Eur. Burn J., Volume 6, Issue 2 (June 2025) – 9 articles

Burn injuries lead to significant physical and psychological consequences, including chronic pain, post-traumatic stress, depression, and social isolation. Mindfulness-based interventions (MBIs) have been proposed as a holistic approach to address these challenges in burn rehabilitation. This systematic review evaluates the efficacy of dispositional mindfulness and MBIs, including mindfulness meditation, yoga, and self-compassion training, in managing pain, emotional distress, and psychosocial adaptation in burn survivors. A comprehensive literature search was conducted through MEDLINE and Web of Science, covering studies up to February 2025, with additional papers retrieved from Google Scholar and Semantic Scholar. Studies were included if they reported quantitative data on the effects of MBIs in burn patients and/or their families, excluding opinion pieces, editorials, reviews, and qualitative studies. After screening 91 studies retrieved from the databases and adding a compelling paper retrieved from the other sources explored, 12 studies were included in the final pool, categorized into cross-sectional studies (n = 6), and intervention studies (n = 6). The extracted data included publication year, research design, sample characteristics, intervention details, main findings, and data for quality assessment. The synthesis of the results suggests that mindfulness is associated with reduced psychological symptoms, improved emotional regulation, and enhanced self-compassion, leading to better coping strategies and social reintegration. However, the long-term efficacy of MBIs remains inconclusive, and further research is needed to differentiate mindfulness-specific effects from those of general physical exercise. Evidence also suggests that mindfulness interventions may reduce anxiety and secondary trauma in children with burns and their caregivers. This review highlights the potential of MBIs as adjuncts to conventional burn rehabilitation programs, but further high-quality trials are needed to establish their sustained efficacy and to understand the specific benefits of mindfulness. Full article

Background and Objectives: Traditionally, full-thickness skin defects (FTSDs) are covered with split-thickness skin grafts (STSGs). This usually provides an epidermal coverage but entails a high risk of hypertrophic scarring mainly due to the absence of the dermal layer. The Novosorb^® Biodegradable Temporising Matrix (BTM) is a novel synthetic dermal substitute that has been used for the reconstruction of various complex and/or large defects in our center. The aim of this article is to evaluate the clinical performance of the BTM as a synthetic dermal substitute for complex FTSD reconstruction in a European context. Materials and methods: This case series focused on the treatment of complex FTSDs with the BTM. After wound debridement, the BTM was applied according to a defined protocol. Once adequate vascularization was observed, the sealing membrane was removed and the neo-dermis was covered with STSGs. Patient demographics, comorbidities, wound defect localization and etiology, wound bed preparations, time of BTM application and removal, time to complete wound healing after STSG, complications, and HTS formation were recorded. Results: The BTM was used to treat FTSDs in six patients with complex wounds from degloving (3), burns (1), ulcerations (1), and necrotizing fasciitis (1). Successful integration occurred in five cases (83%), with one partial integration. The BTM remained in situ for an average of 20.7 days before delamination and STSG coverage. No major complications occurred, though one case had hypergranulation with secondary STSG infection. Two patients were lost to follow-up, while the remaining four had excellent aesthetic and functional outcomes with good-quality scars. Conclusions: Within the limits of this small and heterogeneous case series, the BTM appears to be a promising option for the reconstruction of complex FTSDs of varying etiologies. Its successful integration in most cases and limited complication rate support its clinical potential. However, given this study’s retrospective design and limited sample size, further prospective studies are required to validate these findings and assess long-term outcomes. Full article

The Life Impact Burn Recovery Evaluation (LIBRE) Profile was developed to assess long-term social participation outcomes for adult burn survivors. Traditional clinical burn recovery outcomes focus on early physical complications and psychosocial issues, but there is a growing need for quantitative measures of long-term recovery that assess experiences deemed relevant to burn survivors. The LIBRE Profile, co-produced with input from burn survivors and clinicians and grounded in the World Health Organization’s International Classification of Functioning, Disability and Health (WHO-ICF) conceptual framework, addresses the measurement gap by focusing on six domains of social participation: social interactions, social activities, family and friends, work and employment, romantic relationships, and sexual relationships. The LIBRE Profile uses Item Response Theory (IRT) and computer adaptive tests (CAT) to minimize respondent burden while maintaining accuracy. Psychometric evaluations have validated the LIBRE Profile as a reliable and clinically useful tool that can help clinicians and burn survivors monitor recovery and inform personalized care. Future work includes LIBRE Profile development for pediatric populations, further international language translations, and the development of an APP for broader personal and clinical use. This paper provides a comprehensive overview of the LIBRE Profile’s development, psychometric foundations, and future directions, advocating for its adoption in clinical practice and burn survivor communities. Full article

A PROM is a measure of patient needs and therapeutic progress. This paper outlines the validation of the CARe Burn Scale: Parent/Caregiver Form, a PROM that measures quality of life in parents/caregivers supporting a child with a burn injury. A literature review and interviews with sixteen parents and six burns health professionals informed the development of the PROM conceptual framework/draft form. Cognitive debriefing interviews with five parents and seven burns-specialist health professionals provided feedback to ascertain content validity, and two-hundred and four parents/caregivers took part in the field testing. Rasch measurement theory (RMT) analyses and internal consistency tests were conducted to create a shortened version and for psychometric validation. The final conceptual framework included eight domains/individual scales: Physical Well-being, Confidence with Managing Burn Wound/Scar Treatments, Social Situations, Partner Relationship, Self-worth, Negative Mood, Parent Concerns about the Appearance of their Child’s Burn Wounds/Scars, and Positive Growth. Seven scales had solutions from RMT analyses and passed internal consistency criteria. Confidence with Managing Burn Wound/Scar Treatments did not fit the Rasch model but was retained as a checklist based on theoretical insight. The CARe Burn Scale: Parent/Caregiver Form is the first and only burn-specific PROM that assesses parents’ own health needs when caring for a child with a burn. Full article

Prolonged healing time of acute burn wounds is associated with increased pain, infection, risk of scarring, poorer mobility and higher financial and emotional burden. Electrical stimulation (ES) reduces healing time in chronic wounds; however, its reported use on acute burn wounds is limited. This systematic review (SR) aimed to evaluate the relative benefit of ES compared to routine wound care on the healing time of acute burn wounds in adults. The online databases queried included Cochrane Database of SR’s, MEDLINE, EMBASE, PUBMED and CINAHL. The search criteria included RCTs involving the application of ES of varying voltage, duration and modality in acute burn patients aged ≥18 years. The primary outcome investigated was days to burn wound closure, while the secondary outcomes included edema and infection. Four RCTs were discovered, involving a total of 143 participants with a mean age 35.5 years. Two RCTs demonstrated (a) 36% (2.6 days) reduction in time to wound closure with ES (p < 0.001); and (b) significant reduction in wound area with ES (11.2 ± 3.2 cm², p < 0.001) compared to controls at 21 days. Two RCTs found ES promoted better wound-healing environments, reducing edema, bacterial infection, and biofilm. This review highlighted low-risk wound-healing benefits with ES as a feasible adjunct to routine burn care. Full article

The effective treatment of severe burns in pediatric patients is essential for minimizing complications and promoting optimal recovery. This study investigates the use of non-thermal atmospheric pressure plasma (NTAPP) as an adjuvant therapy in combination with Epifast^® for the experimental group, compared to standard care involving early excisions and Epifast^® for the control group. A randomized controlled trial was conducted with 40 pediatric patients suffering from superficial partial-thickness and deep dermal burns. The experimental group that received NTAPP daily demonstrated a significant reduction in the need for skin grafts, requiring only 10% compared to 40% in the control group (p = 0.02). Although there were no statistically significant differences in the length of hospital stay, the experimental group showed a trend toward shorter stays (9.85 days vs. 11.65 days; p = 0.38) and lower analgesic consumption (13.01 doses vs. 21.15 doses; p = 0.09). Additionally, the infection rate in the NTAPP-treated group was significantly lower at 25%, compared to 37.95% in the control group (p < 0.05). These findings suggest that NTAPP enhances wound healing while reducing surgical morbidity and the risk of infections. In conclusion, this study highlights the transformative potential of NTAPP as an innovative strategy in pediatric burn management. It combines clinical efficacy with a less invasive approach, representing a significant advance in regenerative medicine and opening new avenues for research into advanced therapies. Full article

Background: Burns represent one of the most severe injuries encountered in the pre-hospital and ED environment, with essential features and an often negatively powerful impact on patients’ quality of life. Preventive measures can significantly reduce the number of cases presenting to medical facilities; knowledge and the correct application of first aid measures in the pre-hospital stage have a significant role in reducing the risk of complications and in obtaining optimal outcomes. Methods: This retrospective one-year single-center study analyzed 399 adult burn patients treated at the Clinical Emergency Hospital of Bucharest (CEHB) in 2023. Information concerning the main characteristics of the patients (age, sex, and residence), etiology and severity of burns, and pre-hospital management of patients was analyzed. Results: Most patients (63.41%) resided in urban areas, with a higher prevalence of males (55.89%). Thermal burns accounted for 77.69% of cases, primarily caused by water, food, oil, or flames. Burns covered ≤10% TBSA in 77.19% of cases, while 6.52% extended beyond 50% TBSA. First aid was provided to 52.63% of patients at the accident site, often by non-specialized individuals. The mean time to presentation was 34.90 h, with significant correlations between time, age, burned body surface area, and burn depth. Conclusions: There is a real need for improvements in first-aid training and health initiatives to enhance pre-hospital burn care. Better documentation of the care provided to patients before being admitted to specialized centers, as well as further studies in this field, are absolutely necessary for improving prevention programs and burn management in the acute stage. Full article

Background: The wound healing process presents notable challenges for nursing teams, requiring extensive knowledge of wound care materials. A nanoparticle-free, bioabsorbable pol-yvinyl alcohol (PVA) with citric acid (CA) dressing produced by simple electrospin-ning was evaluated to treat acute wound healing in rats. This PVA-CA combination promotes crosslinking, increases the dressing capacity of absorption and confers heal-ing properties due to the citric acid antioxidant action. Methods: The dressing was tested in a quantitative experiment on 1.9 cm acute dermatological lesions in rats (n = 12), com-paring the PVA-CA-treated group with the untreated control group (CG). Samples were collected at 3, 7 and 14 days after lesion induction to evaluate the inflammatory process and tissue healing. Results: The macroscopic and histological data on the third day showed similar characteristics in both groups; however, after fourteen days, the PVA-CA group exhibited complete healing, accompanied by recomposition of the skin layers, whereas the wounds in the CG did not close completely. Conclusions: The results highlight that electrospun PVA-AC dressings improve healing outcomes and constitute a prom-ising and affordable solution, providing a suitable environment for tissue repair, re-ducing inflammatory cell infiltration, blood vessel formation, and restoration of epi-thelial tissue, reducing the time of the healing process of acute wounds. Full article

Background: Burn injuries constitute a significant global health challenge, especially in pediatric populations, where they are a leading cause of morbidity and mortality. Pediatric burns require particular attention due to their unique pathophysiology, long-term consequences on growth and development, and psychological impacts. Methods: We propose a comprehensive review of recent advancements in understanding the key aspects of hormonal and metabolic changes in burned children, aiming to guide therapeutic interventions, improve outcomes, and reduce the global burden of these injuries. Results: Effective management of the physiological stress response in pediatric burn patients necessitates a multidisciplinary approach integrating medical, nutritional, and rehabilitative strategies. Timely nutritional support and individualized plans preserve muscle mass, promote wound healing, and reduce complications and organ dysfunction risk. Advances in pharmacological interventions, such as beta-blockers, anabolic agents, and hormonal treatment, offer promising pathways to improve recovery and mitigate long-term complications. Early mobilization and physiotherapy are essential for preventing complications of prolonged immobility, including muscle wasting, joint contractures, and functional decline; their effectiveness is closely tied to advancements in minimally invasive procedures, regenerative medicine, and reconstructive techniques, particularly for pediatric patients. Conclusions: While current strategies have significantly improved survival and outcomes for pediatric burn patients, ongoing research is critical to refine these new care strategies. Full article