast growth factor 2 (FGF2), a potent mediator of cellular proliferation, angiogenesis, and extrac...
Burn injuries trigger complex inflammatory and metabolic cascades that impair wound healing and increase morbidity. Fibroblast growth factor 2 (FGF2), a potent mediator of cellular proliferation, angiogenesis, and extracellular matrix remodeling, has emerged as a promising therapeutic agent in burn care. This systematic review evaluated the biological mechanisms, delivery strategies, and clinical outcomes associated with FGF2 in burn wound healing to clarify its therapeutic value and translational potential. Following PRISMA 2020 standards, a structured literature search was conducted across PubMed, EMBASE, Web of Science, Cochrane, and Google Scholar to identify studies investigating FGF2 in thermal injuries. Eligible records included clinical trials, in vivo models, and in vitro experiments. Methodological quality and risk of bias were assessed using the Newcastle-Ottawa Scale, the SYRCLE tool, and the Oxford Levels of Evidence. Thirty-three studies (1992-2025) met inclusion criteria, encompassing randomized controlled trials, animal models, and mechanistic analyses. Fibroblast growth factor 2 accelerated repair by stimulating fibroblast proliferation, keratinocyte migration, angiogenesis, and matrix organization. Topical FGF2 formulations shortened healing time and improved scar quality in partial-thickness burns. Innovative carriers, including hydrogels, liposomes, and gene-activated matrices, enhanced bioavailability and sustained local effects. In diabetic and complex burn models, FGF2 mitigated inflammation, preserved barrier integrity, and promoted re-epithelialization. Efficacy depended on dosage and wound characteristics. Studies reported favorable safety profiles with minimal and mild adverse events. Fibroblast growth factor 2 demonstrates regenerative and immunomodulatory potential in burn management. Broader adoption requires harmonized regulatory evaluation, optimized delivery systems, and multicenter validation to define its role in precision-guided burn care.
Voice, Airway, and Swallowing Function in Patients With Smoke Inhalation Injury to the Upper Airway-A Single Institution Review.
Dontu P, Sulibhavi A, Chambers C … +4 more , Striano M, Voulo A, Rae L, Soliman AMS
J Burn Care Res · 2026 May · PMID 41665264 · Publisher ↗
Voice and swallowing dysfunction are common after smoke inhalation injury; however, burn survivors often do not seek follow-up for ongoing dysphonia, dysphagia, or exercise intolerance, which may be a result of undiagnos...
Voice and swallowing dysfunction are common after smoke inhalation injury; however, burn survivors often do not seek follow-up for ongoing dysphonia, dysphagia, or exercise intolerance, which may be a result of undiagnosed airway scarring or stenosis. The aim of this study is to evaluate trends in dysphonia, dysphagia, and upper airway injury after smoke inhalation injury. A retrospective case series with chart review was performed of all patients admitted with smoke inhalation injury from 2018 to 2022. Patient demographics, injury patterns, voice, airway, and swallowing symptoms, laryngoscopic findings, swallowing evaluations, and hospital course were collected. Fifty patients met inclusion criteria, of whom 36 (72%) were males and 14 (28%) were females. Ages ranged from 20 to 79 (mean 48.2) years. Forty patients (80%) underwent flexible laryngoscopy during admission, of which 80% had abnormalities. Patient-reported dysphonia had a positive predictive value of 76% for abnormal laryngoscopic findings. Patient-reported dysphagia had a positive predictive value of 100% for abnormalities on clinical or instrumental swallowing evaluation but a < 30% negative predictive value. Eight patients were seen in follow-up by Otolaryngology, of whom 75% had abnormal laryngoscopic findings and 50% required surgery for airway stenosis. Although patient symptoms were highly predictive of abnormal findings on laryngoscopy and swallowing evaluation, objective evidence of dysphagia was also very common in asymptomatic patients. Universal Speech-Language Pathology assessment would allow for early detection of swallowing dysfunction in this patient population and long-term follow-up is warranted to avoid missed injuries or delays in care.
Patient-reported levels of pain and itch in hypertrophic scar before and after fractional ablative laser treatment.
Carreras JP, Carney BC, Lee D … +4 more , Allely R, Tejiram S, Shupp JW, Travis TE
J Burn Care Res · 2026 Feb · PMID 41649169 · Publisher ↗
Skin fibrosis, especially hypertrophic scars (HTS), remains understudied with few effective treatments. Studying HTS is challenging due to its natural tendency to improve over time, making it hard to separate interventio...
Skin fibrosis, especially hypertrophic scars (HTS), remains understudied with few effective treatments. Studying HTS is challenging due to its natural tendency to improve over time, making it hard to separate intervention effects. This study evaluated fractional ablative laser treatment for symptomatic HTSs, focusing on variability in patient response. It was hypothesized that pain and itch would decrease post-treatment, and that demographic or injury characteristics might predict responders. A retrospective chart review analyzed pre-treatment and six post-laser sessions using the Patient Scar Assessment Scale (POSAS) for pain and itch (1 = low, 10 = high). Patients showing a ≥ 3 point improvement were classified as "responders" (n = 48 for pain, n = 62 for itch); those with ≤2 point improvement or worsening were "non-responders" (n = 62 for pain, n = 76 for itch). In total, 110 patients were analyzed for pain and 138 for itch. Most patients were non-responders for both pain (56.4%) and itch (55.1%). Responders experienced significant reductions in pain and itch after the first session, with stable scores thereafter (p<.0001). Non-responders showed no significant improvement in pain and, for itch, even a significant worsening after the first session. No significant differences were found between groups based on sex, skin type, race, scar age, scar size, or patient age. Responders had higher baseline pain and itch scores than non-responders. The greatest symptom relief occurred after the first treatment. Demographic and injury characteristics did not predict treatment response.
Association Between the Modified Frailty Index-5 and Clinical Outcomes in Burn Patients.
Schmiechen J, Kremer T, Rein S
J Burn Care Res · 2026 May · PMID 41649161 · Publisher ↗
Frailty is a clinical state characterized by increased vulnerability to stressors, leading to an increased risk of adverse health outcomes. The modified Frailty Index (mFI-5), based on 5 comorbidities-diabetes mellitus,...
Frailty is a clinical state characterized by increased vulnerability to stressors, leading to an increased risk of adverse health outcomes. The modified Frailty Index (mFI-5), based on 5 comorbidities-diabetes mellitus, heart failure, pulmonary disease, hypertension, and totally or partially dependent functional health status-has shown predictive value for treatment outcomes and mortality. The primary objective of this study was to evaluate differences in clinical outcomes between patients with burn injuries who have mFI-5 scores of 0, 1, and ≥ 2. The secondary objective was to determine whether the mFI-5 score independently predicts adverse outcomes. A retrospective analysis of 644 patients with burn injuries treated between September 2018 and May 2022 was conducted. Data on comorbidities, complications, ventilation status, surgical procedures, length of stay, and discharge destination were analyzed. Statistical analyses included Pearson's chi-square test, Kruskal-Wallis test, and adjusted multivariate regression analysis. Higher mFI-5 scores were associated with worse overall outcomes, including longer hospital stays, higher rates of complications, more frequent need for mechanical ventilation, a greater number of skin grafts and necrectomies, and more frequent discharge to nonhome settings. Multivariate analyses showed that a higher mFI-5 score compared to mFI-5 = 0 was independently associated with higher rates of urinary tract infections (mFI-5 ≥ 2: odds ratio [OR] 2, 41, 95% CI, 1.19-4.86; P = .014) and nonhome discharge (mFI-5 = 1: OR 2.34; 95% CI, 1.00-5.45; P = .049). The mFI-5 is a strong predictor of complications and adverse outcomes in patients with burn injuries. Its quick, simple application makes it a valuable risk stratification tool in specialized burn centers.
Burn Anesthesia as a Subspecialty: Time to Formalize Advanced Training Pathways.
Wallace D, Xu R, Rogers AD
J Burn Care Res · 2026 May · PMID 41641967 · Publisher ↗
Abstract loading — click title to view on PubMed.
Burns are a Chronic Disease.
Travis E, Murray D, Fletchall S … +1 more , Knight D
J Burn Care Res · 2026 May · PMID 41636588 · Publisher ↗
Abstract loading — click title to view on PubMed.
Frostbite in January-Amputate in July: Is Watchful Waiting for Surgical Management Following Frostbite Injury Still Standard? An Examination of the National Readmission Database.
Kindt L, Vang C, Lumbard DC … +2 more , Schmitz K, Nygaard RM
J Burn Care Res · 2026 May · PMID 41626751 · Publisher ↗
Frostbite injuries account for 2000-4000 hospital admissions annually in the United States, with 30% of severe cases requiring amputation and up to 70% of cases resulting in long-term sequelae or disability. Traditional...
Frostbite injuries account for 2000-4000 hospital admissions annually in the United States, with 30% of severe cases requiring amputation and up to 70% of cases resulting in long-term sequelae or disability. Traditional practice following frostbite injury is to delay surgical intervention 4-6 weeks to preserve limb length, tissue coverage, and reduce complications. This study examines amputation timing among frostbite patients in the United States and identifies factors influencing early versus delayed amputation. This retrospective study used the Nationwide Readmission Database (NRD) from 2016 to 2020 to identify frostbite admissions. Logistic regression models identified predictors of early amputation. Among 4786 patients with frostbite injury, 1422 (29.7%) underwent amputation. Of these, 977 (68.7%) had early amputations. Drug and alcohol use and housing insecurity were more prevalent among amputated patients, but were not associated with early amputation. Female sex, drug or alcohol use, comorbidities, infection or cellulitis, and mental health diagnoses were associated with a lower likelihood of early amputation. In adjusted models, infection/cellulitis was associated with lower odds of early amputation in the full cohort and not associated with timing in the nonelective subset. Across US admissions captured in the NRD, amputations commonly occurred within 30 days of presentation, diverging from historical "watchful waiting" practices. Social drivers of health influence need for and timing of amputations. Infection and cellulitis, which may necessitate urgent intervention, were not associated with increased likelihood of early amputation timing. Future research should explore factors driving early amputation and assess the impact of amputation timing on functional outcomes.
Rehabilitation Evaluation and Treatment for Skin Graft Complications of the Genitalia.
Tremblay C, Edger-Lacoursière Z, Schneider G … +3 more , Jean S, Calva V, Nedelec B
J Burn Care Res · 2026 May · PMID 41615004 · Full text
Skin graft complications may include pain, contractures, hypertrophic scars (HSc), hypersensitivity, and recurrent wounds. Complications involving grafts to the genitalia, perineum, and/or buttocks can be particularly ch...
Skin graft complications may include pain, contractures, hypertrophic scars (HSc), hypersensitivity, and recurrent wounds. Complications involving grafts to the genitalia, perineum, and/or buttocks can be particularly challenging, directly affecting walking, sitting, voiding, bowel elimination, sexual function, and intimacy, ultimately diminishing quality of life. Perineal and pelvic floor rehabilitation (PPFR) is commonly used to treat various pelvic floor disorders; however, its application following burn injury or necrotizing fasciitis has not been previously described. This manuscript presents the evaluation and treatment outcomes of patients with necrotizing fasciitis or Fournier's gangrene. Initial evaluation was conducted approximately 4 months postadmission by a certified pelvic floor physiotherapist and occupational therapist. Treatment included pelvic floor rehabilitation, patient education, sensory re-education, bladder and bowel training, use of adapted pressure garments, gel application, cutaneous and myofascial stretching, and manual therapy. This report details the outcomes of 2 male patients (37 and 69 years old) who underwent skin grafting and reconstructive surgery following necrotizing fasciitis and Fournier's gangrene. Both presented with complex wounds that closed approximately 4 months postadmission, accompanied by contractures, HSc, altered sensory perception, incontinence, and sexual intimacy dysfunction. Following PPFR treatment, improvements were observed in pruritus, urinary and fecal retention capacity, sexuality-related fear avoidance, penile deviation, lower extremity range of motion, satisfaction with sexual function, and sensory perception. This is the first description of a standardized PPFR protocol in this context, demonstrating that specialized interdisciplinary rehabilitation can enhance sexual function, body-image satisfaction, and overall quality of life in patients with genital, perineal, and/or buttock grafts.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe