Search Results (5)

To define the morphologic pattern of pediatric hand burns as visualized via optical coherence tomography (OCT) and dynamic OCT (D-OCT). We designed a scoring system to assess the depths of burn wounds on pediatric hands and tested this score in our cohort of children with burn injuries to the hand. Overall, 67 hand burns in 48 children (0–15 years) were prospectively examined. Scans were interpreted by two independent observers. Relevant OCT findings were surface irregularity, loss of epidermis, loss of dermal pattern (skin lines or papillary spots, loss of surface regularity and irregular vascular pattern of the plexus papillaris. Score values were calculated retrospectively. A score of 4 was associated with spontaneous healing without the need for skin grafting, with a positive predictive value of 97%. Deeper wounds with delayed healing and/or the need of skin grafting received a score of 5 or above, with an agreement of medical healing in 80% and a positive predictive value of 56%. OCT and D-OCT provide clinically useful additional information in cases of pediatric hand burns. The OCT burn score has the potential to support clinical decision making and, subsequently, improve clinical outcomes and shorten hospital stays. Full article

Pediatric burn injuries are a critical medical condition that triggers a series of ongoing multifactorial stressors that affect both children and their families. To inform healthcare research and clinical practice, this study aimed to understand and describe the perceptions and experiences of the parents of burn-injured children during hospital stay. Forty-six parents (thirty-eight mothers) of forty-six children (eighteen girls) with a mean age of 2.28 years (SD = 1.52) answered ten open-ended questions. This qualitative study was conducted in a referral hospital in the northern region of Portugal. Qualitative data were analyzed using an inductive content analysis. Five key themes emerged from the data analysis: diving into the crisis of the child burn injury, being together and in good hands, becoming aware of an uncertain future, enhancing supportive care and environment, and finding ways to guide parents. Qualitative findings underlined the pressing need for integrated care within this context. Parents were significantly burdened and distressed during the inpatient phase. These parents should be included in the integrated care plan starting from admission. Understanding and addressing parents’ healthcare needs and psychosocial adjustment difficulties is paramount to the development of future intervention programs and the delivery of suitable integrated healthcare. Full article

Fractional carbon dioxide (CO₂) laser therapy has been shown to improve scar contractures following burns. However, the benefits of using other CO₂ laser techniques to treat burn scar contractures are relatively unknown. This pilot study investigated a CO₂ laser technique in which a series of perpendicular “surgical cuts” were created along the contracture. The aim of this study was to evaluate the effectiveness of using the “surgical cuts CO₂ laser technique” in pediatric patients. This study included 12 participants with minor hand burn scar contractures that received one CO₂ laser treatment using the surgical cuts technique. Trained assessors measured contractures pre- and post-laser therapy by assessing range of motion (ROM), digit length, and/or hand-span. All contractures were secondary to contact burns with the mean participant age equal to 5.5 years (SD 3.9). For all participants, at least one of the measured characteristics (ROM, hand-span, and digit length) improved after treatment. This pilot study demonstrated the benefit of using the surgical cuts CO₂ laser technique to treat minor burn scar contractures. Future investigations are needed to further evaluate its effectiveness in comparison to the fractional CO₂ laser therapy technique. Full article

Recombinant human epidermal growth factor (EGF) has been used to treat adult diabetic foot ulcers and pediatric burns by facilitating wound healing and epithelization, especially for elderly patients. Several formulation types of EGF from different expression hosts are clinically available, such as intralesional injection and topical application. On the other hand, no study has compared the in vivo efficacy of EGF products directly in terms of tissue regeneration and wound healing activity. The present study compared two commercial products, Heberprot-P75^® and Easyef^®, in terms of their tissue regeneration activity in adult zebrafish and the developmental speed of zebrafish embryos. Fluorescence spectroscopy showed that the two EGF products had different Trp fluorescence emission spectra: Easyef^® showed a wavelength of maximum fluorescence (WMF) of 337 nm with weak fluorescence intensity (FI), while Heberprot-P75^® showed WMF of 349 nm with a 4.1 times stronger FI than that of Easyef^®. The WMF of Heberprot-P75^® was quenched by adding singlet oxygen in ozonated oil, while the WMF of Easyef^® was not quenched. Treatment with Heberprot-P75^® induced greater embryo development speed with a higher survival rate after exposure to EGF in water and microinjection into embryos. Under normal diet (ND) consumption, Heberprot-P75^® showed a 1.4 times higher tail fin regeneration activity than Easyef^® during seven days from the intraperitoneal injection (10 μL, 50 μg/mL) after amputating the tail fin. Under ND consumption and diabetic condition caused by streptozotocin (STZ) treatment, Heberprot-P75^® showed 2.1 times higher tail fin regeneration activity than Easyef^® from the same injection and amputation protocol. Under a high-cholesterol diet (HCD) alone, Heberprot-P75^® showed 1.2 times higher tail fin regeneration activity than the Easyef^® group and PBS group from the same injection and amputation. Under diabetic conditions (STZ-injected) and HCD consumption, the Heberprot-P75^® group showed 1.7 and 1.5 times higher tail fin regeneration activity than the Easyef^® group and PBS group, respectively, with a distinct and clean regeneration pattern. In contrast, the Easyef^® group and PBS group showed ambiguous regeneration patterns with a severe fissure of the tail fin, which is a typical symptom of a diabetic foot. In conclusion, Heberprot-P75^® and Easyef^® have different Trp fluorescence properties in terms of the WMF and fluorescence quenching. Treatment of Heberprot-P75^® induced a greater developmental speed of zebrafish embryos in both water exposure and microinjection. Heberprot-P75^® induced significantly higher wound healing and tissue regeneration activity than Easyef^® and PBS in the presence or absence of diabetic conditions and cholesterol supplementation. Full article

Although the hands constitute approximately 5% of the total body surface area (TBSA), the sequelae and subsequent functional outcomes following hand burns (HBs) significantly impact the quality of life for affected patients. HBs, which frequently accompany severe burns and are often neglected, deserve additional attention in the management of burns of this anatomical region, as they are responsible for a majority of postburn morbidity. In addition, many questions remain unanswered in almost every aspect of HB management. Moreover, recent articles suggest that the primary issue of optimal timing concerning skin closure for HBs, which seemed well answered, has been questioned, and even this fundamental question may require further investigation. Appropriate initial management of HBs commencing from the acute phase in children remains of great importance in optimizing functional outcomes and minimizing long-term scar formation. In this context, our primary purpose in this retrospective cohort study was to present the epidemiological characteristics of HBs in children as a whole and to discuss the incidence and mechanisms, in addition to the outcomes of superficial and deep HB acute-phase management modalities. During the 5-year study period, HBs were detected in 27% (n = 422) of 1580 hospitalized pediatric burn patients in the Adana Faculty of Medicine-University of Health Sciences (AFM-UHS) Burn Center. Movement and functional status of the hands were evaluated with a simple qualitative staging system adapted from the original scoring tools used by Stiefel et al., and Sheridan et al. Good, moderate, and poor scores in the study were graded as Category A, Category B, and Category C, respectively. According to the hand movement and function assessment categorization, 84% of the cases were observed as Category-A who had good/normal regular movements/functions of the hands/fingers, followed by Category-B and -C with percentages of 15 and 1, respectively, during the 5.8 ± 3.4 month follow-up period. Full article