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Nature Reviews. Disease Primers Feb 2020Burn injuries are under-appreciated injuries that are associated with substantial morbidity and mortality. Burn injuries, particularly severe burns, are accompanied by... (Review)
Review
Burn injuries are under-appreciated injuries that are associated with substantial morbidity and mortality. Burn injuries, particularly severe burns, are accompanied by an immune and inflammatory response, metabolic changes and distributive shock that can be challenging to manage and can lead to multiple organ failure. Of great importance is that the injury affects not only the physical health, but also the mental health and quality of life of the patient. Accordingly, patients with burn injury cannot be considered recovered when the wounds have healed; instead, burn injury leads to long-term profound alterations that must be addressed to optimize quality of life. Burn care providers are, therefore, faced with a plethora of challenges including acute and critical care management, long-term care and rehabilitation. The aim of this Primer is not only to give an overview and update about burn care, but also to raise awareness of the ongoing challenges and stigmata associated with burn injuries.
Topics: Burns; Humans; Multiple Organ Failure; Quality of Life; Shock
PubMed: 32054846
DOI: 10.1038/s41572-020-0145-5 -
Clinics in Plastic Surgery Jul 2017Although pain management is a major challenge for clinicians, appropriate pain control is the foundation of efficacious burn care from initial injury to long-term... (Review)
Review
Although pain management is a major challenge for clinicians, appropriate pain control is the foundation of efficacious burn care from initial injury to long-term recovery. The very treatments designed to treat burn wounds may inflict more pain than the initial injury itself, making it the clinician's duty to embrace a multimodal treatment approach to burn pain. Vigilant pain assessment, meaningful understanding of the pathophysiology and pharmacologic considerations across different phases of burn injury, and compassionate attention to anxiety and other psychosocial contributors to pain will enhance the clinician's ability to provide excellent pain management.
Topics: Anesthesia; Burns; Humans; Pain Management; Pain Measurement
PubMed: 28576242
DOI: 10.1016/j.cps.2017.02.026 -
British Journal of Hospital Medicine... Mar 2022Chemical burns represent a small number of burn injuries in the UK. They have the potential to be life-threatening with serious aesthetic and functional consequences,... (Review)
Review
Chemical burns represent a small number of burn injuries in the UK. They have the potential to be life-threatening with serious aesthetic and functional consequences, accounting for 30% of all deaths from burns. Chemical burns are caused by corrosive agents (acids and alkali) leading to extensive tissue damage. Understanding the pathophysiology of a chemical burn injury and identifying the nature of the offending agent is important for effective management. Prompt assessment and management of chemical injuries is vital to reduce the deleterious effect of the compound involved. This article reviews the pathophysiology of a chemical injury and the management of these burns.
Topics: Burns, Chemical; Humans
PubMed: 35377199
DOI: 10.12968/hmed.2020.0056 -
International Journal of Environmental... Jan 2022According to the World Health Organization (WHO), it is estimated that each year approximately 11 million people suffer from burn wounds, 180,000 of whom die because of... (Review)
Review
According to the World Health Organization (WHO), it is estimated that each year approximately 11 million people suffer from burn wounds, 180,000 of whom die because of such injuries. Regardless of the factors causing burns, these are complicated wounds that are difficult to heal and are associated with high mortality rates. Medical care of a burn patient requires a lot of commitment, experience, and multidirectional management, including surgical activities and widely understood pharmacological approaches. This paper aims to comprehensively review the current literature concerning burn wounds, including classification of burns, complications, medical care, and pharmacological treatment. We also overviewed the dressings (with an emphasis on the newest innovations in this field) that are currently used in medical practice to heal wounds.
Topics: Bandages; Burns; Humans; Knowledge; Patient Care; Wound Healing
PubMed: 35162360
DOI: 10.3390/ijerph19031338 -
Wounds : a Compendium of Clinical... Dec 2019Burn wounds are one of the main causes of skin damage. Based on World Health Organization statistics, almost 300 000 people worldwide die of burns each year. In severe... (Review)
Review
Burn wounds are one of the main causes of skin damage. Based on World Health Organization statistics, almost 300 000 people worldwide die of burns each year. In severe burns, the cells and blood vessels are often injured and the blood supply to the wound is disturbed. Many factors such as oxygenation, infection, aging, hormones, and nutrition potentially can influence burn progression and disrupt repair with unbalanced release of various growth factors and cytokines. Different treatment approaches such as dressings and skin substitutes have been applied to aid wound healing. A thorough understanding of the effective factors on burns can improve wound healing outcomes. This review evaluates articles published on the Scopus, EMBASE, and PubMed databases that attempt to explain the pathophysiology, molecular components, and therapeutic approaches involved in the burn wound healing process.
Topics: Bandages; Burns; Disease Progression; Humans; Oxidative Stress; Skin Transplantation; Skin, Artificial; Wound Healing
PubMed: 31730513
DOI: No ID Found -
Anesthesiology Feb 2015Care of burn-injured patients requires knowledge of the pathophysiologic changes affecting virtually all organs from the onset of injury until wounds are healed. Massive... (Review)
Review
Care of burn-injured patients requires knowledge of the pathophysiologic changes affecting virtually all organs from the onset of injury until wounds are healed. Massive airway and/or lung edema can occur rapidly and unpredictably after burn and/or inhalation injury. Hemodynamics in the early phase of severe burn injury is characterized by a reduction in cardiac output and increased systemic and pulmonary vascular resistance. Approximately 2 to 5 days after major burn injury, a hyperdynamic and hypermetabolic state develops. Electrical burns result in morbidity much higher than expected based on burn size alone. Formulae for fluid resuscitation should serve only as guideline; fluids should be titrated to physiologic endpoints. Burn injury is associated basal and procedural pain requiring higher than normal opioid and sedative doses. Operating room concerns for the burn-injured patient include airway abnormalities, impaired lung function, vascular access, deceptively large and rapid blood loss, hypothermia, and altered pharmacology.
Topics: Anesthesia; Burns; Burns, Electric; Burns, Inhalation; Humans; Pain Management; Perioperative Care
PubMed: 25485468
DOI: 10.1097/ALN.0000000000000559 -
Cells Sep 2022Burn are diverse and complex injuries that not only have local effects but also serious systemic consequences through severe and prolonged inflammatory response. They... (Review)
Review
Burn are diverse and complex injuries that not only have local effects but also serious systemic consequences through severe and prolonged inflammatory response. They are caused by heat, electricity, friction, chemicals, or radiation and are commonly divided into superficial, superficial partial-, deep partial- and full-thickness injuries. The severity of the burn depends mainly on the size and depth of the injury but also on location, age, and underlying systemic diseases. A prolonged and strong immune response makes major burns even worse by causing multiple systemic effects including damage to the heart, lungs, blood vessels, kidneys, and other organs. Burns that do not require surgical excision, superficial and superficial partial-thickness, follow the known progression of wound healing (inflammation, proliferation, remodeling), whilst deep partial- and full thickness injuries requiring excision and grafting do not. For these burns, intervention is required for optimal coverage, function, and cosmesis. Annually millions of people worldwide suffer from burns associated with high morbidity and mortality. Fortunately, over the past decades, burn care has significantly improved. The improvement in understanding the pathophysiology of burn injury and burn wound progression has led to developments in skin grafting, fluid resuscitation, infection control and nutrition This review article focuses on the immune and regenerative responses following burn injury. In the Introduction, we describe the epidemiology of burns and burn pathophysiology. The focus of the following chapter is on systemic responses to burn injury. Next, we define the immune response to burns introducing all the different cell types involved. Subsequently, we discuss the regenerative cell response to burns as well as some of the emerging novel treatments in the battle against burns.
Topics: Burns; Humans; Skin; Skin Transplantation; Wound Healing
PubMed: 36231034
DOI: 10.3390/cells11193073 -
Cellular and Molecular Life Sciences :... Sep 2014Burn injury is a severe form of trauma affecting more than 2 million people in North America each year. Burn trauma is not a single pathophysiological event but a... (Review)
Review
Burn injury is a severe form of trauma affecting more than 2 million people in North America each year. Burn trauma is not a single pathophysiological event but a devastating injury that causes structural and functional deficits in numerous organ systems. Due to its complexity and the involvement of multiple organs, in vitro experiments cannot capture this complexity nor address the pathophysiology. In the past two decades, a number of burn animal models have been developed to replicate the various aspects of burn injury, to elucidate the pathophysiology, and to explore potential treatment interventions. Understanding the advantages and limitations of these animal models is essential for the design and development of treatments that are clinically relevant to humans. This review aims to highlight the common animal models of burn injury in order to provide investigators with a better understanding of the benefits and limitations of these models for translational applications. While many animal models of burn exist, we limit our discussion to the skin healing of mouse, rat, and pig. Additionally, we briefly explain hypermetabolic characteristics of burn injury and the animal model utilized to study this phenomena. Finally, we discuss the economic costs associated with each of these models in order to guide decisions of choosing the appropriate animal model for burn research.
Topics: Animal Experimentation; Animals; Animals, Laboratory; Body Size; Burns; Costs and Cost Analysis; Energy Metabolism; Mice; Models, Animal; Rabbits; Rats; Research; Skin; Smoke Inhalation Injury; Species Specificity; Swine; Wound Healing
PubMed: 24714880
DOI: 10.1007/s00018-014-1612-5 -
Medicina Intensiva 2017Since one of the main challenges in treating acute burn injuries is preventing infection, early excising of the eschar and covering of the wound becomes critical.... (Review)
Review
Since one of the main challenges in treating acute burn injuries is preventing infection, early excising of the eschar and covering of the wound becomes critical. Non-viable tissue is removed by initial aggressive surgical debridement. Many surgical options for covering the wound bed have been described, although split-thickness skin grafts remain the standard for the rapid and permanent closure of full-thickness burns. Significant advances made in the past decades have greatly improved burns patient care, as such that major future improvements in survival rates seem to be more difficult. Research into stem cells, grafting, biomarkers, inflammation control, and rehabilitation will continue to improve individualized care and create new treatment options for these patients.
Topics: Burns; Humans; Injury Severity Score; Pain; Pain Management; Surgical Procedures, Operative
PubMed: 28456441
DOI: 10.1016/j.medin.2017.02.008 -
Burns : Journal of the International... Mar 2017Burns have been more prevalent among low socioeconomic populations and in less developed regions. Incredible advances in burn care and social development over the recent... (Review)
Review
Burns have been more prevalent among low socioeconomic populations and in less developed regions. Incredible advances in burn care and social development over the recent decades, however, should have placed the incidence and severity of burns in a downwards trend. The aim of this review was to give an overview on current trends in burn epidemiology across the world. Also the socioeconomic development in countries that have published epidemiological data used in this study has been taken into account when comparing the results. There was a worldwide downwards trend of burn incidence, burn severity, length of hospital stay, and mortality rate. These findings were particularly pronounced in very highly developed countries. Data from highly and medium developed countries were more heterogeneous. No studies could be obtained from low and middle income countries. Comparisons between the different studies were compromised by the fact that studies emerged from specialized facilities on one hand and general hospitals on the other. Analyzed studies were also frequently focusing on limited patient populations such as "children" or "elderly". Our findings indicate the need for an international burn database with a minimal data-set in order to obtain objective and comparable results in respect of burn epidemiology.
Topics: Burns; Developed Countries; Developing Countries; Global Health; Humans; Incidence; Length of Stay; Socioeconomic Factors; Trauma Severity Indices
PubMed: 27600982
DOI: 10.1016/j.burns.2016.08.013