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Burn Wound Assessment and Initial Surgical Management
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Burn Wound Assessment and Initial Surgical Management

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

Deadline for manuscript submissions: closed (31 March 2022) | Viewed by 9946

Special Issue Editor

Prof. Dr. Hans Oliver Rennekampff

E-Mail Website
Guest Editor
Klinik für Plastische Chirurgie, Hand-und Verbrennungschirurgie, Wurselen, Germany
Interests: burn surgery; plastic and aesthetic surgery; burn injuries; pressure ulcers; skin tissue replacement; wound healing
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Modern treatment for burn injuries necessitates a highly complex, comprehensive and multidisciplinary strategy if we are to optimally manage and care for our patients.

Although there have been remarkable improvements in the care of patients who suffer burns over the last century, tragically, mortality remains high, and the ever-present and often devastating late sequalae such scarring and contracture complicate and require further intervention and treatment. 

It is hypothesized that improved or at least perhaps proper and timely initial management may reduce these complications and improve outcomes.

Even in the 21st century, and despite the many advances, lessons learned and purported adjunctive tools and measures, the assessment of the burn depth remains an inexact science contingent upon experience and subjective evaluation of pain, capillary refill, history and visualization of the wound surface. This can lead to inaccurate characterization of the depth and extent of the burn injury, resulting in unnecessary harm from over-, under- or delayed treatment. 

Effective surgical as well as non-surgical management of thermally injured patients and the wound proper is considered critical for optimized healing. The timing, quality and extent of the initial interventions continue to challenge our efforts and remain a subject of debate.

In summary, the initial management of burn wounds with proper diagnosis, thoughtful and well-defined treatment regimens and appropriate foresight remains critical if we are to obtain optimal outcomes for the patients in our care. Further clinical and experimental research will improve burn management.

Prof. Dr. Hans-Oliver Rennekampff
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. European Burn Journal is an international peer-reviewed open access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 971 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • burn
  • wound
  • assessment
  • outcome
  • debridement
  • surgery

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Published Papers (3 papers)

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Review

7 pages, 251 KiB  
Review
“Out of Touch”—Recovering Sensibility after Burn Injury: A Review of the Literature
by Savas Tsolakidis, Ziyad Alharbi, Hans Oliver Rennekampff, Markus Robert Schmidhammer, Robert Schmidhammer and Rudolf Rosenauer
Eur. Burn J. 2022, 3(2), 370-376; https://doi.org/10.3390/ebj3020032 - 14 Jun 2022
Cited by 3 | Viewed by 3451
Abstract
Background: Full-thickness burn injuries (FTBI) not only lead to a significant burden in multiple ways, including social life and self-esteem, but have also a tremendous impact on environmental interaction by reducing sensibility in manifold ways. On these grounds, possible ways and solutions to [...] Read more.
Background: Full-thickness burn injuries (FTBI) not only lead to a significant burden in multiple ways, including social life and self-esteem, but have also a tremendous impact on environmental interaction by reducing sensibility in manifold ways. On these grounds, possible ways and solutions to recover sensibility in burn wounds are essentials and should not be overlooked. Methods: A review of experimental, clinical studies and the related literature was performed with the aim to highlight post-burn nerve regeneration and discover ways for sensory re-integration to complement the therapeutic concept. Results: In human burn injuries, it has been hypothesized that grafted cells, partly multipotent stem cells, could be additionally responsible for nerve regeneration in burn wound areas. In addition, burn eschar excision, performed within a short post-burn time frame, can reduce or even avoid long-term nerve damage by reducing post-burn toxic mediator release. Various animal studies could demonstrate sensory reinnervation of different qualities in burn wounds. Post-burn scar tissue prevents, or at least decelerates, nerve reinnervation, but could be reduced by targeted mediators. Conclusion: Sensory loss is present in skin grafted areas following full-thickness burn-wound excision, thereby leading to a reduction in quality of life. In addition, various mediators might reduce or avoid nerve damage and should be considered at an early stage as part of a holistic burn-patient therapeutic approach. In addition, supportive multifaceted physical therapy strategies are essential. Full article
(This article belongs to the Special Issue Burn Wound Assessment and Initial Surgical Management)
15 pages, 343 KiB  
Review
Role, Development, and Value of Enzymatic Debridement as Integral Component in Initial Treatment of Burn Injuries Exemplified by NexoBrid®
by Maximilian M. Mattern, Paul C. Fuchs and Jennifer L. Schiefer
Eur. Burn J. 2022, 3(2), 340-354; https://doi.org/10.3390/ebj3020029 - 21 Apr 2022
Cited by 5 | Viewed by 2627
Abstract
Despite intensive research and increased knowledge over the past decades, the handling of severe burn injuries remains complex and is mainly based on clinical experience. High demands in terms of the diagnosis and choice of therapy often confront clinicians with challenging circumstances. Thus, [...] Read more.
Despite intensive research and increased knowledge over the past decades, the handling of severe burn injuries remains complex and is mainly based on clinical experience. High demands in terms of the diagnosis and choice of therapy often confront clinicians with challenging circumstances. Thus, the treatment of burn injuries has predominantly remained under the responsibility of specialised centres. As a new approach in addition to conventional surgery, enzymatically controlled debridement has come into focus for the treatment of burn injuries over the past years. The efficacy and safety of enzymatic debridement has already been implemented by numerous reputable studies. Promising results from the literature are enhanced by feedback from various conference contributions, intradisciplinary exchanges, and international collaborations. The implementation of enzymatic debridement in initial care management was found to be capable of reforming Standards of Care in numerous burn centres by facilitating treatment determinations and reducing the number of classical surgical interventions. Nevertheless, its use is also subject to certain restrictions as usage has shown limitations concerning efficacy when applied to scalds or pre-treated wounds. Enzymatic debridement shows high efficacy in terms of tissue debridement by combining this feature with the minimisation of collateral damage and a broad field of application in burn injuries. Due to their impressive performance in the treatment of burn injuries, enzyme-based techniques have also attracted attention for the treatment of other pathologies such as chronic wounds and are objects of ongoing research in this field. In this article, we illustrate the significance of enzyme-based treatment in initial burn care and shed some light on the potential value of enzymatic approaches in future burn surgery. Full article
(This article belongs to the Special Issue Burn Wound Assessment and Initial Surgical Management)
12 pages, 293 KiB  
Review
Damage Control Surgery after Burn Injury: A Narrative Review
by Hans-Oliver Rennekampff and Mayer Tenenhaus
Eur. Burn J. 2022, 3(2), 278-289; https://doi.org/10.3390/ebj3020024 - 1 Apr 2022
Cited by 5 | Viewed by 3254
Abstract
Burn injuries with cutaneous loss result in a severe systemic response when profound injuries exceed 20% of the total body surface area. The management of severely burned patients is a complex and dynamic process. Timely and safe operative interventions are critical components of [...] Read more.
Burn injuries with cutaneous loss result in a severe systemic response when profound injuries exceed 20% of the total body surface area. The management of severely burned patients is a complex and dynamic process. Timely and safe operative interventions are critical components of multidisciplinary care. Effective management of severely burned patients, their cutaneous injuries, and the associated systemic disease requires a comprehensive understanding of the pathophysiologic response to trauma, objective indicators of patient status, and an appreciation for the dynamic nature of these parameters. Progress in both clinical and basic science research has advanced our understanding of these concepts and our approach to the management of burn patients. Incorporating concepts such as early total care, damage control surgery (DCS), and safe definitive surgery (SDS) in the polytraumatized patient may further aid in optimizing outcomes and quality of care for burn patients. This article connects current knowledge of the lethal triad, inflammation, immunosuppression, and eschar-derived toxins, with surgical burn care, especially burn wound debridement. The concepts of DCS and SDS for the care and management of burn patients are strongly advocated. Experimental and clinical studies are encouraged to validate these concepts in an effort to optimize patient outcomes. Full article
(This article belongs to the Special Issue Burn Wound Assessment and Initial Surgical Management)
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