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 24.8 days after submission; acceptance to publication is undertaken in 4.8 days (median values for papers published in this journal in the second half of 2024).
- Recognition of Reviewers: APC discount vouchers, optional signed peer review, and reviewer names published annually in the journal.
- Companion journal: Healthcare.
Impact Factor:
1.1 (2023);
5-Year Impact Factor:
1.0 (2023)
Latest Articles
The Potential Use of Fibrin Sealants in Burn Wound Management: A Comprehensive Review of Experimental and Clinical Studies
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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Open AccessCase Report
Explosion-Related Polytrauma from Illicit Pyrotechnics: Two Case Reports and a Public Health Perspective
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Maria Fueth, Simon Bausen, Sonja Verena Schmidt, Felix Reinkemeier, Marius Drysch, Yonca Steubing, Jannik Hinzmann, Marcus Lehnhardt, Elisabete Macedo Santos and Christoph Wallner
Eur. Burn J. 2025, 6(2), 31; https://doi.org/10.3390/ebj6020031 - 3 Jun 2025
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Firework-related injuries remain a serious public health issue in Germany, especially during New Year’s Eve. While many injuries are minor, the misuse of illegal or homemade fireworks can cause severe trauma resembling military combat injuries and can heavily burden emergency services. Notably, injury
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Firework-related injuries remain a serious public health issue in Germany, especially during New Year’s Eve. While many injuries are minor, the misuse of illegal or homemade fireworks can cause severe trauma resembling military combat injuries and can heavily burden emergency services. Notably, injury rates declined during the COVID-19 firework bans, underscoring the impact of preventive measures. We report two cases of young males with severe injuries from illicit fireworks. The first is a case of a 16-year-old that detonated an illegal Polish firework ball bomb, sustaining 9% total body surface area (TBSA) burns (second- to third-degree), hand fractures, compartment syndrome of the hand, and soft-tissue trauma. He underwent multiple surgeries, including fasciotomy, osteosynthesis, and skin grafting. The other case presented is a 19-year-old man who was injured by a homemade device made of bundled firecrackers, suffering deep facial and bilateral hand burns. He required prolonged ventilation, surgical debridement, and treatment with Kerecis® fish skin and Epicite® dressings. Both required intensive ICU care, interdisciplinary management, and lengthy rehabilitation. Total hospital costs amounted to €58,459.52 and €94,230.23, respectively, as calculated according to the standardized German DRG. These cases illustrate the devastating impact of illegal fireworks. The devastating consequences of explosive trauma are often difficult to treat and may lead to long-term functional and psychological impairments. Prevention through public education, stricter regulations, and preparedness is essential. Pandemic-era injury reductions support sustained policy efforts.
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Open AccessReview
Laboratory-Generated Autologous Skin Substitutes for Burn Treatment in Europe: Narrative Review, Experts’ Opinion, and Legal Considerations
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Celine Auxenfans, Rocio G. Valencia, Philippe Abdel-Sayed, Miguel Alaminos, Jean-François Brunet, Fernando Campos, Jesus Chato-Astrain, Gloria Carmona, Anthony de Buys Roessingh, Stephanie Droz-Georget, Melinda Farkas, Ana Fernandez Gonzalez, Enikö Gönczi, Fredrik Huss, Bernd Hartmann, Barbara Heusi, Alexandra Karström, Naiem Moiemen, Giulia Sartoris, Antje Spranger, Marina Trouillas, Claudia Rosas, Jyrki Vuola, Vivienne Woodtli, Clemens Schiestl and Sophie Böttcheradd
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Eur. Burn J. 2025, 6(2), 30; https://doi.org/10.3390/ebj6020030 - 3 Jun 2025
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Autologous skin substitutes represent a promising advancement in the treatment of burn injuries, offering personalized solutions for patients with extensive skin loss. This white paper synthesizes the current knowledge on laboratory-generated autologous skin substitutes in Europe, incorporating expert opinions and legal considerations. The
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Autologous skin substitutes represent a promising advancement in the treatment of burn injuries, offering personalized solutions for patients with extensive skin loss. This white paper synthesizes the current knowledge on laboratory-generated autologous skin substitutes in Europe, incorporating expert opinions and legal considerations. The white paper examines the scientific principles underlying autologous skin substitute development, including cell sourcing, bioengineering techniques, and clinical applications. The regulatory framework governing the production and use of these advanced therapies in Europe is also examined, highlighting challenges in standardization, safety, and approval pathways. The text features expert insights that offer a real-world perspective on the clinical viability and translational hurdles of autologous skin substitutes. The findings highlight the potential of autologous skin substitutes to improve burn treatment outcomes while emphasizing the need for harmonized regulations to facilitate clinical implementation. Despite technological advancements, significant challenges persist, including production costs, scalability, and long-term efficacy. Another focus of this white paper are the legal changes, which have significantly impacted the production and availability of these technologies. The review concludes that while autologous skin substitutes hold great promise, further research, regulatory refinement, and interdisciplinary collaboration are essential to optimize their integration into clinical practice.
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Open AccessCase Report
Cosmetic Outcomes of the First Bodybuilder Using a Low-Cost Modified Culture Technique for Burn Wound Coverage: A Case Report and Long-Term Follow-Up
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Wayne George Kleintjes and Tarryn Kay Prinsloo
Eur. Burn J. 2025, 6(2), 29; https://doi.org/10.3390/ebj6020029 - 3 Jun 2025
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Cultured epidermal autografts (CEAs) serve as an alternative permanent skin replacement, though high costs often limit their use in resource-constrained settings and to life-saving cases. This case report presents the first documented cosmetic application of a modified CEA technique in a bodybuilder, demonstrating
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Cultured epidermal autografts (CEAs) serve as an alternative permanent skin replacement, though high costs often limit their use in resource-constrained settings and to life-saving cases. This case report presents the first documented cosmetic application of a modified CEA technique in a bodybuilder, demonstrating favorable aesthetic outcomes. A 28-year-old Black male with a 20% total body surface area burn sustained in a domestic fire exhibited superficial and deep partial-thickness burns to the face, arms, torso, and feet. Refusing grafts from visible donor sites, treatment using a low-cost modified CEA approach was employed to minimize donor site morbidity. Keratinocytes harvested from a groin biopsy were cultured on Cutimed Sorbact® (Essity AB, BSN Medical (Pty) Ltd., Pinetown, RSA) dressings with autogenous plasma and hydrogel supplementation and incubated at 37 °C for two weeks. Xenografts provided temporary coverage before CEA transplantation. Graft take was 85%, with minor (15%) loss at 21 days, requiring small autograft coverage. At two months, the Vancouver Scar Scale score was 4, indicating optimal pigmentation, smoother texture, and minimal scarring. These findings align with limited studies on CEAs for cosmetic applications, suggesting this cost-effective technique may broaden the scope of CEAs beyond life-saving interventions to include aesthetic reconstruction, reducing both donor site morbidity and scarring.
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Open AccessArticle
From Data to Decisions: Leveraging Retrieval-Augmented Generation to Balance Citation Bias in Burn Management Literature
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Ariana Genovese, Srinivasagam Prabha, Sahar Borna, Cesar A. Gomez-Cabello, Syed Ali Haider, Maissa Trabilsy, Cui Tao and Antonio Jorge Forte
Eur. Burn J. 2025, 6(2), 28; https://doi.org/10.3390/ebj6020028 - 2 Jun 2025
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(1) Burn injuries demand multidisciplinary, evidence-based care, yet the extensive literature complicates timely decision making. Retrieval-augmented generation (RAG) synthesizes research while addressing inaccuracies in pretrained models. However, citation bias in sourcing for RAG often prioritizes highly cited studies, overlooking less-cited but valuable research.
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(1) Burn injuries demand multidisciplinary, evidence-based care, yet the extensive literature complicates timely decision making. Retrieval-augmented generation (RAG) synthesizes research while addressing inaccuracies in pretrained models. However, citation bias in sourcing for RAG often prioritizes highly cited studies, overlooking less-cited but valuable research. This study examines RAG’s performance in burn management, comparing citation levels to enhance evidence synthesis, reduce selection bias, and guide decisions. (2) Two burn management datasets were assembled: 30 highly cited (mean: 303) and 30 less-cited (mean: 21). The Gemini-1.0-Pro-002 RAG model addressed 30 questions, ranging from foundational principles to advanced surgical approaches. Responses were evaluated for accuracy (5-point scale), readability (Flesch–Kincaid metrics), and response time with Wilcoxon rank sum tests (p < 0.05). (3) RAG achieved comparable accuracy (4.6 vs. 4.2, p = 0.49), readability (Flesch Reading Ease: 42.8 vs. 46.5, p = 0.26; Grade Level: 9.9 vs. 9.5, p = 0.29), and response time (2.8 vs. 2.5 s, p = 0.39) for the highly and less-cited datasets. (4) Less-cited research performed similarly to highly cited sources. This equivalence broadens clinicians’ access to novel, diverse insights without sacrificing quality. As plastic surgery evolves, RAG’s inclusive approach fosters innovation, improves patient care, and reduces cognitive burden by integrating underutilized studies. Embracing RAG could propel the field toward dynamic, forward-thinking care.
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Open AccessArticle
The Impact of Face and Neck Burns on Respiratory Complications and Mortality
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Rares-Adrian Giurgiu, Eliza-Maria Bordeanu-Diaconescu, Andreea Grosu-Bularda, Adrian Frunza, Sabina Grama, Raducu-Andrei Costache, Carina-Ioana Cristescu, Tiberiu-Paul Neagu, Ioan Lascar and Cristian-Sorin Hariga
Eur. Burn J. 2025, 6(2), 27; https://doi.org/10.3390/ebj6020027 - 22 May 2025
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Face and neck burns present significant clinical challenges due to their proximity to the airway, predisposing patients to inhalation injuries and subsequent respiratory complications. In our cohort of 206 patients, facial and neck burns were associated with a markedly higher incidence of inhalation
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Face and neck burns present significant clinical challenges due to their proximity to the airway, predisposing patients to inhalation injuries and subsequent respiratory complications. In our cohort of 206 patients, facial and neck burns were associated with a markedly higher incidence of inhalation injury (34.8% vs. 2.8%), necessitating more frequent endotracheal intubation (51.9% vs. 14.1%). Furthermore, respiratory infections were significantly more common in patients with facial and neck burns (26.7% vs. 7%, p < 0.001), with respiratory secretion cultures revealing a predominance of Pseudomonas aeruginosa (39.58%), Acinetobacter baumanii (18.75%), and Klebsiella pneumoniae (6.25%). In contrast, patients without facial and neck burns primarily exhibited Pseudomonas aeruginosa (50%) in their cultures. These complications translated into a significantly increased mortality rate in patients with facial and neck burns (31.1% vs. 12.7%), with a reduced mean survival period (66.7 days vs. 84.3 days) and a 2.8-fold increase in the hazard of mortality. Additionally, older age emerged as a significant determinant for the development of respiratory infections. Multivariable model regression analysis revealed that only TBSA remained a consistent and independent predictor for adverse respiratory outcomes and increased mortality, while face and neck burns are more causally associated with TBSA.
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Open AccessArticle
Wound and Short-Term Scar Outcomes of Meek Micrografting Versus Mesh Grafting: An Intra-Patient Randomized Controlled Trial
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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(2), 26; https://doi.org/10.3390/ebj6020026 - 19 May 2025
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Mesh grafting and Meek micrografting are split-thickness skin graft expansion techniques. This study aimed to compare the effectiveness of Meek and Mesh expansion ratios 1:2 and 1:3 in smaller wounds. An intra-patient randomized controlled trial was conducted at two burn centers (the Netherlands
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Mesh grafting and Meek micrografting are split-thickness skin graft expansion techniques. This study aimed to compare the effectiveness of Meek and Mesh expansion ratios 1:2 and 1:3 in smaller wounds. An intra-patient randomized controlled trial was conducted at two burn centers (the Netherlands and Belgium). Wound outcomes, e.g., take rate, re-epithelialization rate, and donor site size, were measured. At 3 months post-surgery, patient preference and scar quality were evaluated with the Patient and Observer Scar Assessment Scale (POSAS), cutometer and dermaspectrometer. Seventy patients with a TBSA of 10 ± 10% (mean ± SD) were included. The take rate was 79 ± 25% vs. 87 ± 19% (p = 0.003), Meek vs. Mesh, respectively. At follow-up, a majority of observer and patient POSAS items were statistically significantly lower, corresponding with better scar quality for Mesh grafting compared to Meek micrografting. The scar elasticity was 0.37 ± 0.20 vs. 0.42 ± 0.21 (p = 0.013) and mean melanin 13.3 ± 8.3 vs. 12.1 ± 7.7 (p = 0.019) for Meek vs. Mesh, respectively, and the patient preference was 32%, 49%, and 19% for Meek, Mesh, and no preference. Other outcomes showed no statistically significant difference. In patients with smaller wounds, Mesh showed superiority on most wound and short-term scar results. Nevertheless, patient preference within the 1:3 expansion ratio group and donor site size were in favor of Meek.
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Open AccessSystematic Review
Effects of Dispositional Mindfulness and Mindfulness-Based Interventions on the Psychosocial Consequences of Burn Injuries: A Systematic Review
by
Luca Simione
Eur. Burn J. 2025, 6(2), 25; https://doi.org/10.3390/ebj6020025 - 15 May 2025
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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
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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.
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Open AccessArticle
The Reconstruction of Various Complex Full-Thickness Skin Defects with a Biodegradable Temporising Matrix: A Case Series
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Julie van Durme, Thibaut Dhont, Ignace De Decker, Michiel Van Waeyenberghe, Kimberly De Mey, Henk Hoeksema, Jozef Verbelen, Petra De Coninck, Nathalie A. Roche, Phillip Blondeel, Stan Monstrey and Karel E. Y. Claes
Eur. Burn J. 2025, 6(2), 24; https://doi.org/10.3390/ebj6020024 - 14 May 2025
Abstract
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
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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.
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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 AccessReview
The Life Impact Burn Recovery Evaluation (LIBRE) Profile: Historical Overview and Future Directions
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Colleen M. Ryan, Jeffrey C. Schneider, Pengsheng Ni, Mary D. Slavin, Amy Acton, Ananya Vasudevan, Allan Sosa-Ebert and Lewis E. Kazis
Eur. Burn J. 2025, 6(2), 23; https://doi.org/10.3390/ebj6020023 - 14 May 2025
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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
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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.
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Open AccessArticle
The Validation of the ‘CARe Burn Scale: Parent/Caregiver Form’—A Patient Reported Outcome Measure (PROM) Using Rasch Measurement Theory (RMT) to Assess Quality of Life for Parents or Caregivers Supporting a Child with a Burn Injury
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Catrin Griffiths, Timothy Pickles, Ella Guest and Diana Harcourt
Eur. Burn J. 2025, 6(2), 22; https://doi.org/10.3390/ebj6020022 - 7 May 2025
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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
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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.
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(This article belongs to the Special Issue Person-Centered and Family-Centered Care Following Burn Injuries)
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Open AccessSystematic Review
Enhancing Burn Recovery: A Systematic Review on the Benefits of Electrical Stimulation in Accelerating Healing
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Dale O. Edwick, Kerry L. Burns, Lara N. Buonvecchi, Xiaolu Wang, Audrey M. Lim and Dale W. Edgar
Eur. Burn J. 2025, 6(2), 21; https://doi.org/10.3390/ebj6020021 - 5 May 2025
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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.
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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.
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Open AccessArticle
Pediatric Burn Treatment with Non-Thermal Atmospheric Plasma and Epifast®: Clinical Results
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Pablo Rodríguez-Ferreyra, Régulo López-Callejas, Teresa Narváez-Robles, Benjamín Gonzalo Rodríguez-Méndez, Omar Israel Gayosso-Cerón, Antonio Mercado-Cabrera, Irene Lule-Reyna, Othoniel Mondragón-Dagio, Raúl Valencia-Alvarado and Jesús Duarte-Mote
Eur. Burn J. 2025, 6(2), 20; https://doi.org/10.3390/ebj6020020 - 14 Apr 2025
Abstract
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
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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.
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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
Emergency Treatment of Burns in Adults—Characteristics of Adult Patients and Acute/Pre-Hospital Burn Management
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Bogdan Oprita, Georgeta Burlacu, Vlad Mircea Ispas, Ioana Adriana Serban and Ruxandra Oprita
Eur. Burn J. 2025, 6(2), 19; https://doi.org/10.3390/ebj6020019 - 10 Apr 2025
Abstract
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;
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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.
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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
Bioabsorbable Poly(vinyl alcohol)–Citric Acid Dressings: Wound Healing Studies in an Experimental In Vivo Model
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Jonalba Mendes Pereira, Emilia Angela Lo Schiavo Arisawa, Antônio Luiz Martins Maia Filho, José Figueredo-Silva, Nicoly Alves, Carolina Hahn da Silveira and Lucia Vieira
Eur. Burn J. 2025, 6(2), 18; https://doi.org/10.3390/ebj6020018 - 8 Apr 2025
Abstract
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
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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.
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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 AccessReview
Metabolic and Hormonal Changes in Pediatric Burn Patients: Mechanisms, Evidence, and Care Strategies
by
Gloria Pelizzo, Valeria Calcaterra, Michela Marinaro, Paola Baldassarre, Carlotta Paola Maria Canonica and Gianvincenzo Zuccotti
Eur. Burn J. 2025, 6(2), 17; https://doi.org/10.3390/ebj6020017 - 7 Apr 2025
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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:
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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.
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Open AccessEditorial
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”
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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
Abstract
The Editors thank the investigators for displaying tenacity, evidenced by the significant revisions that were necessary to complete this project [...]
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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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Improving Nutrition and Nutrition Education in the Burn Unit of a Developing Country: A Qualitative Study
by
Jonathan Bayuo, Joyce Pwavra, Jephtah Davids, Anita Eseenam Agbeko, Paa Ekow Hoyte-Williams, Frank Bediako Agyei and Pius Agbenorku
Eur. Burn J. 2025, 6(1), 15; https://doi.org/10.3390/ebj6010015 - 10 Mar 2025
Abstract
Burn injuries can trigger a series of metabolic and catabolic responses that exert significant impacts on an individual’s nutritional status, necessitating continuous nutritional support and education to aid recovery. However, burn units in developing countries often face resource limitations that can negatively affect
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Burn injuries can trigger a series of metabolic and catabolic responses that exert significant impacts on an individual’s nutritional status, necessitating continuous nutritional support and education to aid recovery. However, burn units in developing countries often face resource limitations that can negatively affect these needs. This study aimed to explore the challenges related to post-burn nutrition and nutrition education in our burn unit and identify ways to improve the situation. An interpretive description approach was used, and convenience sampling recruited fifty-three participants, including 18 adult burn survivors and their primary caregivers (each as a single dyad), 10 informal caregivers of paediatric burn survivors, and 25 burn care staff. The data were analysed through thematic analysis, revealing three main themes and seven subthemes. The findings highlight an unstructured approach to nutrition and education, along with financial constraints affecting adherence. To address these issues, strategies such as using educational materials like videos and booklets/leaflets in the local language are suggested to develop relevant interventions. In conclusion, while there are concerns about nutrition and education, there are also opportunities to improve the situation.
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(This article belongs to the Special Issue Global Perspectives on Burn Prevention, Management, Collaboration, and Disparities)
Open AccessReview
Recreational Use of Nitrous Oxide as a Source of Frostbite Injuries to the Skin: A Review of the Literature and a Case Report
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Sebastian Holm, Reza Tabrisi and Johann Zdolsek
Eur. Burn J. 2025, 6(1), 14; https://doi.org/10.3390/ebj6010014 - 7 Mar 2025
Abstract
Nitrous oxide has a wide range of medical applications, such as being used as an analgesic in general anesthesia, dental procedures, childbirth and sedation. Lately, it has also been employed as an inhalant recreational drug to induce brief euphoria. Recent studies indicate a
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Nitrous oxide has a wide range of medical applications, such as being used as an analgesic in general anesthesia, dental procedures, childbirth and sedation. Lately, it has also been employed as an inhalant recreational drug to induce brief euphoria. Recent studies indicate a worldwide rise in the incidence of skin frostbites associated with nitrous oxide use. A scoping review was conducted to synthesize and summarize the existing literature published in English regarding frostbite injuries associated with the recreational use of nitrous oxide. The literature search was carried out in July 2024 using databases such as Embase, Web of Science and PubMed®. From an initial pool of 83 publications, 8 studies were ultimately selected for full-text review as they met our inclusion criteria for analysis. Additionally, we provide a representative clinical case involving a 21-year-old male who experienced frostbite following skin exposure to nitrous oxide. Most publications on nitrous oxide induced frostbites are from recent years, primarily between 2022 and 2024, with the first case documented in 1996. These injuries are mostly observed in young adults, with a female dominance, and are typically localized to the inner thighs. According to the existing literature, the predominant treatment approach is conservative management, with excision and split-thickness skin grafting (STSG) in the second place. This study represents the first literature review summarizing frostbite injuries to the skin from nitrous oxide misuse. There is a need for enhanced preventive measures to raise public awareness and reduce the incidence of frostbite injuries associated with the recreational use of nitrous oxide.
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(This article belongs to the Special Issue Global Perspectives on Burn Prevention, Management, Collaboration, and Disparities)
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Open AccessReview
Novel Techniques in Fractional Skin Replacement
by
Courtney Kelly, Rodney K. Chan and Anders H. Carlsson
Eur. Burn J. 2025, 6(1), 13; https://doi.org/10.3390/ebj6010013 - 6 Mar 2025
Abstract
The gold standards for coverage of wounds that cannot be primarily closed are full thickness skin grafts (FTSGs) and split thickness skins graft (STSGs). FTSGs harvest sites generally require primary closure, which limits availability, especially when treating larger wounds. STSGs have many shortcomings,
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The gold standards for coverage of wounds that cannot be primarily closed are full thickness skin grafts (FTSGs) and split thickness skins graft (STSGs). FTSGs harvest sites generally require primary closure, which limits availability, especially when treating larger wounds. STSGs have many shortcomings, including donor site morbidity. Fractional autologous skin replacement can be utilized in conjunction with or in lieu of STSGs to both improve graft outcomes of large wounds and to decrease donor site morbidity. Skin can be mechanically or chemically fractionated. Fractionated skin can be advantageous, as adnexal structures provide additional functionality without donor site morbidity. In this review, we will discuss current and emerging techniques in fractional skin replacement.
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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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Innovative Applications and Challenges of Emerging Materials and Technologies in Burn Treatment
Guest Editor: Fredrik HussDeadline: 31 August 2025