J Burn Care Res [JOURNAL]
Sun
200 papers
Pediatric Compassionate Use of DenovoSkin, a Novel, Autologous, Engineered, Hydrogel-Based Skin Graft With Keratinocytes and Fibroblasts.
Supple M, Requena D, Mujynya K … +2 more , Marino D, Goverman J
J Burn Care Res · 2026 May · PMID 41614982 · Publisher ↗
The development of an autologous, full-thickness skin replacement remains the holy grail for the treatment of full-thickness skin loss from burns, wounds, and trauma. With massive burn injury and limited donor-site, cult...
The development of an autologous, full-thickness skin replacement remains the holy grail for the treatment of full-thickness skin loss from burns, wounds, and trauma. With massive burn injury and limited donor-site, cultured epidermal autografts (CEAs) can be lifesaving, however, they have significant limitations. Furthermore, reconstruction in such patients is challenging. We describe the compassionate use of an autologous, engineered, hydrogel skin graft with keratinocytes and fibroblasts (EHSG-KF), in the treatment of a pediatric patient with massive burn injury. A compassionate use exemption was obtained from the US Food and Drug Administration allowing for up to 3 separate treatments using an EHSG-KF for a 3-year-old patient with a 90% TBSA burn. Grafts were based on plastically compressed collagen type I hydrogels with incorporated keratinocytes and fibroblasts. We retrospectively review our experience with 2 separate applications and early outcomes. A 2 × 2 cm split-thickness skin graft was harvested and shipped internationally for processing. At the same time, contracture releases were performed, and dermal matrices were applied. Engineered, hydrogel skin graft with keratinocytes and fibroblasts were then applied approximately 4 weeks after contracture release. In some areas, EHSG-KF was applied without a dermal matrix, immediately after debridement. Grafts were secured for 7 days with staples and covered with silver foam and tie over bolsters or circumferential gauze wrapping. Graft take was > 95%. This novel EHSG-KF was relatively easy to handle, apply, and care for, similar to a traditional autologous FTSG. Engraftment rate was > 95% and the resulting healed skin appears to be durable. Our impression has been extremely positive, particularly when compared to traditional CEAs. Additional trials in Europe using this particular EHSG-KF are ongoing.
Correction to: Intraoperative Intravenous Methadone and Postoperative Opioid Requirements in Adult Patients With Burns.
J Burn Care Res · 2026 May · PMID 41614549 · Full text
Abstract loading — click title to view on PubMed.
The Outcomes of SJS/TEN: A Nationwide Analysis.
Murphy TJ, Fijany AJ, Swafford EP … +7 more , Garcia JT, Vyas P, Beyene RT, Gondek SP, Wagner AL, Patel MB, Slater ED
J Burn Care Res · 2026 May · PMID 41609106 · Full text
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) syndrome are potentially fatal skin conditions frequently cared for in burn units. In a national database study, we studied the demographics and outcome...
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) syndrome are potentially fatal skin conditions frequently cared for in burn units. In a national database study, we studied the demographics and outcomes of this patient population. This retrospective cohort study included patient admissions for SJS/TEN. Patient demographics and outcomes were compared and adjusted for age, sex, inhalation injury, and percent total body surface area (TBSA). Logistical regression was used for binary outcomes, and linear regression was used for continuous outcomes. All outcomes were described in reference to the entire disease continuum (SJS/TEN) and each specific disease subcohort (SJS, SJS-TEN overlap, and TEN). Of 271 971 patients queried within the Noncommercial Burn Research Dataset, 2416 patients had a diagnosis of SJS/TEN. These patients were statistically more likely to be older (48 ± 22 years vs 36 ± 22 years), housed (1% vs 2%), females (57% vs 34%), and have a higher mean TBSA (8 ± 13% vs 7 ± 12%). In multivariable analysis, SJS/TEN was associated with increased risk of unplanned intubations (odds ratio [OR] 1.69) and pneumonia (OR 1.26), but not respiratory failure (OR 0.36). There was also an increased risk for sepsis (OR 1.43). Patients were significantly more likely to have a shorter hospital LOS (OR -3.7). There was no significant difference in mortality. In subcohort analysis, a stepwise increase in morbidity and mortality was observed when comparing SJS, SJS-TEN overlap, and TEN. Stevens-Johnson syndrome/TEN is a rare but extremely morbid disease continuum that frequently affects female patients and results in increased respiratory and alternative complications.
Treatment of Friction Injury Using Enzymatic Debridement and Autologous Skin Cell Suspension.
Hewgley WP, Black J, Jansen JO … +7 more , Hurst S, White E, Fairburn SC, Holderfield A, Morrison J, Lovorn M, Hwang J
J Burn Care Res · 2026 May · PMID 41603543 · Publisher ↗
Friction injury occurs when a patient slides across a surface at high velocity, resulting in mechanical abrasion, laceration, and thermal burn. Mechanical abrasion removes tissue to a variable depth depending on surface...
Friction injury occurs when a patient slides across a surface at high velocity, resulting in mechanical abrasion, laceration, and thermal burn. Mechanical abrasion removes tissue to a variable depth depending on surface texture in contact, and thermal burn devitalizes tissue to a variable depth based on contact pressure and transfer of kinetic energy. In these heterogenous wounds, tangential excision can excise healthy tissue alongside devitalized tissue, and other debridement techniques like hydrosurgery or dermabrasion may not reach deeper crevices created by abrasion and laceration. In addition, traditional skin grafts create significant donor site morbidity. This case series presents an early experience with a novel approach using bromelain-based enzymatic debridement combined with autologous skin cell suspension. Bromelain-based enzymatic debridement acts uniformly on a wound surface despite its topography, optimizing removal of devitalized tissue while preserving healthy tissue. Autologous skin cell suspension reduces donor site morbidity. This combined strategy minimizes dressing changes, optimizing pain control and enabling outpatient management. We observe rapid healing and outstanding cosmetic outcomes, and no patients experienced wound infection or other complications or required secondary procedures for nonhealing.
Impact of Housing Status on Mortality Following Frostbite Injury: A Multicenter Cohort Analysis.
Lacey AM, Colonna E, Tilahun R … +3 more , Vang C, Larson NJ, Nygaard RM
J Burn Care Res · 2026 May · PMID 41593814 · Publisher ↗
Unhoused persons are particularly vulnerable to frostbite injury due to prolonged exposure to extreme temperatures. This study hypothesized that unhoused frostbite injured patients have a higher mortality risk compared t...
Unhoused persons are particularly vulnerable to frostbite injury due to prolonged exposure to extreme temperatures. This study hypothesized that unhoused frostbite injured patients have a higher mortality risk compared to housed individuals. Data from 2 high-volume frostbite centers were analyzed and linked to state health department records. A longitudinal cohort of 933 frostbite patients who survived their initial hospital stay (n = 925) was examined with Cox proportional hazards regression to adjust for confounders (age, sex, race, alcohol use, and drug use). Nearly one-third of patients were unhoused at the time of injury. Most patients discharged home (56.7%), but alternative discharge locations included: [alternative housing (6.1%), inpatient psychiatric care (7.0%), acute rehabilitation (5.7%), nursing care (11.2%), shelter/street (6.4%), and AMA discharge (3.5%)]. During follow-up, 185 (19.8%) of the patients died. Time from frostbite injury to death ranged from 5 days to 17 years. Mortality between unhoused and housed frostbite patients was similar (19.7% vs 20.2%), but unhoused individuals died at significantly younger ages. Age was a significant predictor of mortality, while sex, race, and alcohol abuse were not. Living situation and drug use showed a trend toward increased mortality risk, but did not reach significance. The model (LR chi2 = 150.43, P < .001) indicated that the combined set of predictors significantly explained the variability in mortality risk. Findings highlight the need for targeted healthcare strategies to address socioeconomic disparities and improve outcomes for unhoused persons.
When Burns Lead to Silence: Catatonia a Case Report.
Semprun C, Bensimon G, Alothman MAS … +2 more , Shahrokhi S, Elloso M
J Burn Care Res · 2026 May · PMID 41582889 · Publisher ↗
Abstract loading — click title to view on PubMed.
The Changing Landscape of Pediatric Burns in the United Kingdom: A 20-Year Epidemiological Study.
Hoade LMS, Jovic TH, Rees EN … +2 more , Jessop ZM, Drew PJ
J Burn Care Res · 2026 May · PMID 41575221 · Publisher ↗
Burns are a leading cause of childhood injury. Analysis of pediatric burn epidemiology is essential for targeting educational and public health strategies, but there is limited available UK data, particularly traversing...
Burns are a leading cause of childhood injury. Analysis of pediatric burn epidemiology is essential for targeting educational and public health strategies, but there is limited available UK data, particularly traversing the COVID-19 pandemic. We hypothesize that the last 20 years have seen significant changes in injury patterns and service provision, with a marked effect from national lockdown measures. This study aims to describe the epidemiology of pediatric burns referrals and admissions within a pediatric burns unit in the United Kingdom over 20 years (2005-2024). A retrospective analysis was performed for pediatric patients referred to our center between 2005 and 2024. The International Burn Injury Database (iBID) was used to extract demographic and injury information. Data before, during, and after COVID-19 lockdown periods were compared. A total of 6919 patients met the inclusion criteria. In total, 1872 (27.1%) of the patients required admission. There was a significant reduction in admission rate following COVID despite an increase in average TBSA (P < .01). Most cases were scalds (n = 3100, 44.8%) or contact burns (n = 2650, 38.3%). The majority of patients were aged under 5 years (n = 4529, 65.5%), with a rise in referrals for older children across the study period. There was a noticeable rise in aerosol-related flash burns, cold burns, and treadmill-related friction burns during and after the pandemic. This study provides epidemiological data for the development of public health initiatives and adaptation of pediatric burns services. Emerging mechanistic trends and service re-design following the COVID pandemic require further multicenter evaluation to inform future care.
Nigella sativa and Its Bioactive Compound Thymoquinone in Burn Therapy: Mechanisms, Efficacy, and Safety.
Karhana S, Bint E Attar G, Alshammari W … +1 more , Khan MA
J Burn Care Res · 2026 May · PMID 41575220 · Publisher ↗
INTRODUCTION: Burn injuries represent a worldwide public health concern. Nigella sativa (NS), a herbal medicinal plant, widely used in Ayurveda, Unani, and Siddha holds potential to address this issue. This review evalua...
INTRODUCTION: Burn injuries represent a worldwide public health concern. Nigella sativa (NS), a herbal medicinal plant, widely used in Ayurveda, Unani, and Siddha holds potential to address this issue. This review evaluated the potential of NS extract and its key component, Thymoquinone (TQ), in accelerating burn wound healing, focusing on their mechanisms, safety, and efficacy. METHODS: Studies were retrieved from PubMed, Google Scholar, and ScienceDirect using keywords "Nigella sativa," "Thymoquinone," "burns," and "wound healing." Reports were screened for suitability, and the scientific name was verified on www.worldfloraonline.org. RESULTS: NS extract and TQ accelerate burn wound healing in vitro and in vivo through various mechanisms involving anti-inflammatory, anti-oxidative, anti-microbial, and tissue regenerative effects. TQ achieved 91.35% wound closure in NIH/3T3 cells and wound closure rate of 2.35% ± 0.05% in 3T3-CCL92 cells. It also reduced oxidative stress and inflammation in murine burn models. Nanoformulations of TQ showed higher safety (LD50: 300-2000 mg/kg) than pure TQ (LD50: 50-300 mg/kg). A Phase I trial confirmed the safety of black cumin oil (5% TQ) at 200 mg/day for 90 days in healthy adults. CONCLUSION: Formulations based on NS extract and TQ can manage burn injuries and be extrapolated into clinical settings.
Prescription Analysis of Antihistamines' Use in Patients With Moderate to Severe Burns.
Karim AA, Karim N, Shah S … +7 more , Syed R, Akbar Z, Marzook F, Song J, Golovko G, Wolf SE, El Ayadi A
J Burn Care Res · 2026 May · PMID 41575194 · Publisher ↗
Postburn pruritus (PBP) significantly affects patients, causing discomfort and hindering recovery. Antihistamines, which block H1 receptors, are commonly prescribed for PBP, yet large-scale studies on their usage pattern...
Postburn pruritus (PBP) significantly affects patients, causing discomfort and hindering recovery. Antihistamines, which block H1 receptors, are commonly prescribed for PBP, yet large-scale studies on their usage patterns are limited. This study evaluates antihistamine prescription trends and provider practices for PBP across varying burn severities from moderate to severe burns (≥20% TBSA). A treatment-pathways analysis was performed using TriNetX, a global, federated, deidentified database. Patients with burns ≥ 20% TBSA from the past 20 years (2004-2024) who developed pruritus were identified and stratified into 4 cohorts: 20%-40%, 40%-60%, 60%-80%, and ≥ 80% TBSA. The analysis evaluated trends in antihistamine prescriptions, including the number of patients treated with antihistamines, types prescribed, and median times to treatment initiation, duration, and therapy switching. The total sample included 2754 patients (20%-40% TBSA, n = 1712; 40%-60%, n = 613; 60%-80%, n = 253; ≥80%, n = 176). Over 70% received antihistamines, with hydroxyzine as the most common first-line therapy, followed by diphenhydramine. Across all cohorts, the average of the median times for initiation, therapy duration, and time before switching was 16.75 days, 90.25 days, and 27.75 days, respectively. Significant variations in the timing of therapy initiation suggest a gap in consistent symptom management during critical recovery periods, potentially affecting patient comfort and overall outcomes. These findings underscore the importance of vigilant postburn assessment, stepwise escalation based on response, and complementary strategies to optimize PBP management. Frequent switching and prolonged durations suggest a need for more effective and tailored therapeutic approaches to improve recovery outcomes for patients with burn injuries.
Synthesis of Sericin-Based Stretchable and Self-healing Hydrogel Loaded With Psidium guajava L. Extract for Treatment of Burn Wound.
Arshad S, Tahir HM, Mahnoor R … +7 more , Ali A, Muzamil A, Munir F, Faiz S, Ijaz F, Afzal A, Shafique F
J Burn Care Res · 2026 May · PMID 41543144 · Publisher ↗
Burn wounds pose significant challenges due to their susceptibility to microbial invasion and limited effective dressing options. This study aimed to evaluate the wound-healing potential of a sericin-based self-healing a...
Burn wounds pose significant challenges due to their susceptibility to microbial invasion and limited effective dressing options. This study aimed to evaluate the wound-healing potential of a sericin-based self-healing and stretchable hydrogel loaded with Psidium guajava L. extract against full-thickness burn wounds in mice. The hydrogel was characterized by physicochemical analyses including scanning electron microscopy, Fourier transform infrared spectroscopy, X-ray diffraction, viscosity, pH, swelling degree, weight loss, and mechanical strength. In vivo experiments used a Swiss albino mouse burn model, where 6 mm full-thickness wounds were induced with a hot metal rod. Hydrogels were applied topically at regular intervals, and wound healing was assessed through wound contraction measurements, healing time, and histological analysis. Hematological parameters and serum biomarkers, ie, pro- and anti-inflammatory cytokines, matrix metalloproteinases (MMPs), tissue inhibitors of metalloproteinases (TIMPs), antioxidants (glutathione [GSH], glutathione peroxidase [GPx], catalase [CAT], and superoxide dismutase [SOD]), angiogenic factors (vascular endothelial growth factor [VEGF]), and oxidative stress markers (malondialdehyde [MDA]) were also evaluated. Results demonstrated that the hydrogels exhibited high swelling capacity and notable weight loss, suggesting effective absorption of wound exudates and reduced infection risk. Notably, hydrogel 4 (3% sericin +3% P guajava L.) achieved significantly improved wound healing (89.66%) compared with controls (37.16%) by day 15. Histological examination confirmed collagen deposition and hair follicle regeneration, indicative of complete healing. Hematological findings showed increased red blood cell counts and reduced white blood cells, reflecting resolution of inflammation. Serum analyses revealed elevated anti-inflammatory markers (interleukin [IL]-10), TIMPs, and antioxidants (GSH, GPx, CAT, and SOD), alongside decreased pro-inflammatory cytokines (IL-6, IL-8, IL-1β, and tumor necrosis factor-α), MMPs, angiogenic factor VEGF, and oxidative stress marker MDA. Hydrogel 4 showed a 3.47-fold increase in SOD and a 68% reduction in MDA, underscoring its efficacy in mitigating oxidative stress. In conclusion, the sericin-based hydrogel infused with P guajava L. exhibited excellent physicochemical and biological properties, promoting effective burn wound healing. Hydrogel 4 demonstrated the most pronounced therapeutic benefits, making it a promising candidate for advanced wound dressing applications.
Metabolic and Immunomodulatory Effects of α-Ketoglutarate in Burn Injuries: A Systematic Review.
Niederegger T, Munzinger R, Schaschinger T … +6 more , Brandt JC, Knoedler L, Knoedler S, Palackic A, Panayi AC, Hundeshagen G
J Burn Care Res · 2026 May · PMID 41504365 · Publisher ↗
Severe burns unleash a hyper-catabolic and immunosuppressive state that erodes lean tissue and delays repair. Alpha-ketoglutarate (α-KG), usually delivered enterally as the dipeptide ornithine α-ketoglutarate (OKG), feed...
Severe burns unleash a hyper-catabolic and immunosuppressive state that erodes lean tissue and delays repair. Alpha-ketoglutarate (α-KG), usually delivered enterally as the dipeptide ornithine α-ketoglutarate (OKG), feeds the tricarboxylic-acid cycle, donates nitrogen for amino-acid synthesis, and modulates collagen formation and immunity. We systematically appraised the biological mechanisms, delivery strategies, and clinical outcomes associated with α-KG/OKG in burn care to clarify its therapeutic value and translational readiness. A PRISMA-2020-compliant search of PubMed, EMBASE, Web of Science, Cochrane, and Google Scholar up to May 2025 identified clinical, in vivo, and relevant in vitro studies linking α-KG or OKG with thermal injury. Study quality was assessed using the Newcastle-Ottawa Scale, SYRCLE Risk-of-Bias tool, and Oxford Levels of Evidence. Fifteen studies published between 1984 and 2024 met inclusion criteria, including clinical, animal, and mechanistic work, most conducted in France. Across studies, OKG supplementation replenished glutamine and arginine pools, improved nitrogen balance, preserved muscle mass, and promoted wound healing through enhanced collagen synthesis and immune modulation. Clinical data confirmed improved nitrogen retention, reduced muscle breakdown, and faster wound closure. Preclinical studies further showed that α-KG preconditioning enhances stem cell-driven regeneration and vascularization. Additional effects, such as improved glucose tolerance and hepatic enzyme preservation, suggest some benefits occur independently of glutamine pathways. This review highlights α-KG and OKG as promising adjuncts to enhance metabolic recovery, wound repair, and immune competence after burns. Evidence supports improved nitrogen balance and healing, but findings remain limited by heterogeneity and small cohorts, warranting renewed and well-powered studies.
Ablative Fractional Carbon Dioxide Laser Surgery Improves Sleep Disorder in Pediatric Patients With Hypertrophic Scars.
Liu H, Xie C, Luo P … +3 more , Xu H, Xiao S, Lv K
J Burn Care Res · 2026 May · PMID 41482863 · Publisher ↗
Hypertrophic scarring from burns can lead to sleep disturbances in children and significantly impact their quality of life and that of their caregivers. This study investigated the sleep quality of 9 pediatric patients w...
Hypertrophic scarring from burns can lead to sleep disturbances in children and significantly impact their quality of life and that of their caregivers. This study investigated the sleep quality of 9 pediatric patients with hypertrophic scars who underwent ablative fractional carbon dioxide laser (CO2-AFL) surgery. Electrocardiography was recorded before the first CO2-AFL treatment and after the final treatment. Cardiopulmonary coupling software was used to automatically generate sleep reports, including total time in bed, total sleep time, sleep efficiency, sleep latency time, deep sleep time, light sleep time, rapid eye movement sleep time, wake time, and apnea-hypopnea index. This study found that pediatric patients with hypertrophic scars commonly experience sleep disorders, and CO2-AFL surgery could improve sleep quality, including sleep efficiency, deep sleep duration, awakening time, and apnea-hypopnea index. This study provides preliminary objective evidence that CO₂-AFL treatment is associated with improvements in sleep quality parameters in pediatric patients with hypertrophic scars.
Safety and Efficacy of an Early Low-Dose Fresh Frozen Plasma Infusion in Burn Resuscitation.
Wiktor AJ, Vogler TO, Carmichael H … +2 more , Far M, Mueller SW
J Burn Care Res · 2026 May · PMID 41466517 · Full text
Growing evidence supports the addition of fresh frozen plasma (FFP) to a standardized crystalloid-based burn resuscitation. Fresh frozen plasma is thought to mitigate endotheliopathy, decrease total fluids and improve ou...
Growing evidence supports the addition of fresh frozen plasma (FFP) to a standardized crystalloid-based burn resuscitation. Fresh frozen plasma is thought to mitigate endotheliopathy, decrease total fluids and improve outcomes; however, when and how much FFP to give remains controversial. Here, we assessed the safety and efficacy of adding a non-titratable, 8-hr FFP infusion of 0.5 mL/kg/% total body surface area (TBSA) to a burn resuscitation. We performed an unmatched retrospective cohort review on all patients with burn injuries aged > 18 years old with > 20% TBSA burns who underwent our nursing-driven resuscitation protocol that included this early, standardized FFP infusion, from November 2016 to May 2020. Fifty-three patients received FFP and met inclusion criteria. Patients were primarily male (85%), with a median age of 36 years and a TBSA burn of 39% (range 24.5%-94%). Median time to FFP administration was 7 h from injury with a median of 1517 mL infused. Median input/output (I/O) ratio improved from 0.8 at FFP initiation to 0.4 at 3 h post-FFP, P < .001. Median urine output (UOP) improved from 0.19 mL/kg/h prior to FFP administration to 0.52 mL/kg/h at 3 h post-FFP, P < .001. No complications related to resuscitation such as abdominal compartment syndrome, acute respiratory distress syndrome, or transfusion reactions occurred. Therefore, adding a low-dose, standardized FFP infusion to burn resuscitations significantly improved UOP, normalized I/O ratios, and did not cause any known complications. Standardizing a safe, effective, non-titratable FFP infusion provides the framework to systematically test how colloids can be optimized during burn resuscitations in the future.
Within-Patient, Quasi-Experimental Clinical Trial to Assess the Immediate Effects of Paraffin Wax on Adult, Post-Burn Hypertrophic Scar.
Bellali YA, Jetté S, Delisle M … +3 more , Pinard-LaRoche A, Edger-Lacoursière Z, Nedelec B
J Burn Care Res · 2026 May · PMID 41439581 · Full text
Paraffin wax is applied to scar tissue for its proposed benefits of increasing skin pliability and relieving pain. However, limited studies have objectively assessed hypertrophic scar (HSc) response. This study examined...
Paraffin wax is applied to scar tissue for its proposed benefits of increasing skin pliability and relieving pain. However, limited studies have objectively assessed hypertrophic scar (HSc) response. This study examined immediate HSc changes after paraffin treatment compared with intra-individual controls. A quasi-experimental, within-subject, evaluator-blinded, pre-post design was used. Two homogeneous HSc were identified per participant: one treated with paraffin wax and one with mineral oil for 20 minutes. Normal skin also received paraffin to assess scar-specific effects. Objective measures included elasticity (Cutometer), erythema and melanin (Mexameter), transepidermal water loss (TEWL) (Tewameter), thickness (High-frequency Ultrasound), and self-reported pain, itch, stiffness, and overall scar impression. Thirty-nine burn survivors were recruited; 35 completed the study. Paired t-tests showed increased elasticity and erythema in paraffin-treated HSc and normal skin, decreased pigmentation in paraffin-treated normal skin, and decreased TEWL in the mineral oil-treated control scars. ANCOVA of post-treatment values, controlling for baseline, revealed significant increases in erythema and TEWL in paraffin-treated versus control scars. Participants perceived greater improvement in paraffin-treated HSc than controls, though controls improved across all items. Although paraffin significantly increased elasticity in both HSc and normal skin, it did not significantly differ from mineral oil-treated scars, suggesting that some of the effect may be attributable to mineral oil, as there was a slight increase in skin elasticity within the mineral oil group. However, paraffin improved self-reported outcomes, highlighting its potential clinical value in relieving pain and itch rather than increasing scar elasticity. As mineral oil also improved self-reported items, its benefits need further investigation. Future studies should recruit participants with baseline pain and itch to ensure adequate power.
Risk of Amputation and Associated Outcomes in Conveyance Burn Injuries, a Burn Model System Project.
Alexander I, Kim E, Humbert A … +4 more , Miles MVP, Mandell SP, Clark AT, Kowalske KJ
J Burn Care Res · 2026 May · PMID 41427852 · Publisher ↗
Despite improved safety standards, motor vehicle collisions remain a significant source of flame burn injury. The objective of this study is to characterize differences in demographics and outcomes between patients with...
Despite improved safety standards, motor vehicle collisions remain a significant source of flame burn injury. The objective of this study is to characterize differences in demographics and outcomes between patients with burn injuries related to motor vehicle collisions and patients with flame burn injuries not involved in motor vehicle collisions. The analysis included participants enrolled in the Burn Model Systems from 2015 to 2023. Conveyance burn participants had more amputations than patients with non-conveyance burn injuries (15% vs 4.9%, P < .001), with an increase in lower extremity amputations (2.5% vs 0.7%, P = .027). In addition, conveyance burns involved a greater total body surface area (TBSA) (26% vs 23%, P < .034) and were associated with longer hospital stays (40 days vs 33 days, P < .006). Participants who sustained injuries during conveyance demonstrated significantly lower global physical health t-scores (42.3 vs 44.1, P = .037) and physical function t-scores (42.0 vs 46.1, P = .002) at 6 months postinjury compared with those with non-conveyance flame burns. In addition, conveyance burn participants reported significantly lower t-scores for their ability to participate in social roles at 6 months (48.8 vs 50.8, P = .044) and 12 months postinjury (49.9 vs 54.0, P = .015). This study highlights the significant impact of conveyance-related burn injuries, particularly with respect to higher amputation rates and poorer early physical outcomes, compared with non-conveyance flame burns. This supports the need for targeted preventive strategies, especially those focused on vehicle maintenance and safety among younger and underrepresented populations.
Wound Management Strategy for Burn Injuries During Pelvic External Fixation: A Case Report on the Practical Use of Negative Pressure Wound Therapy.
Ohashi W, Yoneda K, Kanda D … +6 more , Ueda K, Ito H, Takegawa R, Hirose T, Sakai T, Oda J
J Burn Care Res · 2026 May · PMID 41410419 · Publisher ↗
Burn management in patients requiring pelvic external fixation is extremely challenging due to restricted positioning and difficulty maintaining airtight negative pressure wound therapy (NPWT). Practical techniques to se...
Burn management in patients requiring pelvic external fixation is extremely challenging due to restricted positioning and difficulty maintaining airtight negative pressure wound therapy (NPWT). Practical techniques to secure NPWT in this setting are rarely described. A 53-year-old man sustained 26% TBSA deep burns and an unstable pelvic fracture treated with external fixation. Circumferential trunk eschar excision was achieved by alternating lateral positions, as prone positioning was not feasible. Negative pressure wound therapy was applied for wound bed preparation and graft fixation. Airtight sealing was obtained using stoma paste around fixation pins and a belt-like silver-containing dressing on raw surfaces, reinforced with stoma paste to create a stable adhesion ridge. These methods enabled sustained negative pressure and stable graft take without regrafting. (1) Safe circumferential debridement achieved by alternating lateral positions. (2) Stoma paste effectively sealed difficult contours. (3) Silver dressing under stoma paste created an antimicrobial, sealable ridge for film adhesion. (4) "Double-sided film sealing" around pins maintained airtight NPWT. This case highlights practical NPWT sealing strategies enabling safe burn care under pelvic external fixation.
Evaluating First Positive Cultures in Burns: Rethinking Broad-Spectrum Antibiotic Choices.
Sadeghighazichaki P, Rogers AD, Elligsen M … +4 more , Natanson R, Mason SA, Lam P, Wallace DL
J Burn Care Res · 2026 May · PMID 41410360 · Publisher ↗
Infection is a nearly universal complication among patients with major burns, yet guidance on early empiric antibiotic therapy remains limited. Broad-spectrum antibiotics are commonly initiated in the early phase of care...
Infection is a nearly universal complication among patients with major burns, yet guidance on early empiric antibiotic therapy remains limited. Broad-spectrum antibiotics are commonly initiated in the early phase of care but carry risks of antimicrobial resistance and drug toxicities. This single-center, retrospective study evaluated the microbiological profiles and antibiotic prescribing patterns associated with first positive cultures (FPCs) in patients with major burn injuries admitted to Canada's highest-volume adult burn center between January 1, 2018 and May 1, 2023. A total of 114 patients with ≥ 20% total body surface area burns were included. Among 145 FPCs, the most commonly cultured sites were respiratory (55%) and wound (30%). The most frequently identified organisms were methicillin-sensitive Staphylococcus aureus (19%), Haemophilus influenzae (15%), Enterobacter cloacae complex (8%), Escherichia coli (7%), methicillin-resistant S aureus (MRSA) (7%), and Pseudomonas aeruginosa (6%). Notably, only 3% of patients who screened negative for MRSA on admission developed MRSA-positive cultures. Antibiotic therapy was initiated in 99% of patients with FPCs, most commonly with piperacillin-tazobactam (41%), vancomycin (16%), and cefazolin (14%). Dual therapy, typically piperacillin-tazobactam plus vancomycin, was used in 13% of cases. Sensitivity data demonstrated that meropenem (90%) and the combination of ciprofloxacin with cefazolin (83%) covered the highest proportion of isolates. While piperacillin-tazobactam remains effective for early empiric use, our findings indicate that targeted alternatives-such as reserving meropenem for select cases or using ciprofloxacin plus cefazolin in appropriate patients-could provide comparable coverage while adhering to antimicrobial stewardship principles. A negative MRSA screening swab on admission demonstrated a high negative predictive value (~97%), supporting the withholding of vancomycin in screen-negative patients. This study supports evidence-based antibiotic use in patients with burn injuries and underscores the need for local, data-driven stewardship.
Efficacy and optimal dose of acetic acid for treating colonised burns wounds (AceticA): a double-blind, single Centre, randomised, controlled phase II trial.
Moiemen N, Homer V, Nice L … +6 more , Brock K, Jenkins S, Altarrah K, Imran R, Tullie S, Barton D
J Burn Care Res · 2025 Dec · PMID 41410357 · Publisher ↗
Evaluate the effectiveness and tolerability of 0.5% and 2.0% (w/v) acetic acid on colonised burns wounds for three days after hospital admission. Burn wound infection and secondary sepsis are serious complications. Due t...
Evaluate the effectiveness and tolerability of 0.5% and 2.0% (w/v) acetic acid on colonised burns wounds for three days after hospital admission. Burn wound infection and secondary sepsis are serious complications. Due to growing bacterial resistance worldwide, effective antimicrobial agents that do not increase the risk of resistance and are non-toxic are required. In this is phase II trial, 0.5% or 2.0% acetic acid was applied to burns colonised by specifically identifiable bacteria. Participants aged ≥16 years with burns ≥1% body surface area were randomly assigned 1:1. Efficacy was measure by change in bacterial load from swabs taken daily for four consecutive days. The study encountered two interruptions during the Covid-19 pandemic lockdown. Consequently, major protocol amendments were implemented to ensure alignment with established hospital clinical pathways. Between Feb-2018 and Oct-2021, 22 participants were randomized. Participant characteristics were balanced, except fewer full thickness burns in the 2.0% acetic acid group. Two percent acetic acid significantly decreased the bacterial load compared to 0.5% concentration (p=.0129) but also increased the pain score (p=.012). Only one serious adverse event occurred: a grade 3 urinary tract infection unrelated to acetic acid, which resolved without sequalae. Acetic acid was safe and well-tolerated. Both concentrations lowered bacterial load, with 2.0% proving more effective. The study also indicates that dressing changes every 12 hours may be required.
Potential Cardiovascular Autonomic Dysfunction in Burn Survivors: A Pilot Study.
Sukhoplyasova M, Burns K, Alsharif MN … +4 more , Hamner JW, Deng H, Schneider JC, Taylor JA
J Burn Care Res · 2026 Mar · PMID 41400497 · Full text
Burn injury is increasingly recognized as a chronic condition associated with long-term cardiovascular risk; however, few studies have explored underlying mechanisms. This study aimed to evaluate cardiovascular autonomic...
Burn injury is increasingly recognized as a chronic condition associated with long-term cardiovascular risk; however, few studies have explored underlying mechanisms. This study aimed to evaluate cardiovascular autonomic function in individuals with chronic burn injuries. Ten adults, 3-11 years post burn injury of 10%-70% TBSA (mean: 34% ± 5%) underwent standard autonomic function tests: Valsalva's maneuver, paced breathing, and isometric handgrip. Heart rate and blood pressure responses were compared to either established normative values or to matched controls for each respective test. Burn survivors had significantly lower Valsalva ratios (1.32 ± 0.19) compared to age/sex normative values (1.47 ± 0.07, P < .05) and reduced heart rate variability (root mean square of successive differences, RMSSD) compared to matched controls (31 ± 21 vs 57 ± 19 ms, P < .05), indicating impaired cardiac vagal modulation. Valsalva ratio and RMSSD were related in the burn survivors (r = 0.58, P = .079), and RMSSD but not Valsalva ratio, tended to relate to burn size (r = -0.57, P = .082). No group differences were observed in responses to isometric exercise. Chronic burn injury appears to be associated with diminished cardiac vagal control which may underlie elevated cardiovascular risk observed in this population.
The Creatinine-to-Protein Ratio Predicts All-Cause In-Hospital Mortality After Major Burns.
Obed D, Eid AE, Salim M … +6 more , Knoedler S, Dastagir N, Tamulevicius M, Bucher F, Vogt PM, Wellkamp L
J Burn Care Res · 2025 Dec · PMID 41369285 · Publisher ↗
Serum creatinine and protein levels have been proposed as potential biomarkers for predicting adverse outcomes in burn patients. This study aimed to investigate the prognostic utility of these markers and the serum creat...
Serum creatinine and protein levels have been proposed as potential biomarkers for predicting adverse outcomes in burn patients. This study aimed to investigate the prognostic utility of these markers and the serum creatinine-to-protein ratio in relation to in-hospital mortality following severe burn injuries. This retrospective cohort study included burn patients admitted within a 13-year period, with a total body surface area (TBSA) affected of ≥20%. Creatinine, serum protein levels, and the creatinine-to-protein ratio were assessed on post-burn days (PBD) 1, 3, and 7. Multivariate analysis identified independent mortality predictors, and receiver operating characteristic (ROC) curves assessed predictive accuracy. Among 283 patients, an overall mortality rate of 24.7% was noted. Neither creatinine nor protein levels independently predicted mortality. However, the creatinine-to-protein ratio was significantly elevated in non-survivors on all measured days, with the PBD 7 value emerging as an independent predictor of in-hospital mortality. Ratios measured on PBD 3 and 7 yielded an area under the ROC curve of 0.75, indicating robust predictive capability. The post-burn creatinine-to-protein ratio, particularly on PBD 7, is a reliable, accessible, and cost-effective biomarker for mortality risk in severe burn patients. Its use could enhance early prognostic evaluation in burn care.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe