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Exercise and Sport Sciences Reviews Jan 2015Severe burn trauma results in persistent skeletal muscle catabolism and prolonged immobilization. We hypothesize that structured rehabilitative exercise is a safe and... (Review)
Review
Severe burn trauma results in persistent skeletal muscle catabolism and prolonged immobilization. We hypothesize that structured rehabilitative exercise is a safe and efficacious strategy to restore lean body mass and physical function in burn victims. Here, we review the evidence for the utility of rehabilitative exercise training in restoring physiological function in burn survivors.
Topics: Burns; Cardiovascular System; Exercise Therapy; Humans; Lung; Muscle, Skeletal
PubMed: 25390300
DOI: 10.1249/JES.0000000000000029 -
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 -
Scientific Reports Aug 2017Honey was used to treat wounds since ancient times till nowadays. The present study aimed at preparing a honey-based hydrogel and assay its antimicrobial properties and...
Honey was used to treat wounds since ancient times till nowadays. The present study aimed at preparing a honey-based hydrogel and assay its antimicrobial properties and wound healing activity; in-vitro and in-vivo. Topical honey hydrogel formulations were prepared using three honey concentrations with gelling agents; chitosan and carbopol 934. The prepared formulae were evaluated for pH, spreadability, swelling index, in-vitro release and antimicrobial activity. The pH and spreadability were in the range of 4.3-6.8 and 5.7-8.6 cm, respectively. Chitosan-based hydrogel showed higher in-vitro honey release with diffusional exponent 'n ≤ 0.5 indicates Fickian diffusion mechanism. Hydrogel formulae were assessed for in-vitro antimicrobial activity using Disc Diffusion antibiotic sensitivity test against common burn infections bacteria; Pseudomonas aeruginosa, Staphylococcus aureus, Klebsiella pneumonia and Streptococcus pyogenes. The 75% honey-chitosan hydrogel showed highest antimicrobial activity. This formula was tested for in-vivo burn healing using burn-induced wounds in mice. The formula was evaluated for burn healing and antibacterial activities compared to commercial product. 75% honey-chitosan hydrogel was found to possess highest healing rate of burns. The present study concludes that 75% honey-chitosan hydrogel possesses greater wound healing activity compared to commercial preparation and could be safely used as an effective natural topical wound healing treatment.
Topics: Animals; Anti-Infective Agents; Burns; Chemical Phenomena; Drug Compounding; Female; Honey; Hydrogels; Male; Mice; Microbial Sensitivity Tests; Wound Healing; Wound Infection
PubMed: 28851905
DOI: 10.1038/s41598-017-08771-8 -
Critical Care (London, England) Jan 2020Acute kidney injury (AKI) is a common complication in burn patients admitted to the intensive care unit (ICU) associated with increased morbidity and mortality. Our... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Acute kidney injury (AKI) is a common complication in burn patients admitted to the intensive care unit (ICU) associated with increased morbidity and mortality. Our primary aim was to review incidence, risk factors, and outcomes of AKI in burn patients admitted to the ICU. Secondary aims were to review the use of renal replacement therapy (RRT) and impact on health care costs.
METHODS
We conducted a systematic search in PubMed, UpToDate, and NICE through 3 December 2018. All reviews in Cochrane Database of Systematic Reviews except protocols were added to the PubMed search. We searched for studies on AKI according to Risk, Injury, Failure, Loss of kidney function, and End-stage kidney disease (RIFLE); Acute Kidney Injury Network (AKIN); and/or Kidney Disease: Improving Global Outcomes (KDIGO) criteria in burn patients admitted to the ICU. We collected data on AKI incidence, risk factors, use of RRT, renal recovery, length of stay (LOS), mortality, and health care costs.
RESULTS
We included 33 observational studies comprising 8200 patients. Overall study quality, scored according to the Newcastle-Ottawa scale, was moderate. Random effect model meta-analysis revealed that the incidence of AKI among burn patients in the ICU was 38 (30-46) %. Patients with AKI were almost evenly distributed in the mild, moderate, and severe AKI subgroups. RRT was used in 12 (8-16) % of all patients. Risk factors for AKI were high age, chronic hypertension, diabetes mellitus, high Total Body Surface Area percent burnt, high Abbreviated Burn Severity Index score, inhalation injury, rhabdomyolysis, surgery, high Acute Physiology and Chronic Health Evaluation II score, high Sequential Organ Failure Assessment score, sepsis, and mechanical ventilation. AKI patients had 8.6 (4.0-13.2) days longer ICU LOS and higher mortality than non-AKI patients, OR 11.3 (7.3-17.4). Few studies reported renal recovery, and no study reported health care costs.
CONCLUSIONS
AKI occurred in 38% of burn patients admitted to the ICU, and 12% of all patients received RRT. Presence of AKI was associated with increased LOS and mortality.
TRIAL REGISTRATION
PROSPERO (CRD42017060420).
Topics: Acute Kidney Injury; Burns; Humans; Incidence; Intensive Care Units
PubMed: 31898523
DOI: 10.1186/s13054-019-2710-4 -
Journal of Burn Care & Research :... 2017At the 2016 State of the Science meeting, clinicians and burn survivors met to discuss the advances in scar prevention, evaluation and treatment. While emerging evidence... (Review)
Review
At the 2016 State of the Science meeting, clinicians and burn survivors met to discuss the advances in scar prevention, evaluation and treatment. While emerging evidence exists to support pressure garment treatment of scars and the use of silicone gel, further research is necessary to better delineate indications duration and efficacy of established therapies and to develop and test badly needed new treatments. More accurate and objective assessment of burn depth would assist in the prevention and identification of wounds requiring customized surgery. Laser treatment of scar while rapidly gaining popularity, still lacks high quality evidence as to its efficacy. The psychological impact of burn scars on the recovering patient is poorly appreciated and increased interaction with our patients is needed to more fully understand and address the impact on health related quality of life of their burn scars.
Topics: Burns; Cicatrix, Hypertrophic; Clothing; Compression Bandages; Humans; Laser Therapy; Occlusive Dressings; Quality of Life; Silicone Gels
PubMed: 28338518
DOI: 10.1097/BCR.0000000000000548 -
Medicina (Kaunas, Lithuania) May 2021Burn injuries are still one of the most common and devastating injuries in humans and the treatment of major burns remains a major challenge for physicians worldwide...
Burn injuries are still one of the most common and devastating injuries in humans and the treatment of major burns remains a major challenge for physicians worldwide [...].
Topics: Burns; Humans
PubMed: 34071253
DOI: 10.3390/medicina57060541 -
Journal of Plastic Surgery and Hand... 2023Autologous cell suspensions obtained by a stromal vascular fraction (SVF) and enzyme-free mechanical isolation (EMI) are an alternative in the treatment of burn wounds....
BACKGROUND
Autologous cell suspensions obtained by a stromal vascular fraction (SVF) and enzyme-free mechanical isolation (EMI) are an alternative in the treatment of burn wounds. In this study, we aimed to investigate the effect of autologous cell suspensions obtained by SVF and EMI on full-thickness skin burn wounds.
METHODS
A total of 45 male Sprague-Dawley rats were divided into three groups, SVF group, EMI group, and SVF + EMI group. The groups were also classified as the first, second, and third week of the burn to reveal the effect of the treatment on the burn in the early, middle, and late stages. For treatment, 0.2 ml SVF or 0.2 ml EMI was injected subcutaneously into the burn lesions of the subjects. Histopathological examination was performed on the burn wounds taken at the end of the experiment, and Ki67, CD44, CD73, CD90, and CK17 expressions were evaluated.
RESULTS
Histological examination revealed that there was no improvement in the control samples, but the skin was multicellular, vascularization was present. Histologic scores in all groups was significantly better than control, and SVF + EMI was the best group in terms of recovery ( < 0.05). Ki67, CK17, CD44, CD73, and CD90 expressions were significantly higher in the treatment groups compared to the control ( < 0.05).
CONCLUSION
We found in our study that both applications significantly increased the healing of the burn wound. Moreover, SVF + EMI application provided more improvement than SVF or EMI alone.
Topics: Rats; Animals; Male; Ki-67 Antigen; Stromal Vascular Fraction; Rats, Sprague-Dawley; Wound Healing; Burns; Soft Tissue Injuries; Adipose Tissue; Stromal Cells
PubMed: 34709935
DOI: 10.1080/2000656X.2021.1993234 -
Shock (Augusta, Ga.) Sep 2021Burn injuries are a common form of traumatic injury that leads to significant morbidity and mortality worldwide. Burn injuries are characterized by inflammatory... (Review)
Review
Burn injuries are a common form of traumatic injury that leads to significant morbidity and mortality worldwide. Burn injuries are characterized by inflammatory processes and alterations in numerous organ systems and functions. Recently, it has become apparent that the gastrointestinal bacterial microbiome is a key component of regulating the immune response and recovery from burn and can also contribute to significant detrimental sequelae after injury, such as sepsis and multiple organ failure. Microbial dysbiosis has been linked to multiple disease states; however, its role in exacerbating acute traumatic injuries, such as burn, is poorly understood. In this article, we review studies that document changes in the intestinal microbiome after burn injury, assess the implications in post-burn pathogenesis, and the potential for further discovery and research.
Topics: Burns; Dysbiosis; Gastrointestinal Microbiome; Humans
PubMed: 33481548
DOI: 10.1097/SHK.0000000000001736 -
The Journal of Surgical Research Jan 2020In the management of indeterminate-depth burns (IDB), common challenges include the ability to predict time to healing and regenerative potential, risk of burn wound... (Review)
Review
In the management of indeterminate-depth burns (IDB), common challenges include the ability to predict time to healing and regenerative potential, risk of burn wound progression, and timing of excision. Several technologies exist to aid in determination of the depth of a burn injury, yet surgeons continue to rely on the naked eye-visual assessment-as the standard of care. Newer and improved imaging technologies are closing in on the goal of inexpensive, accurate, noninvasive modalities for depth determination. Likewise, management of IDB is becoming more sophisticated as newer wound healing technologies continue to be developed. By describing what is meant by "indeterminate" depth burns, and their associated challenges, we hope to stimulate interest in research to develop new therapies and management strategies. The ultimate goal is to treat IDB without the need for autografts.
Topics: Burns; Debridement; Disease Progression; Humans; Patient Selection; Severity of Illness Index; Skin; Skin Transplantation; Skin, Artificial; Standard of Care; Time Factors; Treatment Outcome; Uncertainty; Wound Healing
PubMed: 31421361
DOI: 10.1016/j.jss.2019.07.063 -
Wounds : a Compendium of Clinical... Jan 2018The problem of postburn itch has been underevaluated and undertreated in the past. However, recently published data have expanded the evidence base, which provides... (Review)
Review
The problem of postburn itch has been underevaluated and undertreated in the past. However, recently published data have expanded the evidence base, which provides clinicians and their patients with new evaluation and treatment options that can help reduce and potentially eliminate the prolonged distress experienced by burn survivors faced with postburn itch. Although a gold standard evaluation method has not yet been agreed upon, there are a number of tools that have been published that clinicians can use for assessment. Epidemiological evidence has confirmed that the vast majority of both adult and pediatric burn survivors experience itch for years following injury. At discharge from the acute care hospital, 93% of burn survivors with major burn injuries report postburn itch that is still experienced by 44% of adult burn survivors 30 years postburn. Although larger surface area injuries are more likely to require a multimodal treatment approach to reduce the itch intensity as well as the episode duration and frequency, burn survivors with small surface area injuries also experience itch that needs to be addressed. A number of treatment protocols have been described that commonly call for concurrent administration of both pharmacological and nonpharmacological treatment approaches. These protocols provide clinicians with a structured, systematic approach to treatment decisions that are evidence-based. Although many questions require further investigation, the current state of the science creates an ethical imperative that all burn survivors' itch experience should be quantitatively evaluated and appropriate treatment options explored until satisfactory outcomes are obtained.
Topics: Antipruritics; Burns; Evidence-Based Medicine; Humans; Pruritus; Quality of Life; Severity of Illness Index; Survivors; Treatment Outcome
PubMed: 29406295
DOI: No ID Found