Search Results (218)

Burn injuries are increasingly recognized as chronic conditions with enduring physical, psychological and social consequences that extend beyond acute survival. This narrative review synthesizes and interpretatively discusses recent evidence on health-related quality of life (HRQoL) in adult burn survivors, focusing on recovery patterns following discharge. Persistent physical sequelae—particularly chronic pain, pruritus, contractures and scarring—remain major determinants of reduced HRQoL, mainly mediated by functional limitation and self-perception. Psychological morbidity is common, with high rates of depression, anxiety and post-traumatic stress disorder, particularly early after injury, although post-traumatic growth may also emerge. Social reintegration, including return to work, is often delayed or incomplete and is influenced by injury severity, mental health status and social support. Recovery trajectories are nonlinear: the greatest improvements occur within the first six months, followed by slower gains up to 18–24 months, after which many patients fail to reach population norms. Pain and psychological symptoms may persist for years. Overall, these findings support a multidisciplinary, longitudinal approach to burn care, emphasizing early risk stratification and rehabilitation to optimize individualized recovery. In this narrative review, we aim to outline the main dimensions of long-term quality of life, with a particular focus on the temporal dynamics of recovery patterns. Full article

Background: Radiation dermatitis (ARD), particularly its most severe form, moist desquamation (MD), is a frequent and distressing complication of external beam radiotherapy (RT) in head and neck (H&N) cancer patients. Standard management often provides limited benefit for healing and symptom control. Silicone-based foam dressings, including Mepilex Lite and Mepilex Ag, may offer atraumatic adherence, moisture balance, and pain reduction. This study evaluated their real-world effectiveness for MD after conventional RT. Methods: Ten H&N cancer patients with clinically confirmed MD post-radiotherapy were prospectively followed until healing. Patients received Mepilex Lite or Mepilex Ag based on exudate level and infection risk, with dressings changed every three days. Patient- and healthcare provider-reported measures were collected throughout follow-up. The primary endpoint was time to MD resolution, defined as healing to grade 1 skin status. Secondary endpoints included changes in symptom burden, dressing tolerability and satisfaction, and adverse events. Results: Median age was 69 years (range 44–78). All wounds healed to grade 1, with a mean time of 8.6 days (SD 3.9). No infections or adverse events occurred. Pain, burning, and interference with daily activity decreased, and most patients reported improved comfort. Conclusions: In this small prospective cohort study, use of Mepilex dressings was associated with rapid healing, good tolerability, and improvement in patient-reported symptoms of acute radiation dermatitis. These findings suggest that Mepilex dressings may be a promising management option and warrant evaluation in larger comparative studies. Full article

Background: While ibuprofen is a widely used non-opioid analgesic with growing evidence in surgical settings, its safety and efficacy in acute burn care remain poorly characterized. This review aims to address this gap. Methods: A systematic search was conducted in accordance with PRISMA-ScR (September 2025) across PubMed, MEDLINE, CENTRAL, CINAHL, and Scopus for original, English-language studies evaluating the safety and/or efficacy of ibuprofen, distinguishable from multimodal regimens, for acute burn analgesia. Results: Of 136 studies, six met inclusion criteria (5 adult, 1 pediatric). Populations primarily consisted of second- and third-degree burns; only two studies included >10% total body surface area (TBSA). Study designs were heterogeneous, all with moderate to high risk of bias, including one retrospective study (oral ibuprofen), two experimental double-blind placebo randomized controlled trials (RCTs) (topical; oral), and three clinical RCTs (intravenous; topical; topical and oral). No study reported associations with increased adverse events; a retrospective study found no increased bleeding risk with perioperative ibuprofen in skin graft patients. Analgesic outcomes were not directly comparable across studies due to heterogeneity. Experimental models found that ibuprofen did not reduce acute burn pain, but attenuated pain within hyperalgesic skin. Among clinical studies, both oral and dressing ibuprofen formulations demonstrated reduced procedural pain. One topical study noted faster wound healing, though this was confounded by less frequent dressing changes. Conclusions: The available studies were insufficient to draw definitive conclusions, limited by sample size, heterogeneity, bias, and exclusion of high-risk patients. Nonetheless, no study reported increased adverse events across diverse ibuprofen protocols. These findings underscore the need for adequately powered, agent-specific trials in clinically representative burn populations to inform evidence-based multimodal compositions amidst growing advocacy for opioid-sparing analgesia. Full article

Military burn pits used during post-9/11 U.S. military deployments functioned as uncontrolled combustion systems and were widely utilized to dispose of large volumes of outdoor waste by burning. Burn pits involved heterogeneous waste materials burned under variable temperature and oxygen conditions. These combustion environments generated complex, toxic, multipollutant airborne emission mixtures that included particulate matter (PM_2.5), polycyclic aromatic hydrocarbons (PAHs), and volatile organic compounds (VOCs). This narrative review synthesizes epidemiologic, experimental, and mechanistic evidence linking burn pit emissions to disruption of the lung–brain axis and adverse neurological outcomes. We specifically aim to address a critical gap in understanding how combustion-derived toxicants impact brain health and are associated with unfavorable neuropsychiatric outcomes, including increased risk of post-traumatic stress disorder (PTSD) and depression. Combustion-related exposures promote pulmonary inflammation and system-wide immune signaling that propagate to the central nervous system, contributing to neuroinflammation and dysregulation of the hypothalamic–pituitary–adrenal (HPA) axis. These interconnected mechanisms are associated with toxic encephalopathy and related cognitive and mood disturbances, underscoring the need to integrate fire science with military and environmental health services research to better define the systemic and neurological consequences of acute and chronic fire-derived inhalation exposures. Full article

Background: Burn injuries are increasingly being recognized as chronic conditions with long-term physical, emotional, and social consequences. As survival after acute burn trauma improves, greater attention has shifted toward health-related quality of life (QoL) in survivors, particularly in regions where data remain limited. Methods: This study included burn survivors treated between January 2022 and December 2023 in the Department of Plastic Surgery and Reconstructive Microsurgery of the Emergency Clinical Hospital “Bagdasar-Arseni,” Bucharest, Romania. Patients who survived hospitalization and follow-up were invited to complete a Romanian-adapted version of the Burn Specific Health Scale-Brief (BSHS-B). Demographic and clinical data were collected from medical records, including burn type, total body surface area (TBSA), burn depth, burn localization, and access to rehabilitation services. Statistical analysis included descriptive methods, chi-square tests, t-tests, Kendall’s tau-b, Cramer’s V, Cronbach’s alpha, and exploratory factor analysis. Results: Thirty-eight patients were included. Most burns were thermal (94.74%), while burns involving <10% TBSA were most frequent (60.53%). Functional outcomes were generally favorable, with most patients reporting no difficulty in basic daily activities such as bathing, dressing, and writing. However, fine motor activities and return to previous work were more frequently affected. Emotional recovery appeared less complete, with persistent mild-to-moderate loneliness, sadness, and emotional distress reported by many participants. Women reported higher levels of loneliness (p = 0.015), while third-degree burns were associated with more frequent depressive symptoms (p = 0.008). Depressive symptoms were also significantly associated with functional limitations (such as getting dressed, p = 0.002) and work impairment (p < 0.001). The adapted functional and emotional subscales showed excellent internal consistency. Conclusions: Post-burn recovery extends beyond physical healing. Although most patients regained functional independence, emotional distress and occupational difficulties often persisted. These findings support the need for multidisciplinary long-term burn care integrating physical rehabilitation, psychological screening, and psychosocial support. Full article

Skin injuries are common and can result from surgeries, burns, pressure sores, cuts, and diseases. Proper wound healing is crucial for maintaining homeostasis; wounds can be classified as acute or chronic. Acute wounds heal in four sequential phases: hemostasis, inflammation, proliferation, and remodeling. Chronic wounds arise when this process fails, often due to prolonged inflammation. Existing treatments for chronic wounds are limited, and antibiotic resistance complicates infection control, highlighting the urgent need for new therapies. Biomaterials, particularly gelatin, have gained attention for their biomimetic properties, biocompatibility, and ability to promote healing. Gelatin’s ECM-like structure supports tissue metabolism, and it can be enriched with bioactive compounds to enhance tissue regeneration, collagen deposition, angiogenesis, and antimicrobial activity. This study evaluates the effectiveness of a 3D gelatin-based patch in vivo, using Hirudo verbana as a model. The patch, functionalized with chitosan and bioactive apatite nanoparticles, was implanted in injured leeches, with tissue samples collected at 72 h, 1 week, and 2 weeks. Scaffold integration, cell colonization, and healing effects were assessed through morphological, immunohistochemical, and ultrastructural analyses. The findings confirm H. verbana as a robust in vivo model for regenerative medicine and demonstrate the promising potential of gelatin-based patches. Full article

Burn injury induces profound immune dysregulation that extends beyond the acute phase of wound healing, contributing to complications such as delayed repair, infection, and long-term immune dysfunction. Importantly, these effects are not restricted to severe trauma, as similar immune alterations occur following small- to moderate-sized burns. Despite increasing recognition of post-burn immune dysregulation, targeted immunomodulatory therapies remain limited. In this review, we synthesize current insights into the mechanisms driving immune dysfunction after burn injury and outline therapeutic strategies aimed at restoring immune homeostasis. We examine approaches targeting inflammatory triggers and mediators, including acute clinical interventions, reduction in microbial burden, and inhibition of immune cell activation through systemic and local delivery. We also explore strategies to modulate dysregulated innate immune responses by targeting cell-specific functions, such as neutrophil activity and monocyte/macrophage polarization. Persistent activation and exhaustion of the adaptive immune system may be alleviated through interventions such as β-adrenergic blockade, while metabolic, endocrine, and oxidative stress pathways represent additional therapeutic targets. Finally, we highlight key challenges, including the need for improved diagnostics, early prognostic stratification, and personalized treatment approaches to improve outcomes following burn injury. Full article

Background: Burn injuries remain a major health problem in low- and middle-income countries. Contemporary data from Jordan are scarce, and the last report from Jordan University Hospital (JUH) was published more than four decades ago. This study describes the epidemiology, characteristics, management, and outcomes of burn admissions to JUH during 2016–2020 and compares them with historical and regional data. Methods: We conducted a retrospective cohort study of all consecutive patients admitted to the JUH burn unit with acute burn injury between 1 January 2016 and 31 December 2020. Demographic and clinical variables were abstracted from electronic and paper records using a standardised case-report form. Descriptive statistics summarised injury patterns, while bivariate tests and multivariable linear regression were used to identify factors associated with hospital length of stay (LOS). Results: A total of 575 patients were included (50.3% male; median age 19 years). Children constituted 43.5% of admissions. Median TBSA was 7%, and partial-thickness burns predominated (73.9%). Scalds were the leading aetiology (60.7%), followed by flame burns (19.5%). Most injuries occurred at home (92.5%). The median LOS was 6 days, and 2.1% of patients died. Burn degree, aetiology, TBSA, surgical grafting, and adverse clinical events were independently associated with longer LOS, whereas escharectomy shortened hospitalisation. Conclusions: Domestic scald injuries in children remain the dominant burn pattern in Jordan, although mortality has fallen markedly compared with the 1980 JUH cohort. Prevention efforts should prioritise household safety and child supervision, while continued investment in specialised burn care is likely to further improve outcomes. Full article

Background/Objectives: Effective wound antisepsis and infection control remain central challenges in both acute and chronic wound management. pH-controlled sodium hypochlorite solution (HACCP’ER^®) is a novel agent that optimizes the proportion of bactericidal hypochlorous acid (HOCl) by maintaining pH at 6.0–7.3. The present preliminary study aimed to evaluate its broad-spectrum antimicrobial activity in vitro and clinical outcomes in a retrospective cohort of patients with diverse acute and chronic wounds. Methods: A retrospective observational study was conducted, involving 193 consecutive patients who received HACCP’ER-based wound care between May 2022 and February 2023. Wound categories included pressure ulcers (n = 61), foot ulcers (n = 44), burns (n = 42), acute traumatic wounds (n = 29), and other chronic wounds (n = 17). HACCP’ER was applied at a free available chlorine (FAC) concentration of 50–200 ppm at pH = 6.0–7.3. In vitro antimicrobial suspension testing against ten microbial species was performed at 57 ppm (pH = 5.2, 23 °C) according to Japanese Industrial Standards. Results: HACCP’ER at 57 ppm eliminated Escherichia coli, Staphylococcus aureus, methicillin-resistant S. aureus (MRSA), Streptococcus spp., Salmonella spp., and Pseudomonas aeruginosa to below the detection limit (<10 CFU/mL) within 1 min, Candida within 3 min, and black Aspergillus within 5 min. In clinical wound cultures, bacterial burden was reduced in 6 of 10 (60%) patients. The mean patient age was 67.4 years. No adverse events attributable to HACCP’ER were recorded. Progressive wound healing was documented across all wound categories, with representative cases achieving closure at 1–11 months. Conclusions: HACCP’ER demonstrates potent broad-spectrum antimicrobial activity at wound-relevant concentrations and is clinically safe in acute and chronic wound care. Its physiologically aligned mechanism of HOCl generation supports both efficacy and biocompatibility. Prospective randomized controlled trials are warranted to definitively establish clinical efficacy. Full article

Fibroblast Growth Factor 2 (FGF2) is a highly effective regulator of cell proliferation, differentiation, migration, and adhesion, suggesting a significant therapeutic potential as a tissue regeneration promoter both in acute and chronic tissue damage settings. Despite an extensive list of pathologies that lend themselves as viable targets for FGF2-based therapy (ranging from periodontics to burns to diabetic ulcers to coronary artery disease), the success record in the clinic remains modest, with no FDA approvals obtained so far. The inferior stability of this protein is frequently cited as the most significant factor behind its disappointing performance as a biotherapeutic. Multiple strategies have been designed and tested in an effort to ameliorate this problem, but the success remains elusive. We investigate the aggregation propensity of a recombinantly produced FGF2 using native mass spectrometry (MS) to identify conditions favoring formation of small soluble oligomers, which are considered precursors to larger aggregates. Tandem MS of proteolytic fragments produced by digestion of the oligomeric species allows the formation of external disulfide bonds to be identified as the process leading to oligomerization. Specifically, Cys-31 (one of the two unpaired cysteine residues in intact FGF2) appears to be a particularly active promoter of oligomerization by forming external disulfide bonds. As a high-pI protein, FGF2 readily associates with heparin, and molecular modeling identifies a positive charge basin proximal to Cys-31 as a potential heparin binding site, which can readily accommodate a synthetic heparin mimetic fondaparinux. Adding an equimolar amount of the latter to the FGF2 solution not only leads to formation of a stable protein/polyanion complex (as revealed by native MS), but also inhibits formation of FGF2 oligomers (presumably via a combination of steric hindrance and electrostatic repulsion). These findings advance our understanding of FGF2 stability, which will be invaluable for optimizing its formulation, storage, and administration. Full article

This study investigates long-term wildfire emissions and smoke-plume geospatial characteristics in Greece by analyzing a multi-pollutant dataset spanning January 2003 to August 2025. Details of emissions of carbon monoxide (CO), carbon dioxide (CO₂), methane (CH₄), particulate matter (PM_2.5), organic carbon (OC), and black carbon (BC) were derived from the Global Fire Assimilation System (GFAS), which converts MODIS fire radiative power into trace gas and aerosol fluxes at 0.1° resolution, and also accounts for the land type. Burned-area statistics from the European Forest Fire Information System (EFFIS) were used for cross-validation. Data were processed into daily, monthly, annual, and cumulative time series, with spatial mapping at the municipality scale and information regarding long-term trends. The analysis shows that while there are several sizeable wildfire events in the country every year, the bulk of the total of Greek wildfire emissions for the last 23 years is attributable to a few extreme fire seasons (2007, 2021, and 2023) that produced abrupt emission surges and accounted for a disproportionate share of national totals. Analysis of spatial data identifies the areas of Evia, East Attica, Messinia, and Evros as persistent emission hotspots. Although wildfire CO₂ emissions are generally a minor fraction of Greece’s anthropogenic totals (<5%), they reached 15–17% during peak fire years. Plume-injection height analysis reveals that most smoke remains below ~1 km but can reach 3–6 km during extreme events, facilitating long-range transport. Overall, the dataset demonstrates a shift toward more intense and concentrated wildfire events in recent years, highlighting both their growing climatic relevance and their acute impacts on regional air quality. Full article

Objectives: Seawater-immersed burn wounds are highly susceptible to contamination, persistent inflammation, oxidative stress, and delayed healing, while current irrigation solutions remain suboptimal for such acute injuries. This study aimed to evaluate the therapeutic efficacy and underlying mechanisms of plasma-activated water (PAW) as a novel irrigation strategy for these complex wounds. Methods: The antibacterial efficacy of PAW against marine pathogens was first evaluated in vitro. Subsequently, a rat model of seawater-immersed burn injury was established in male Sprague-Dawley (SD) rats to assess the therapeutic effects of PAW irrigation on wound healing, infection control, and underlying biological mechanisms. Results: In vitro, PAW significantly eradicated two major marine pathogens, Vibrio vulnificus and Vibrio parahaemolyticus (p < 0.001). In vivo, PAW markedly accelerated wound closure, achieving complete healing in 23.60 ± 6.50 days vs. 38.67 ± 2.08 days (Normal saline group) and 58.33 ± 10.97 days (Model group) (p < 0.05). PAW significantly reduced bacterial burden, modulated inflammation by decreasing interleukin-6 and increasing interleukin-10, and alleviated oxidative stress, as evidenced by reduced malondialdehyde levels and enhanced superoxide dismutase activity. Histological evaluation demonstrated enhanced re-epithelialization, collagen deposition, and increased expression of vascular endothelial growth factor and platelet endothelial cell adhesion molecule-1. No adverse effects on serum biochemistry or major organ histopathology were observed. Conclusions: PAW may be a safe, promising, and multifunctional irrigation strategy that promotes seawater-immersed burn healing through coordinated antibacterial, anti-inflammatory, antioxidant, and pro-angiogenic effects, highlighting its strong potential for clinical translation. Full article

The treatment of skin diseases remains a significant clinical challenge. Cellulose and its derivatives have emerged as research hotspots in skin-related applications due to their excellent biocompatibility, structural modifiability, and biomimetic properties. This review systematically summarizes the diverse construction forms of cellulose-based materials, including films, nanofibrous scaffolds, hydrogels, and aerogels, with a focus on smart responsive systems tailored to various microenvironmental conditions. Their application progresses in acute/chronic wound healing, bacterial infections, burns, scar prevention, immunomodulation, and smart wearable monitoring are highlighted. The underlying mechanisms involving anti-infection, pro-regeneration, microenvironment modulation, and sensing are analyzed, aiming to provide insights for further exploration of cellulose-based materials in skin disease therapy and even smart wearable devices. Full article

Skin wound management in veterinary medicine requires therapies able to control inflammation, limit microbial burden, and support tissue repair. This study evaluated the anti-inflammatory, wound-healing, and immunomodulatory effects of four novel topical formulations combining synthetic anti-inflammatory drugs, antibiotics, and plant extracts in rat experimental models. Burn injury was induced in male Wistar rats for wound-healing assessment, while kaolin- and dextran-induced paw edema models were used to assess anti-inflammatory activity. The tested formulations were meloxicam, dexamethasone, and levofloxacin; thyme extract with meloxicam and dexamethasone; burdock extract with dexamethasone and levofloxacin; and thyme extract combined with burdock extract. Wound evolution was monitored macroscopically, edema was quantified by plethysmometry, and selected inflammatory mediators were measured by immunoassay. In the burn model, the thyme-containing formulation with meloxicam and dexamethasone, and the thyme–burdock formulation, achieved complete wound closure by the end of follow-up, whereas the reference product did not. In the acute inflammation models, all innovative formulations significantly reduced edema at the main early time points compared with the negative control and outperformed the reference product. The thyme–burdock formulation also showed the most favorable immunomodulatory profile, including normalization of interleukin-10 and marked reduction in interleukin-1 beta in both models. These results support the potential of multi-component topical formulations, particularly plant extract-based combinations, as promising candidates for veterinary wound care. Full article

Over the past years, burn care has evolved from a discipline focused on survival to one centered on restoring long-term health, function, and quality of life. Significant advances in critical care, early excision and grafting, infection control, and metabolic support have transformed survival outcomes for even the most severe injuries. As a result, the field now faces a new frontier: understanding and managing the long-term physical, psychological, and systemic sequelae of survival. This review traces the evolution of burn care over the last century and outlines the challenges and priorities for the next 25 years. The first era of progress, defined by innovations in resuscitation, surgery, and critical care, has given rise to a growing cohort of long-term survivors. Research over the past decade has revealed that major burns induce chronic multisystem alterations, including metabolic, cardiovascular, neurocognitive, and immunological dysfunctions. Emerging concepts such as burn-associated heart failure exemplify this shift from acute to chronic disease understanding. Looking ahead, the future of burn medicine lies in personalized and lifelong care, supported by translational research, digital health, regenerative therapies, and interdisciplinary collaboration. Overall, burn care stands at a pivotal crossroads. By integrating precision medicine, rehabilitation science, and psychosocial care, we aim to move the field from survival toward sustained, holistic recovery over the next 25 years. Full article