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Enhancing Burn Rehabilitation: Contemporary Improvements across the Spectrum of Influence
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Enhancing Burn Rehabilitation: Contemporary Improvements across the Spectrum of Influence

A special issue of European Burn Journal (ISSN 2673-1991).

Deadline for manuscript submissions: closed (31 March 2025) | Viewed by 4677

Special Issue Editors

Prof. Dale W. Edgar

E-Mail Website
Guest Editor
1. Burn Injury Research Node, Institute for Health Research, The University of Notre Dame Australia, Fremantle, WA 6160, Australia
2. Armadale Kalamunda Group Health Service, Armadale Hospital, Mount Nasura, WA 6112, Australia
Interests: burns; injury; surgery; physical therapy; rehabilitation; outcome measurement; prehabilitation; PROMS
Prof. Dr. Colleen Ryan

E-Mail Website
Guest Editor
Massachusetts General Hospital, Harvard Medical School, Shriners Hospitals for Children, Boston, MA 02114, USA
Interests: burn injury; surgery; critical care; PROMS; disaster preparedness
Prof. Dr. Marianne K. Nieuwenhuis

E-Mail Website
Guest Editor
1. Association of Dutch Burn Centers, Burn Centre Groningen, Martini Hospital, 9700 RM Groningen, The Netherlands
2. Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, 9713 AV Groningen, The Netherlands
3. Research Group on Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, 9747 AS Groningen, The Netherlands
Interests: burn injury and rehabilitation; burn critical care; physical therapy; physical fitness, activity and participation
Dr. Ulrike Van Daele

E-Mail Website
Guest Editor
1. Research Group MOVANT (Movement Antwerp), Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, 2000 Antwerp, Belgium
2. OSCARE, Organisation for Burns, Scar Aftercare and Research, 2170 Antwerp, Belgium
Interests: burn and scar rehabilitation; physical therapy; metabolic changes post burns; scar changes; scar assessment
Dr. Jill Marie Cancio

E-Mail Website
Guest Editor
U.S. Army Burn Center, U.S. Army Institute of Surgical Research, Ft. Sam Houston, San Antonio, TX 78234, USA
Interests: hand burns; burn injuries; burn patient; burn injury and rehabilitation; burn critical care; burn physical perform

Special Issue Information

Dear Colleagues,

Health disciplines such as cardiology and cancer services have markedly improved patient outcomes and symptom management through the use of early and ongoing rehabilitation, particularly with the application of exercise, nutrition, and psychosocial interventions. In burn care, the evidence for and, therefore, the broader use of rehabilitation methods is less well developed.

Thus, we invite authors to submit comprehensive or systematic literature reviews that rigorously evaluate research questions, particularly those related to the effectiveness of early rehabilitative interventions in burn care. These reviews should focus on strategies aimed at minimizing long-term morbidity and enhancing the quality of life for burn survivors.

Furthermore, we seek original research reports featuring high-quality study designs that explore the breadth of post-burn rehabilitation interventions. Contributions may include, but are not limited to, empirical studies of psychological and physical treatments administered at any stage following a burn injury.

Submissions should strive to contribute to the body of knowledge that informs clinical best practices, and attention to the multidisciplinary approaches in burn rehabilitation is appreciated.

Prof. Dale W. Edgar
Prof. Dr. Colleen Ryan
Prof. Dr. Marianne K. Nieuwenhuis
Dr. Ulrike Van Daele
Dr. Jill Marie Cancio
Guest Editors

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. European Burn Journal is an international peer-reviewed open access quarterly 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 971 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

  • burn injuries
  • rehabilitation
  • early rehabilitative interventions
  • post-burn rehabilitation interventions
  • psychological and physical treatments
  • burn survivors

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

Published Papers (5 papers)

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Editorial

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2 pages, 149 KiB  
Editorial
Comment from the Enhancing Burn Rehabilitation Special Edition Editors on “Fractional CO2 Laser for Pediatric Hypertrophic Scars: Lessons Learned from a Prematurely Terminated Split-Scar Trial”
by Dale W. Edgar, Colleen M. Ryan, Marianne K. Nieuwenhuis, Ulrike Van Daele and Jill M. Cancio
Eur. Burn J. 2025, 6(1), 16; https://doi.org/10.3390/ebj6010016 - 13 Mar 2025
Viewed by 313
Abstract
The Editors thank the investigators for displaying tenacity, evidenced by the significant revisions that were necessary to complete this project [...] Full article
(This article belongs to the Special Issue Enhancing Burn Rehabilitation: Contemporary Improvements across the Spectrum of Influence)

Research

Jump to: Editorial

11 pages, 1018 KiB  
Article
Fractional CO2 Laser for Pediatric Hypertrophic Scars: Lessons Learned from a Prematurely Terminated Split-Scar Trial
by Sarthak Sinha, Altay Baykan, Karen Hulin, Doug Baron, Vincent Gabriel and Frankie O. G. Fraulin
Eur. Burn J. 2025, 6(1), 10; https://doi.org/10.3390/ebj6010010 - 20 Feb 2025
Cited by 1 | Viewed by 405
Abstract
Background: Assessing hypertrophic scar (HTS) interventions is challenging because scars continue to undergo dynamic changes. A split-scar design can distinguish treatment effects from natural HTS evolution. Despite promising reports of ablative fractional CO2 lasers (AFCO2Ls) for HTS, split-scar evidence, particularly [...] Read more.
Background: Assessing hypertrophic scar (HTS) interventions is challenging because scars continue to undergo dynamic changes. A split-scar design can distinguish treatment effects from natural HTS evolution. Despite promising reports of ablative fractional CO2 lasers (AFCO2Ls) for HTS, split-scar evidence, particularly in pediatric scars, remains limited. Objective: To explore the feasibility of a split-scar design in assessing AFCO2L’s impact on pediatric HTS and to identify potential trends in treatment outcomes. Methods: Initially designed as a prospective single-center split-scar randomized controlled trial, our study transitioned to a feasibility trial due to recruitment challenges. Pediatric patients aged 1–17 years with HTS suitable for split-scar evaluation received three AFCO2L treatments at 6–8-week intervals, with outcomes assessed using the Vancouver Scar Scale (VSS), SCAR-Q, and Cutometer. Results: Recruitment was limited by COVID-19 restrictions, concerns about general anesthesia for split-scar treatment, and low interest in divided-scar interventions, resulting in only 6 participants with 9 scars enrolled, far below the target sample size of 44. This small heterogeneous sample precluded meaningful clinical outcome analysis. Conclusions: Our feasibility trial highlights challenges in conducting rigorous pediatric HTS studies and the need for careful interpretation of evidence due to potential publication bias. Future trials should focus on tailored recruitment and comprehensive reporting to improve feasibility and reliability. Full article
(This article belongs to the Special Issue Enhancing Burn Rehabilitation: Contemporary Improvements across the Spectrum of Influence)
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14 pages, 925 KiB  
Article
Bouncing Back: The Psychosocial Benefits of a Community-Based Exercise Program for Children with Non-Severe Burns
by Dinithi Atapattu, Victoria M. Shoesmith, Eva Kierath, Mark W. Fear, Fiona M. Wood and Lisa J. Martin
Eur. Burn J. 2025, 6(1), 9; https://doi.org/10.3390/ebj6010009 - 17 Feb 2025
Viewed by 455
Abstract
Burns significantly impact children’s physical and psychosocial recovery, even in cases of non-severe injuries, leading to long-term health and mental health risks. This study explores the psychosocial benefits of a community-based exercise program for children recovering from burn injuries, addressing concerns such as [...] Read more.
Burns significantly impact children’s physical and psychosocial recovery, even in cases of non-severe injuries, leading to long-term health and mental health risks. This study explores the psychosocial benefits of a community-based exercise program for children recovering from burn injuries, addressing concerns such as anxiety, reduced physical activity, and social challenges. A pre-test–post-test design assessed the effects of an 8-week community-based trampoline exercise intervention on psychosocial outcomes in children and their caregivers. No significant or clinically meaningful physical improvements were observed across measures such as MET score, grip strength, BMI percentile, or heart-rate recovery despite a significant improvement in trampolining performance (p < 0.0001). Psychosocial outcomes showed improved child emotional function (PedsQL, p = 0.024) as reported by parents, though children’s self-reported emotional function and Child PTSD Symptom Scale (CPSS) scores remained unchanged. Parent-reported strengths and difficulty scores for the child remained stable over time but were higher than population norms for hyperactivity and emotional difficulty. Parental post-traumatic stress symptoms decreased significantly over time (p = 0.050), with reductions in avoidance (p = 0.009), hypervigilance (p = 0.007), and intrusion scores (p = 0.026). Children significantly improved their trampolining performance, while parents reported enhanced emotional function for their child. However, children’s self-reports did not reflect these emotional improvements. Full article
(This article belongs to the Special Issue Enhancing Burn Rehabilitation: Contemporary Improvements across the Spectrum of Influence)
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20 pages, 275 KiB  
Article
What Outcomes Matter Most to Paediatric Burn Patients and Their Caregivers: A Comparison of Short-Term and Long-Term Priorities
by Inge Spronk, Dale W. Edgar, Victoria Shoesmith, Corine A. Lansdorp, Mark W. Fear, Fiona M. Wood and Lisa J. Martin
Eur. Burn J. 2024, 5(4), 369-388; https://doi.org/10.3390/ebj5040033 - 22 Oct 2024
Viewed by 1138
Abstract
Identifying outcomes that matter most is key in driving specialized paediatric burn care. The aim of this study was to discover the most important outcomes for paediatric burns. Parents of children (0–3 year and 4–11 years old) and adolescents (12–17 yearss old) completed [...] Read more.
Identifying outcomes that matter most is key in driving specialized paediatric burn care. The aim of this study was to discover the most important outcomes for paediatric burns. Parents of children (0–3 year and 4–11 years old) and adolescents (12–17 yearss old) completed surveys to identify outcomes that matter most in the short-term (<6 months postburn) and long-term (6–24 months postburn). The percentage of patients scoring an outcome as ‘very important’ was used to rank the outcomes. Fifty-four parents/adolescents participated (response rate: 27%). Children had a median TBSA burned of 5.0% (IQR: 2.0–7.0%). In the short-term, ‘good wound healing’ and ‘no wound infection’ (both at 71.4–100%) were very important for all children. ‘Not having pain’ (90.3–93.8%) was ranked highest for children ≤11 years old, whereas ‘walking or moving around’ (85.7%) was most important for older children. In the long-term, more variation was seen in outcome priorities; however, both ‘not having pain’ (53.6–85.7%) and ‘flexibility of scar(s)’ (60.7–71.4%) were considered very important by all three groups. Patient- and parent-derived priorities are important for developing consumer-centric, highest-value care pathways. The priority of the outcomes identified is a starting point to discuss treatment options and recovery priorities in a family-centric approach to guide high-value, individualized care. Full article
(This article belongs to the Special Issue Enhancing Burn Rehabilitation: Contemporary Improvements across the Spectrum of Influence)
11 pages, 1530 KiB  
Article
Balance Impairment in the Burn Population: A Burn Model System National Database Study
by Edward Santos, Kaitlyn L. Chacon, Lauren J. Shepler, Kara A. McMullen, Mary D. Slavin, Marc van de Rijn, Karen J. Kowalske, Colleen M. Ryan and Jeffrey C. Schneider
Eur. Burn J. 2024, 5(3), 238-248; https://doi.org/10.3390/ebj5030023 - 25 Jul 2024
Viewed by 1200
Abstract
Balance is an important component of daily function and impairments can lead to injury and quality-of-life limitations. Balance is not well studied in the burn population. This study examines the frequency of long-term balance impairments and associated factors after a burn injury. The [...] Read more.
Balance is an important component of daily function and impairments can lead to injury and quality-of-life limitations. Balance is not well studied in the burn population. This study examines the frequency of long-term balance impairments and associated factors after a burn injury. The Burn Model System National Database was analyzed. Trouble with balance was self-reported at discharge, 6, 12, 24, and 60 months after injury. Regression analyses examined the associations between demographic and clinical characteristics and balance impairments at 12 months. Of 572 participants, balance impairments were most reported at discharge (40.3%), continuing over 60 months (26.8–36.0%). Those reporting balance impairments (n = 153) were more likely to be older, unemployed, have Medicaid or Medicare, receive inpatient rehabilitation, receive outpatient physical or occupational therapy, have vision problems, have leg or feet burns and swelling, and have foot numbness compared to those without (p ≤ 0.001). Regression analysis demonstrated a 4% increased odds of balance impairment for every increase in year of age (p < 0.001), 71% lower odds if employed at time of injury (p < 0.001), and 140% higher odds if receiving outpatient physical or occupational therapy at 12 months (p = 0.008). Common reports of balance impairments highlight the need for routine screenings to identify burn survivors that may benefit from targeted interventions. Full article
(This article belongs to the Special Issue Enhancing Burn Rehabilitation: Contemporary Improvements across the Spectrum of Influence)
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