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), Scopus and other databases.
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 24.7 days after submission; acceptance to publication is undertaken in 5.6 days (median values for papers published in this journal in the first 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:
1.0 (2023);
5-Year Impact Factor:
1.0 (2023)
Latest Articles
Establishing a Collaborative Genomic Repository for Adult Burn Survivors: A Burn Model System Feasibility Study
Eur. Burn J. 2024, 5(4), 389-398; https://doi.org/10.3390/ebj5040034 - 6 Nov 2024
Abstract
In this study, we aimed to integrate a genetic repository with an existing longitudinal national burn database. We set out two primary objectives, namely (1) to develop standard operating procedures for genetic sample collection and storage, DNA isolation, and data integration into an
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In this study, we aimed to integrate a genetic repository with an existing longitudinal national burn database. We set out two primary objectives, namely (1) to develop standard operating procedures for genetic sample collection and storage, DNA isolation, and data integration into an existing multicenter database; and (2) to demonstrate the feasibility of correlating genetic variation to functional outcomes in a pilot study, using the catechol-O-methyltransferase (COMT) gene. Dubbed the worrier/warrior gene, COMT variants have been associated with varying phenotypes of post-traumatic stress, wellbeing, and resilience. Between August 2018 and July 2020, COMT variants were identified for 111 participants from three sites and correlated with their outcome data. We found no association between COMT variants and functional outcomes, likely due to the inadequate sample size. We also asked all potential participants why they consented to or refused genetic analysis. A thematic analysis of responses revealed altruism and personal interest/enthusiasm in the study as top reasons for consenting. Privacy concerns were the most common reason for refusal. In conclusion, we successfully developed standard operating procedures for genetic sample collection and storage, DNA isolation, and data integration into an existing database, and we demonstrated the feasibility of conducting a multicenter collaborative study using a centralized lab location.
Full article
(This article belongs to the Special Issue Long-Term Outcomes after Burn Injuries: Strategies to Optimize Recovery)
Open AccessArticle
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
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
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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)
Open AccessConference Report
The 3rd Educational Course of the European Burns Association (EBA)
by
Nadia Depetris, Alette E. E. de Jong, Clemens Schiestl, Frank Siemers, Jill Meirte, Jyrki Vuola, Luís Cabral, Paul Van Zuijlen and Stian Almeland
Eur. Burn J. 2024, 5(4), 346-368; https://doi.org/10.3390/ebj5040032 - 21 Oct 2024
Abstract
Abstracts of the plenary sessions, workshops, and poster presentations of the 3rd EBA Educational Course in Porto, Portugal, 17–18 October 2024.
Full article
Open AccessArticle
Suprathel Versus Hypafix in the Management of Split-Thickness Donor Site Wounds in the Elderly: A Randomised Controlled Trial
by
David Cussons, Justine Sullivan, Quentin Frew and David Barnes
Eur. Burn J. 2024, 5(4), 335-345; https://doi.org/10.3390/ebj5040031 - 17 Oct 2024
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(1) Background: Effective wound management aims for expedited healing, improved functional and scar outcomes, and reduced complications including infection. Delayed wound healing remains a prevalent problem in the elderly. Suprathel is a synthetic absorbable skin substitute and an attractive option in partial thickness
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(1) Background: Effective wound management aims for expedited healing, improved functional and scar outcomes, and reduced complications including infection. Delayed wound healing remains a prevalent problem in the elderly. Suprathel is a synthetic absorbable skin substitute and an attractive option in partial thickness wounds. The objective of this randomised controlled study was to assess the effect of skin substitute dressings on elderly split-skin graft (STSG) donor sites, evaluating time to heal, pain, itch and scar outcome. (2) Methods: 40 patients over 65 undergoing split-thickness skin grafting for non-melanoma skin cancer excision were randomised to STSG donor site dressings with either Suprathel or Hypafix. Patients were followed up weekly until healed and at 13 weeks post-procedure. (3) Results: There was no significant difference in time to healing, pain, itch, or scar outcome at 13 weeks between the two groups. The mean time to healing was 31.7 days for the skin substitute group and 27.3 days for the adhesive tape control group (p = 0.182). (4) Conclusions: Both dressings are appropriate for STSG donor sites. Hypafix remains a cost-effective dressing of choice for donor sites. Benefits demonstrated in other studies using skin substitutes have not translated into the elderly population. There remains scope in developing dressings that reduce elderly donor site morbidity.
Full article
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Open AccessArticle
Measurement Equivalence and Feasibility of the Electronic and Paper Versions of the POSAS, EQ-5D, and DLQI: A Randomized Crossover Trial
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Jill Meirte, Nick Hellemans, Ulrike Van Daele, Koen Maertens, Lenie Denteneer, Mieke Anthonissen and Peter Moortgat
Eur. Burn J. 2024, 5(4), 321-334; https://doi.org/10.3390/ebj5040030 - 11 Oct 2024
Abstract
Patient-reported outcome measures (PROMs) are crucial within person-centered care. The use of electronic PROMs (ePROMs) is increasing and multiple advantages have been described. The Patient and Observer Scar Assessment Scale (POSAS) is a validated paper questionnaire to assess patient-reported scar quality in the
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Patient-reported outcome measures (PROMs) are crucial within person-centered care. The use of electronic PROMs (ePROMs) is increasing and multiple advantages have been described. The Patient and Observer Scar Assessment Scale (POSAS) is a validated paper questionnaire to assess patient-reported scar quality in the burn and scar population. In burn and scar rehabilitation, quality of life questionnaires such as the Euroqol 5 Dimensions 5 level (EQ-5D-5L) and the Dermatology Life Quality Index (DLQI) allow us to measure physical and psychosocial impact. The goal of this research was to compare the equivalence of the electronic versions of the POSAS, the EQ-5D-5L, and the DLQI with their original paper counterparts. To ensure the psychometric properties of the electronic versions, we assessed the equivalence of scores, the differences in completion time, and patients’ preferred mode and ease of use. We used a randomized crossover design using a within-subject comparison of the formats of the questionnaires. Participants aged over 18 with a scar were recruited from an outpatient after-care and research center for burns and scars in Antwerp, Belgium. The equivalence of the electronic questionnaires POSAS, EQ-5D-5L, and DLQI is assumed based on the findings of this study. Completion times were faster for all the electronic versions but only statistically different (p = 0.002) for the electronic version of the EQ-5D-5L. The number of missing answers could be reduced to 0. The electronic assessment was preferred in >75% of the cases and subjects found it easy to use, and a tool that could improve the quality of care. Our findings support the electronic delivery of POSAS, EQ-5D, and DLQI, within the burn and scar population.
Full article
(This article belongs to the Special Issue Person-Centered and Family-Centered Care Following Burn Injuries)
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Open AccessArticle
Working Conditions for Burns Resident Doctors—Better Now than Ever?
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Grant Coleman, Toby Austin, James F. Forrest and Sarah E. Bache
Eur. Burn J. 2024, 5(4), 309-320; https://doi.org/10.3390/ebj5040029 - 25 Sep 2024
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Background: The work and life of a resident (or “junior”) doctor has changed dramatically over the past 50 years. Descriptions of historic working conditions are usually anecdotal and tinted with nostalgia, but do today’s burns and plastic surgery doctors feel working conditions have
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Background: The work and life of a resident (or “junior”) doctor has changed dramatically over the past 50 years. Descriptions of historic working conditions are usually anecdotal and tinted with nostalgia, but do today’s burns and plastic surgery doctors feel working conditions have improved or declined over the last 50 years, and does this have an impact on recruitment and retention? Methods: An interview was conducted with a retired surgeon who, in 1970, worked as a house surgeon (Year 2 doctor equivalent) in a burns unit for the pioneering burn surgeon Mr. Douglas MacGregor Jackson. This was coupled with a literature review to objectively assess working conditions in that period for doctors. The information generated from this produced a poster summarizing the key differences between these periods. This was presented to the current medical work force, and a survey was conducted to determine their preferences for working conditions. Results: The questionnaire was completed by 68 doctors of mixed grades and backgrounds. The majority of respondents (60%) would choose to work in today’s burns centres. There was a significant difference between the mean age of respondents’ preference of working conditions in 1970 (37 years) and those preferring today (31 years) (p = 0.035). Conclusions: Multiple changes in the working conditions and the management of burns patients were identified. The majority of those who were asked consider today’s working conditions to be better than those of the past. However, more senior clinicians tended to prefer the conditions of 1970 over the present day, suggesting a generational shift in opinion.
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Open AccessReview
Diagnosis and Treatment of Infections in the Burn Patient
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David G. Greenhalgh and John L. Kiley
Eur. Burn J. 2024, 5(3), 296-308; https://doi.org/10.3390/ebj5030028 - 4 Sep 2024
Abstract
Infection is very common in burn patients because they lose the primary barrier from microorganism invasion, the skin. While there are attempts to prevent infections, topical antimicrobials and systemic prophylaxis tend to lead to more resistant organisms. After the initial resuscitation, the most
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Infection is very common in burn patients because they lose the primary barrier from microorganism invasion, the skin. While there are attempts to prevent infections, topical antimicrobials and systemic prophylaxis tend to lead to more resistant organisms. After the initial resuscitation, the most common cause of death is from sepsis and multiple organ dysfunction syndrome. The diagnosis is difficult in the burn population because the constant exposure from the open wound leads to an inflammatory response that leads to persistent hypermetabolism. This paper reviews the current understanding and treatment of infection and sepsis in burns.
Full article
(This article belongs to the Special Issue Burn Injuries Associated with Wars and Disasters)
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Open AccessCase Report
High-Voltage Electrical Burn Requiring Urgent Scalp Reconstruction after Developing a Brain Abscess
by
Elena Blyth, Elizabeth Vujcich and Darryl Dunn
Eur. Burn J. 2024, 5(3), 288-295; https://doi.org/10.3390/ebj5030027 - 3 Sep 2024
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Electrical burn injuries to the scalp are at risk of extensive tissue damage and neurological complications. We present the case of a patient who came into contact with a high-voltage power line while cherry picking, resulting in a large full-thickness scalp defect. Early
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Electrical burn injuries to the scalp are at risk of extensive tissue damage and neurological complications. We present the case of a patient who came into contact with a high-voltage power line while cherry picking, resulting in a large full-thickness scalp defect. Early on in his presentation, he developed progressive global weakness which remained relatively static during his admission. An incidental finding of an extradural abscess complicated his management, requiring urgent surgical intervention with definitive tissue coverage. The scalp was reconstructed using a free myocutaneous anterolateral thigh flap. There were no postoperative complications. Following rehabilitation, the patient was discharged home with limited functional recovery. He mobilises independently with a wheelchair and requires full-time carers.
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Open AccessEditorial
Introduction to the Special Issue on Wars and Disasters: Advancing Care during Times of Crisis
by
Leopoldo C. Cancio
Eur. Burn J. 2024, 5(3), 283-287; https://doi.org/10.3390/ebj5030026 - 2 Sep 2024
Abstract
Civilian mass-casualty disasters and armed conflict share many features, including the fact that both maximally challenge multidisciplinary burn teams. Rigorous training is required to build teams and systems that can respond effectively. One of the critical but potentially overlooked components of readiness for
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Civilian mass-casualty disasters and armed conflict share many features, including the fact that both maximally challenge multidisciplinary burn teams. Rigorous training is required to build teams and systems that can respond effectively. One of the critical but potentially overlooked components of readiness for crisis care is a robust clinical research program. Rather than stalling progress, disasters and conflict over the last 100 years consistently energized advances in care. This was made possible by the hard work of our predecessors to learn from the crisis in the midst of the crisis, and resulted in significant reductions in postburn mortality. Now, further work is needed not only to maintain these improvements in mortality, but also to understand the long-term functional outcomes and to improve the quality of life of burn survivors. Clinical research programs to address these issues must be established now, so that we are optimally prepared for the next conflict or disaster.
Full article
(This article belongs to the Special Issue Burn Injuries Associated with Wars and Disasters)
Open AccessCase Report
The Successful Treatment of Multi-Resistant Colonized Burns with Large-Area Atmospheric Cold Plasma Therapy and Dermis Substitute Matrix—A Case Report
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Moritz R. Milewski, Frederik Schlottmann, Vincent März, Thorben Dieck and Peter M. Vogt
Eur. Burn J. 2024, 5(3), 271-282; https://doi.org/10.3390/ebj5030025 - 26 Aug 2024
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The treatment of severe burn injuries, which occur particularly in the context of armed conflicts, is based on a multimodal treatment concept. In addition to complex intensive care therapy, the surgical reconstruction options of plastic surgery and typical antiseptic wound treatment are the
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The treatment of severe burn injuries, which occur particularly in the context of armed conflicts, is based on a multimodal treatment concept. In addition to complex intensive care therapy, the surgical reconstruction options of plastic surgery and typical antiseptic wound treatment are the main focuses. In recent years, atmospheric cold plasma therapy (ACPT) has also become established for topical, antiseptic wound treatment and for the optimization of re-epithelialization. This case report shows a successful treatment of extensive burn injuries using dermal skin substitute matrix and topical treatment with a large-area cold plasma device to control multi-resistant pathogen colonization. This case report illustrates the importance of ACPT in burn surgery. However, larger case series and randomized controlled trials in specialized centers are needed to assess its place in future clinical practice.
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Open AccessArticle
Sustainable Primary Cell Banking for Topical Compound Cytotoxicity Assays: Protocol Validation on Novel Biocides and Antifungals for Optimized Burn Wound Care
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Zhifeng Liao, Nicolas Laurent, Nathalie Hirt-Burri, Corinne Scaletta, Philippe Abdel-Sayed, Wassim Raffoul, Shengkang Luo, Damian J. Krysan, Alexis Laurent and Lee Ann Applegate
Eur. Burn J. 2024, 5(3), 249-270; https://doi.org/10.3390/ebj5030024 - 6 Aug 2024
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Thorough biological safety testing of topical therapeutic compounds and antimicrobials is a critical prerequisite for appropriate cutaneous wound care. Increasing pathogen resistance rates to traditional antibiotics and antifungals are driving the development and registration of novel chemical entities. Although they are notably useful
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Thorough biological safety testing of topical therapeutic compounds and antimicrobials is a critical prerequisite for appropriate cutaneous wound care. Increasing pathogen resistance rates to traditional antibiotics and antifungals are driving the development and registration of novel chemical entities. Although they are notably useful for animal testing reduction, the gold standard in vitro cytotoxicity assays in continuous cell lines (HaCaT keratinocytes, 3T3 fibroblasts) may be discussed from a translational relevance standpoint. The aim of this study was thus to establish and validate a sustainable primary cell banking model with a view to performing optimized in vitro cytotoxicity assay development. Primary dermal fibroblasts and adipose-derived stem cell (ASC) types were established from four infant polydactyly sources. A multi-tiered primary cell banking model was then applied to prepare highly sustainable and standardized dermal fibroblast and ASC working cell banks (WCBs), potentially allowing for millions of biological assays to be performed. The obtained cellular materials were then validated for use in cytotoxicity assays through in vitro biosafety testing of topical antiseptics (chlorhexidine, hypochlorous acid) and an antifungal compound (AR-12) of interest for optimized burn wound care. The experimental results confirmed that IC50 values were comparable between cytotoxicity assays, which were performed with cell lines and with primary cells. The results also showed that hypochlorous acid (HOCl) displayed an enhanced toxicological profile as compared to the gold standard chlorhexidine (CLX). Generally, this study demonstrated that highly sustainable primary cell sources may be established and applied for consistent topical compound biological safety assessments with enhanced translational relevance. Overall, the study underscored the safety-oriented interest of functionally benchmarking the products that are applied on burn patient wounds for the global enhancement of burn care quality.
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Open AccessArticle
Balance Impairment in the Burn Population: A Burn Model System National Database Study
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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
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
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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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Open AccessArticle
Resource Requirements in a Burn Mass Casualty Event
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Wei Lun Wong, Kristina Carlsson, Marie Lindblad, Olivia Sjökvist and Fredrik Huss
Eur. Burn J. 2024, 5(3), 228-237; https://doi.org/10.3390/ebj5030022 - 2 Jul 2024
Abstract
Burn mass casualty event occurrences are rare but will place significant burdens on any burn unit or healthcare system. Effective disaster preparedness plays a significant role in mitigating the aftermath of a burn mass casualty. The aim of this study was to assess
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Burn mass casualty event occurrences are rare but will place significant burdens on any burn unit or healthcare system. Effective disaster preparedness plays a significant role in mitigating the aftermath of a burn mass casualty. The aim of this study was to assess the resource requirements during the initial two weeks of a burn mass casualty event. Eight patients in a burn mass casualty event were simulated using the Emergo Train System®. These simulated patients were matched with real historical patients treated in our burn centre, and their resource requirements were analysed. An average of eight staff is required to care for a patient per day along with almost 75 h of operating time (excluding anaesthesia and turnover time). A substantial quantity of consumables was used in the first two weeks. This study has demonstrated the substantial material consumption and staff requirements in the first two weeks of management in a burn mass casualty event. Such findings will offer valuable insight for disaster preparedness planning and resource management strategies.
Full article
(This article belongs to the Special Issue Burn Injuries Associated with Wars and Disasters)
Open AccessArticle
Qualitative Descriptive Research Investigating Burn Survivors’ Perspectives on Quality of Care Aspects
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Raaba S. M. Thambithurai, Lotte van Dammen, Margriet E. van Baar, Hendriët Wanders, Angelique E. A. M. Weel-Koenders, Tsjitske M. Haanstra, Carine M. H. van Schie, Paul P. M. van Zuijlen, Cornelis H. van der Vlies, Eelke Bosma, Corine A. Lansdorp, Inge Spronk, Nancy E. E. Van Loey and on behalf of the National Burn Care, Education & Research Group, The Netherlands
Eur. Burn J. 2024, 5(3), 215-227; https://doi.org/10.3390/ebj5030021 - 1 Jul 2024
Abstract
Burn care quality indicators are used to monitor and improve quality of care and for benchmark purposes. The perspectives of burn survivors, however, are not included in current sets of quality indicators while patient-centred care gains importance. The aim of this study was
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Burn care quality indicators are used to monitor and improve quality of care and for benchmark purposes. The perspectives of burn survivors, however, are not included in current sets of quality indicators while patient-centred care gains importance. The aim of this study was to explore burn survivors’ perspectives on quality aspects of burn care, which was used to translate their perspectives into patient-centred quality of care indicators. Qualitative descriptive research was conducted in a patient panel group. First, thematic analysis was applied to the focus groups to identify overarching themes. Second, patient-centred quality indicators, informed by burn survivors’ valued aspects of care, were defined. Ten burn survivors with an average age of 54 years (SD = 11; range 38–72 years) and mean TBSA burned of 14% (SD = 11%; range 5–35%) participated in two focus groups. Four overarching themes were identified, pointing to the importance of (1) information tailored to the different phases of recovery, (2) significant others’ wellbeing and involvement, (3) a therapeutic relationship and low-threshold access to healthcare professionals and (4) to participate in decision-making. Eighteen patient-centred process quality of care indicators within nine aspects of care were formulated. The overarching themes are reflected in patient-centred quality indicators, which present a broadened and complementary view of existing clinical quality indicators for burn care. Evaluating these patient-centred quality indicators may increase quality of care and refine patient-centred care.
Full article
Open AccessOpinion
Hypnosis in Burn Care: Efficacy, Applications, and Implications for Austere Settings
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Deanna C. Denman
Eur. Burn J. 2024, 5(3), 207-214; https://doi.org/10.3390/ebj5030020 - 1 Jul 2024
Abstract
Burn injuries are among the most traumatic events a person can endure, often causing significant psychological dysfunction and severe pain. Hypnosis shows promise as a complementary intervention to manage pain and reduce the psychological distress associated with burn injury and treatment. This paper
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Burn injuries are among the most traumatic events a person can endure, often causing significant psychological dysfunction and severe pain. Hypnosis shows promise as a complementary intervention to manage pain and reduce the psychological distress associated with burn injury and treatment. This paper reviews the literature regarding hypnosis and potential applications of hypnosis in the management of burns. Hypnosis offers an effective, low-cost intervention that is widely applicable in the management of burns and can play a role in more acute and austere settings where resources are often limited.
Full article
(This article belongs to the Special Issue Burn Injuries Associated with Wars and Disasters)
Open AccessCase Report
Optimising Scar Management Intervention in the Case of a Head-and-Neck Burn for a Patient with a Learning Disability
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Katie Spooner, Matthew Pilley, Liz Rose, Stephen Frost and Reena Agarwal
Eur. Burn J. 2024, 5(3), 198-206; https://doi.org/10.3390/ebj5030019 - 25 Jun 2024
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Scars following burns can often prove complex to manage, particularly when crossing joints or special areas such as the head and neck, due to contractures. This case report discusses the individualised care and rehabilitation provided to a burn patient with a learning disability.
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Scars following burns can often prove complex to manage, particularly when crossing joints or special areas such as the head and neck, due to contractures. This case report discusses the individualised care and rehabilitation provided to a burn patient with a learning disability. The patient suffered both full and partial thickness burns equating to a total body surface area (%TBSA) of 7% of the face, neck, and anterior chest via the self-ignition of clothing. Acute treatment was provided at a regional burn unit followed by further in-patient care and rehabilitation at our burn facility. A motion rehabilitation instrument was employed to manage potential orofacial contracture; however, due to the patient’s impaired social functioning, this device was found to be unsuitable. Subsequently, a bespoke mouth-opening device replicating an ice lolly was fabricated utilising computer-aided design (CAD), enhancing the patient’s understanding along with encouraging independence. Microstomia was a risk in this case; however, this was prevented via the discussed regime, and successful patient rehabilitation was achieved.
Full article
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Open AccessArticle
Person-Centred Pain Measurement in the ICU: A Multicentre Clinimetric Comparison Study of Pain Behaviour Observation Scales in Critically Ill Adult Patients with Burns
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Alette E. E. de Jong, Wim E. Tuinebreijer, Helma W. C. Hofland and Nancy E. E. Van Loey
Eur. Burn J. 2024, 5(2), 187-197; https://doi.org/10.3390/ebj5020018 - 17 Jun 2024
Abstract
Pain in critically ill adults with burns should be assessed using structured pain behavioural observation measures. This study tested the clinimetric qualities and usability of the behaviour pain scale (BPS) and the critical-care pain observation tool (CPOT) in this population. This prospective observational
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Pain in critically ill adults with burns should be assessed using structured pain behavioural observation measures. This study tested the clinimetric qualities and usability of the behaviour pain scale (BPS) and the critical-care pain observation tool (CPOT) in this population. This prospective observational cohort study included 132 nurses who rated pain behaviour in 75 patients. The majority of nurses indicated that BPS and CPOT reflect background and procedural pain-specific features (63–72 and 87–80%, respectively). All BPS and CPOT items loaded on one latent variable (≥0.70), except for compliance ventilator and vocalisation for CPOT (0.69 and 0.64, respectively). Internal consistency also met the criterion of ≥0.70 in ventilated and non-ventilated patients for both scales, except for non-ventilated patients observed by BPS (0.67). Intraclass correlation coefficients (ICCs) of total scores were sufficient (≥0.70), but decreased when patients had facial burns. In general, the scales were fast to administer and easy to understand. Cut-off scores for BPS and CPOT were 4 and 1, respectively. In conclusion, both scales seem valid, reliable, and useful for the measurement of acute pain in ICU patients with burns, including patients with facial burns. Cut-off scores associated with BPS and CPOT for the burn population allow professionals to connect total scores to person-centred treatment protocols.
Full article
Open AccessEditorial
European Burns Association (EBA)—Summer 2024 News
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Stian Almeland, Nadia Depetris and on behalf of the European Burns Association Executive Board
Eur. Burn J. 2024, 5(2), 185-186; https://doi.org/10.3390/ebj5020017 - 14 Jun 2024
Abstract
The European Burns Association (EBA), as the proud owner of the European Burn Journal (EBJ), is committed to fostering collaboration and maximizing the impact of our common goals, i [...]
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Open AccessArticle
Total Body Surface Area Adjusted Daily Diagnostic Blood Loss May Be Higher in Minor Burns—Are Our Patients the Victims of Daily Routine?
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Christian Smolle, Anna Alexandra Elisabeth Persson, Caroline Lind and Fredrik Huss
Eur. Burn J. 2024, 5(2), 175-184; https://doi.org/10.3390/ebj5020016 - 6 Jun 2024
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Burns are common and devastating injuries, often necessitating intensive care treatment and long-term hospitalisation, making burn patients susceptible to hospital-acquired anaemia and blood transfusion. The purpose of this study was to assess diagnostic blood loss in burn patients at the burn intensive care
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Burns are common and devastating injuries, often necessitating intensive care treatment and long-term hospitalisation, making burn patients susceptible to hospital-acquired anaemia and blood transfusion. The purpose of this study was to assess diagnostic blood loss in burn patients at the burn intensive care unit (BICU) at Uppsala University Hospital between 1 September 2016 and 30 June 2019. Medical records were screened; age, gender, mechanism, % total body surface area (TBSA), Baux score, length of stay, days on the respirator, days of continuous renal replacement therapy, number of operations, and number of blood tests per patient were assessed. Volume per blood test was estimated as the volume needed for the specific test tube. A total of 166 patients were included in the study. The mean TBSA was 18.0% ± 20, and the mean length of stay was 17.0 ± 41 days. Median diagnostic blood loss was 13.1 mL/day/patient (IQR 7.0, 23.9) and correlated positively with burn extent, Baux score, and mortality. Daily diagnostic blood loss/%TBSA/patient was 1.2 mL (IQR 0.7, 2.3). Transfusion of blood products occurred in 73/166 patients (44%). In conclusion, diagnostic blood loss is greatly influenced by TBSA extent. The diagnostic blood loss can reach significant levels and may affect the transfusion rate.
Full article
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Open AccessCase Report
Management of Concomitant Severe Thermal Injury and ST-Elevation Myocardial Infarction
by
Julie Beveridge, Curtis Budden, Abelardo Medina, Kathryne Faccenda, Shawn X. Dodd and Edward Tredget
Eur. Burn J. 2024, 5(2), 169-174; https://doi.org/10.3390/ebj5020015 - 4 Jun 2024
Abstract
Acute coronary thrombosis is a known, but rare, contributor to morbidity and mortality in patients with thermal and electrical injuries. The overall incidence of myocardial infarction among burn patients is 1%, with an in-hospital post-infarction mortality of approximately 67%, whereas the overall mortality
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Acute coronary thrombosis is a known, but rare, contributor to morbidity and mortality in patients with thermal and electrical injuries. The overall incidence of myocardial infarction among burn patients is 1%, with an in-hospital post-infarction mortality of approximately 67%, whereas the overall mortality rate of the general burn patient population is from 1.4% to 18%. As such, early detection and effective peri-operative management are essential to optimize patient outcomes. Here, we report the details of the management of an adult male patient with a 65% total body surface area severe thermal injury, who developed an ST-elevation myocardial infarction (STEMI) in the resuscitation period. The patient was found to have 100% occlusion of his left anterior descending coronary artery, for which prompt coronary artery stent placement with a drug-eluting stent (DES) was performed. Following stent placement, the patient required dual antiplatelet therapy. The ongoing dual antiplatelet therapy required the development of a detailed peri-operative protocol involving pooled platelets, packed red blood cells, desmopressin (DDAVP™) and intraoperative monitoring of the patient’s coagulation parameters with thromboelastography for three staged operative interventions to achieve complete debridement and skin grafting of his burn wounds.
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