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Advances in Burn Management
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Advances in Burn Management

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "General Surgery".

Deadline for manuscript submissions: 15 January 2025 | Viewed by 4760

Special Issue Editor

Prof. Dr. Juan P. Barret

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Guest Editor
Department of Plastic Surgery and Burns, Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain
Interests: wound healing; transplantation; stem cells, plastic and reconstructive surgery; microsurgery; facial plastic surgery; head and neck surgery; maxillofacial surgery

Special Issue Information

Dear Colleagues,

This Special Issue in the Journal of Clinical Medicine, titled "Advances in Burn Management", presents cutting-edge research and advancements in the field of burn care. With burns being a significant cause of morbidity and mortality worldwide, this Special Issue addresses the need for novel approaches to improve patient outcomes.

This Special Issue covers a broad spectrum of topics, including innovative techniques in wound healing, pain management strategies, infection control measures, and psychological support for burn survivors. It highlights recent developments in the use of advanced dressings, skin grafts, regenerative medicine, immune response regulation, and tissue engineering to enhance healing and minimize scarring.

By bringing together diverse perspectives from leading experts in the field, this Special Issue aims to provide a comprehensive overview of the latest advancements in burn management. It serves as a valuable resource for clinicians, researchers, and policymakers, fostering innovation and ultimately improving the quality of care provided to burn patients worldwide.

Prof. Dr. Juan P. Barret
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • burns
  • wound healing
  • immune response
  • stem cells 
  • burn surgery 
  • rehabilitation 
  • PROMs
  • PREMs

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Further information on MDPI's Special Issue polices can be found here.

Published Papers (4 papers)

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Research

17 pages, 3456 KiB  
Article
Long-Term Functional Outcomes after Hand Burns: A Monocentric Controlled Cohort Study
by Nikolaus Watzinger, Andrzej Hecker, David Petschnig, Jana Tran, Caroline Glantschnig, Maximilian Moshammer, Anna-Lisa Pignet, Anna-Maria Ellersdorfer and Lars-Peter Kamolz
J. Clin. Med. 2024, 13(12), 3509; https://doi.org/10.3390/jcm13123509 - 15 Jun 2024
Viewed by 758
Abstract
Background: Hand burns are involved in 80–90% of severe burn injuries. Even though hands correspond to a small total burn surface area (TBSA) of less than 5%, the loss of their functionality has a significant impact on the patient’s life. Studies that [...] Read more.
Background: Hand burns are involved in 80–90% of severe burn injuries. Even though hands correspond to a small total burn surface area (TBSA) of less than 5%, the loss of their functionality has a significant impact on the patient’s life. Studies that provide long-term results regarding hand functionality after hand burns are scarce. Therefore, this study aimed to investigate functional long-term results in a patient-centric approach regarding burn depth, unilateral and bilateral hand involvement, and (non-)isolated hand burns as potential influencing factors in patients with hand burns. Methods: We conducted a controlled cohort study of patients with burned hands treated at our department between 2005 and 2022. Healthy age-, sex-, and handedness-matched participants were used as controls. Data on the demographics, burn-related injuries, and treatments were collected. For a patient-centric approach, we used the Disabilities of the Arm, Shoulder, and Hand Questionnaire (Quick-DASH) and the Michigan Hand Questionnaire (MHQ) as patient-reported outcome measures for functional long-term evaluation, and the Patient and Observer Scar Assessment Scale (patient scale) for assessing long-term scar quality. Results: We enrolled 61 patients with 88 affected hands and 63 matched control participants. Up to 77.1% of the participants were male, with a mean age of 50.7 (±15.5) years and a follow-up of 8.1 (±4.7) years. The mean TBSA was 13.9% (±15.8), with 72.4% of the hands presenting with deep partial-thickness and full-thickness burns and most of the patients had only one hand affected (55.7%). The hand burn patients perceived significantly worse long-term functional scores in every domain of the MHQ as well as in the “overall function” and “work” of the Quick-DASH. Superficial hand burns negatively affected the two-handed activities of daily living (p = 0.013) and aesthetic appearance (p = 0.005) when both hands were involved. Isolated hand burns were associated with more difficulties in work performance (p = 0.03), whereas patients with bilateral hand involvement perceived more pain (p = 0.025). Conclusions: The patients with hand burns can achieve satisfactory long-term functional outcomes over time, but they do not reach the same long-term hand functionality as the healthy matched control group. Our study revealed that factors such as burn depth, unilateral or bilateral hand involvement, and (non-)isolated hand burns indeed have an impact on certain aspects of perceived long-term hand functionality. Full article
(This article belongs to the Special Issue Advances in Burn Management)
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12 pages, 2728 KiB  
Article
Management of Pediatric Superficial Partial-Thickness Burns with Polyhexamethylene Biguanide: Outcomes and Influencing Factors
by Aba Lőrincz, Hermann Nudelman, Anna Gabriella Lamberti, András Garami, Krisztina Adrienne Tiborcz, Tamás Zoltán Kovács and Gergő Józsa
J. Clin. Med. 2024, 13(11), 3074; https://doi.org/10.3390/jcm13113074 - 24 May 2024
Viewed by 1002
Abstract
Background: In burn care, achieving swift healing with minimal complications remains paramount. This investigation assesses the role of polyhexamethylene biguanide (PHMB) in managing pediatric superficial partial-thickness burns, focusing on the effects of various patient-specific factors on recovery. Methods: Through a retrospective analysis of [...] Read more.
Background: In burn care, achieving swift healing with minimal complications remains paramount. This investigation assesses the role of polyhexamethylene biguanide (PHMB) in managing pediatric superficial partial-thickness burns, focusing on the effects of various patient-specific factors on recovery. Methods: Through a retrospective analysis of 27 pediatric cases treated with PHMB, we evaluated the impact of age, burn size, dressing frequency, treatment delay, cold therapy application, and analgesic usage on the time until reepithelialization (TTRE). Results: The majority of patients benefited from early cold therapy, yet only 1 in 3 patients received analgesics. A mean healing time of 8.78 (SD: 2.64) days was observed, with the extent of the burn showing a strong correlation (r: 0.63) to TTRE. Most treatments were managed outpatient, evidenced by a negligible average hospital stay (0.96 days), with recorded no complications. Conclusions: Our findings endorse PHMB as a promising treatment for superficial second-degree burns in young patients, due to the observed stable and rapid wound closure without the association of increased risks. Continued exploration into the optimal application of prehospital interventions and the comprehensive benefits of PHMB in pediatric burn management is necessary. Future research should assess long-term outcomes, including functionality, scar quality, and patient satisfaction. Full article
(This article belongs to the Special Issue Advances in Burn Management)
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21 pages, 3193 KiB  
Article
Serum Plasminogen Activator Inhibitor-1, α 1-Acid Glycoprotein, C-Reactive Protein, and Platelet Factor 4 Levels—Promising Molecules That Can Complete the “Puzzle” of the Biochemical Milieu in Severe Burns: Preliminary Results of a Cohort Prospective Study
by Silviu Constantin Badoiu, Dan Mircea Enescu, Raluca Tatar, Iulia-Ioana Stanescu-Spinu, Daniela Miricescu, Maria Greabu, Ileana Paula Ionel and Viorel Jinga
J. Clin. Med. 2024, 13(10), 2794; https://doi.org/10.3390/jcm13102794 - 9 May 2024
Cited by 2 | Viewed by 1017
Abstract
Background: Burns represent a serious health problem, associated with multiple-organ failure, prolonged hospitalization, septic complications, and increased rate of mortality. The main aim of our study was to evaluate the levels of various circulating molecules in children with severe burns (more than [...] Read more.
Background: Burns represent a serious health problem, associated with multiple-organ failure, prolonged hospitalization, septic complications, and increased rate of mortality. The main aim of our study was to evaluate the levels of various circulating molecules in children with severe burns (more than 25% TBSA), in three different moments: 48 h, day 10, and day 21 post-burn. Materials and Methods: This study included 32 children with burns produced by flame, hot liquid, and electric arc and 21 controls. Serum plasminogen activator inhibitor-1 (PAI-1), α 1-acid glycoprotein (AGP), C-reactive protein (CRP), and platelet factor 4 (PF4) were detected using the Multiplex technique. Several parameters, such as fibrinogen, leucocyte count, thrombocyte count, triiodothyronine, thyroxine, and thyroid-stimulating hormone were also determined for each patient during hospitalization. Results: Significant statistical differences were obtained for CRP, AGP, and PF4 compared to the control group, in different moments of measurements. Negative correlations between CRP, AGP, and PF4 serum levels and burned body surface, and also the hospitalization period, were observed. Discussions: CRP levels increased in the first 10 days after burn trauma and then decreased after day 21. Serum PAI-1 levels were higher immediately after the burn and started decreasing only after day 10 post-burn. AGP had elevated levels 48 h after the burn, then decreased at 7–10 days afterwards, and once again increased levels after 21 days. PF4 serum levels increased after day 10 since the burning event. Conclusions: Serum CRP, AGP, PAI-1, and PF4 seem to be promising molecules in monitoring patients with a burn within the first 21 days. Full article
(This article belongs to the Special Issue Advances in Burn Management)
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16 pages, 579 KiB  
Article
Thermal Imaging for Burn Wound Depth Assessment: A Mixed-Methods Implementation Study
by Jesse de Haan, Matthea Stoop, Paul P. M. van Zuijlen and Anouk Pijpe
J. Clin. Med. 2024, 13(7), 2061; https://doi.org/10.3390/jcm13072061 - 2 Apr 2024
Cited by 1 | Viewed by 1389
Abstract
Background: Implementing innovations emerging from clinical research can be challenging. Thermal imagers provide an accessible diagnostic tool to increase the accuracy of burn wound depth assessment. This mixed-methods implementation study aimed to assess the barriers and facilitators, design implementation strategies, and guide the [...] Read more.
Background: Implementing innovations emerging from clinical research can be challenging. Thermal imagers provide an accessible diagnostic tool to increase the accuracy of burn wound depth assessment. This mixed-methods implementation study aimed to assess the barriers and facilitators, design implementation strategies, and guide the implementation process of thermal imaging in the outpatient clinic of a burn centre. Methods: This study was conducted between September 2022 and February 2023 in Beverwijk, The Netherlands. Semi-structured interviews with burn physicians guided by the Consolidated Framework for Implementation Research (CFIR) were conducted to identify barriers and facilitators. Based on the barriers, implementation strategies were developed with the CFIR-ERIC Matching Tool, and disseminated to support the uptake of the thermal imager. Subsequently, thermal imaging was implemented in daily practice, and an iterative RE-AIM approach was used to evaluate the implementation process. Results: Common facilitators for the implementation of the thermal imager were the low complexity, the relative advantage above other diagnostic tools, and benefits for patients. Common barriers were physicians’ attitude towards and perceived value of the intervention, the low compatibility with the current workflow, and a lack of knowledge about existing evidence. Six implementation strategies were developed: creating a formal implementation blueprint, promoting adaptability, developing educational materials, facilitation, conducting ongoing training, and identifying early adopters. These strategies resulted in the effective implementation of the thermal imager, reflected by a >70% reach among eligible patients, and >80% effectiveness and adoption. Throughout the implementation process, compatibility, and available resources remained barriers, resulting in low ratings on RE-AIM dimensions. Conclusions: This study developed implementation strategies based on the identified CFIR constructs that impacted the implementation of a thermal imager for burn wound assessment in our outpatient clinic. The experiences and findings of this study could be leveraged to guide the implementation of thermal imaging and other innovations in burn care. Full article
(This article belongs to the Special Issue Advances in Burn Management)
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