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Eur. Burn J., Volume 6, Issue 1 (March 2025) – 9 articles

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14 pages, 497 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 (registering DOI) - 17 Feb 2025
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
11 pages, 251 KiB  
Article
Self-Inflicted Burns: A Comparative Study in a Spanish Sample
by Sara Guila Fidel-Kinori, Vicente García-Sánchez, Maria Sonsoles Cepeda-Diez, Carmina Castellano-Tejedor, Josep Antoni Ramos-Quiroga and Joan Pere Barret-Nerín
Eur. Burn J. 2025, 6(1), 8; https://doi.org/10.3390/ebj6010008 (registering DOI) - 17 Feb 2025
Viewed by 53
Abstract
Background: In 1994, the first Spanish study on patients with self-inflicted burns (SIB) was published, showing a prototypical profile of a patient with SIB: adult male, unmarried and, in 75% of the cases, with a psychiatric background. In addition, SIB accounted for 1.98% [...] Read more.
Background: In 1994, the first Spanish study on patients with self-inflicted burns (SIB) was published, showing a prototypical profile of a patient with SIB: adult male, unmarried and, in 75% of the cases, with a psychiatric background. In addition, SIB accounted for 1.98% of the total admissions in a Burns Unit between 1983 and 1991, a lower percentage than other European studies. The present study aims to replicate this work, updating this profile and comparing it with the current profile. Methods: We compared the clinical and socio-demographic characteristics of 67 patients admitted during 1983–1991 (Study I) with those of 36 patients admitted during 2010–2015 (Study II). Results: It was observed that the percentage of patients with SIB admitted to the Burns Unit was lower in Study II than in Study I (1.45% vs. 1.98%). Significant age differences were identified (t(101) = −2.074, p = 0.041, 95% CI [−11.739, −0.261]). Similarly, there were statistically significant differences in several clinical characteristics, such as psychiatric history (X2 = 11.591, p = 0.001), the occurrence of previous autolytic attempts (X2 = 7.714, p = 0.007), the place where the incident occurred (X2 = 11.647, p = 0.020), the etiology of the burn (X2 = 13.142, p = 0.004), and triggers (X2 = 6.420, p = 0.036). Conclusions: Several differences have arisen between the two studies, mainly related to the specific characteristics of SIB (e.g., etiology, triggering cause, and place of the incident), possibly attributable to the social changes that have occurred in the last 20 years. These results will add to our knowledge and will stress various precipitating factors that may lead to SIB, with the final goal of designing preventive strategies. Full article
13 pages, 3045 KiB  
Article
Burn Wound Dynamics Measured with Hyperspectral Imaging
by Thomas Wild, Jörg Marotz, Ahmed Aljowder and Frank Siemers
Eur. Burn J. 2025, 6(1), 7; https://doi.org/10.3390/ebj6010007 - 13 Feb 2025
Viewed by 235
Abstract
Introduction: Hyperspectral Imaging (HSI) combined with an augmented model-based data processing enables the measurement of the depth-resolved perfusion of burn wounds. With these methods, the fundamental problem of the wound dynamics (wound conversion or progression) in the first 4 days should be parametrically [...] Read more.
Introduction: Hyperspectral Imaging (HSI) combined with an augmented model-based data processing enables the measurement of the depth-resolved perfusion of burn wounds. With these methods, the fundamental problem of the wound dynamics (wound conversion or progression) in the first 4 days should be parametrically analyzed and evaluated. Material and Methods: From a cohort of 59 patients with burn injuries requiring medical intervention, 281 homogenous wound segments were selected and subjected to clinical classification based on the duration of healing. The classification was retrospectively assigned to each segment during the period from day 0 to day 2 post-burn. The perfusion parameters were presented in two parameter spaces describing the upper and deeper perfusion. Results: The investigation of value distributions within the parameter spaces pertaining to four distinct categories of damage from superficial dermal to full-thickness burns during the initial four days reveals the inherent variability and distinct patterns associated with wound progression, depending on the severity of damage. The analysis highlights the challenges associated with estimating the burn degrees during this early stage and elucidates the significance of deeper tissue perfusion in the classification process, which cannot be discerned through visual inspections. Conclusions: The feasibility of early classification on day 0 or 1 was assessed, and the findings indicate a restricted level of reliability, particularly on day 0, primarily due to the substantial variability observed in wound characteristics and inherent dynamics. Full article
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14 pages, 1490 KiB  
Review
Early Detection, Diagnosis, Prevention, and Treatment of Infection to Avoid Sepsis and Septic Shock in Severely Burned Patients: A Narrative Review
by Patrick M. Honoré, Sydney Blackman, Emily Perriens, Jean-Charles de Schoutheete and Serge Jennes
Eur. Burn J. 2025, 6(1), 6; https://doi.org/10.3390/ebj6010006 - 6 Feb 2025
Viewed by 418
Abstract
The early detection, diagnosis, anticipation, and therapy of infections to prevent sepsis and septic shock remain significant challenges in cases of grave burns. This narrative review explores various tools for early infection detection, including emerging biomarkers, the American Burn Association’s clinical criteria, and [...] Read more.
The early detection, diagnosis, anticipation, and therapy of infections to prevent sepsis and septic shock remain significant challenges in cases of grave burns. This narrative review explores various tools for early infection detection, including emerging biomarkers, the American Burn Association’s clinical criteria, and traditional blood parameters. A comparative study of the American Burn Association, Mann-Salinas, and Sepsis-3 criteria highlights the superior early detection capabilities of the Sepsis-3 criteria. However, the authors recommend that sepsis should be prospectively evaluated, identified, and classified by the intensive care group, rather than by relying solely on retrospective items, though the latter may still be necessary in certain cases. Advances in biomarker identification, including polymerase chain reaction (PCR) and gene expression (mRNA) profiling, offer diagnostic advantages over current methods, enabling early detection within 4 to 6 h of intensive care unit admission. Mass spectrometry also shows promise for the rapid determination of bacteria, yeast, and fungi based on bacteria protein profiles. Source control remains crucial, and the use of antibacterial topical agents has significantly improved the survival rates of severely burned patients. However, antibiotic selection must be made judiciously to avoid resistance. Despite these advancements, significant progress is still needed to improve the rapid identification, actual presence, prevention, and therapy of infections to reduce the incidence of sepsis and septic shock in this patient subgroup. Full article
(This article belongs to the Special Issue Controversial Issues in Intensive Care-Related Burn Injuries)
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13 pages, 800 KiB  
Article
Parent-Reported Burn-Specific Health-Related Quality of Life in Children 5–7 Years After Burns: A Multicenter Cross-Sectional Study
by Marina C. Heijblom, J. Nicolaas Dijkshoorn, Marianne K. Nieuwenhuis, Anouk Pijpe, Cornelis H. van der Vlies, Margriet E. van Baar and Inge Spronk
Eur. Burn J. 2025, 6(1), 5; https://doi.org/10.3390/ebj6010005 - 30 Jan 2025
Viewed by 459
Abstract
Surviving a burn can dramatically alter a child’s life, yet few studies examined long-term health-related quality of life (HRQL). This study assessed HRQL 5–7 years post-burn in children with mild/intermediate and severe burns and identified associated factors. Parents of children (5− < 18 [...] Read more.
Surviving a burn can dramatically alter a child’s life, yet few studies examined long-term health-related quality of life (HRQL). This study assessed HRQL 5–7 years post-burn in children with mild/intermediate and severe burns and identified associated factors. Parents of children (5− < 18 years) who were hospitalized or had burn surgery between 08/2011 and 09/2012 completed the Burn Outcomes Questionnaire (BOQ). Outcomes were compared between two subgroups: children with mild/intermediate burns (<10% total body surface area (TBSA) burned) versus severe burns ((1) aged <10 years old at the time of injury with >10% (TBSA) burned; (2) aged ≥10 years with >20% TBSA burned; or (3) >5% full-thickness burns). A total of 102 children were included (mean age at survey: 8.4 (3.0) years; mean former TBSA: 7.1%). At a mean of 5.7 years post-burn, many parents rated their child’s health as excellent (46.1%) or very good (35.3%), with few reporting issues with ‘pain’ (2.3%), ‘physical function and sports’ (1.6%), and ‘upper extremity function’ (0.9%). Parents of children with severe burns indicated significantly more problems with ‘appearance’ (89.2% versus 71.5%; p = 0.014) and ‘parental concern’ (94.1% versus 84.8%; p = 0.021). Upper limb burns, facial burns, burn size, length of hospital stay, full-thickness burns, and the number of surgeries predicted poorer outcomes. In general, these findings indicate positive long-term HRQL, though especially children with full-thickness burns and/or surgical interventions face a higher risk of reduced HRQL. The results can be used to inform children and their families about the long-term implications. Furthermore, healthcare professionals can use these insights to identify children at higher risk of poorer long-term HRQL. Full article
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13 pages, 247 KiB  
Article
Session Rating of Perceived Exertion Is a Valid Method to Monitor Intensity of Exercise in Adults with Acute Burn Injuries
by Joanne S. Page, Dale W. Edgar, Tiffany L. Grisbrook, Angela Jacques, Paul M. Gittings, Fiona M. Wood and Carly J. Brade
Eur. Burn J. 2025, 6(1), 4; https://doi.org/10.3390/ebj6010004 - 30 Jan 2025
Viewed by 588
Abstract
Measuring exercise intensity for safety and to inform prescription in acute burn survivors, is challenging. This study aimed to assess the validity of adult patient end-of-workout rating of session perceived exertion (sRPE); and calculated training load (TL) (sRPE × session duration) as measures [...] Read more.
Measuring exercise intensity for safety and to inform prescription in acute burn survivors, is challenging. This study aimed to assess the validity of adult patient end-of-workout rating of session perceived exertion (sRPE); and calculated training load (TL) (sRPE × session duration) as measures of exercise intensity. Secondly, the study aimed to compare clinician and patient perception of exercise effort during physiotherapist-led sessions. Repeated RPE data were collected every 5-min during two resistance exercise sessions completed by 25 burns patients. Physiological (heart rate [HR], blood lactate [BLa]) and perceptual measures (sRPE, ratings of pain, fatigue, delayed onset muscle soreness, sleep quality and stress) were also captured. Adjusted, multivariable linear regression models were used to determine the associations between sRPE and TL and significant predictor variables. Paired t-tests were performed to compare clinician and participant sRPE. Results: Average RPE calculated from 5-min repeats, after adjustment for age and %TBSA, was significantly associated with sRPE, F(1, 45) = 100.82, (p < 0.001, adjusted R2 = 0.64) and TL, F(1, 45) = 33.66, (p < 0.001, adjusted R2 = 0.39). No significant differences between patient and clinician sRPE were apparent (p = 0.948). Thus, one-off reporting of sRPE and calculated TL may be appropriate markers to monitor exercise intensity and aid prescription in individuals with burn injuries, regardless of patient and burn characteristics or time since burn. There was also no difference between patient and clinician’s perceptions of exercise effort. Full article
17 pages, 3544 KiB  
Systematic Review
Healing Rates and Dressing Frequency of Silver Foam Dressings in Paediatric Burns: A Systemic Review and Meta-Analysis
by Nathanael Q. E. Yap, Dilip K. Vankayalapati, Sum-Yu C. Lee, Hafsa O. Sulaiman, Alma Sato, M Zaid Shami, Valeria Antoniou, James W. F. Burns, Hayato Nakanishi, Christian A. Than and Graeme Southwick
Eur. Burn J. 2025, 6(1), 3; https://doi.org/10.3390/ebj6010003 - 27 Jan 2025
Viewed by 436
Abstract
Silver foam dressings have been extensively used in the management of burn injuries; however, its application in children requires elucidation. A literature search was conducted from database inception to October 2023. Eligible studies reported paediatrics patients under 21 years of age receiving silver [...] Read more.
Silver foam dressings have been extensively used in the management of burn injuries; however, its application in children requires elucidation. A literature search was conducted from database inception to October 2023. Eligible studies reported paediatrics patients under 21 years of age receiving silver dressings for burns or scalds. This review was registered prospectively with PROSPERO (CRD42023470239). 18 studies met the inclusion criteria with a total of 701 patients. The pooled mean time to re-epithelisation (TTRE) was 12.9 days (95% CI: 11.2, 14.6, I2 = 94%). The pooled mean duration of hospitalisation was 9.8 days (95% CI: 3.9, 15.7; I2 = 100%). Mean number of total dressing changes per patient was 3.6 (95% CI: 2.2, 4.9; I2 = 99%). There were a total of 98 complications, including 30 (30.6%) infections, 29 (29.6%) surgical requirements, 14 (14.3%) hypertrophic scarring, 17 (17.3%) escalations of care, 5 (5.1%) burn depth progression, and 3 (3.1%) others. Silver foam dressings appear as a safe and effective approach in terms of healing rate and dressing change frequency for selected paediatric patients with burn injuries. Despite the promising results, further comparative studies are required to evaluate the selection criteria and long-term effect of silver foam dressing. Full article
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7 pages, 194 KiB  
Perspective
Promising Strategies for the Management of Burn-Wound-Associated Pruritus
by Mayer Tenenhaus and Hans-Oliver Rennekampff
Eur. Burn J. 2025, 6(1), 2; https://doi.org/10.3390/ebj6010002 - 24 Jan 2025
Viewed by 341
Abstract
Patients who have been injured by burns often suffer from persistent and debilitating post burn pruritus. Despite a myriad of therapeutic interventions and medications, this complex condition remains particularly difficult to ameliorate. Recently, a new generation of antipruritic medications has demonstrated clinical success [...] Read more.
Patients who have been injured by burns often suffer from persistent and debilitating post burn pruritus. Despite a myriad of therapeutic interventions and medications, this complex condition remains particularly difficult to ameliorate. Recently, a new generation of antipruritic medications has demonstrated clinical success in managing pruritus in a number of dermatologic, nephritic and hepatic disease states, targeting unique aspects of the pruritic pathways. While specific trials demonstrating efficacy and safety are currently lacking, the purported mechanisms of action and similarities to the targeted inflammatory markers, pruritogens and neural pathways of these new medications, in concert with clinical evidence, hold promise for burn patients. Full article
20 pages, 1425 KiB  
Review
Efficacy of Dialkylcarbamoylchloride (DACC)-Impregnated Dressings in Surgical Wound Management: A Review
by Madhan Jeyaraman, Naveen Jeyaraman, Swaminathan Ramasubramanian, Arulkumar Nallakumarasamy, Shrideavi Murugan, Tarun Jayakumar and Sathish Muthu
Eur. Burn J. 2025, 6(1), 1; https://doi.org/10.3390/ebj6010001 - 21 Jan 2025
Viewed by 639
Abstract
Surgical site infections (SSIs) are a significant challenge in postoperative care, leading to increased morbidity, extended hospital stays, and elevated healthcare costs. Traditional antimicrobial dressings, such as those containing silver or iodine, have limitations, including cytotoxicity and the potential for antimicrobial resistance. Dialkylcarbamoyl [...] Read more.
Surgical site infections (SSIs) are a significant challenge in postoperative care, leading to increased morbidity, extended hospital stays, and elevated healthcare costs. Traditional antimicrobial dressings, such as those containing silver or iodine, have limitations, including cytotoxicity and the potential for antimicrobial resistance. Dialkylcarbamoyl chloride (DACC)-impregnated dressings offer a novel approach, employing a physical mechanism to bind and remove bacteria without the use of chemical agents, thereby reducing the risk of resistance. This review summarizes current evidence on the efficacy of DACC dressings in preventing SSIs and promoting wound healing. Findings from multiple studies indicate that DACC dressings reduce bacterial burden and SSI rates across various surgical procedures, including cesarean sections and vascular surgeries. Additionally, DACC dressings demonstrate potential in managing hard-to-heal wounds, such as diabetic foot ulcers, by reducing bacterial load and biofilm formation. Furthermore, they present advantages in antimicrobial stewardship and cost-effectiveness by minimizing the need for antibiotics and decreasing overall healthcare expenses. However, the current literature is limited by small sample sizes, methodological weaknesses, heterogeneity in study designs, and a lack of long-term data. Future research should focus on high-quality randomized controlled trials across diverse surgical populations, comprehensive cost-effectiveness analyses, and long-term outcomes to establish the full clinical impact of DACC dressings. With further validation, DACC-impregnated dressings could become a critical tool in sustainable postoperative wound care. Full article
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