Journal Description
European Burn Journal
European Burn Journal
(formerly European Journal of Burn Care) is an international, peer-reviewed, open access journal on burn care and burn prevention. The journal is owned by the European Burns Association (EBA) and is published quarterly online by MDPI.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within ESCI (Web of Science), PMC, PubMed, Scopus and other databases.
- Journal Rank: CiteScore - Q2 (Health Professions (miscellaneous))
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 29.7 days after submission; acceptance to publication is undertaken in 5.7 days (median values for papers published in this journal in the first half of 2025).
- Recognition of Reviewers: APC discount vouchers, optional signed peer review, and reviewer names published annually in the journal.
- Companion journal: Healthcare.
Impact Factor:
1.2 (2024);
5-Year Impact Factor:
1.3 (2024)
Latest Articles
Scientific Production on Chemical Burns: A Bibliometric Analysis (1946–2024)
Eur. Burn J. 2025, 6(3), 51; https://doi.org/10.3390/ebj6030051 - 9 Sep 2025
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Background: Chemical burns represent a persistent global health challenge due to their high prevalence, causing lifelong disabilities and socioeconomic burdens. Although research on chemical burns has expanded over the past century, no comprehensive study has mapped the intellectual structure, global collaboration patterns, and
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Background: Chemical burns represent a persistent global health challenge due to their high prevalence, causing lifelong disabilities and socioeconomic burdens. Although research on chemical burns has expanded over the past century, no comprehensive study has mapped the intellectual structure, global collaboration patterns, and thematic evolution of scientific production on chemical burns to determine how research in the area has evolved and the existence of gaps or imbalances that need to be addressed. Objective: The aim was to analyze the scientific production on chemical burns using bibliometric methods, identifying key contributors, evolving themes, and research gaps. Methods: Eligible documents contained the MeSH descriptor and were listed both in PubMed (1946 to 2024) and in the Web of Science Core Collection. The documents were analyzed with Bibliometrix version 5.0 and VOSviewer version 1.6.20. The metrics included were annual productivity, citation networks, co-authorship patterns, and keyword co-occurrence. Results: The analysis included 3943 articles from 757 journals. The annual average was 25.8 articles, with a growth rate of 0.65% from 1946 to 2024. The USA produced the most articles (n = 1547), followed by China (n = 890). The USA also led in international collaboration, working with 26 countries. Harvard University was the leading institution (n = 325) and Burns the leading journal (n = 306), followed by Cornea (n = 132). The most common subject category of the research was surgery (n = 1185 docs) and ophthalmology (n = 984). Reim M. was the most prolific author (n = 35), while Basu S. had the most citations (n = 1159). The main clinical MeSH descriptors were “Eye burns” (n = 1158), “Esophageal stenosis” (n = 683), and “Caustics” (n = 659). Conclusions: The results show slight growth in scientific production on chemical burns. The USA and China are leading research in this field, and the main reported finding was eye burns.
Full article
Open AccessSystematic Review
Evaluation of the Efficacy of Fish Skin Grafts as Wound Dressings: A Systematic Review
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Jocelyn Ivana and I Gusti Putu Hendra Sanjaya
Eur. Burn J. 2025, 6(3), 50; https://doi.org/10.3390/ebj6030050 - 8 Sep 2025
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The use of fish skin grafts as xenografts is a promising alternative for wound healing. Several studies have shown fish skin grafts to be a safer and more effective option compared to other alternatives, due to the large amount of fatty acids, including
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The use of fish skin grafts as xenografts is a promising alternative for wound healing. Several studies have shown fish skin grafts to be a safer and more effective option compared to other alternatives, due to the large amount of fatty acids, including omega-3, which have been proven to promote wound healing. The purpose of this study was to evaluate the efficacy of fish skin grafts as wound dressing. A literature search up to March 2024 was conducted using the electronic databases of PubMed, Cochrane, and ScienceDirect. A total of 158 patients from six studies were included in this systematic review. All studies showed early wound healing using fish skin grafts; one study showed that wound healing was halved compared to paraffin gauze. Complete wound healing using fish skin grafts was noted as early as 30 days. Out of 114 patients treated with fish skin grafts, 1 patient showed signs of infection, and no patients showed allergic reactions. One study also found that fish skin grafts provide satisfactory wound scar quality. This study concludes that fish skin grafts are a great alternative and should be considered in wound treatment. The high omega-3 component that is preserved in fish skin grafts promotes faster wound healing and contains antibacterial agents that prevent infection. However, randomized control trials with a larger sample size are recommended to further assess the efficacy of fish skin grafts.
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Open AccessConference Report
21st Congress of the European Burns Association (EBA)
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Nadia Depetris, Alette E. E. de Jong, Jill Meirte, Thomas Leclerc, Jose Ramon Martinez Mendez, Clemens Schiestl, Frank Siemers, Andy Williams, Paul P. M. van Zuijlen, Jyrki Vuola, Stian Almeland, Luís Cabral and Bernd Hartmann
Eur. Burn J. 2025, 6(3), 49; https://doi.org/10.3390/ebj6030049 - 3 Sep 2025
Abstract
Abstracts of the plenary and special interest sessions, workshops, and oral and poster presentations of the 21st EBA Congress in Berlin, Germany, from 3 to 6 September 2025.
Full article
Open AccessSystematic Review
Exploring Ethnic Disparities in Burn Injury Outcomes in the UK: A Systematic Review
by
Uashar Badakhshan, Reza Zamani and Tanimola Martins
Eur. Burn J. 2025, 6(3), 48; https://doi.org/10.3390/ebj6030048 - 22 Aug 2025
Abstract
Background: Burn injuries are among the most distressing injuries, affecting approximately 250,000 people annually in the UK. While extensive research has explored how gender, health, and socioeconomic factors influence burn injury rates, ethnic disparities in burns have received less attention. Methods: The review
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Background: Burn injuries are among the most distressing injuries, affecting approximately 250,000 people annually in the UK. While extensive research has explored how gender, health, and socioeconomic factors influence burn injury rates, ethnic disparities in burns have received less attention. Methods: The review followed the PRISMA framework for database searches. Search terms included concepts of ethnicity and burn injuries in the UK. Results: From the initial 3339 search results, 11 studies were selected following the eligibility screening. White ethnic groups made up 52.4% of admissions, whereas Asians and Black groups made up 24.9% and 5.9%, respectively. Trends showed a decline in admissions among White patients and a rise in admissions among Black patients. Children aged 1 to 5 years were most affected, particularly in the Asian and Black groups. Males constituted 58.0% of admissions, while females accounted for 42.0%. Most burns occurred at home, with scalds, particularly among children. Ethnic minorities were more likely to apply unsuitable topical treatments and had higher rates of psychological referrals. Conclusions: The review underscores important ethnic disparities in burn injuries and outcomes. Targeting policies to address them could result in a more equitable healthcare system and improved outcomes for burn patients in the UK.
Full article
(This article belongs to the Special Issue Global Perspectives on Burn Prevention, Management, Collaboration, and Disparities)
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Open AccessArticle
In Vitro Silencing of MHC-I in Keratinocytes by Herpesvirus US11 Protein to Model Alloreactive Suppression
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Frederik Schlottmann, Sarah Strauß, Peter Maria Vogt and Vesna Bucan
Eur. Burn J. 2025, 6(3), 47; https://doi.org/10.3390/ebj6030047 - 21 Aug 2025
Abstract
Background: Secondary rejection remains a major obstacle in skin allografting. Some viruses, such as human herpesvirus and cytomegalovirus, evade immune detection through proteins like the unique short glycoprotein 11 (US11), which down-regulates major histocompatibility complex (MHC) class I expression. This study explores the
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Background: Secondary rejection remains a major obstacle in skin allografting. Some viruses, such as human herpesvirus and cytomegalovirus, evade immune detection through proteins like the unique short glycoprotein 11 (US11), which down-regulates major histocompatibility complex (MHC) class I expression. This study explores the use of recombinant US11 protein as a biopharmaceutical approach to reduce MHC-I expression and thus decrease alloreactivity in human primary keratinocytes. Methods: Human keratinocytes were treated with recombinant US11 protein, and MHC-I expression was assessed via Western blot and flow cytometry. To evaluate immunomodulatory effects, US11-stimulated keratinocytes were co-cultured with peripheral blood mononuclear cells (PBMCs), and interferon-gamma (IFN-γ) levels were measured by ELISA. Additionally, ex vivo human skin tissue was stimulated with US11 to assess long-term MHC-I modulation. Results: US11 treatment significantly reduced MHC-I surface expression in keratinocytes. Co-cultures showed decreased IFN-γ secretion, indicating lower T cell activation. Human skin tissue stimulated with US11 exhibited reduced MHC-I expression after 7 days. Conclusions: This proof-of-concept study suggests that recombinant US11 protein may serve as an effective biopharmaceutical to reduce keratinocyte immunogenicity. Further in vitro and in vivo studies are warranted to validate its potential for clinical application in skin transplantation.
Full article
(This article belongs to the Special Issue Innovative Applications and Challenges of Emerging Materials and Technologies in Burn Treatment)
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Open AccessReview
Interventions for Functional and Cosmetic Outcomes Post Burn for Eyelid Ectropion—A Scoping Review
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Andrea Mc Kittrick, Lola Hammond and Jason Brown
Eur. Burn J. 2025, 6(3), 46; https://doi.org/10.3390/ebj6030046 - 19 Aug 2025
Abstract
Rationale: Burn injuries to the face can have devastating consequences functionally and cosmetically for individuals and can result in increased depressive symptoms and low self-esteem. Burn injuries have the potential to cause contracture of the skin, especially on the face due to
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Rationale: Burn injuries to the face can have devastating consequences functionally and cosmetically for individuals and can result in increased depressive symptoms and low self-esteem. Burn injuries have the potential to cause contracture of the skin, especially on the face due to multiple concave surfaces, possibly causing facial deformity. These functional and cosmetic implications can interrupt activities of daily living. Although there is consensus in the literature that early interventions contribute to improved outcomes for eyelid ectropion, there is currently limited consensus regarding the techniques used in the management of eyelid ectropion post burn injuries. Objectives: The aim of this scoping review was to explore the evidence in the literature to identify surgical and non-surgical techniques to manage and prevent eyelid ectropion post burn. Method: Five databases (PubMed, CINAHL, Embase, Cochrane, and Scopus) were searched for articles published between January 2014 and August 2024. Two reviewers completed the search. Each article was screened independently by each reviewer against the inclusion and exclusion criteria. Where disagreement arose, a third reviewer was consulted for resolution. Results: n = 56 articles were sources in the initial search. Post screening, n = 20 met the criteria for full review; n = 14 were included in the final review. All studies reported on surgical techniques used to manage eyelid ectropion post burn, and only one study reported on non-surgical techniques. All studies were observational in design. Conclusions: There is a paucity of research addressing the surgical and non-surgical techniques for the management and prevention of eyelid ectropion following burns in the adult population. The existing literature primarily consists of case studies and case series, which limits the robustness of the evidence base for the effective management of this condition post burn.
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(This article belongs to the Special Issue Enhancing Burn Rehabilitation: Contemporary Improvements across the Spectrum of Influence)
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Open AccessReview
Use of Integra® Dermal Regeneration Template Bilayer in Burn Reconstruction: Narrative Review, Expert Opinion, Tips and Tricks
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Clemens Maria Schiestl, Naiem Moiemen, Patrick Duhamel, Isabel Jones, Marcello Zamparelli, Juan Carlos López-Gutiérrez and Simon Kuepper
Eur. Burn J. 2025, 6(3), 45; https://doi.org/10.3390/ebj6030045 - 18 Aug 2025
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Burn injuries remain a complex clinical challenge, particularly in reconstructive settings where donor sites are limited. Integra® Dermal Regeneration Template (IDRT), a bilayer dermal substitute, facilitates neodermis formation and supports functional and aesthetic recovery following burn trauma. This narrative review and expert
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Burn injuries remain a complex clinical challenge, particularly in reconstructive settings where donor sites are limited. Integra® Dermal Regeneration Template (IDRT), a bilayer dermal substitute, facilitates neodermis formation and supports functional and aesthetic recovery following burn trauma. This narrative review and expert opinion synthesizes current literature and clinical experience on the application of IDRT in post-burn reconstruction. It discusses the biological mechanism of dermal regeneration, surgical protocols including wound bed preparation and grafting, and considerations for anatomical regions such as the face, torso, and limbs. The review emphasizes key factors influencing successful outcomes, including patient selection, timing, and multidisciplinary coordination. Potential complications, such as infection, hematoma, and poor graft adherence, are addressed along with prevention and management strategies. Special considerations for pediatric and elderly populations are also highlighted. Through evidence-based insights and illustrative case examples, this review aims to inform surgical decision-making and promote best practices in reconstructive burn care using IDRT.
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Open AccessArticle
Development of a Device for Defatting Full Skin Grafts Through Mechanical Defatting in Children and Adolescents
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Philipp Christoph Köhler, Helen Glosse, Steffan Loff and Raphael Staubach
Eur. Burn J. 2025, 6(3), 44; https://doi.org/10.3390/ebj6030044 - 14 Aug 2025
Abstract
Full-thickness skin grafts are a cornerstone in reconstructive surgery for extensive skin defects, particularly in pediatric patients, where rapid vascularization is essential for successful engraftment. Traditional defatting methods using scalpels and scissors are labor-intensive and increase the risk of graft or operator injury.
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Full-thickness skin grafts are a cornerstone in reconstructive surgery for extensive skin defects, particularly in pediatric patients, where rapid vascularization is essential for successful engraftment. Traditional defatting methods using scalpels and scissors are labor-intensive and increase the risk of graft or operator injury. To improve efficiency and safety, a mechanical defatting device called LOMA (named after the inventors Loff and Maja) was developed at Klinikum Stuttgart. This study evaluates the first 28 transplants performed with it, assessing graft outcomes using the POSAS and comparing physical properties of the grafts with those of healthy contralateral skin, ankle skin, and palmar skin using DermaLab Combo’s ultrasound and elasticity probes. Results showed that grafts prepared with LOMA exhibited similar physical characteristics to contralateral healthy skin. Differences in elasticity were observed when compared to ankle skin, and significant disparities were found when compared to palmar skin. POSAS scores averaged 3.3 from patients and 2.2 from physicians, indicating satisfaction with functional and aesthetic outcomes. The findings support the effectiveness of full-thickness skin grafts, particularly when prepared using the LOMA system. Further multicenter studies are recommended to compare LOMA-prepared grafts with those using conventional techniques to quantify the added value of this mechanical defatting approach.
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(This article belongs to the Special Issue Innovative Applications and Challenges of Emerging Materials and Technologies in Burn Treatment)
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Open AccessArticle
Post-Traumatic Stress Disorder (PTSD) Is Associated with Increased Physical Skin Symptom Burden Following Severe Burn Injuries: Subgroup Analysis of a Multicenter Prospective Cohort
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Felix J. Klimitz, Martin Aman, Hubert Neubauer, Annette Stolle, Hans Ziegenthaler, Tobias Niederegger, Adriana C. Panayi, Gabriel Hundeshagen, Ulrich Kneser and Leila Harhaus
Eur. Burn J. 2025, 6(3), 43; https://doi.org/10.3390/ebj6030043 - 8 Aug 2025
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Background: Severe burn injuries often lead to lasting physical and psychological consequences. Post-traumatic stress disorder (PTSD) is common among burn survivors and may be influenced by persistent somatic complaints. This study examined whether PTSD is associated with a higher burden of physical symptoms
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Background: Severe burn injuries often lead to lasting physical and psychological consequences. Post-traumatic stress disorder (PTSD) is common among burn survivors and may be influenced by persistent somatic complaints. This study examined whether PTSD is associated with a higher burden of physical symptoms during and after inpatient rehabilitation. Methods: We conducted a subgroup analysis of a multicenter prospective cohort study involving 103 adult burn patients in inpatient rehabilitation. Based on Impact of Event Scale—Revised (IES-R) scores and clinical evaluation, patients were grouped as PTSD (n = 43) or No PTSD (n = 60). Physical symptoms assessed included skin dryness (xerosis), temperature sensitivity (cold/heat), numbness, skin tightness, and increased sweating. Results: Patients with PTSD reported significantly more physical symptoms at follow-up than those without PTSD: xerosis (74% vs. 50%, p = 0.03), cold sensitivity (61% vs. 35%, p = 0.02), heat sensitivity (63% vs. 39%, p = 0.03), numbness (63% vs. 33%, p = 0.006), skin tightness (82% vs. 52%, p = 0.004), and sweating (45% vs. 19%, p = 0.01). PTSD patients also had more severe burns, reflected in higher full-thickness TBSA (2% vs. 0%, p = 0.03) and elevated ABSI scores (median 6 vs. 5, p = 0.04). Conclusion: PTSD is associated with a higher and more persistent burden of physical skin symptoms after severe burns. These findings underscore the importance of early PTSD screening and integrated psychological-somatic rehabilitation to improve long-term recovery and quality of life.
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Open AccessArticle
Pilot Study on Resuscitation Volume’s Effect on Perfusion and Inflammatory Cytokine Expression in Peri-Burn Skin: Implications for Burn Conversion
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Tamer R. Hage, Edward J. Kelly, Eriks Ziedins, Babita Parajuli, Cameron S. D’Orio, David M. Burmeister, Lauren Moffatt, Jeffrey W. Shupp and Bonnie C. Carney
Eur. Burn J. 2025, 6(3), 42; https://doi.org/10.3390/ebj6030042 - 28 Jul 2025
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Fluid resuscitation after thermal injury is paramount to avoid burn shock and restore organ perfusion. Both over- and under-resuscitation can lead to unintended consequences affecting patient outcomes. While many studies have examined systemic effects, limited data exist on how fluid resuscitation impacts burn
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Fluid resuscitation after thermal injury is paramount to avoid burn shock and restore organ perfusion. Both over- and under-resuscitation can lead to unintended consequences affecting patient outcomes. While many studies have examined systemic effects, limited data exist on how fluid resuscitation impacts burn wound progression in the acute period. Furthermore, the mechanisms underlying burn wound progression remain not fully understood. This study used a swine model to investigate how varying resuscitation levels affect peri-burn wound dynamics. Twenty-seven female Yorkshire pigs were anesthetized, subjected to 40% total body surface area burn and 15% hemorrhage, then randomized (n = 9) to receive decision-support-driven (adequate, 2–4 mL/kg/%TBSA), fluid-withholding (under, <1 mL/kg/%TBSA), or high-constant-rate (over, >>4 mL/kg/%TBSA) resuscitation. Pigs were monitored for 24 h in an intensive care setting prior to necropsy. Laser Doppler Imaging (LDI) was conducted pre-burn and at 2, 6, 12, and 24 h post burn to assess perfusion. Biopsies were taken from burn, peri-burn (within 2 cm), and normal skin. RNA was isolated at 24 h for the qRT-PCR analysis of IL-6, CXCL8, and IFN-γ. At hour 2, LDI revealed increased peri-burn perfusion in over-resuscitated animals vs. under-resuscitated animals (p = 0.0499). At hour 24, IL-6 (p = 0.0220) and IFN-γ (p = 0.0253) were elevated in over-resuscitated peri-burn skin. CXCL8 showed no significant change. TUNEL staining revealed increased apoptosis in over- and under-resuscitated peri-burn skin. Differences in perfusion and cytokine expression based on resuscitation strategy suggest that fluid levels may influence burn wound progression.
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Open AccessArticle
Can Pure Silk Compete with the Established Mepilex Ag® in the Treatment of Superficial Partial Thickness Burn Wounds? A Prospective Intraindividual Study
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Jan Akkan, Mahsa Bagheri, Sophia Mezger, Paul Christian Fuchs, Maria von Kohout, Wolfram Heitzmann, Rolf Lefering and Jennifer Lynn Schiefer
Eur. Burn J. 2025, 6(3), 41; https://doi.org/10.3390/ebj6030041 - 11 Jul 2025
Abstract
Introduction: Superficial partial thickness burns generally do not require surgical intervention and are managed with specialized wound dressings. Mepilex Ag® is commonly used and often represents the standard of care. This study evaluated the clinical performance of pure silk compared to Mepilex
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Introduction: Superficial partial thickness burns generally do not require surgical intervention and are managed with specialized wound dressings. Mepilex Ag® is commonly used and often represents the standard of care. This study evaluated the clinical performance of pure silk compared to Mepilex Ag®. Methods: A prospective, single-center intraindividual study was conducted on adult patients with superficial partial thickness burns. Each burn wound was divided, treating one half with pure silk and the other with Mepilex Ag®. Clinical parameters including wound closure time, pain levels, and scar quality at 3-month follow-up were analyzed. Results: Twenty-four patients were included (mean TBSA: 5.8%). Mepilex Ag® showed a trend towards a shorter wound closure time (10.5 vs. 11.5 days; p = 0.223). Pain scores remained below 4/10 for both dressings throughout treatment. However, Mepilex Ag® demonstrated significantly lower pain on day one (3.5 vs. 2.77; p = 0.039) and day two (2.91 vs. 2.27; p = 0.041). Scar quality after 3 months was similar. Conclusion: Both dressings proved to be effective treatment options. Pure silk required fewer resources, showed high clinical practicality, and demonstrated a similar performance to Mepilex Ag® in key clinical parameters, making it an interesting option for other clinics and our standard of care.
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(This article belongs to the Special Issue Innovative Applications and Challenges of Emerging Materials and Technologies in Burn Treatment)
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Open AccessArticle
An Epidemiological Survey of Fluid Resuscitation Practices for Adult Burns Patients in the United Kingdom
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Ascanio Tridente, Joanne Lloyd, Pete Saggers, Nicole Lee, Brendan Sloan, Kathryn Puxty, Kayvan Shokrollahi and Nina C. Dempsey
Eur. Burn J. 2025, 6(3), 40; https://doi.org/10.3390/ebj6030040 - 9 Jul 2025
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Fluid management is a critical component in the treatment of patients suffering with major burns. Clinicians must carefully balance judicious resuscitation with the risks of over- or under-resuscitation. We aimed to identify factors associated with survival in burns patients and determine the importance
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Fluid management is a critical component in the treatment of patients suffering with major burns. Clinicians must carefully balance judicious resuscitation with the risks of over- or under-resuscitation. We aimed to identify factors associated with survival in burns patients and determine the importance of resuscitation practices. Patients requiring admission to Burns Services in the United Kingdom between 1 April 2022 and 31 March 2023 were included in the National Burns Audit project on fluid resuscitation practices, to evaluate factors associated with survival and Critical Care Length of Stay (CCLoS). A total of 198 patients were included in the analyses, with median age of 51 years (interquartile range, (IQR) 35–62 years), median Total Burn Surface Area (TBSA%) of 27.5% (IQR 20–40%), and median Baux score 82.5 (IQR 66–105). The following were found to be significant for survival: younger age, smaller TBSA%, lower Baux score and independence from renal replacement therapy. Neither the mechanism of burns nor the fluid resuscitation volumes appeared to influence survival. Although interventions such as tracheostomy or the number of surgical procedures did not appear to affect survival, fluid replacement of more than 6 mL/kg/%TBSA independently predicted longer CCLoS. Volume of fluid resuscitation, within the limits examined in this cohort, did not impact likelihood of survival.
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Open AccessCorrection
Correction: Rijpma et al. Wound and Short-Term Scar Outcomes of Meek Micrografting Versus Mesh Grafting: An Intra-Patient Randomized Controlled Trial. Eur. Burn J. 2025, 6, 26
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Danielle Rijpma, Karel Claes, Anouk Pijpe, Henk Hoeksema, Ignace De Decker, Jozef Verbelen, Matthea Stoop, Kimberly De Mey, Febe Hoste, Paul van Zuijlen, Stan Monstrey and Annebeth Meij-de Vries
Eur. Burn J. 2025, 6(3), 39; https://doi.org/10.3390/ebj6030039 - 4 Jul 2025
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In the original publication [...]
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Open AccessArticle
Exploring Disparities in Pavement Burns: A Comparative Analysis of Housed and Unhoused Burn Patients
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Henry Krasner, Emma Chevalier, Samantha Chang, David Slattery and Syed Saquib
Eur. Burn J. 2025, 6(3), 38; https://doi.org/10.3390/ebj6030038 - 1 Jul 2025
Abstract
In some regions, extreme heat can result in pavement temperatures that are high enough to cause severe burn injuries within seconds of skin contact. This risk is elevated for unhoused individuals who may lack adequate clothing and shelter and have susceptibility to other
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In some regions, extreme heat can result in pavement temperatures that are high enough to cause severe burn injuries within seconds of skin contact. This risk is elevated for unhoused individuals who may lack adequate clothing and shelter and have susceptibility to other risk factors, including substance use and in turn loss of consciousness. While prior studies have shown worse outcomes for unhoused individuals due to delays in care and higher susceptibility, there is a lack of data on the impact of pavement burns specifically within this population. This single-institution retrospective cohort study aims to explore burn severity and hospital outcomes in housed vs. unhoused patients with pavement burns. The data were analyzed using independent samples t-tests and logistic regression when appropriate, with p < 0.05 considered statistically significant. A total of 305 individuals met the inclusion/exclusion criteria and comprised the final study cohort, 17.7% of which were unhoused. There was no significant difference in TBSA, survival to discharge, or hospital length of stay between housed and unhoused patients. While unhoused individuals may still be at heightened risk for pavement burns due to exposure to extreme heat and a lack of protective measures, these results may additionally suggest consistent emergency care for patients regardless of housing status. Furthermore, these results highlight the importance of developing targeted outreach and prevention programs and equitable emergency care protocols for vulnerable populations.
Full article
(This article belongs to the Special Issue Global Perspectives on Burn Prevention, Management, Collaboration, and Disparities)
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Open AccessArticle
It Is Written in the Clot: Coagulation Assessment in Severe Burn Injury
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Eirini Nikolaidou, Andriana Lazaridou, Christina Iasonidou, Alexandra Tsaroucha, Sophia Papadopoulou, Eleni Kaldoudi, Apostolos Sovatzidis and Despoina Kakagia
Eur. Burn J. 2025, 6(3), 37; https://doi.org/10.3390/ebj6030037 - 24 Jun 2025
Abstract
Background: Coagulopathy in severe burn injury is associated with complications and mortality. Methods: We compared 3 tests (EXTEM, INTEM, FIBTEM) of rotational thromboelastometry (ROTEM), a viscoelastic coagulation assay (VCA), with conventional coagulation assays (CCAs), fibrinogen, d-dimers and coagulation factors during the five post-burn
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Background: Coagulopathy in severe burn injury is associated with complications and mortality. Methods: We compared 3 tests (EXTEM, INTEM, FIBTEM) of rotational thromboelastometry (ROTEM), a viscoelastic coagulation assay (VCA), with conventional coagulation assays (CCAs), fibrinogen, d-dimers and coagulation factors during the five post-burn days in survivors and non-survivors with severe burn injury, in order to correlate the results with burn coagulopathy and prognosis. Results: Seventeen survivors and ten non-survivors, with mean total burn surface area of 33.78% were included. CCAs measurements were abnormal, but unable to detect coagulopathy. At day 2, D-dimers and fibrinogen levels were statistically augmented for non-survivors. Regarding VCAs, FIBTEM MCF increased for non-survivors at day 2 and remained increased for the whole post-burn period. Furthermore, FIBTEM A10 and A20 at day 2 and EXTEM A10, EXTEM A20, EXTEM MCF, and EXTEM CFT at day 5 took abnormal values for the same group (p < 0.05). These changes were underlined through abnormal measurements of coagulation factors. Conclusions:CCAs are poor indicators of coagulation status in burn injury, whereas VCAs are more sensitive markers, demonstrating coagulopathy and patients at greater risk of mortality.
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(This article belongs to the Special Issue Controversial Issues in Intensive Care-Related Burn Injuries)
Open AccessArticle
Hand Function Recovers to Near Normal in Patients with Deep Dermal Hand Burns Treated with Enzymatic Debridement: A Prospective Cohort Study
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Kelly Aranka Ayli Kwa, Annika Catherina Reuvers, Jorien Borst-van Breugel, Anouk Pijpe, Paul P. M. van Zuijlen, Roelf S. Breederveld and Annebeth Meij-de Vries
Eur. Burn J. 2025, 6(2), 36; https://doi.org/10.3390/ebj6020036 - 12 Jun 2025
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Short- and long-term hand function was evaluated in adult patients with deep dermal and full-thickness hand burns after treatment with enzymatic debridement (NexoBrid® MediWound Ltd., Yavne, Israel), assessing the results at discharge and 3, 6, and 12 months post-burn. This prospective cohort
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Short- and long-term hand function was evaluated in adult patients with deep dermal and full-thickness hand burns after treatment with enzymatic debridement (NexoBrid® MediWound Ltd., Yavne, Israel), assessing the results at discharge and 3, 6, and 12 months post-burn. This prospective cohort study was performed in the Burn Center in Beverwijk between March 2017 and December 2019. Hand function was assessed using Modified Kapandji Index scores, the Jebsen-Taylor Hand Function Test, and range of motion; scar quality using the Patient and Observer Scar Assessment Scale version 2.0; and quality of life using the Quick Disability Arm Shoulder Hand Questionnaire and the Canadian Occupational Performance Measure. Ten patients (14 hand burns) were included. The need for a skin graft after NexoBrid® was 86%, and 50% needed additional surgical excision before skin grafting. Digits 3 and 4 achieved near-to-normal total active motion, and at least 50% of the hands achieved a normal range within the Jebsen-Taylor Hand Function Test in four items at 12 months post-burn. Scar quality and quality of life improved significantly over time. The present study can be considered as a proof-of-concept study for future clinical trials on enzymatic debridement for hand burns.
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Open AccessArticle
Characterisation of Fluid Administration in Burn Shock—A Retrospective Cohort Analysis
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Marianne Kruse, Ida Katinka Lenz, David Josuttis, Philip Plettig, Klaus Hahnenkamp, Denis Gümbel, Claas Güthoff, Bernd Hartmann, Martin Aman, Marc Dominik Schmittner and Volker Gebhardt
Eur. Burn J. 2025, 6(2), 35; https://doi.org/10.3390/ebj6020035 - 10 Jun 2025
Abstract
Background: Finding the optimal amount of fluid is a major challenge in burn shock. Although there is evidence that a restrictive fluid regime is beneficial, current practice shows fluid resuscitation still well above recommendations. The extent of trauma, pre-hospital care and the patient’s
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Background: Finding the optimal amount of fluid is a major challenge in burn shock. Although there is evidence that a restrictive fluid regime is beneficial, current practice shows fluid resuscitation still well above recommendations. The extent of trauma, pre-hospital care and the patient’s pre-existing conditions influence requirements. Methods: We analysed outcomes and influencing factors of fluid regimes in a retrospective cohort study including 90 severely burnt patients resuscitated with the same protocol. Results: The mean amount of fluids in the first 24 h was 6.5 mL/kg bodyweight (BW)/% total burn surface area (TBSA). A total of 14% received restrictive (<4), 34% received liberal (4–6) and 51% received excessive (>6) mL/kgBW/%TBSA fluids. There was no difference regarding mortality, age, complications, organ failure, inhalation injury or full-thickness burns in the groups. Patients with excessive fluid therapy had a significantly lower ABSI score (9 vs. 11, p = 0.05) and TBSA (35 vs. 51%, p < 0.001), while patients with a restrictive fluid therapy needed fewer incidences of surgery to cover burn wounds (3.5 vs. 9.0 vs. 7.0, p = 0.008). History of liver disease or alcohol abuse tended to indicate excessive fluid administration. Patients with pre-existing heart failure received restrictive fluid therapy (23 vs. 3 vs. 4%, p = 0.03). Conclusions: Individualised, timely therapy monitoring is as essential as identifying patients with a higher or lower fluid requirement. Excessive fluid resuscitation had fewer deleterious consequences in complications than expected but seems to influence wound healing. Awareness of circumstances that prompt deviations from recommended fluid rates remains elementary.
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(This article belongs to the Special Issue Controversial Issues in Intensive Care-Related Burn Injuries)
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Open AccessArticle
Anterolateral Thigh Flap for Acute/Primary Burn Reconstruction
by
Eva Verdaguer, Antonio Bulla, Jordi Serracanta, Danilo Rivas and Juan P. Barret
Eur. Burn J. 2025, 6(2), 34; https://doi.org/10.3390/ebj6020034 - 10 Jun 2025
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Introduction: The indication for a free flap in acute burn reconstruction is very specific. It should avoid several complications that are more common in the burned patient population. We propose an anterolateral thigh (ALT) flap as a first option for primary burn reconstruction
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Introduction: The indication for a free flap in acute burn reconstruction is very specific. It should avoid several complications that are more common in the burned patient population. We propose an anterolateral thigh (ALT) flap as a first option for primary burn reconstruction in microvascular free flap reconstruction in burned patients. Patients and Methods: A retrospective review of all acutely burned patients treated with microvascular ALT free flap reconstruction between the years 2005 and 2022 in the Vall d’Hebron Barcelona Hospital Campus Burn Centre was conducted. Results: We performed 30 ALT flaps for primary burn reconstruction. The majority of patients were male (87.5%), with a mean age of 36.7 years, and 37% of patients were smokers. High-voltage electrical burns were the most common etiology. The mean time between burn injury and microsurgery was 22 days. The main recipient site was the lower limb. The flap survival rate was 96.6%. One patient required a meshed skin graft to cover a defect in the proximal third due to peripheral flap necrosis. One flap experienced mild congestion, which resolved spontaneously. Another flap had a local infection, which resolved with antibiotic therapy and surgical debridement. Conclusions: An ALT flap offers several advantages to a burned patient, provided that the surgical technique and postoperative management described in this study are followed. We propose it as the first option for primary burn reconstruction using free flaps in a burned patient.
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Open AccessReview
Review of the 100 Most Cited Articles in Burns from 2014 to 2024: A Bibliometric Analysis
by
Anna Jolly Neriamparambil, Richard Wong She, Paul Andrew Baker, Lindsay Damkat-Thomas and Joyce Antony
Eur. Burn J. 2025, 6(2), 33; https://doi.org/10.3390/ebj6020033 - 10 Jun 2025
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Substantial research interest has been shown over the past ten years in the management of burn injuries. This bibliometric analysis aims to identify and evaluate the most cited articles that have significantly advanced the field of burn injury management. The 100 most cited
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Substantial research interest has been shown over the past ten years in the management of burn injuries. This bibliometric analysis aims to identify and evaluate the most cited articles that have significantly advanced the field of burn injury management. The 100 most cited articles published from January 2014 to September 2024 were collated using the Web of Science database. The full text of each article was meticulously analyzed for descriptive parameters including subject matter, journal of publication, authorship, institutional affiliation, country of origin, and year of publication. The 100 most cited articles had an average of 203 citations, with the most cited article reaching 754 citations and the least cited article cited 105 times. The subjects ranged from enhancing wound care outcomes to metabolic support, fluid management, and infection prevention and management. These articles were distributed across 59 source journals, with 44% of articles having been published in just ten prominent journals. While bibliometric analyses do not accurately gauge scientific merit, this study illuminates the significant contributions to burn management over the past decade and provides valuable insights into research trends in the field.
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The Potential Use of Fibrin Sealants in Burn Wound Management: A Comprehensive Review of Experimental and Clinical Studies
by
Christina Nikolaou, Maximos Frountzas, Emmanouil I. Kapetanakis, Dimitrios Stefanoudakis, Nikolaos A. Papadopulos, Stylianos Kykalos, Dimitrios Schizas and Dimitrios Iliopoulos
Eur. Burn J. 2025, 6(2), 32; https://doi.org/10.3390/ebj6020032 - 5 Jun 2025
Abstract
Fibrin sealants have been implemented in the management of burn wounds. They can be used either in combination with skin grafts for full-thickness burns or alone for treating superficial and deep dermal burns. The aim of this review was to provide critical insights
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Fibrin sealants have been implemented in the management of burn wounds. They can be used either in combination with skin grafts for full-thickness burns or alone for treating superficial and deep dermal burns. The aim of this review was to provide critical insights regarding the efficacy of fibrin sealants in enhancing wound healing, improving graft adherence, and reducing complications. Therefore, evidence from experimental models and clinical trials was synthesized, underscoring the transformative role of fibrin sealants in modern burn care. This comprehensive review includes recent evidence on the potential benefits of fibrin sealants in the management of superficial and deep dermal or full-thickness burn injuries. Clinical and experimental evidence underscores some benefits in utilizing fibrin sealants in the management of superficial and deep dermal burn injuries, or in combination with skin grafts in full-thickness burns. Furthermore, fibrin sealants diminish postoperative pain and facilitate quick recovery for daily activities; however, controversy regarding their cost still remains. This review concludes that fibrin sealants could serve as a safe and effective therapeutic option for burn wound management. The safety and efficacy of their utilization, along with their wide availability and easiness to use, could make them an alternative treatment choice when a specialized plastic surgery service is not available, or in the emergency setting across different healthcare systems.
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(This article belongs to the Special Issue Innovative Applications and Challenges of Emerging Materials and Technologies in Burn Treatment)
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