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EMERGENCY AND INTENSIVE CRITICAL CARE (121 journals)                     

Showing 1 - 124 of 124 Journals sorted alphabetically
AACN Advanced Critical Care     Full-text available via subscription   (Followers: 36)
Academic Emergency Medicine     Hybrid Journal   (Followers: 90)
Acta Colombiana de Cuidado Intensivo     Full-text available via subscription   (Followers: 1)
Acute and Critical Care     Open Access   (Followers: 9)
Acute Cardiac Care     Hybrid Journal   (Followers: 11)
Acute Medicine     Full-text available via subscription   (Followers: 8)
Advances in Emergency Medicine     Open Access   (Followers: 16)
Advances in Neonatal Care     Hybrid Journal   (Followers: 43)
African Journal of Anaesthesia and Intensive Care     Full-text available via subscription   (Followers: 7)
African Journal of Emergency Medicine     Open Access   (Followers: 7)
AINS - Anasthesiologie - Intensivmedizin - Notfallmedizin - Schmerztherapie     Hybrid Journal   (Followers: 5)
American Journal of Emergency Medicine     Hybrid Journal   (Followers: 54)
Annals of Emergency Medicine     Hybrid Journal   (Followers: 132)
Annals of Intensive Care     Open Access   (Followers: 37)
Annals of the American Thoracic Society     Full-text available via subscription   (Followers: 15)
Archives of Academic Emergency Medicine     Open Access   (Followers: 6)
Archives of Trauma Research     Open Access   (Followers: 4)
ASAIO Journal     Hybrid Journal   (Followers: 2)
Australasian Journal of Paramedicine     Open Access   (Followers: 7)
Australian Critical Care     Full-text available via subscription   (Followers: 21)
Bangladesh Critical Care Journal     Open Access   (Followers: 1)
BMC Emergency Medicine     Open Access   (Followers: 25)
BMJ Quality & Safety     Hybrid Journal   (Followers: 65)
Burns Open     Open Access  
Canadian Journal of Respiratory, Critical Care, and Sleep Medicine     Hybrid Journal   (Followers: 2)
Case Reports in Acute Medicine     Open Access   (Followers: 3)
Case Reports in Critical Care     Open Access   (Followers: 13)
Case Reports in Emergency Medicine     Open Access   (Followers: 19)
Chronic Wound Care Management and Research     Open Access   (Followers: 7)
Clinical and Applied Thrombosis/Hemostasis     Open Access   (Followers: 32)
Clinical Intensive Care     Hybrid Journal   (Followers: 6)
Clinical Medicine Insights : Trauma and Intensive Medicine     Open Access   (Followers: 3)
Clinical Risk     Hybrid Journal   (Followers: 5)
Crisis: The Journal of Crisis Intervention and Suicide Prevention     Hybrid Journal   (Followers: 15)
Critical Care     Open Access   (Followers: 74)
Critical Care and Resuscitation     Full-text available via subscription   (Followers: 29)
Critical Care Clinics     Full-text available via subscription   (Followers: 34)
Critical Care Explorations     Open Access   (Followers: 3)
Critical Care Medicine     Hybrid Journal   (Followers: 293)
Critical Care Research and Practice     Open Access   (Followers: 13)
Current Emergency and Hospital Medicine Reports     Hybrid Journal   (Followers: 5)
Current Opinion in Critical Care     Hybrid Journal   (Followers: 73)
Disaster and Emergency Medicine Journal     Open Access   (Followers: 12)
Egyptian Journal of Critical Care Medicine     Open Access   (Followers: 2)
EMC - Urgenze     Full-text available via subscription  
Emergency Care Journal     Open Access   (Followers: 7)
Emergency Medicine (Medicina neotložnyh sostoânij)     Open Access  
Emergency Medicine Australasia     Hybrid Journal   (Followers: 17)
Emergency Medicine Clinics of North America     Full-text available via subscription   (Followers: 19)
Emergency Medicine International     Open Access   (Followers: 8)
Emergency Medicine Journal     Hybrid Journal   (Followers: 53)
Emergency Medicine News     Full-text available via subscription   (Followers: 7)
Emergency Nurse     Full-text available via subscription   (Followers: 17)
Enfermería Intensiva (English ed.)     Full-text available via subscription  
European Burn Journal     Open Access   (Followers: 12)
European Journal of Emergency Medicine     Hybrid Journal   (Followers: 23)
Frontiers in Emergency Medicine     Open Access   (Followers: 8)
Global Journal of Transfusion Medicine     Open Access   (Followers: 1)
Hong Kong Journal of Emergency Medicine     Full-text available via subscription   (Followers: 5)
Indian Journal of Burns     Open Access   (Followers: 2)
Injury     Hybrid Journal   (Followers: 20)
Intensive Care Medicine     Hybrid Journal   (Followers: 82)
Intensive Care Medicine Experimental     Open Access   (Followers: 2)
Intensivmedizin up2date     Hybrid Journal   (Followers: 4)
International Journal of Critical Illness and Injury Science     Open Access   (Followers: 1)
International Journal of Emergency Medicine     Open Access   (Followers: 9)
International Journal of Emergency Mental Health and Human Resilience     Open Access   (Followers: 2)
International Paramedic Practice     Full-text available via subscription   (Followers: 14)
Iranian Journal of Emergency Medicine     Open Access  
Irish Journal of Paramedicine     Open Access   (Followers: 2)
Journal Européen des Urgences et de Réanimation     Hybrid Journal   (Followers: 1)
Journal of Acute Care Physical Therapy     Hybrid Journal   (Followers: 4)
Journal of Cardiac Critical Care TSS     Open Access   (Followers: 1)
Journal Of Cardiovascular Emergencies     Open Access  
Journal of Concussion     Open Access  
Journal of Critical Care     Hybrid Journal   (Followers: 48)
Journal of Critical Care Medicine     Open Access   (Followers: 18)
Journal of Education and Teaching in Emergency Medicine     Open Access   (Followers: 1)
Journal of Emergencies, Trauma and Shock     Open Access   (Followers: 13)
Journal of Emergency Medical Services     Full-text available via subscription   (Followers: 12)
Journal of Emergency Medicine     Hybrid Journal   (Followers: 53)
Journal of Emergency Medicine, Trauma and Acute Care     Open Access   (Followers: 25)
Journal of Emergency Practice and Trauma     Open Access   (Followers: 6)
Journal of Intensive Care     Open Access   (Followers: 9)
Journal of Intensive Care Medicine     Hybrid Journal   (Followers: 22)
Journal of Intensive Medicine     Open Access  
Journal of Neuroanaesthesiology and Critical Care     Open Access   (Followers: 3)
Journal of Stroke Medicine     Hybrid Journal  
Journal of the American College of Emergency Physicians Open     Open Access   (Followers: 1)
Journal of the Intensive Care Society     Hybrid Journal   (Followers: 4)
Journal of the Royal Army Medical Corps     Hybrid Journal   (Followers: 6)
Journal of Thrombosis and Haemostasis     Hybrid Journal   (Followers: 81)
Journal of Translational Critical Care Medicine     Open Access   (Followers: 5)
Journal of Trauma and Acute Care Surgery, The     Hybrid Journal   (Followers: 34)
La Presse Médicale Open     Open Access  
Médecine de Catastrophe - Urgences Collectives     Hybrid Journal  
Medicina Intensiva     Open Access   (Followers: 3)
Medicina Intensiva (English Edition)     Hybrid Journal   (Followers: 1)
Mediterranean Journal of Emergency Medicine & Acute Care : MedJEM     Open Access  
Notfall + Rettungsmedizin     Hybrid Journal   (Followers: 3)
OA Critical Care     Open Access   (Followers: 3)
OA Emergency Medicine     Open Access   (Followers: 2)
Open Access Emergency Medicine     Open Access   (Followers: 6)
Open Journal of Emergency Medicine     Open Access   (Followers: 2)
Palliative Care : Research and Treatment     Open Access   (Followers: 19)
Palliative Medicine     Hybrid Journal   (Followers: 54)
Prehospital Emergency Care     Hybrid Journal   (Followers: 19)
Regulatory Toxicology and Pharmacology     Hybrid Journal   (Followers: 41)
Research and Opinion in Anesthesia and Intensive Care     Open Access   (Followers: 3)
Resuscitation     Hybrid Journal   (Followers: 54)
Resuscitation Plus     Open Access   (Followers: 1)
Saudi Critical Care Journal     Open Access   (Followers: 2)
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine     Open Access   (Followers: 11)
Seminars in Thrombosis and Hemostasis     Hybrid Journal   (Followers: 45)
Shock : Injury, Inflammation, and Sepsis : Laboratory and Clinical Approaches     Hybrid Journal   (Followers: 10)
Sklifosovsky Journal Emergency Medical Care     Open Access  
The Journal of Trauma Injury Infection and Critical Care     Full-text available via subscription   (Followers: 24)
Therapeutics and Clinical Risk Management     Open Access   (Followers: 1)
Transplant Research and Risk Management     Open Access  
Trauma Case Reports     Open Access   (Followers: 1)
Trauma Monthly     Open Access   (Followers: 3)
Visual Journal of Emergency Medicine     Full-text available via subscription   (Followers: 1)
Western Journal of Emergency Medicine     Open Access   (Followers: 11)
 AEM Education and Training : A Global Journal of Emergency Care     Open Access   (Followers: 1)


Similar Journals
Journal Cover
European Burn Journal
Number of Followers: 12  

  This is an Open Access Journal Open Access journal
ISSN (Online) 2673-1991
Published by MDPI Homepage  [84 journals]
  • EBJ, Vol. 3, Pages 391-400: Burden and Costs of Severe Burn Injury in
           Victoria, Australia

    • Authors: Heather Cleland, Ieva Sriubaite, Belinda Gabbe
      First page: 391
      Abstract: This study examines the costs of severe burn injury in Victoria, Australia. It quantifies the funding generated through an activity-based case-mix system for hospital treatment of acute injury and presentations in the subsequent two years and costs of the longer-term burden of burn injury due to premature burn-related deaths and disability. Severe adult burns cases in Victoria from 2007–2016 were identified using the Victorian State Trauma Registry (VSTR). Cases were linked with the Victorian Admitted Episodes Dataset (VAED), Victoria Emergency Minimum Dataset (VEMD), and the National Coronial Information System (NCIS). Hospital re-imbursements and costs of Disability-Adjusted Life Years (DALYs) were calculated using disability weights derived from the EQ-5D-3L questionnaire responses at 24 months post injury. There were 331 patients hospitalised with a burn ≥20% total body surface area (TBSA) from 2007–2016. Total mean re-imbursement (SD) for the acute treatment episode per patient in Australian dollars (AUD) was $87,570 ($97,913). There was significant variation in the number of cases by year and re-imbursement per patient, with high outliers common. Excluding 2009, when 173 people died in bushfires, there were 7749 DALYs which cost $991,872,000. Severe burns are uncommon and variable. Economic treatment costs of severe burns are high, and among survivors there is high incidence of long-term disability and overall burden of injury.
      Citation: European Burn Journal
      PubDate: 2022-07-13
      DOI: 10.3390/ebj3030034
      Issue No: Vol. 3, No. 3 (2022)
  • EBJ, Vol. 3, Pages 401-406: How Did This Happen' Xenograft Conversion
           to Dermal Scaffolding after Scalding Grease Burn

    • Authors: Aurelie Tran, Elizabeth Windell, Luke Pumiglia, Amanda Bettencourt, Gary Vercruysse
      First page: 401
      Abstract: Xenograft and other biologic dressings have been an integral part of burn care for many years. Porcine graft is both inexpensive and, for partial thickness burns, provides the additional benefit of avoiding painful dressing changes when compared with topical agents. In this case, we discuss a patient suffering from deep partial thickness burns for whom xenograft was used for initial wound coverage. This porcine graft became unexpectedly incorporated, and the patient ultimately underwent operative debridement and autologous re-grafting. The case demonstrates a gap in the understanding of wound-healing mechanisms around porcine xenografts and raises the potential for future innovation in expedited wound healing using xenografting.
      Citation: European Burn Journal
      PubDate: 2022-08-05
      DOI: 10.3390/ebj3030035
      Issue No: Vol. 3, No. 3 (2022)
  • EBJ, Vol. 3, Pages 407-424: Toxic Epidermal Necrolysis: A Clinical and
           Therapeutic Review

    • Authors: Canhão, Pinheiro, Cabral
      First page: 407
      Abstract: Toxic Epidermal Necrolysis is a rare dermatological condition with high mortality and serious consequences on its survivors. Despite having been first described in 1956, its pathophysiology remains uncertain, mainly regarding its mechanisms, although it seems that certain apoptosis pathways are pivotal in starting keratinocytes’ apoptosis and in activating T cells, especially those mediated by tumour necrosis factor, Fas-FasL and granulysin. In general, its aetiology and presentation are consensual, being defined as a generalized necrolysis of the epidermis that occurs as an uncontrolled immune response to a specific drug or one of its metabolites, highlighting cotrimoxazole and allopurinol as the most important. This necrolysis leads to a massive shedding of the epidermal layer of the skin, with stronger incidences in the torso, upper limbs and face. Its complications tend to be severe, noting that septic ones are responsible for over half of the disease’s mortality. Nearly all survivors develop long-term sequelae, namely hypertrophic scarring and skin pigmentation anomalies. Regarding treatment, many different opinions arise, including contradictory ones, regarding more importantly immunomodulation therapies that have been the focus of several studies through the years. It is safe to state that supportive therapy is the only modality that has significantly strong evidence backing its efficacy in reducing mortality and improving prognosis, which have improved in the past years as general health care quality increased. In conclusion, it is imperative to say that more research is needed for new potential therapies with large study populations and more scientific rigor. Likewise, investigation towards its basic pathophysiology should also be promoted, mainly at a biomolecular level, allowing for an improved prevention of this illness.
      Citation: European Burn Journal
      PubDate: 2022-08-08
      DOI: 10.3390/ebj3030036
      Issue No: Vol. 3, No. 3 (2022)
  • EBJ, Vol. 3, Pages 425-431: The Impact of Body Mass Index in Patients with
           Severe Burn Injury

    • Authors: Aline C. V. Walger, Lucienne T. Q. Cardoso, Marcos T. Tanita, Tiemi Matsuo, Alexandre J. F. Carrilho, Cintia M. C. Grion
      First page: 425
      Abstract: This study evaluated the association of body mass index (BMI) with mortality, length of stay in the intensive care unit (ICU), and length of hospital stay in major burn patients. It was a retrospective cohort study that was originally conducted from January 2017 to January 2020 and that used data from patients admitted to the intensive care unit for burns at a university hospital. The patients were divided into groups for the purposes of comparing relevant variables according to their BMI. We evaluated 288 patients: 52.8% were classified as eutrophic, 33.7% were classified as overweight, and 13.5% were classified as obese. The median length of stay in the ICU was 11 days for all patients, 9 days for eutrophic patients, 13 days for overweight patients, and 16 days for obese patients (p = 0.004). In the multivariate analysis, age (HR = 1.026; p < 0.001), total body surface area (HR = 1.047; p < 0.001), and the presence of inhalation injury (HR = 1.658; p = 0.026) were associated with mortality. Obesity was not associated with higher hospital mortality in this sample of burn patients. The length of stay in the ICU was longer among obese patients. Age, burned body surface, and the presence of inhalation injury were the major determinants of death in these patients.
      Citation: European Burn Journal
      PubDate: 2022-08-22
      DOI: 10.3390/ebj3030037
      Issue No: Vol. 3, No. 3 (2022)
  • EBJ, Vol. 3, Pages 432-449: The Use of Infrared Thermography (IRT) in
           Burns Depth Assessment: A Diagnostic Accuracy Meta-Analysis

    • Authors: Asif, Poyiatzis, Raheman, Rojoa
      First page: 432
      Abstract: Background: The timely diagnosis of burns depth is crucial to avoid unnecessary surgery and delays in adequate management of patients with burn injuries. Whilst it is mostly a clinical diagnosis, indocyanine green, laser Doppler imaging and infrared thermography have been used alongside clinical findings to support the diagnosis. Infrared thermography is a noninvasive technique which uses temperature differences to diagnose tissue burn depth. Our study aims to assess its use in differentiating between superficial and deep burns. Methods: We conducted a systematic literature review and meta-analysis using electronic databases. We used a mixed-effects logistic regression bivariate model to estimate summary sensitivity and specificity and developed hierarchical summary receiver operating characteristic (HSROC) curves. Results: We identified 6 studies reporting a total of 197 burns, of which 92 were proven to be deep burns. The reference standard was clinical assessment at the time of injury and burn healing time. The pooled estimates for sensitivity and specificity were 0.84 (95%CI 0.71–0.92) and 0.76 (95%CI 0.56–0.89), respectively. Conclusions: IRT is a promising burns assessment modality which may allow surgeons to correctly classify burn injuries at the time of presentation. This will allow a more efficient management of burns and timely surgical intervention.
      Citation: European Burn Journal
      PubDate: 2022-09-01
      DOI: 10.3390/ebj3030038
      Issue No: Vol. 3, No. 3 (2022)
  • EBJ, Vol. 3, Pages 447-456: Early Impact of COVID-19 Pandemic on Burn
           Injuries, Admissions, and Care in a Statewide Burn Service

    • Authors: Lincoln M. Tracy, Cheng Hean Lo, Heather J. Cleland, Warwick J. Teague, Belinda J. Gabbe
      First page: 447
      Abstract: Anecdotal evidence from specialist burn clinicians suggested patient numbers and workloads increased during lockdown periods. This study aimed to describe the impact of the early COVID-19-related public health control measures (i.e., lockdowns) on burn injuries, hospital admissions, and care in a statewide burn service. We examined admissions data from The Victorian Adult Burns Service (located at the Alfred Hospital) and the Royal Children’s Hospital Burns Service—both of which contribute to the Burns Registry of Australia and New Zealand—during lockdown periods between March and October 2020, compared to the same periods in previous years. There were 714 patients admitted during the control period and 186 during the COVID-19 period. Burns sustained during COVID-19 lockdowns were larger in size. During COVID-19 lockdowns a greater proportion of patients were admitted to intensive care. Although the number of burn-related admissions did not increase during lockdowns, burn injuries that did occur were more severe (i.e., affected a greater percentage of body surface area). These more severe injuries placed an additional and significant burden on an already strained healthcare system. Future public health messaging should include prevention information to minimize the number of injuries occurring during lockdowns and other responses.
      Citation: European Burn Journal
      PubDate: 2022-09-12
      DOI: 10.3390/ebj3030039
      Issue No: Vol. 3, No. 3 (2022)
  • EBJ, Vol. 3, Pages 457-471: An Evaluation of the Treatment of
           Full-Thickness Wounds Using Adipose Micro-Fragments within a Liquid Dermal

    • Authors: Sara Sheikh-Oleslami, Ida Hassanpour, Nafise Amiri, Reza Jalili, Ruhangiz Taghi Kilani, Aziz Ghahary
      First page: 457
      Abstract: In full-thickness wounds, inflammation, lack of matrix deposition, and paucity of progenitor cells delay healing. As commercially available solid (sheet) scaffolds are unable to conform to wounds of varying shapes and sizes, we previously generated a nutritious, injectable, liquid skin substitute that can conform to wound topography. In combination with adipose micro-fragments as a viable source of progenitor cells, a composite, in situ forming skin substitute was tested for the treatment of silicon ring splinted full-thickness wounds in rats. The in vitro survivability and migratory capacity of adipocytes derived from rat micro-fragmented fat cultured in our scaffold was examined with a Live/Dead assay, showing viability and migration after 7 and 14 days. In vivo, the efficacy of our scaffold alone (LDS) or with adipose micro-fragments (LDS+A) was compared to a standard dressing protocol (NT). LDS and LDS+A showed ameliorated wound healing, including complete epithelialization and less immune cell infiltration, compared to the NT control. Our findings demonstrate that a 3D liquid skin scaffold is a rich environment for adipocyte viability and migration, and that the addition of adipose micro-fragments to this scaffold can be used as a rich source of cells for treating full-thickness wounds.
      Citation: European Burn Journal
      PubDate: 2022-09-17
      DOI: 10.3390/ebj3030040
      Issue No: Vol. 3, No. 3 (2022)
  • EBJ, Vol. 3, Pages 241-255: Mechanomodulation: Physical Treatment
           Modalities Employ Mechanotransduction to Improve Scarring

    • Authors: Ulrike Van Daele, Jill Meirte, Mieke Anthonissen, Tine Vanhullebusch, Koen Maertens, Lot Demuynck, Peter Moortgat
      First page: 241
      Abstract: Every year, surgical interventions, traumatic wounds, and burn injuries lead to over 80 million scars. These scars often lead to compromised skin function and can result in devastating disfigurement, permanent functional loss, psychosocial problems, and growth retardation. Today, a wide variety of nonsurgical scar management options exist, with only few of them being substantiated by evidence. The working mechanisms of physical anti-scarring modalities remained unclear for many years. Recent evidence underpinned the important role of mechanical forces in scar remodeling, especially the balance between matrix stiffness and cytoskeleton pre-stress. This perspective article aims to translate research findings at the cellular and molecular levels into working mechanisms of physical anti-scarring interventions. Mechanomodulation of scars applied with the right amplitude, frequency, and duration induces ECM remodeling and restores the ‘tensile’ homeostasis. Depending on the scar characteristics, specific (combinations of) non-invasive physical scar treatments are possible. Future studies should be aimed at investigating the dose-dependent effects of physical scar management to define proper guidelines for these interventions.
      Citation: European Burn Journal
      PubDate: 2022-03-26
      DOI: 10.3390/ebj3020021
      Issue No: Vol. 3, No. 2 (2022)
  • EBJ, Vol. 3, Pages 256-263: Matching Qualitative Inquiry Design and
           Practice to Contemporary Burns Research Questions: Are We Getting It

    • Authors: Megan Simons, Jodie A. Copley
      First page: 256
      Abstract: Qualitative methodology has continued to develop through scholarly inquiry, with its application to burn scar research progressed substantially since early use. Concerns were raised in 2015 that qualitative inquiry in burn care and rehabilitation used a limited range of qualitative research approaches. The aim of this commentary paper is to consider how broadly the suite of methodologies available within the qualitative research paradigm have been applied to burn scar research since that call. Observations from a scan of qualitative burn scar papers published since 2015 to March 2022 (n = 36) are presented. Less commonly used qualitative methodologies (such as interpretive design, interpretive phenomenological analysis, narrative inquiry, grounded theory, explanatory case study) and their contribution to burn scar research is discussed. Examples are presented to consider how the application of qualitative methodological approaches (including post-qualitative research methodologies) can be ultimately used to inform meaningful outcomes.
      Citation: European Burn Journal
      PubDate: 2022-03-28
      DOI: 10.3390/ebj3020022
      Issue No: Vol. 3, No. 2 (2022)
  • EBJ, Vol. 3, Pages 264-277: Assessing Health-Related Quality of Life of
           Adult Patients with Intermediate Burns: The Added Value of an Itching and
           Cognition Item for the EQ-5D: A Retrospective Observational Study

    • Authors: J. Nicolaas Dijkshoorn, Juanita A. Haagsma, Cornelis H. van der Vlies, M. Jenda Hop, Margriet E. van Baar, Inge Spronk
      First page: 264
      Abstract: The EQ-5D is increasingly used to assess the health-related quality of life (HRQL) of adult patients with intermediate burns. However, this generic instrument may lack sensitivity, as important problems for burn patients, such as itching and cognition problems are not included in this instrument. This retrospective observational study investigates the value of adding an itching and cognition item to the EQ-5D-3L. Patients completed the EQ-5D-3L, and the Patient and Observer Scar Assessment Scale (POSAS), including an itching item and an extra cognition item three months postburn. The potential added value of an itching and cognition item was studied by distribution, informativity, convergent validity, dimension dependency, and explanatory analyses. In total, 120 patients were included of whom 65% reported itching and 23% reported cognition problems. Adding an itching item to the EQ-5D improved the discriminatory power and informativity of the EQ-5D-3L, but barely increased the explanatory power (0.4%) and decreased the convergent validity (r = −0.529 vs. r = −0.612). In contrast, adding a cognition item slightly improved the informativity and discriminatory power. Moreover, convergent validity (r = −0.617 vs. r = −0.612) and explanatory power increased (4.0%). In conclusion, adding an itching item to the EQ-5D-3L provides some additional information, however, the added value is small, whereas adding a cognition item improved the measurement properties of the EQ-5D-3L in our sample and should be considered when assessing HRQL in adult patients with intermediate burns.
      Citation: European Burn Journal
      PubDate: 2022-03-30
      DOI: 10.3390/ebj3020023
      Issue No: Vol. 3, No. 2 (2022)
  • EBJ, Vol. 3, Pages 278-289: Damage Control Surgery after Burn Injury: A
           Narrative Review

    • Authors: Hans-Oliver Rennekampff, Mayer Tenenhaus
      First page: 278
      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 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.
      Citation: European Burn Journal
      PubDate: 2022-04-01
      DOI: 10.3390/ebj3020024
      Issue No: Vol. 3, No. 2 (2022)
  • EBJ, Vol. 3, Pages 290-308: Electronic Patient-Reported Outcome Measures
           in Burn Scar Rehabilitation: A Guide to Implementation and Evaluation

    • Authors: Jill Meirte, Zephanie Tyack
      First page: 290
      Abstract: In burn scar rehabilitation, electronic patient-reported outcome measures (ePROMs) are increasingly being used in research and clinical settings as part of patient- and family-centred care. These measures can identify patients’ needs and monitor the therapeutic progress of both adults and children. The feedback of information from ePROMs to clinicians treating patients with scarring and psychosocial issues may have therapeutic benefits. However, testing the effectiveness of ePROMs used in the routine clinical care of patients with burn scarring is in its infancy, and one of the greatest challenges remains the implementation of ePROMs in real-world clinical settings. The aim of this paper is to provide a guide for clinicians and researchers involved in burn scar rehabilitation to assist in implementing ePROMs in clinical settings. The guide outlines strategies, processes, and considerations for ePROM implementation and the accompanying resources. Two real-world case studies of ePROM implementation are presented in burn scar clinics in Belgium and Australia. Additionally, ten recommendations for the implementation of ePROMs are provided based on research evidence and the lessons learned by the authors. The information provided should pave the way forward for using and testing these ePROMs in research and practice.
      Citation: European Burn Journal
      PubDate: 2022-04-05
      DOI: 10.3390/ebj3020025
      Issue No: Vol. 3, No. 2 (2022)
  • EBJ, Vol. 3, Pages 309-319: Treatment Adherence Interventions for Burn
           Patients: What Works and What Role Can Motivational Interviewing Play'

    • Authors: Christian R. R. Goans, Karen J. Meltzer, Blake Martin, Kimberly Roaten
      First page: 309
      Abstract: The unique challenges burn patients face along the trajectory of recovery necessitate an interdisciplinary team approach to care. As much as providers rely on care-team members for delivery of optimal treatment, the patient must be an active collaborator in their care. Optimal burn recovery outcomes hinge on treatment adherence. In addition to general challenges faced in ubiquity by burn patients, there are specific patient populations for whom treatment adherence is particularly challenging. Although psychological interventions have been used successfully with burn patients, very few are appropriate for both inpatient and outpatient care environments and most do not focus on treatment adherence. This paper reviews unique facets of Motivational Interviewing (MI) that may be applicable in interdisciplinary burn treatment teams across inpatient and outpatient settings to optimize treatment adherence.
      Citation: European Burn Journal
      PubDate: 2022-04-06
      DOI: 10.3390/ebj3020026
      Issue No: Vol. 3, No. 2 (2022)
  • EBJ, Vol. 3, Pages 320-327: Aspects of Clinical Utility of the Distress
           Thermometer and Problem List after Burns

    • Authors: Helma W. C. Hofland, Anneke van de Steenoven, Nancy E. E. Van Loey
      First page: 320
      Abstract: Burn survivors may benefit from screening for a broad area of problems to improve communication and inform referral needs. Therefore, the aim of this study was to investigate clinical utility aspects such as appropriateness and acceptability to clinicians and completers of an existing, frequently used screening instrument in oncological populations, the Distress Thermometer and Problem List (DT and PL). Methods: Paediatric and adult patients visiting the outpatient clinic after admission to the burn centre were invited to complete the instrument. The DT and (problem domains of) the PL were related and compared to the need to discuss the reported problems. Results: A total of 160 patients were invited to complete the DT and PL, of which 139 agreed. The study shows evidence for appropriateness and high acceptability to clinicians and completers, although the effectiveness of the PL may be lower compared to the DT and needs adaptation to better meet the burn survivors’ situation. Discussion: The use of a screening instrument in the outpatient clinic environment has shown to be appropriate and acceptable and informs clinical practice to identify supportive needs in patients with burns. However, the PL needs to be adapted to the situation of the burn survivors.
      Citation: European Burn Journal
      PubDate: 2022-04-08
      DOI: 10.3390/ebj3020027
      Issue No: Vol. 3, No. 2 (2022)
  • EBJ, Vol. 3, Pages 328-339: Techniques to Assess Long-Term Outcomes after
           Burn Injuries

    • Authors: Rae Spiwak, Shaan Sareen, Sarvesh Logsetty
      First page: 328
      Abstract: Burn injuries have a tremendous impact on not only the physical health of the burn survivor, but also mental health and social outcomes of the individual and their support systems. While much effect occurs at the point of injury, post-injury pain, infection, scarring, inflammatory response and metabolic changes all impact the long-term health of the burn survivor. The goal of the following article is to explore how to examine long term outcomes associated with burn injury, including mental disorders, suicide, loss of work and quality of life in the context of risk factors for burn injury, including social determinants of health. We then discuss ways to examine post-burn outcomes, including the important role of administrative data, the advantages of mixed methodology research studies including qualitative research, and the importance of considering sex, gender and vulnerable populations, not only in study design, but in prevention and intervention programs.
      Citation: European Burn Journal
      PubDate: 2022-04-20
      DOI: 10.3390/ebj3020028
      Issue No: Vol. 3, No. 2 (2022)
  • EBJ, Vol. 3, Pages 340-354: Role, Development, and Value of Enzymatic
           Debridement as Integral Component in Initial Treatment of Burn Injuries
           Exemplified by NexoBrid®

    • Authors: Maximilian M. Mattern, Paul C. Fuchs, Jennifer L. Schiefer
      First page: 340
      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, 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.
      Citation: European Burn Journal
      PubDate: 2022-04-21
      DOI: 10.3390/ebj3020029
      Issue No: Vol. 3, No. 2 (2022)
  • EBJ, Vol. 3, Pages 355-361: Is Post-Burn Scarring a Research Priority'

    • Authors: Amber E. Young, Robert M. T. Staruch
      First page: 355
      Abstract: National and international research budgets are insufficient to approve all requests for funding, even if a methodology is of high quality and the outputs are likely to have an impact on improving patient outcomes [...]
      Citation: European Burn Journal
      PubDate: 2022-05-03
      DOI: 10.3390/ebj3020030
      Issue No: Vol. 3, No. 2 (2022)
  • EBJ, Vol. 3, Pages 362-369: Preventable Burns from Domestic Tap Water

    • Authors: Max Prokopenko, Alistair J. M. Reed, Maria Chicco, Fadi Issa
      First page: 362
      Abstract: Tap water scalds from domestic outlets can afflict large body surface areas. Such injuries are preventable and carry significant associated morbidity, mortality, and economic burden. Previously identified risk factors include age (<5 or >65 years old) and the presence of physical or mental disabilities. Education campaigns and advances in legislation mandating the restriction of tap water temperature at user outlets have been employed in an attempt to prevent such injuries. Nonetheless, the incidence of these injuries persists, and further mitigating measures must be implemented to minimize their occurrence. The purpose of this study was to determine the groups at risk for such injuries and whether this has recently changed. A retrospective observational study was carried out to include patients admitted with tap water scalds to a regional burn’s unit from October 2016 to September 2020. Twenty-three patients were included, and their incidence was 5.75 cases per year, equating to 5.1% of all scalds requiring inpatient treatment. The very young (<5 years old) and elderly (>65 years old) accounted for the majority of admissions (65.2%), 26.1% had a mental disability, and 30.4% had a physical disability. Tap water scalds continue to cause preventable injuries affecting all ages, and in particular, the elderly and patients with pre-existing disabilities.
      Citation: European Burn Journal
      PubDate: 2022-05-09
      DOI: 10.3390/ebj3020031
      Issue No: Vol. 3, No. 2 (2022)
  • EBJ, Vol. 3, Pages 370-376: “Out of Touch”—Recovering
           Sensibility after Burn Injury: A Review of the Literature

    • Authors: Savas Tsolakidis, Ziyad Alharbi, Hans Oliver Rennekampff, Markus Robert Schmidhammer, Robert Schmidhammer, Rudolf Rosenauer
      First page: 370
      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 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.
      Citation: European Burn Journal
      PubDate: 2022-06-14
      DOI: 10.3390/ebj3020032
      Issue No: Vol. 3, No. 2 (2022)
  • EBJ, Vol. 3, Pages 377-390: What Fuels the Fire: A Narrative Review of the
           Role Social Determinants of Health Play in Burn Injuries

    • Authors: Kimberly H. Khoo, Emily S. Ross, Joshua S. Yoon, Tomer Lagziel, Feras Shamoun, Joseph S. Puthumana, Julie A. Caffrey, Sheera F. Lerman, Charles Scott Hultman
      First page: 377
      Abstract: Social determinants of health (SDOH) are the conditions where people live, learn, work, and play that affect their health and quality of life. There has been an increasing focus on the SDOH in the field of medicine to both explain and address health outcomes. Both the risk of burn injuries and outcomes after burns have been found to be associated with multiple aspects of the SDOH. This narrative review seeks to explore the main domains of the social determinants of health, reiterate their importance to the general and burn injury population, examine each’s association with risks of burn injuries and burn-related outcomes, and provide an overview of the current burn research landscape that describes the social determinants of health.
      Citation: European Burn Journal
      PubDate: 2022-06-16
      DOI: 10.3390/ebj3020033
      Issue No: Vol. 3, No. 2 (2022)
  • EBJ, Vol. 3, Pages 18-26: Effect of Central Line Duration and Other Risk
           Factors on Central Line-Associated Bloodstream Infection in Severe Adult
           Burns Patients at a Large Tertiary Referral Burns Centre: A 5-Year
           Retrospective Study

    • Authors: Alexandra Miller, Elizabeth Vujcich, Jason Brown
      First page: 18
      Abstract: Central line-associated bloodstream infection (CLABSI) and catheter-related bloodstream infection (CLABSI with a positive catheter tip culture, CRBSI) are preventable causes of morbidity and mortality for severe adult burns patients. Routine central line changes as a CLABSI prevention strategy in burns patients is controversial due to the paucity of evidence to guide the appropriate timing of line changes. This study aimed to address this evidence gap by investigating risk factors associated with central line sepsis, including the duration of central line insertion, in a population of severe adult burns patients (burns involving ≥20% total body surface area (TBSA)) admitted to the Royal Brisbane and Women’s Hospital Intensive Care Unit over five years (2015–2019 inclusive). On multivariate analysis, central line duration and burn TBSA were identified as independent risk factors for CLABSI, with central line duration the most significant predictor (p = 0.0008; OR 1.177, 95% CI 1.072–1.299). No risk factor independently predicted CRBSI. CLABSI detection occurred a median of 8.5 days (IQR 6.0–11.0) post central line insertion. These findings suggest further research to assess the efficacy of routine line changes prior to the at-risk period of 6–11 days post central line insertion in reducing CLABSI in severe adult burns patients may be beneficial.
      Citation: European Burn Journal
      PubDate: 2022-01-11
      DOI: 10.3390/ebj3010003
      Issue No: Vol. 3, No. 1 (2022)
  • EBJ, Vol. 3, Pages 27-33: Limb Salvage through Intermediary Wound Coverage
           with Acellular Dermal Matrix Template after Persistent Pseudomonas
           Aeruginosa Infection in a Burn Patient

    • Authors: Mateusz Gładysz, Vincent März, Stefan Ruemke, Evgenii Rubalskii, Peter Maria Vogt, Nicco Krezdorn
      First page: 27
      Abstract: Secondary infections of skin grafts pose a continuous problem in burn patients, very often leading to loss of transplanted skin grafts and making multiple surgical revisions necessary. We present a case report about persisting Pseudomonas aeruginosa infection in burn patients with known diabetes. The burn wounds in lower extremities required repeated debridements, multiple skin grafting attempts and finally an application of the dermal scaffold NovoSorb BTM. With these measures, we managed to undertake a successful reconstruction of infected burn defects and pre-vent an amputation. We concluded that the NovoSorb BTM could be seen as an additional promising tool in a burn surgery armamentarium. In cases where radical surgical wound decontamination is not possible without risking the loss of the limb, the application of NovoSorb BTM over a contaminated field can win extra time for topical infection treatment and additionally provide an excellent skin grafting ground.
      Citation: European Burn Journal
      PubDate: 2022-01-12
      DOI: 10.3390/ebj3010004
      Issue No: Vol. 3, No. 1 (2022)
  • EBJ, Vol. 3, Pages 34-42: Clinical Profile and Acute-Phase Management
           Modalities of Pediatric Hand Burn: A Retrospective Study

    • Authors: Kayhan Gurbuz, Mete Demir
      First page: 34
      Abstract: 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.
      Citation: European Burn Journal
      PubDate: 2022-01-25
      DOI: 10.3390/ebj3010005
      Issue No: Vol. 3, No. 1 (2022)
  • EBJ, Vol. 3, Pages 43-55: The Use of Intact Fish Skin as a Novel Treatment
           Method for Deep Dermal Burns Following Enzymatic Debridement: A
           Retrospective Case-Control Study

    • Authors: Christoph Wallner, Jana Holtermann, Marius Drysch, Sonja Schmidt, Felix Reinkemeier, Johannes Maximilian Wagner, Mehran Dadras, Alexander Sogorski, Khosrow Siamak Houschyar, Mustafa Becerikli, Marcus Lehnhardt, Björn Behr
      First page: 43
      Abstract: Background: The optimal therapy for deep burn wounds is based on the early debridement of necrotic tissue followed by wound coverage to avoid a systemic inflammatory response and optimize scar-free healing. The outcomes are affected by available resources and underlying patient factors, which represent challenges in burn care and suboptimal outcomes. In this study, we aimed to determine optimal burn-wound management using enzymatic debridement (NexoBrid™, MediWound Germany GmbH, Rüsselsheim, Germany) and intact fish skin (Kerecis® Omega3 Wound, Isafjordur, Iceland). Methods: In this retrospective case series, 12 patients with superficial or deep dermal burn wounds were treated with enzymatic debridement followed by fish skin, Suprathel® (PolyMedics Innovations GmbH, Denkendorf, Germany), or a split-thickness skin graft (STSG). Patients’ outcomes regarding healing and scar quality were collected objectively and subjectively for 12 months after the burn injury. Results: Wounds treated with fish skin demonstrated accelerated wound healing, a significantly higher water-storage capacity, and better pain relief. Furthermore, improved functional and cosmetic outcomes, such as elasticity, skin thickness, and pigmentation, were demonstrated. The pain and itch expressed as POSAS scores (Patient and Observer Scar Assessment Scale) for fish skin decreased compared to those for wounds managed with an STSG or Suprathel. Importantly, fish skin-treated wounds had significantly improved sebum production and skin elasticity than those treated with Suprathel but showed no significant superiority compared to STSG-treated wounds. Conclusions: Enzymatic debridement in combination with intact fish skin grafts resulted in the faster healing of burn wounds and better functional and aesthetic outcomes than split-thickness skin grafts and Suprathel treatment.
      Citation: European Burn Journal
      PubDate: 2022-01-27
      DOI: 10.3390/ebj3010006
      Issue No: Vol. 3, No. 1 (2022)
  • EBJ, Vol. 3, Pages 56: Acknowledgment to Reviewers of European Burn
           Journal in 2021

    • Authors: EBJ Editorial Office EBJ Editorial Office
      First page: 56
      Abstract: Rigorous peer-reviews are the basis of high-quality academic publishing [...]
      Citation: European Burn Journal
      PubDate: 2022-01-28
      DOI: 10.3390/ebj3010007
      Issue No: Vol. 3, No. 1 (2022)
  • EBJ, Vol. 3, Pages 57-88: Screening and Assessment for Psychological
           Distress among Burn Survivors

    • Authors: Valerie Loehr, William Goette, Kimberly Roaten
      First page: 57
      Abstract: Given the high rates of psychological distress after burn injury, thorough screening and assessment for psychosocial factors and psychiatric pathology should be routinely completed for individuals with burn injuries. Burn survivors experience unique psychosocial changes and injury sequelae, such as body image concerns, trauma-related pathology, and itching. Screening for these factors is integral to understanding how these may be contributing to psychological distress. Proactively identifying distress and psychiatric pathology is important to optimize physical and emotional outcomes. The aim of this manuscript is to summarize information about the available screening and assessment tools for psychological distress among burn survivors.
      Citation: European Burn Journal
      PubDate: 2022-02-03
      DOI: 10.3390/ebj3010008
      Issue No: Vol. 3, No. 1 (2022)
  • EBJ, Vol. 3, Pages 89-121: Resilience and Posttraumatic Growth after Burn:
           A Review of Barriers, Enablers, and Interventions to Improve Psychological

    • Authors: Alix Woolard, Indijah Bullman, Amira Allahham, Treya Long, Helen Milroy, Fiona Wood, Lisa Martin
      First page: 89
      Abstract: Burn injuries are traumatic experiences that can detrimentally impact an individual’s psychological and emotional wellbeing. Despite this, some survivors adapt to psychosocial challenges better than others despite similar characteristics relating to the burn. Positive adaptation is known as resilience or posttraumatic growth, depending on the trajectory and process. This review aimed to describe the constructs of resiliency and growth within the burn injury context, examine the risk factors that inhibit resilience or growth after burn (barriers), the factors that promote resilience or growth after burn (enablers), and finally to assess the impact of interventions that have been tested that may facilitate resilience or growth after burn. This review was performed according to the recently updated Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guidelines. An electronic search was conducted in November 2021 on the databases PubMed, Medline (1966-present), Embase (1974-present), PsycINFO for English-language peer-reviewed academic articles. There were 33 studies included in the review. Findings were mixed for most studies; however, there were factors related to demographic information (age, gender), burn-specific characteristics (TBSA, time since burn), person-specific factors (personality, coping style), psychopathology (depression, PTSD), and psychosocial factors (social support, spirituality/religion, life purpose) that were evidenced to be related to resilience and growth. One qualitative study evaluated an intervention, and this study showed that a social camp for burn patients can promote resilience. This study has presented a variety of factors that inhibit or encourage resilience and growth, such as demographic, individual, and social factors. We also present suggestions on interventions that may be used to promote growth following this adverse event, such as improving social support, coping styles and deliberate positive introspection.
      Citation: European Burn Journal
      PubDate: 2022-02-09
      DOI: 10.3390/ebj3010009
      Issue No: Vol. 3, No. 1 (2022)
  • EBJ, Vol. 3, Pages 122-134: When Is Being Sad on the Burn Unit
           Pathological' Differential Diagnosis of Demoralization, Adjustment
           Disorder and Major Depressive Disorder in Burn Survivors

    • Authors: Marissa L. Beal, Sheera F. Lerman, Idris E. Leppla
      First page: 122
      Abstract: Many burn survivors have pre-existing psychiatric conditions or develop psychological or psychiatric symptoms over the course of their hospital stay. Patients often present with low mood and neurovegetative symptoms which can be conceptualized as demoralization, adjustment disorder, or major depressive disorder. We review the literature on these syndromes in burn survivors and present three cases that highlight the continuum of these syndromes for patients who present with symptoms of depression following a burn injury. We discuss the clinical challenges of differentiating these syndromes as well as psychotherapeutic and psychopharmacologic considerations and recommendations.
      Citation: European Burn Journal
      PubDate: 2022-02-10
      DOI: 10.3390/ebj3010010
      Issue No: Vol. 3, No. 1 (2022)
  • EBJ, Vol. 3, Pages 135-144: Pre-Burn Health-Related Quality of Life:
           Patient and Partner Perspectives

    • Authors: Elise Boersma-van Dam, Helma Hofland, Alette de Jong, Nancy Van Loey
      First page: 135
      Abstract: A proxy-assessment of health-related quality of life (HRQL) may be an alternative for burn patients who are medically unable to self-report shortly after being admitted to the hospital. This study examined the patient–partner agreement on the recalled pre-injury HRQL of burn patients. In a multi-centre study of 117 patient–partner pairs, the recalled pre-burn HRQL was assessed with the EQ-5D-3L + Cognition during the acute phase following the burns. Agreement was evaluated with Kappa and ICC statistics. Burn severity and PTSD symptoms were assessed as potential predictors of disagreement. The results showed that pre-burn EQ-Index scores were similar to population norms, whereas the EQ Visual Analog Scale (EQ-VAS) scores of patients were significantly higher. Agreement varied across EQ-5D domains and, after adjusting for prevalence, was substantial to almost perfect. Average agreement on the EQ-Index and EQ-VAS was, respectively, substantial and moderate, but differences between partners were larger at lower levels of HRQL, and specifically in the pain/discomfort domain. Patient–partner differences could not be explained by the patient’s age or gender, number of surgeries, partner’s presence at the burn event, or post-traumatic stress disorder (PTSD) symptoms of either the patient or partner. In conclusion, patient–partner agreement is substantial and partner–proxy reports of pre-burn EQ-5D domains and EQ-Index scores may be used to complement or serve as a substitute for the patient’s assessment. Given the moderate agreement on the EQ-VAS, it may be less suited for proxy assessment.
      Citation: European Burn Journal
      PubDate: 2022-02-11
      DOI: 10.3390/ebj3010011
      Issue No: Vol. 3, No. 1 (2022)
  • EBJ, Vol. 3, Pages 145-155: Relations among Stigma, Quality of Life,
           Resilience, and Life Satisfaction in Individuals with Burn Injuries

    • Authors: Jack D. Watson, Paul B. Perrin
      First page: 145
      Abstract: This study examined the relations among burn stigma, quality of life, resilience, and life satisfaction, hypothesizing that higher stigma and lower burn-related quality of life would lead to lower life satisfaction; however, resilience would moderate this relation. A sample of 89 participants was recruited from an outpatient clinic of a burn center in a critical care hospital. Participants completed a battery of measures assessing these constructs. Results suggested that burn stigma was associated with reduced life satisfaction after accounting for other variables. Multiple regression models found that burn stigma predicted both affect and body image but not interpersonal relationship quality or sexuality. Interpersonal relationship quality, sexuality, affect, and body image all predicted life satisfaction. Both affect and body image partially accounted for the relation between stigma and life satisfaction, and resilience accounted for the relation between stigma and affect. Findings reinforce previous literature that has shown a relationship between stigma and life satisfaction but also emphasizes the role of resilience and burn-related quality of life. Individuals who experience a burn injury may have innate resilience abilities, which allow them to bounce back from stressors; thus, resilience can be a targeted strength to bootstrap in order to improve adjustment outcomes.
      Citation: European Burn Journal
      PubDate: 2022-02-15
      DOI: 10.3390/ebj3010012
      Issue No: Vol. 3, No. 1 (2022)
  • EBJ, Vol. 3, Pages 156-164: Two Modified Questionnaires for the Assessment
           of Nutrition Impact Symptoms in the Rehabilitation Phase after Burn
           Injury: A Content Validation Study

    • Authors: Josefin Dimander, Agneta Andersson, Adriana Miclescu, Fredrik Huss
      First page: 156
      Abstract: Disease Related Appetite Questionnaire (DRAQ) and Eating Symptom Questionnaire (ESQ) are used to assess nutrition impact symptoms, which are symptoms that can negatively affect the patients’ food intake. However, these questionnaires have not yet been adapted to the needs of patients recovering from burn injuries. Our aim was therefore to develop DRAQ and ESQ for assessments of nutrition impact symptoms after burn injury. A content validation index (I-CVI) for items included in DRAQ and ESQ, regarding their relevance for possible nutrition impact symptoms in a burn-injured patient (Likert scale 1–4), was performed by an expert review group. A clarity validation by expert and non-expert reviewers was carried out. Two of the eleven questions in DRAQ and eight of the fourteen questions in ESQ were not considered relevant and were therefore removed from the questionnaires. Five additional questions were added to DRAQ and two to ESQ. A high degree of consensus on relevance (scale-content validity index average, S-CVI/Ave, 0.86 for DRAQ-burn and 0.83 for ESQ-burn) was reached in the expert group. To conclude, it is suggested that we use developed forms of DRAQ and ESQ (DRAQ-burn and ESQ-burn) for the assessment of nutrition impact symptoms, specifically during the rehabilitation phase of burn-injured patients.
      Citation: European Burn Journal
      PubDate: 2022-02-18
      DOI: 10.3390/ebj3010013
      Issue No: Vol. 3, No. 1 (2022)
  • EBJ, Vol. 3, Pages 165-179: Infection and Burn Injury

    • Authors: Edward J. Kelly, Mary A. Oliver, Bonnie C. Carney, Jeffrey W. Shupp
      First page: 165
      Abstract: Burn injury is debilitating and among one of the most frequently occurring traumas. Critical care improvements have allowed for increasingly positive outcomes. However, infection, whether it be localized to the site of the wound or systemic in nature, remains a serious cause of morbidity and mortality. Immune suppression predisposes the burn population to the development of invasive infections; and this along with the possibility of inhalation injury puts them at a significant risk for mortality. Emerging multi-drug-resistant pathogens, including Staphylococcus aureus, Enterococcus, Pseudomonas, Acinetobacter, Enterobacter, and yeast spp., continue to complicate clinical care measures, requiring innovative therapies and antimicrobial treatment. Close monitoring of antimicrobial regimens, strict decontamination procedures, early burn eschar removal, adequate wound closure, proper nutritional maintenance, and management of shock and resuscitation all play a significant role in mitigating infection. Novel antimicrobial therapies such as ultraviolet light, cold plasma and topical antiseptics must continue to evolve in order to lower the burden of infection in burn.
      Citation: European Burn Journal
      PubDate: 2022-02-22
      DOI: 10.3390/ebj3010014
      Issue No: Vol. 3, No. 1 (2022)
  • EBJ, Vol. 3, Pages 180-187: Pros and Cons of Early and Late Skin Grafting
           in Children with Burns—Evaluation of Common Concepts

    • Authors: Islam Abdelrahman, Ingrid Steinvall, Folke Sjöberg, Mohamed A. Ellabban, Johann Zdolsek, Moustafa Elmasry
      First page: 180
      Abstract: Background: There is no consensus regarding the timing of surgery in children with smaller burn size, specifically in deep dermal burns. Delayed surgery has risks in terms of infection and delayed wound healing. Early surgery also risks the removal of potentially viable tissue. Our aim was to investigate the effect of the timing of surgical intervention on the size of the area operated on and the time to wound healing. Methods: A retrospective analysis for all children (<18 years) with burn size <20% body surface area (BSA%) during 2009–2020 who were operated on with a split-thickness skin graft. The patients were grouped by the timing of the first skin graft operation: early = operated on within 14 days of injury; delayed = operated on more than two weeks after injury. Results: A total of 84 patients were included in the study, 43 who had an early operation and 41 who had a delayed operation. There were no differences between the groups regarding burn size, or whether the burns were superficial or deep. The mean duration of healing time was seven days longer in the group with delayed operation (p = 0.001). The area operated on was somewhat larger (not significantly so) in the group who had early operation. Nine children had two skin graft operations, eight in the early group and one in the delayed group (p = 0.03). Conclusion: The patients who were operated on early had the advantage of a shorter healing time, but there was a higher rate of complementary operations and a tendency towards a larger burn excision.
      Citation: European Burn Journal
      PubDate: 2022-02-22
      DOI: 10.3390/ebj3010015
      Issue No: Vol. 3, No. 1 (2022)
  • EBJ, Vol. 3, Pages 188-196: Spiritual Healing: A Triple Scoping Review of
           the Impact of Spirituality on Burn Injuries, Wounds, and Critical Care

    • Authors: Tomer Lagziel, Malik Muhammad Sohail, Harold G. Koenig, Jeffrey E. Janis, Stephen J. Poteet, Kimberly H. Khoo, Julie A. Caffrey, Sheera F. Lerman, Charles S. Hultman
      First page: 188
      Abstract: Burn patients are unique because their recovery requires prolonged hospital admissions, often complicated by a myriad of medical and surgical complications as well as psychological and emotional challenges. Religion and spirituality have been linked to improved health outcomes in other medical fields. Our scoping review aimed to examine the available literature for evidence of the impact of spirituality on burns, complex wounds, and critical care to shed more light on the relationship between spirituality and the conditions treated by multidisciplinary burn center teams. We performed three systematic reviews to examine the relationship between spirituality and these conditions. Searches were performed using MeSH terms utilizing four databases (MEDLINE via PubMed, Embase, Cochrane, Web of Science, and Scopus). A systematic and independent title/abstract screening was carried out by two independent reviewers and a full-text review was followed. Our review demonstrated a clear lack of overlap between study outcomes and lack of objective spirituality measurements. Most articles primarily focused on psychological outcomes, such as stress or mental health, instead of objective measures such as wound size or scar formation. We found a trend toward better psychological outcomes in patients with more spirituality, either pre-existing or interventional. To increase comparability and uniformity of outcomes, future studies would benefit from utilizing standardized spiritual assessment tools and objective wound metrics.
      Citation: European Burn Journal
      PubDate: 2022-02-24
      DOI: 10.3390/ebj3010016
      Issue No: Vol. 3, No. 1 (2022)
  • EBJ, Vol. 3, Pages 197-206: Cross-Cultural Review of Sexuality,
           Relationships, and Body Image after Burns: Analysis of the BSHS-B

    • Authors: Joseph S. Puthumana, Emily S. Ross, Patrick R. Keller, Carolyn S. Drogt, Kimberly H. Khoo, Eliana F. Duraes, Charles S. Hultman, Sheera F. Lerman
      First page: 197
      Abstract: Burn survivors are at risk for dissatisfaction with body image, relationships, and sexuality due to disfiguring changes secondary to the injury. This review compares available global data on BSHS-B psychosocial scores. Twenty-four studies were included in the final analysis encompassing 14 countries; significant differences were found in scores across all BSHS-B psychological sub-sections of affect, body image, interpersonal relationships, and sexuality. On the whole, psychological well-being after burn injury was lower in Asian and South Asian countries compared to Europe or the United States. This study provides information for providers in burn centers caring for patients from a variety of cultural contexts and begins to steer initiatives to remedy psychological inequities in global burn care.
      Citation: European Burn Journal
      PubDate: 2022-02-24
      DOI: 10.3390/ebj3010017
      Issue No: Vol. 3, No. 1 (2022)
  • EBJ, Vol. 3, Pages 207-210: Towards the Holistic Assessment of Scar
           Management Interventions

    • Authors: Jonathan Mathers
      First page: 207
      Abstract: Presently, research assessments of burn scar management interventions focus on measures of scarring and scar features. However, qualitative research demonstrates that patients experience scarring and scar management therapies holistically. Patient-centred assessment should reflect this. An agreement is required regarding what to assess, which tools and measures to use and at what time points. Key issues include (1) whether and how burn- or scar-related quality-of-life measures could be included in the assessment of scar management interventions and how these are weighed against scar measures; (2) routine inclusion of the assessment of treatment burden (or treatment experience) in comparative research and (3) generating further understanding of the relationship between scar management and psychosocial adaptation, along with an assessment of this. A debate concerning a holistic and standardized evaluation of scar management interventions is needed to ensure that future evidence-based decisions are made in a patient-centred manner.
      Citation: European Burn Journal
      PubDate: 2022-03-08
      DOI: 10.3390/ebj3010018
      Issue No: Vol. 3, No. 1 (2022)
  • EBJ, Vol. 3, Pages 211-233: The CARe Burn Scale—Adult Form:
           Identifying the Responsiveness and Minimal Important Difference (MID)
           Values of a Patient Reported Outcome Measure (PROM) to Assess Quality of
           Life for Adults with a Burn Injury

    • Authors: Catrin Griffiths, Philippa Tollow, Danielle Cox, Paul White, Timothy Pickles, Diana Harcourt
      First page: 211
      Abstract: The CARe Burn Scales are a suite of burn-specific PROMs for adults, children, young people, and parents affected by burns. This study aimed to determine the responsiveness and minimal important difference (MID) values of the Adult Form for use in adult burn care and research. Participants were recruited by 11 UK Burn Services. They completed online or paper versions of the CARe Burn Scale –Adult Form and a set of appropriate comparison validated measures and anchor questions at baseline (T1, up to 4 weeks post-burn), 3 months (T2), and 6 months post-burn (T3). A total of 269 participants took part at baseline and 226 (84%) were retained at the 6-month follow-up. Spearman’s correlation analysis and effect sizes based on Cohen’s d thresholds were reported and MID values calculated. MID values were created for all subscales and ranged from 4–15. The CARe Burn Scale–Adult Form is responsive to change over time and can therefore be used to reliably inform the management of adults’ burn injury treatment and recovery. It is freely available for clinical and research use.
      Citation: European Burn Journal
      PubDate: 2022-03-10
      DOI: 10.3390/ebj3010019
      Issue No: Vol. 3, No. 1 (2022)
  • EBJ, Vol. 3, Pages 234-240: Novel Application of a Surgeon-Operated Clysis
           Delivery System in Burn Surgery

    • Authors: Alexander Morzycki, Peter O. Kwan, Edward E. Tredget, Joshua N. Wong
      First page: 234
      Abstract: Insufflation of epinephrine-containing solutions (clysis) has shown to decrease blood loss in burn surgery. Current delivery methods are associated with significant cost and may predispose burn patients to hypothermia. This was a proof-of-concept study to evaluate a novel surgeon-operated clysis delivery system. Our initial experience with a novel fluid management system is presented. Temperature, pressure, and volume of clysis was recorded. Patient and burn factors were evaluated and complications collected. Finally, a cost-effectiveness analysis was conducted. Thirty-seven consecutive cases comprising 22 adult patients (15/22, 68% male), with a mean age of 49 years (+/−19) were reviewed. The mean % total body surface area of all patients was 39 (+/−21.7). The mean temperature, pressure, and volume of administered clysis was 32.2 degrees Celsius (+/−4.4), 265.04 mmHg (+/−56.17), and 5805.8 mL (+/−4844.4), respectively. The mean dose of epinephrine administered was 14.5 mg (+/−12.1). The mean temperature variability was 1.1 °C (+/−1.2). The total mean of packed red blood cells (PRBC) transfused was 507.6 mL (+/−624.4). There were no recorded complications. We identified a cost savings of CAD 20,766 over the cases examined, compared to our conventional clysis delivery technique. This novel technique provides rapid and safe infiltration of warmed clysis in burn surgery. We were able to maintain intra-operative euthermia. In addition, this technique may be transfusion-sparing. The introduction of this method of clysis administration was associated with significant cost-savings. Future randomized study is necessary.
      Citation: European Burn Journal
      PubDate: 2022-03-21
      DOI: 10.3390/ebj3010020
      Issue No: Vol. 3, No. 1 (2022)
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
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