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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 -
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 -
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 -
Burns : Journal of the International... Jun 2020Bromelain-based Enzymatic Debridement has been introduced as an additional concept to the burn surgeon's armamentarium and is best indicated for mid-to deep dermal burns...
INTRODUCTION
Bromelain-based Enzymatic Debridement has been introduced as an additional concept to the burn surgeon's armamentarium and is best indicated for mid-to deep dermal burns with mixed patterns. Increasing evidence has been published focusing on special regions and settings as well as on limitations of Enzymatic Debridement to improve patient care. To better guide Enzymatic Debridement in view of the increasing experience, there is a need to update the formerly published consensus guidelines with user-orientated recommendations, which were last produced in 2017.
METHODS
A multi-professional expert panel of plastic surgeons and burn care specialists from twelve European centers was convened, to assist in developing current recommendations for best practices with use of Enzymatic Debridement. Consensus statements were based on peer-reviewed publications and clinical relevance, and topics for re-evaluation and refinement were derived from the formerly published European guidelines. For consensus agreement, the methodology employed was an agreement algorithm based on a modification of the Willy and Stellar method. For this study on Enzymatic Debridement, consensus was considered when there was at least 80 % agreement to each statement.
RESULTS
The updated consensus guidelines from 2019 refer to the clinical experience and practice patterns of 1232 summarized patient cases treated by the panelists with ED in Europe (2017: 500 cases), reflecting the impact of the published recommendations. Forty-three statements were formulated, addressing the following topics: indications, pain management and anesthesia, large surface treatment, timing of application for various indications, preparation and application, post-interventional wound management, skin grafting, outcome, scar and revision management, cost-effectiveness, patient´s perspective, logistic aspects and training strategies. The degree of consensus was remarkably high, with consensus in 42 out of 43 statements (97.7%). A classification with regard to timing of application for Enzymatic Debridement was introduced, discriminating immediate/very early (≤12 h), early (12-72 h) or delayed (>72 h) treatment. All further recommendations are addressed in the publication.
CONCLUSIONS
The updated guidelines in this publication represent further refinement of the recommended indication, application and post-interventional management for the use of ED. The published statements contain detailed, user-orientated recommendations aiming to align current and future users and prevent pitfalls, e.g. for the successful implementation of ED in further countries like the USA. The significance of this work is reflected by the magnitude of patient experience behind it, larger than the total number of patients treated in all published ED clinical trials.
Topics: Bandages; Body Surface Area; Bromelains; Burns; Debridement; Europe; Humans; Practice Guidelines as Topic; Skin Transplantation; Time Factors; Wound Healing
PubMed: 32241591
DOI: 10.1016/j.burns.2020.03.002 -
International Journal of Molecular... Nov 2023According to the World Health Organization (WHO), around 11 million people suffer from burns every year, and 180,000 die from them. A burn is a condition in which heat,... (Review)
Review
According to the World Health Organization (WHO), around 11 million people suffer from burns every year, and 180,000 die from them. A burn is a condition in which heat, chemical substances, an electrical current or other factors cause tissue damage. Burns mainly affect the skin, but can also affect deeper tissues such as bones or muscles. When burned, the skin loses its main functions, such as protection from the external environment, pathogens, evaporation and heat loss. Depending on the stage of the burn, the patient's condition and the cause of the burn, we need to choose the most appropriate treatment. Personalization and multidisciplinary collaboration are key to the successful management of burn patients. In this comprehensive review, we have collected and discussed the available treatment options, focusing on recent advances in topical treatments, wound cleansing, dressings, skin grafting, nutrition, pain and scar tissue management.
Topics: Humans; Wound Healing; Skin; Skin Transplantation; Bandages; Burns
PubMed: 38003548
DOI: 10.3390/ijms242216357 -
Australian Journal of General Practice Sep 2019Approximately 1% of the Australian and New Zealand population seeks medical assistance for a burn injury each year, and many patients presenting with burns are children....
BACKGROUND
Approximately 1% of the Australian and New Zealand population seeks medical assistance for a burn injury each year, and many patients presenting with burns are children. Minor burns that do not meet referral criteria can be managed by the family general practitioner (GP). If there are any concerns about the injury or progress of the burn wound healing, GPs are encouraged to contact their local burns service for advice.
OBJECTIVE
The aim of this article is to provide primary healthcare clinicians with a summary of the acute management of minor burns in children.
DISCUSSION
Effective first aid for burns will minimise burn progression and alleviate pain. Appropriate wound care will promote optimal healing and potentiate favourable outcomes. Although a minor burn may not meet initial referral criteria for transfer to a specialised burn centre, GPs are encouraged to refer if there are any concerns in relation to wound healing, pain management or scarring, or if consultative advice regarding management is required.
Topics: Bandages; Body Surface Area; Burn Units; Burns; Child; Cicatrix; First Aid; General Practice; Humans; Pain Management; Pruritus; Referral and Consultation; Skin Cream; Sunscreening Agents; Trauma Severity Indices; Wound Healing
PubMed: 31476838
DOI: 10.31128/AJGP-04-19-4919 -
Acute Respiratory Distress Syndrome, Mechanical Ventilation, and Inhalation Injury in Burn Patients.The Surgical Clinics of North America Jun 2023Respiratory failure occurs with some frequency in seriously burned patients, driven by a combination of inflammatory and infection factors. Inhalation injury contributes... (Review)
Review
Respiratory failure occurs with some frequency in seriously burned patients, driven by a combination of inflammatory and infection factors. Inhalation injury contributes to respiratory failure in some burn patients via direct mucosal injury and indirect inflammation. In burn patients, respiratory failure leading to acute respiratory distress syndrome, with or without inhalation injury, is effectively managed using principles evolved for non-burn critically ill patients.
Topics: Humans; Respiration, Artificial; Burns; Respiratory Distress Syndrome; Critical Illness; Respiratory Insufficiency
PubMed: 37149380
DOI: 10.1016/j.suc.2023.01.006 -
Medicina (Kaunas, Lithuania) Apr 2021The past one hundred years have seen tremendous improvements in burn care, allowing for decreased morbidity and mortality of this pathology. The more prominent... (Review)
Review
The past one hundred years have seen tremendous improvements in burn care, allowing for decreased morbidity and mortality of this pathology. The more prominent advancements occurred in the period spanning 1930-1980; notably burn resuscitation, early tangential excision, and use of topical antibiotic dressings; and are well documented in burn literature. This article explores the advancements of the past 40 years and the areas of burn management that are presently topics of active discussion and research.
Topics: Anti-Bacterial Agents; Bandages; Burns; Humans; Resuscitation; Wound Healing
PubMed: 33923571
DOI: 10.3390/medicina57040386