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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 -
Physical Medicine and Rehabilitation... Feb 2019A major burn is a severe injury with a global impact. Our system of medical evacuation has led to the survival of many severely injured service members. Burn... (Review)
Review
A major burn is a severe injury with a global impact. Our system of medical evacuation has led to the survival of many severely injured service members. Burn rehabilitation is a complex and dynamic process and will not be linear. Recovery requires a comprehensive, interdisciplinary team-based approach, individually designed to maximize function, minimize disability, promote self-acceptance, and facilitate survivor and family reintegration into the community.
Topics: Burns; Humans; Military Personnel
PubMed: 30470416
DOI: 10.1016/j.pmr.2018.08.004 -
Experimental Dermatology Sep 2010Burn injury is a complex traumatic event with various local and systemic effects, affecting several organ systems beyond the skin. The pathophysiology of the burn... (Review)
Review
Burn injury is a complex traumatic event with various local and systemic effects, affecting several organ systems beyond the skin. The pathophysiology of the burn patient shows the full spectrum of the complexity of inflammatory response reactions. In the acute phase, inflammation mechanism may have negative effects because of capillary leak, the propagation of inhalation injury and the development of multiple organ failure. Attempts to mediate these processes remain a central subject of burn care research. Conversely, inflammation is a necessary prologue and component in the later-stage processes of wound healing. In this review, we are attempting to present the current science of burn wound pathophysiology and wound healing. We also describe the evolution of innovative strategies for burn management.
Topics: Burns; Humans; Wound Healing
PubMed: 20629737
DOI: 10.1111/j.1600-0625.2010.01105.x -
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 -
Critical Care (London, England) Oct 2013Between 4 and 22% of burn patients presenting to the emergency department are admitted to critical care. Burn injury is characterised by a hypermetabolic response with... (Review)
Review
Between 4 and 22% of burn patients presenting to the emergency department are admitted to critical care. Burn injury is characterised by a hypermetabolic response with physiologic, catabolic and immune effects. Burn care has seen renewed interest in colloid resuscitation, a change in transfusion practice and the development of anti-catabolic therapies. A literature search was conducted with priority given to review articles, meta-analyses and well-designed large trials; paediatric studies were included where adult studies were lacking with the aim to review the advances in adult intensive care burn management and place them in the general context of day-to-day practical burn management.
Topics: Burn Units; Burns; Critical Care; Critical Illness; Disease Management; Humans; Resuscitation
PubMed: 24093225
DOI: 10.1186/cc12706 -
The Surgical Clinics of North America Jun 2023Infections are the leading cause of mortality in burn patients who survive their initial resuscitation. Burn injury leads to immunosuppression and a dysregulated... (Review)
Review
Infections are the leading cause of mortality in burn patients who survive their initial resuscitation. Burn injury leads to immunosuppression and a dysregulated inflammatory response which can have a prolonged impact. Early surgical excision along with support of the multidisciplinary burn team has improved mortality in burn patients. The authors review diagnostic and therapeutic challenges as well as strategies for management of burn related infections.
Topics: Humans; Burns; Wound Infection
PubMed: 37149379
DOI: 10.1016/j.suc.2023.02.005 -
Journal of Burn Care & Research :... 2017As part of the State of Science Meeting, care in elderly was one of the foci. This "white paper" deriving from this meeting indicates advances in the field of burn... (Review)
Review
As part of the State of Science Meeting, care in elderly was one of the foci. This "white paper" deriving from this meeting indicates advances in the field of burn injuries in the elderly but more importantly areas that are in need of novel insights and investigations. The group created specific segments of a patient's course pre- and postinjury to selectively identify specifics we need to improve on. Tasks were created that were assigned to volunteers of the group and are given in detail in this article. The overarching aim is to initiate substantial momentum among the members of the American Burn Association to improve the outcomes in the elderly burn patients.
Topics: Age Factors; Aged; Burn Units; Burns; Continuity of Patient Care; Humans; Patient Care Team; Quality of Life
PubMed: 28362655
DOI: 10.1097/BCR.0000000000000535 -
Physical Medicine and Rehabilitation... Nov 2023Burns are the fifth leading cause of non-fatal childhood injuries. Physiological differences between children and adults lead to unique considerations when treating... (Review)
Review
Burns are the fifth leading cause of non-fatal childhood injuries. Physiological differences between children and adults lead to unique considerations when treating young burn survivors. In addition to the physical and psychological concerns which must be considered in adult burn rehabilitation, pediatric burn rehabilitation must also consider the developmental stage of the child, preexisting developmental delays, and the impact of scaring on growth and motor skill attainment. Treatment of pediatric burn survivors requires a multidisciplinary approach centered around caring for not only the child but also for their parents, siblings, and other caregivers. For children who sustain burns early in life, long-term follow-up is essential and should be conducted under the guidance of a burn center for the early identification of needed interventions during periods of growth and development. This article considers pediatric-specific factors, which may present during the rehabilitation of a child with a burn injury.
Topics: Child; Humans; Survivors; Burns
PubMed: 37806700
DOI: 10.1016/j.pmr.2023.05.004 -
Pediatrics in Review Jun 2018
Review
Topics: Burns; Child; Combined Modality Therapy; Critical Care; Fluid Therapy; Humans; Rehabilitation; Resuscitation; Wound Closure Techniques
PubMed: 29858290
DOI: 10.1542/pir.2016-0179 -
The Surgical Clinics of North America Jun 2023Better understanding of long-term outcomes after burn injury is essential for the burn clinician. Contractures are present in almost half of patients at discharge.... (Review)
Review
Better understanding of long-term outcomes after burn injury is essential for the burn clinician. Contractures are present in almost half of patients at discharge. Although less common, neuropathy and heterotopic ossification may be missed or go unaddressed. Close attention to psychological distress and to challenges with community reentry is essential. Obviously long-term problems with skin issues occur but other issues must be attended to maximize health and quality of life after injury. Facilitating access to community resources and providing long-term medical follow-up should be the standard of care.
Topics: Humans; Burns; Quality of Life
PubMed: 37149386
DOI: 10.1016/j.suc.2023.02.004