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Ahmed FA, Zia N, Khan SA, Munir T, Mashreky SR, Hashmi M, Al-Ibran E, Rahman AF, Khondoker S, Asif F, Hyder AA, Latif A. Burns in South Asia: Outcomes from South Asian Burn Registry (SABR). Burns 2024; 50:1504-1512. [PMID: 38604825 DOI: 10.1016/j.burns.2024.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 03/24/2024] [Accepted: 04/01/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND South Asian region contributes 59 % to the global mortality due to burns. However, we find a paucity of literature on the outcomes of burns from low- and middle-income countries (LMICs). South Asian Burn Registry (SABR) is a facility-based burns registry that collected data on in-patient burn care. This study assesses factors associated with mortality, length of hospital stay at the burns center, and functional status of burn patients. METHODS Prospective data was collected from two specialized public sector burn centers between September 2014 - January 2015 from Bangladesh and Pakistan. Multivariable logistic, linear, and ordinal logistic regression was conducted to assess factors associated with inpatient-mortality, length of hospital stay, and functional status at discharge, respectively. RESULTS Data on 883 patients was analyzed. Increased association with mortality was observed with administration of blood product (OR:3, 95 % CI:1.18-7.58) and nutritional support (OR:4.32, 95 % CI:1.55-12.02). Conversely, antibiotic regimens greater than 8 days was associated with decreased mortality (OR:0.1, 95 % CI:0.03-0.41). Associated increase in length of hospital stay was observed in patients with trauma associated with their burn injury, history of seizures (CE:47.93, 95 % CI 12.05-83.80), blood product (CE:22.09, 95 % CI:0.83-43.35) and oxygen administration (CE:23.7, 95 % CI:7.34-40.06). Patients who developed sepsis (OR:6.89, 95 % CI:1.92-24.73) and received blood products during hospitalization (OR:2.55, 95 % CI:1.38- 4.73) were more likely to have poor functional status at discharge. CONCLUSION This study identified multiple factors associated with worse clinical outcomes for burn patients in South Asia. Understanding these parameters can guide targeted efforts to improve the process and quality of burn care in LMICs.
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Affiliation(s)
- Fasih Ali Ahmed
- Centre for Patient Safety, The Aga Khan University, Karachi, Pakistan; University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Nukhba Zia
- Johns Hopkins International Injury Research Unit (IIRU), Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sameer Ahmad Khan
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Tahir Munir
- Department of Anesthesiology, Aga Khan University Hospital, Karachi, Pakistan
| | | | - Madiha Hashmi
- Department of Critical Care Medicine, Ziauddin University Hospital, Karachi, Pakistan
| | | | | | - Sazzad Khondoker
- National Institute of Burn and Plastic Surgery, Dhaka, Bangladesh
| | - Fozia Asif
- Centre for Patient Safety, The Aga Khan University, Karachi, Pakistan
| | - Adnan A Hyder
- The Milken Institute School of Public Health, George Washington University, DC, USA
| | - Asad Latif
- Centre for Patient Safety, The Aga Khan University, Karachi, Pakistan; Department of Anesthesiology, Aga Khan University Hospital, Karachi, Pakistan; Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, Baltimore, MD, USA
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Simon MH, Ujjal MUR, Botman M, van Hövell Tot Westerflier C, Ahmed MS, Vries AMD. Burn injuries and acute burn management in the rural areas in northern Bangladesh - A household survey. Burns 2024; 50:1480-1486. [PMID: 38704315 DOI: 10.1016/j.burns.2024.03.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 03/07/2024] [Accepted: 03/31/2024] [Indexed: 05/06/2024]
Abstract
INTRODUCTION Burn injuries pose a significant public health challenge, especially in low- and middle-income countries (LMICs). In Bangladesh, burn injuries are prevalent and often result in severe disability or death. However, knowledge regarding the causes of burn injuries, acute burn management, and barriers to seeking burn care in the riverine areas of northern Bangladesh is limited. METHODS We conducted a questionnaire-based study in eight subunits and five selected districts in northern Bangladesh to determine the prevalence, causes, and management of burn injuries in these areas. A total of 210 individuals from different households were interviewed, which represented a population of 1020 persons. RESULTS Among the respondents, 55% reported that at least one member of their household suffered from a burn injury in the past. The most common causes of burn injuries were open fire (41%) and hot fluids (30%). More than 40% of burns were not rinsed with water directly after sustaining the injury. Additionally, almost 30% of respondents did not seek medical care immediately after the injury, with financial constraints being the most commonly cited reason. DISCUSSION We found a low rate of adequate cooling and seeking medical care. The need for basic knowledge on prevention and treatment of burn injuries and improved access to affordable health care services in the region is high.
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Affiliation(s)
- M H Simon
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Centre, the Netherlands; Global Surgery Amsterdam, Amsterdam, the Netherlands.
| | | | - M Botman
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Centre, the Netherlands; Global Surgery Amsterdam, Amsterdam, the Netherlands
| | - C van Hövell Tot Westerflier
- Department of Plastic, Reconstructive and Hand Surgery, University Medical Centre Utrecht, the Netherlands; Global Surgery Amsterdam, Amsterdam, the Netherlands
| | | | - A Meij-de Vries
- Global Surgery Amsterdam, Amsterdam, the Netherlands; Department of Surgery/Burn Centre, Red Cross Hospital, Beverwijk, the Netherlands; Department of Paediatric Surgery, Amsterdam University Medical Centre, the Netherlands
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Makhmalzadeh BS, Dehkordi SKH, Rezaie A, Karami MA. Superoxide dismutase-contained solid lipid nanoparticles: Formulation development and In-vivo evaluation for second-degree burn wound healing in rats. Burns 2024:S0305-4179(24)00169-4. [PMID: 38918152 DOI: 10.1016/j.burns.2024.05.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/11/2024] [Accepted: 05/28/2024] [Indexed: 06/27/2024]
Abstract
INTRODUCTION Superoxide dismutase (SOD), a natural enzyme with high antioxidant activity, reduces injury and accelerates wound healing by scavenging superoxide radicals. This enzyme plays an important role in cellular defense against oxidative stress such as burn injury. The aim of this study was to load SOD into solid lipid nanoparticles for the treatment of rat burn wounds. METHODS Solid lipid nanoparticles were prepared by Solvent Emulsification Diffusion method and evaluated for particle size, enzyme activity and enzyme entrapment efficiency. Twenty-seven rats in 3 different groups were induced with deep second-degree burns and then treated with SOD-loaded solid lipid nanoparticles, solid lipid nanoparticles without enzyme, or SOD solution. After the treatment period, the wounds were evaluated macroscopically for the area of healing and microscopically for indices of re-epithelialization, granulation tissue and angiogenesis. RESULTS The optimized SOD-loaded solid lipid nanoparticles showed a particle size of 35-85 ± 2.41 nm, 78.4 ± 4.31 % entrapment efficiency and 90 % initial enzyme activity. Macroscopic examination showed that the best recovery rate belonged to the solid lipid nanoparticle group. Pathological studies also showed that angiogenesis and granulation tissue were significantly better in this group. Compared to the other two groups, SOD-loaded solid lipid nanoparticles showed a significant improvement in pathological factors, particularly angiogenesis and granulation tissue, as well as a faster reduction in the number of inflammatory cells. CONCLUSION Based on this study, solid lipid nanoparticles could be used as an effective delivery system for SOD in the treatment of second-degree burns.
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Affiliation(s)
- Behzad Sharif Makhmalzadeh
- Nanotechnology Research Center, Medical Basic Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | | | - Anahita Rezaie
- Department of Pathology, Faculty of Veterinary Medicine, Shahid Chamran University, Ahwaz, Iran.
| | - Masoud Ali Karami
- Nanotechnology Research Center, Medical Basic Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Department of Pharmaceutics, Faculty of Pharmacy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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Su S, Zhang Y, Wu D, Wang C, Hu J, Wei Y, Peng X. 1H-nuclear magnetic resonance analysis reveals dynamic changes in the metabolic profile of patients with severe burns. BURNS & TRAUMA 2024; 12:tkae007. [PMID: 38756185 PMCID: PMC11097601 DOI: 10.1093/burnst/tkae007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 02/08/2024] [Accepted: 02/29/2024] [Indexed: 05/18/2024]
Abstract
Background Severe burn injury causes a hypermetabolic response, resulting in muscle protein catabolism and multiple organ damage syndrome. However, this response has not yet been continuously characterized by metabolomics in patients. This study aims to quantify temporal changes in the metabolic processes of patients with severe burns. Methods We employed 1H-nuclear magnetic resonance (NMR) spectroscopy to scrutinize metabolic alterations during the initial 35 days following burn injury in a cohort of 17 adult patients with severe burns, with 10 healthy individuals included as controls. Plasma specimens were collected from patients on postburn days 1, 3, 7, 14, 21, 28 and 35. After performing multivariate statistical analysis, repeated-measures analysis of variance and time-series analysis, we quantified changes in metabolite concentrations. Results Among the 36 metabolites quantified across 119 samples from burn patients, branched-chain amino acids, glutamate, glycine, glucose, pyruvate, lactate, trimethylamine N-oxide and others exhibited obvious temporal variations in concentration. Notably, these metabolites could be categorized into three clusters based on their temporal characteristics. The initial response to injury was characterized by changes in lactate and amino acids, while later changes were driven by an increase in fatty acid catabolism and microbial metabolism, leading to the accumulation of ketone bodies and microbial metabolites. Conclusions Metabolomics techniques utilizing NMR have the potential to monitor the intricate processes of metabolism in patients with severe burns. This study confirmed that the third day after burn injury serves as the boundary between the ebb phase and the flow phase. Furthermore, identification of three distinct temporal patterns of metabolites revealed the intrinsic temporal relationships between these metabolites, providing clinical data for optimizing therapeutic strategies.
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Affiliation(s)
- Sen Su
- Clinical Medical Research Center, Southwest Hospital, Third Military Medical University (Army Medical University), Gaotanyan Street, Shapingba District, Chongqing, 400038, China
| | - Yong Zhang
- Department of Burns and Plastic Surgery, General Hospital of Xinjiang Military Command, Youhao North Road, Shayibake District, Urumqi, 830092, China
| | - Dan Wu
- Clinical Medical Research Center, Southwest Hospital, Third Military Medical University (Army Medical University), Gaotanyan Street, Shapingba District, Chongqing, 400038, China
| | - Chao Wang
- State Key Laboratory of Trauma, Burns and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Gaotanyan Street, Shapingba District, Chongqing, 400038, China
| | - Jianhong Hu
- State Key Laboratory of Trauma, Burns and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Gaotanyan Street, Shapingba District, Chongqing, 400038, China
| | - Yan Wei
- Clinical Medical Research Center, Southwest Hospital, Third Military Medical University (Army Medical University), Gaotanyan Street, Shapingba District, Chongqing, 400038, China
| | - Xi Peng
- Clinical Medical Research Center, Southwest Hospital, Third Military Medical University (Army Medical University), Gaotanyan Street, Shapingba District, Chongqing, 400038, China
- State Key Laboratory of Trauma, Burns and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Gaotanyan Street, Shapingba District, Chongqing, 400038, China
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El-Kersh DM, Abou El-Ezz RF, Ramadan E, El-kased RF. In vitro and in vivo burn healing study of standardized propolis: Unveiling its antibacterial, antioxidant and anti-inflammatory actions in relation to its phytochemical profiling. PLoS One 2024; 19:e0302795. [PMID: 38743731 PMCID: PMC11093344 DOI: 10.1371/journal.pone.0302795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 04/12/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Natural propolis has been used since decades owing to its broad-spectrum activities. Burn injuries are a global health problem with negative impacts on communities. Bacterial infections usually accompany burns, which demand implementation of antibiotics. Antibiotics abuse led to emergence of microbial drug resistance resulting in poor treatment outcomes. In such instances, the promising alternative would be natural antimicrobials such as propolis. OBJECTIVE Full chemical profiling of propolis and evaluation of in vitro antibacterial, antioxidant and anti-inflammatory activities as well as in vivo burn healing properties. METHODS Chemical profiling of propolis was performed using Liquid chromatography (UHPLC/MS-PDA and HPLC-PDA). In vitro assessment was done using Disc Diffusion susceptibility test against Staphylococcus aureus and infected burn wound mice model was used for in vivo assessment. In vitro antioxidant properties of propolis were assessed using DPPH, ABTS and FRAP techniques. The anti-inflammatory effect of propolis was assessed against lipopolysaccharide/interferon-gamma mediated inflammation. RESULTS UHPLC/MS-PDA results revealed identification of 71 phytochemicals, mainly flavonoids. Upon flavonoids quantification (HPLC-PDA), Pinocembrin, chrysin and galangin recorded high content 21.58±0.84, 22.73±0.68 and 14.26±0.70 mg/g hydroalcoholic propolis extract, respectively. Propolis showed concentration dependent antibacterial activity in vitro and in vivo burn healing via wound diameter reduction and histopathological analysis without signs of skin irritation in rabbits nor sensitization in guinea pigs. Propolis showed promising antioxidant IC50 values 46.52±1.25 and 11.74±0.26 μg/mL whereas FRAP result was 445.29±29.9 μM TE/mg. Anti-inflammatory experiment results showed significant increase of Toll-like receptor 4 (TLR4), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) mRNA levels. Nitric oxide and iNOS were markedly increased in Griess assay and western blot respectively. However, upon testing propolis against LPS/IFN-γ-mediated inflammation, TLR4, IL-6 and TNF-α expression were downregulated at transcriptional and post-transcriptional levels. CONCLUSION Propolis proved to be a promising natural burn healing agent through its antibacterial, antioxidant and anti-inflammatory activities.
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Affiliation(s)
- Dina M. El-Kersh
- Faculty of Pharmacy, Pharmacognosy Department, The British University in Egypt, Cairo, Egypt
| | - Rania F. Abou El-Ezz
- Faculty of Pharmacy, Pharmacognosy Department, Misr International University, Cairo, Egypt
| | - Eman Ramadan
- Faculty of Pharmacy, Department of Pharmacology and Toxicology, The British University in Egypt, Cairo, Egypt
| | - Reham F. El-kased
- Center for Drug Research and Development (CDRD), The British University in Egypt, Cairo, Egypt
- Faculty of Pharmacy, Department of Microbiology and Immunology, The British University in Egypt, Cairo, Egypt
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Zia N, Mashreky SR, He H, Patel N, Ahmed FA, Hashmi M, Al-Ibran E, Rahman AF, Khondoker S, Hyder AA, Latif A. Factors associated with emergency department disposition among burn injury patients: Analysis of prehospital and emergency care characteristics using South Asia Burn Registry (SABR) data. Burns 2024; 50:874-884. [PMID: 38245393 PMCID: PMC11055681 DOI: 10.1016/j.burns.2024.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 12/17/2023] [Accepted: 01/10/2024] [Indexed: 01/22/2024]
Abstract
INTRODUCTION Improvement in burn injury data collections and the quality of databanks has allowed meaningful study of the epidemiologic trends in burn care. The study assessed factors associated with disposition of burn injury patients from emergency department accounting for pre-hospital care and emergency care. METHODS This prospective observational pilot study of the South Asia Burn Registry project was conducted at selected public sector burn centers in Bangladesh and Pakistan (September 2014 - January 2015). All age groups with an initial presentation to the burn centers were enrolled. Descriptive and regression analysis is presented. RESULTS A total of 2749 patients were enrolled. The mean age was 21.7 ± 18.0 years, 55.3% were males, and about a quarter were children < 5 years. About 46.9% of the females were housewives. Scald burns were common among children (67.6%) while flame burns were common among adults (44.3%). About 75% of patients were brought in via non-ambulance mode of transport. More than 55% of patients were referrals from other facilities or clinics. The most common first aid given pre-hospital was the use of water or oil. About 25% were admitted for further care. The adjusted odds of being admitted compared to being sent home were highest for children < 5 yrs, those with higher total body surface area burnt, having arrived via ambulance, scald and electrical burn, having an associated injury and inhalational injury. CONCLUSION The study provides insight into emergency burn care and associated factors that influenced outcomes for patients with burn injuries.
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Affiliation(s)
- Nukhba Zia
- Johns Hopkins International Injury Research Unit, Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | | | - Huan He
- Johns Hopkins International Injury Research Unit, Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Nishit Patel
- Johns Hopkins International Injury Research Unit, Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Fasih Ali Ahmed
- Division of Surgical Oncology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Madiha Hashmi
- Department of Critical Care Medicine, Ziauddin University Hospital, Karachi, Pakistan
| | | | | | - Sazzad Khondoker
- National Institute of Burn and Plastic Surgery, Dhaka, Bangladesh
| | - Adnan A Hyder
- Center on Commercial Determinants of Health and Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Asad Latif
- Johns Hopkins International Injury Research Unit, Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Anesthesiology, Aga Khan University, Karachi, Pakistan
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Roy S, Mukherjee P, Kundu S, Majumder D, Raychaudhuri V, Choudhury L. Microbial infections in burn patients. Acute Crit Care 2024; 39:214-225. [PMID: 38863352 PMCID: PMC11167422 DOI: 10.4266/acc.2023.01571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 03/16/2024] [Accepted: 03/27/2024] [Indexed: 06/13/2024] Open
Abstract
Polymicrobial infections are the leading causes of complications incurred from injuries that burn patients develop. Such patients admitted to the hospital have a high risk of developing hospital-acquired infections, with longer patient stays leading to increased chances of acquiring such drug-resistant infections. Acinetobacter baumannii, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Proteus mirabilis are the most common multidrug-resistant (MDR) Gram-negative bacteria identified in burn wound infections (BWIs). BWIs caused by viruses, like Herpes Simplex and Varicella Zoster, and fungi-like Candida spp. appear to occur occasionally. However, the preponderance of infection by opportunistic pathogens is very high in burn patients. Variations in the causative agents of BWIs are due to differences in geographic location and infection control measures. Overall, burn injuries are characterized by elevated serum cytokine levels, systemic immune response, and immunosuppression. Hence, early detection and treatment can accelerate the wound-healing process and reduce the risk of further infections at the site of injury. A multidisciplinary collaboration between burn surgeons and infectious disease specialists is also needed to properly monitor antibiotic resistance in BWI pathogens, help check the super-spread of MDR pathogens, and improve treatment outcomes as a result.
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Affiliation(s)
- Souvik Roy
- Postgraduate and Research Department of Biotechnology, St. Xavier’s College (Autonomous), Kolkata, India
| | - Preeti Mukherjee
- Postgraduate and Research Department of Biotechnology, St. Xavier’s College (Autonomous), Kolkata, India
| | - Sutrisha Kundu
- Postgraduate and Research Department of Biotechnology, St. Xavier’s College (Autonomous), Kolkata, India
| | - Debashrita Majumder
- Postgraduate and Research Department of Biotechnology, St. Xavier’s College (Autonomous), Kolkata, India
| | - Vivek Raychaudhuri
- Postgraduate and Research Department of Biotechnology, St. Xavier’s College (Autonomous), Kolkata, India
| | - Lopamudra Choudhury
- Department of Microbiology, Sarsuna College (under Calcutta University), Kolkata, India
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Hundeshagen G, Blears E, Mertin V, Day AG, Palackic A, Tapking C, Haug V, Kneser U, Bliesener B, Panayi AC, Aballay A, Depret F, Stoppe C, Heyland DK. Administration and effects of beta blockers and oxandrolone in severely burned adults: a post hoc analysis of the RE-ENERGIZE trial. BURNS & TRAUMA 2024; 12:tkad063. [PMID: 38650969 PMCID: PMC11033841 DOI: 10.1093/burnst/tkad063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 10/15/2023] [Accepted: 12/13/2023] [Indexed: 04/25/2024]
Abstract
Background Prospective randomized trials in severely burned children have shown the positive effects of oxandrolone (OX), beta blockers (BB) and a combination of the two (BBOX) on hypermetabolism, catabolism and hyperinflammation short- and long-term post-burn. Although data on severely burned adults are lacking in comparison, BB, OX and BBOX appear to be commonly employed in this patient population. In this study, we perform a secondary analysis of an international prospective randomized trial dataset to provide descriptive evidence regarding the current utilization patterns and potential treatment effects of OX, BB and BBOX. Methods The RE-ENERGIZE (RandomizEd Trial of ENtERal Glutamine to minimIZE Thermal Injury, NCT00985205) trial included 1200 adult patients with severe burns. We stratified patients according to their receipt of OX, BB, BBOX or none of these drugs (None) during acute hospitalization. Descriptive statistics describe the details of drug therapy and unadjusted analyses identify predisposing factors for drug use per group. Association between OX, BB and BBOX and clinical outcomes such as time to discharge alive and 6-month mortality were modeled using adjusted multivariable Cox regressions. Results More than half of all patients in the trial received either OX (n = 138), BB (n = 293) or BBOX (n = 282), as opposed to None (n = 487, 40.6%). Per study site and geographical region, use of OX, BB and BBOX was highly variable. Predisposing factors for the use of OX, BB and BBOX included larger total body surface area (TBSA) burned, higher acute physiology and chronic health evaluation (APACHE) II scores on admission and younger patient age. After adjustment for multiple covariates, the use of OX was associated with a longer time to discharge alive [hazard ratio (HR) 0.62, confidence interval (CI) (0.47-0.82) per 100% increase, p = 0.001]. A higher proportion of days on BB was associated with lower in-hospital-mortality (HR: 0.5, CI 0.28-0.87, p = 0.015) and 6-month mortality (HR: 0.44, CI 0.24-0.82, p = 0.01). Conclusions The use of OX, BB and BBOX is common within the adult burn patient population, with its use varying considerably across sites worldwide. Our findings found mixed associations between outcomes and the use of BB and OX in adult burn patients, with lower acute and 6-month-mortality with BB and longer times to discharge with OX. Further research into these pharmacological modulators of the pathophysiological response to severe burn injury is indicated.
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Affiliation(s)
- Gabriel Hundeshagen
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwig-Guttmann-Str. 13, 67071 Ludwigshafen, Germany
| | - Elisabeth Blears
- Department of Plastic Surgery, Bayview Medical Center, Johns Hopkins University, 4940 Eastern Ave, Baltimore 21224, MD, USA
| | - Viktoria Mertin
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwig-Guttmann-Str. 13, 67071 Ludwigshafen, Germany
| | - Andrew G Day
- Kingston General Health Research Institute, Kingston Health Sciences Centre, 76 Stuart Street, Kingston, Ontario, K7L 2V7, Canada
| | - Alen Palackic
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwig-Guttmann-Str. 13, 67071 Ludwigshafen, Germany
| | - Christian Tapking
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwig-Guttmann-Str. 13, 67071 Ludwigshafen, Germany
| | - Valentin Haug
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwig-Guttmann-Str. 13, 67071 Ludwigshafen, Germany
| | - Ulrich Kneser
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwig-Guttmann-Str. 13, 67071 Ludwigshafen, Germany
| | - Björn Bliesener
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwig-Guttmann-Str. 13, 67071 Ludwigshafen, Germany
| | - Adriana C Panayi
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwig-Guttmann-Str. 13, 67071 Ludwigshafen, Germany
| | - Ariel Aballay
- Department of Plastic Surgery, Bayview Medical Center, Johns Hopkins University, 4940 Eastern Ave, Baltimore 21224, MD, USA
| | - Francois Depret
- Department of Anaesthesiology, Intensive Care Medicine and Burn center, Saint-Louis Hospital, 1 avenue Claude-Vellefaux, 75010, Asistance Publique Hôpitaux de Paris, Paris Cité University, France
| | - Christian Stoppe
- Department of Anaesthesiology and Intensive Care Medicine, University Medical Center Schleswig-Holstein, Campus Kiel, Schwanenweg 21, 24105 Kiel, Germany
- University Hospital, Würzburg, Department of Anesthesiology, Intensive Care, Emergency and Pain Medicine, Oberdürrbacher Str. 6, 97080 Würzburg, Germany
- Departments of Cardiac Anesthesiology & Intensive Care Medicine, Charité Berlin, Augustenburger Platz 1 | 13353, Berlin, Germany
| | - Daren K Heyland
- Department of Critical Care Medicine, Queen’s University, 76 Stuart Street, Kingston, K7L 2V7 Ontario, Canada
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Zvizdic Z, Hukic L, Ljubovic AD, Milisic E, Jonuzi A, Vranic S. Epidemiology and early bacterial colonization of minor and moderate pediatric burns: A retrospective study from a developing country. Burns 2024; 50:623-629. [PMID: 37981486 DOI: 10.1016/j.burns.2023.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 09/03/2023] [Accepted: 10/26/2023] [Indexed: 11/21/2023]
Abstract
OBJECTIVES Infection is still the leading cause of morbidity and mortality among burn patients worldwide. Isolation and identification of pediatric burn wound bacterial colonizers can prevent infection and improve burn trauma treatment. In this study, we explored early microbial colonizers within the burn wounds and the susceptibility of those isolates to antibiotics among hospitalized pediatric patients with minor and moderate burns, clinically significant infections and outcomes. METHODS A retrospective analysis of pediatric patients admitted to the inpatient pediatric surgical ward and treated for minor and moderate burns from 2009 to 2018 was performed. RESULTS One hundred six patients met the inclusion criteria. The mean age was 3.6 ± three years (0.2-14.1 years). The most common type of burn was scald burns (82.1%). The mean TBSA of the hospitalized pediatric burn cases was 8.5% (IQR, 6-12%). Seventy-nine (74.5%) patients had positive wound cultures at admission, regardless of the hospital admission day. Fifty-eight (73.4%) had one bacterial growth (mono isolate), while 21 (26.6%) had mixed growth or poly isolates. Among patients with mixed growth or poly isolate, 16 had two bacteria, three had three bacteria, and one had four bacteria isolated, totaling 105 isolated microorganisms (14 different species, 70.5% Gram-positive bacteria and 29.5% Gram-negative bacteria). Twelve patients (11%) developed clinically significant infections (eleven got burn wound infection, and one had septicemia). All patients received prophylactic systemic antibiotics. Only 35.2% of the isolated bacteria from the wounds were sensitive to the prophylactic antibiotics, and only ∼17% in case of clinically significant infections. We found a statistically significant difference in the length of hospital stay between patients with initially colonized samples of burn wounds compared with patients with initial negative samples (p = 0.008). All patients in the cohort survived hospital discharge. CONCLUSION Despite common bacterial colonization of acute burn wounds, only ∼10% of the patients developed clinically significant infections, a minority of which were sensitive to prophylactic antibiotics. Our findings indicate the need to refine the antibiotic approach in pediatric patients with minor/moderate burns in our local setting.
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Affiliation(s)
- Zlatan Zvizdic
- Clinic of Pediatric Surgery, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Lamija Hukic
- Public Institution Health Center of the Canton Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Amela Dedeic Ljubovic
- Department of Clinical Microbiology, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Emir Milisic
- Clinic of Pediatric Surgery, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Asmir Jonuzi
- Clinic of Pediatric Surgery, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Semir Vranic
- College of Medicine, QU Health, Qatar University, Doha, Qatar.
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AlQhtani AZ, Al-swedan NH, Alkhunani TA, Basalem AA, Alotaibi AM, Alsaygh KW, AlSahabi AM, Alabdulkarim AO. Knowledge, Attitudes, and Practices Regarding Electrical Burns. J Burn Care Res 2024; 45:478-486. [PMID: 37962554 PMCID: PMC10911689 DOI: 10.1093/jbcr/irad182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Indexed: 11/15/2023]
Abstract
Burn prevention programs can effectively reduce morbidity and mortality rates. In this article, we present the findings of our investigation of the knowledge, attitudes, and practices of the Saudi Arabian population regarding electrical burns. Our study was a cross-sectional online survey that used a five-part questionnaire to assess the participant's demographic information, knowledge of electrical burns, attitudes toward electrical injuries, and practices related to electrical burns and their prevention. Overall, 2314 individuals responded to the survey (males: 41.2%; females: 58.8%). A total of 839 participants (36%) had a personal or family history of electrical burns. Approximately ≥90% of the responses to questions on electrical burn-related knowledge were correct; relatively less responses to questions on the extent of tissue damage from electrical burns and arcs were correct (74% and 29%, respectively). Only 54% of the respondents knew that applying first aid to the burn-affected areas at home could lead to a better outcome; 27% and 19% did not know the correct answer and thought that this would not lead to a better outcome, respectively. The most common source of information was school or college (38.9%), followed by social media (20.8%) and internet websites (16.3%). Enhancing community awareness and practices related to electrical burns is a cost-effective and straightforward strategy to prevent the morbidity and mortality associated with electrical injuries.
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Affiliation(s)
- Abdullh Z AlQhtani
- Surgery Department, College of Medicine, Prince Sattam Bin Abdulaziz University, Al Kharj 11942, Saudi Arabia
| | - Nasser H Al-swedan
- Surgery Department, College of Medicine, Prince Sattam Bin Abdulaziz University, Al Kharj 11942, Saudi Arabia
| | - Tala A Alkhunani
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh 11481, Saudi Arabia
| | - Abdulaziz A Basalem
- Surgery Department, College of Medicine, Prince Sattam Bin Abdulaziz University, Al Kharj 11942, Saudi Arabia
| | - Abdulwhab M Alotaibi
- Surgery Department, College of Medicine, Prince Sattam Bin Abdulaziz University, Al Kharj 11942, Saudi Arabia
| | - Khaled W Alsaygh
- Surgery Department, College of Medicine, Prince Sattam Bin Abdulaziz University, Al Kharj 11942, Saudi Arabia
| | - Abdulrahman M AlSahabi
- Plastic Surgery Department, Prince Sultan Military Medical City, Riyadh 11159, Saudi Arabia
| | - Abdulaziz O Alabdulkarim
- Surgery Department, College of Medicine, Prince Sattam Bin Abdulaziz University, Al Kharj 11942, Saudi Arabia
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Labouchère A, Haselbach D, Michetti M, Pythoud C, Raffoul W, Applegate LA, Hirt-Burri N, de Buys Roessingh A. A New Ex Vivo Human Skin Burn Model. J Burn Care Res 2024; 45:308-317. [PMID: 37202124 PMCID: PMC10911692 DOI: 10.1093/jbcr/irad071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Indexed: 05/20/2023]
Abstract
Currently, most burn models for preclinical testing are on animals. For obvious ethical, anatomical, and physiological reasons, these models could be replaced with optimized ex vivo systems. The creation of a burn model on human skin using a pulsed dye laser could represent a relevant model for preclinical research. Six samples of excess human abdominal skin were obtained within one hour after surgery. Burn injuries were induced on small samples of cleaned skin using a pulsed dye laser on skin samples, at varying fluences, pulse numbers and illumination duration. In total, 70 burn injuries were performed on skin ex vivo before being histologically and dermato-pathologically analyzed. Irradiated burned skin samples were classified with a specified code representing burn degrees. Then, a selection of samples was inspected after 14 and 21 days to assess their capacity to heal spontaneously and re-epithelize. We determined the parameters of a pulsed dye laser inducing first, second, and third degree burns on human skin and with fixed parameters, especially superficial and deep second degree burns. After 21 days with the ex vivo model, neo-epidermis was formed. Our results showed that this simple, rapid, user-independent process creates reproducible and uniform burns of different, predictable degrees that are close to clinical reality. Human skin ex vivo models can be an alternative to and complete animal experimentation, particularly for preclinical large screening. This model could be used to foster the testing of new treatments on standardized degrees of burn injuries and thus improve therapeutic strategies.
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Affiliation(s)
- Ania Labouchère
- PlasticReconstructive, and Hand Surgery Service, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
- Regenerative Therapy Unit, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
- Lausanne Burn Center, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Daniel Haselbach
- PlasticReconstructive, and Hand Surgery Service, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Murielle Michetti
- Regenerative Therapy Unit, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
- Lausanne Burn Center, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Catherine Pythoud
- Regenerative Therapy Unit, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Wassim Raffoul
- PlasticReconstructive, and Hand Surgery Service, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
- Lausanne Burn Center, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Lee Ann Applegate
- Regenerative Therapy Unit, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
- Lausanne Burn Center, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
- Center for Applied Biotechnology and Molecular Medicine, University of Zurich, Zurich, Switzerland
| | - Nathalie Hirt-Burri
- Regenerative Therapy Unit, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
- Lausanne Burn Center, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Anthony de Buys Roessingh
- Lausanne Burn Center, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
- Children and Adolescent Surgery Service, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
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Balseven-Odabaşı A, Yıldırım MŞ, Akçan R, Yalçın SS, I Nce T, Tümer AR, Yorgancı K. Dark side of customs: scalding burns in childhood due to use of traditional teacup and teapot, in Turkey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024; 34:1479-1486. [PMID: 37288960 DOI: 10.1080/09603123.2023.2221644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 05/30/2023] [Indexed: 06/09/2023]
Abstract
The most common type of burn among children is scalding burn. This study aims to reveal child abuse and neglect as a specific etiological factor that specific to our country, traditional teapot- and teacup-related scalding burns. Burn cases that admitted to our Burn Center were investigated, and among these, 72 cases suffering from scalding burns were included in the study. The interview forms issued upon admission of these cases were evaluated in detail. Out of 148 scalding burn cases, 48.6% were related to the use of traditional teapots and teacups. After a detailed assessment, all cases were considered neglect-related burns. As a result of considering the role of traditional teapots and teacups in pediatric injuries in our country, parents and caregivers should be warned about these types of injuries. Also, physicians must determine the possibility of child abuse or neglect in all pediatric burn cases.
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Affiliation(s)
| | - Mahmut Şerif Yıldırım
- Department of Forensic Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Ramazan Akçan
- Department of Forensic Medicine, Hacettepe University, Ankara, Turkey
| | - S Songül Yalçın
- Department of Pediatrics, Hacettepe University, Ankara, Turkey
| | - Tolga I Nce
- Department of Pediatrics, Dokuz Eylül University, Izmir, Turkey
| | - Ali Rıza Tümer
- Department of Forensic Medicine, Hacettepe University, Ankara, Turkey
| | - Kaya Yorgancı
- Department of General Surgery, Hacettepe University, Ankara, Turkey
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13
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Krstic B, Krstic M, Selakovic D, Jovicic N, Rosic G. Therapeutic approach to emotional reactions accompanied with thermal skin injury - from basic to epidemiological research. World J Psychiatry 2024; 14:199-203. [PMID: 38464772 PMCID: PMC10921289 DOI: 10.5498/wjp.v14.i2.199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 12/15/2023] [Accepted: 01/24/2024] [Indexed: 02/06/2024] Open
Abstract
In this editorial, we discuss the status of a therapeutic approach to emotional reactions accompanying thermal skin injuries. Burns are considered a major health problem, as well as an economic and social problem, with potentially devastating and life-changing consequences. They affect a wide range of patients with different damage mechanisms, varied depths, and localizations of the burns. The most common are thermal burns, with more than 11 million occurrences annually according to the World Health Organization data. Thermal skin injuries are among the most tragic and catastrophic injuries, almost unsurpassed in terms of severity, morbidity, and mortality, as well as functional, aesthetic, social, economic, and psychological consequences. Burn survivors face stress, anxiety, depression, low self-esteem, body deformity, social isolation, unemployment, financial burden, and family problems. The advances in acute burn care have allowed researchers and physicians to pay more attention to other effects of burns, focusing on psychological consequences in particular. Apart from the significant improvements in routine protocols, it seems useful to take care of psychological disturbances that occur simultaneously but may emerge as the most lasting outcome of those injuries. In that sense, various standards and additional approaches may be involved to achieve overall recovery.
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Affiliation(s)
- Bojana Krstic
- Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac 34000, Serbia
| | - Milos Krstic
- Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac 34000, Serbia
| | - Dragica Selakovic
- Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac 34000, Serbia
| | - Nemanja Jovicic
- Department of Histology and Embryology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac 34000, Serbia
| | - Gvozden Rosic
- Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac 34000, Serbia
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Keshavarzi A, Akrami R, Zarshenas MM, Zareie S, Ghadimi T, Najafi A, Rostami Chijan M, Dehghan A, Zarenezhad E. Evaluation of the Effect of Cichorium intybus L. on the Liver Enzymes in Burn Patients: A Randomized Double-Blind Clinical Trial. Int J Clin Pract 2024; 2024:1016247. [PMID: 38239768 PMCID: PMC10796187 DOI: 10.1155/2024/1016247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 09/02/2023] [Accepted: 12/30/2023] [Indexed: 01/22/2024] Open
Abstract
Burn injuries are considered an important public health problem in the world. Burns are considered the fourth most common kind of trauma in the world, after traffic accidents, falls, and interpersonal violence. Various biochemical agents are involved in the burn healing process such as cytokines (such as IL-6 and TNF-α), antioxidants, and liver and kidney damage biomarkers. Cichorium intybus L. and milk thistle extracts showed a wide range of pharmacological activities such as significant antimicrobial effect and antioxidant activity, as well as anti-inflammatory, antidiabetic, antiproliferative, antiprotozoal, and hepatoprotective effect. Also, these two herbs possess blood-cleansing, detoxifying, laxative, and invigorating activities. Some research confirmed that the preparations of the extract are very suitable for the treatment of nonalcoholic fatty liver disease. This is a double-blind randomized controlled clinical trial. Patients with 2nd and 3rd degree burns have been selected to participate in the study according to the inclusion criteria. A total of 60 patients were selected and divided into intervention and control groups (30 patients in each group). Patients in the intervention group received chicory seed syrup 10 cc three times a day and 1 placebo capsule, and those in the control group received placebo syrup (10 cc three times a day) and one Livergol (140 mg of silymarin in each capsule) capsule. Lab data such as liver function tests, albumin, creatinine, BUN, and hemoglobin were checked every 3 days and 1 week after discharge. The treatment lasted for 4 weeks. According to the results of the study, although the average of liver enzymes at the end of the study does not show a significant difference between the two groups, the level of liver enzymes in each group decreased on the 15th day of the study compared to the first day. This trial is registered with IRCT20180609040016N1.
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Affiliation(s)
- Abdolkhalegh Keshavarzi
- Shiraz Burn and Wound Healing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Rahimeh Akrami
- Shiraz Burn and Wound Healing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad M. Zarshenas
- Traditional Medicine and Hydrotherapy Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
- Department of Phytopharmaceuticals (Traditional Pharmacy), School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Saeid Zareie
- Nurse of Intensive Care Unit (ICU) of Amir Al-Momenin Burn Injury Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Tayyeb Ghadimi
- Department of Plastic and Reconstructive Surgery, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Najafi
- Shiraz Burn and Wound Healing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahsa Rostami Chijan
- Department of Persian Medicine, Fasa University of Medical Sciences, Fasa, Iran
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Azizallah Dehghan
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Elham Zarenezhad
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
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Malhotra H, Sharma P, Kamal MA, Kaushik P, Rani N. Concise Review on Scientific Approaches to Burns and Scars. Curr Drug Saf 2024; 19:191-199. [PMID: 37165593 DOI: 10.2174/1574886318666230509143017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 02/06/2023] [Accepted: 02/16/2023] [Indexed: 05/12/2023]
Abstract
Burns are large open surgical lesions bathed in virulent pus that result in rupturing of the cutaneous membrane, which has serious consequences such as an extensive loss of proteins, and body fluids, increased chances of infections, and sometimes death. These can be classified based on their penetration levels, i.e., first-degree burns penetrating the epidermis, second-degree burns including both epidermis and dermis, third-degree burns to both layers including the hair follicular cells, sweat glands and various core tissues, fourth-degree burns to adipose tissue, fifth stage burns to muscles, and sixth stage burns to bones. Wound healing/wound repair is a very perplexing process in which the tissues of the affected/burnt area repairs themselves to attain their original form and functionality but develop a scar at the wound site. This article mainly focuses on the algorithms to differentiate various degrees of burns, general first aid approaches to burns and scars, the rationale of treatment of burns, basic mechanisms highlighting the healing processes in humans in terms of free from scar formation as well as with scar formation at their elementary levels including cellular as well as biochemical levels, utility, and progression of pre-clinical data to humans and finally approaches for the improvement of scar formation in man.
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Affiliation(s)
- Hitesh Malhotra
- Department of Pharmaceutical Science, Guru Gobind Singh College of Pharmacy, Yamuna Nagar (Haryana), India
| | - Prerna Sharma
- Department of Pharmaceutical Science, Guru Gobind Singh College of Pharmacy, Yamuna Nagar (Haryana), India
| | - Mohammad Amjad Kamal
- Institutes for Systems, Chengdu, Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, China
- King Fahd Medical Research Center, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka 1207, Bangladesh
- 4 Enzymoics, Novel Global Community Educational Foundation, 7 Peterlee place, Hebersham, NSW 2770, Australia
| | - Peeyush Kaushik
- Department of Pharmaceutical Science, Guru Gobind Singh College of Pharmacy, Yamuna Nagar (Haryana), India
| | - Nidhi Rani
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
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Abubakar AI, Okpechi SC, Euguagie OO, Ikpambese AA. Demographics and Clinical Characteristics of Burn Injuries in Nigeria: A Tertiary Hospital Cohort. Niger J Clin Pract 2023; 26:1916-1920. [PMID: 38158361 DOI: 10.4103/njcp.njcp_470_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 07/31/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Burn injuries account for 4.8% of trauma deaths in Nigeria and annually for 20,000 deaths. AIM This study was to catalogue the demographics of patient who presented at a referral center in Nigeria. PATIENTS AND METHODS In a retrospective study, we reviewed the records of all burn patients who presented over a 36-month period (January 2018 to December 2020). The clinical and demographic data was extracted using a self-designed questionnaire. Information obtained included biodata, etiology, time of presentation, first aid used, TBSA, length of hospital stay (LOHS), and outcome which was analyzed with SPSS version 28. RESULTS A total of 112 burn patients presented at our facility, 87 male and 25 female (m: f = 3.5:1). Forty-four percent were children 10 years old and below. Though scalding with hot liquids was the commonest cause of injury in children, flame burn was the commonest etiology (57.1%). Inhalational injuries occurred in 14.2%. Raw eggs and pap were used as first aid by 23%. Most patients were discharged home, and 19.6% died. CONCLUSION The prevalence of burn injuries remains high in developing countries. Most causes of burns are preventable. Dangerous traditional practices add to patient morbidity. Education on effective prevention strategies is important in reducing morbidity and mortality.
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Affiliation(s)
- A I Abubakar
- Department of Surgery, University of Abuja, Abuja, Nigeria
| | - S C Okpechi
- Department of Surgery, University of Abuja Teaching Hospital, Abuja, Nigeria
| | - O O Euguagie
- Department of Surgery, University of Abuja Teaching Hospital, Abuja, Nigeria
| | - A A Ikpambese
- Department of Surgery, University of Abuja Teaching Hospital, Abuja, Nigeria
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Martin T, Nanjebe D, Atwine D. Assessment of the proportion of households with burn victims, associated risk factors and knowledge of burn injury prevention strategies in South Western Uganda. A population based cross sectional survey. Burns 2023; 49:1756-1764. [PMID: 37032274 DOI: 10.1016/j.burns.2023.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 03/14/2023] [Accepted: 03/16/2023] [Indexed: 03/31/2023]
Abstract
BACKGROUND Burn injuries are a major cause of morbidity and mortality within Low- and Middle-income countries (LMICs). Most of these burn injuries occur at home with children most at risk. The majority of burn related deaths and disability in LMICs have been described as preventable. Burns prevention requires adequate knowledge of the epidemiological characteristics and associated risk factors. The aim of this study was to assess the proportion of households with burn victims, the associated risk factors and knowledge of prevention strategies of burn injuries in Kakoba division, Mbarara city. METHODS We did a population based cross sectional survey of households in Kakoba division. This is the most populous division in Mbarara city. Face-to-face interviews were conducted using a pretested structured questionnaire. Descriptive analysis was performed to establish prevalence and knowledge of preventive strategies for household burns. Univariate and multivariate logistic regression models were fitted to establish the factors influencing burn injuries at household level. RESULTS Of the households in Kakoba Division, 41.2% had individuals who had previously sustained burn injuries within the household. Children were the most affected population with scald burns the most common type. The highest risk of burn injuries was associated with overcrowding in the households. Electricity as a light source was found to be protective. Candles and Kerosene lamps were the commonest alternative light sources. Majority 98% of the individuals in the households knew at least one burns prevention strategy with 93% practicing at least one. CONCLUSION Burns within the household are still high despite knowledge of risk factors with children being the most affected. Overcrowding still plays a significant role in household burn injuries. We therefore recommend closer supervision of children within the households. Cooking areas need to be properly designated and secured to limit access. Safer alternative light sources need to be explored such as solar lamps. Political leaders need to be involved in setting up and monitoring community-based fire safety practices to ensure compliance.
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Affiliation(s)
- Tungotyo Martin
- Department of Surgery, Mbarara University of Science and Technology (MUST), P.O. Box 1410, Uganda.
| | | | - Daniel Atwine
- Soar Research Foundation, P.O. Box 1596, Mbarara, Uganda
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Tolouei M, Bagheri Toolaroud P, Letafatkar N, Feizkhah A, Sadeghi M, Esmailzadeh M, Daghighi Masooleh M, Mobayen M. An 11-year retrospective study on the epidemiology of paediatric burns in the north of Iran. Int Wound J 2023; 20:3523-3530. [PMID: 37160373 PMCID: PMC10588361 DOI: 10.1111/iwj.14225] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/14/2023] [Accepted: 04/24/2023] [Indexed: 05/11/2023] Open
Abstract
Burn injuries in children are distressing physical and emotional events with long-term disability. However, there is little research on the epidemiology of paediatric burns. This information is essential for the development of prevention intervention and acute management. This study aimed to describe epidemiologic characteristics and clinical outcomes of paediatric burns in a burn center in the north of Iran. A retrospective, single-center study was conducted of children (<18 years) admitted to the burns center between 2011 and 2021. The data were analysed by SPSS 24.0 software. The chi-squared test and Fisher's exact test were used to assess categorical variables, and Student's t-tests or One-Way ANOVA was used to evaluate continuous variables. 2951 paediatric burns with mean age 5.30 ± 5.27 years, were admitted during the 11 years, with 1777 boys (60.2%) and 1174 girls (39.8%). By age groups, the majority of children (59.7%) were between 0 and 4 years old, followed by 5 to 8 years (15.7%), 13 to 18 years (14.6%), and 9 to 12 years (10.0%), respectively. The most cause of injury was Hot liquids & vapours (1604, 54.4%). The mean age for burns with fire & flames, hot liquids & vapours, contact, chemical, and electrical was 4.46 ± 4.84, 5.70 ± 5.39, 5.44 ± 5.42, 3.93 ± 3.86, and 3.53 ± 4.06 years, respectively. The total body surface area (TBSA) burned was 14.96 ± 11.94. The longest length of stay (LOS) related to fire and flame was 5.63 ± 7.57 days. The mortality rate was 1.56%. There were significant differences among aetiology groups for the cost per % TBSA (F = 15.784, P < 0.001), which correlated with the burn depth, TBSA, aetiology, LOS, and age. The Ministry of Health should establish strategies for burn prevention and incorporate data surveillance for burn injuries. Community education on kitchen and cooking safety could positively impact the prevalence and outcomes of paediatric burns.
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Affiliation(s)
- Mohammad Tolouei
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
| | - Parissa Bagheri Toolaroud
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Health Information Management Research CenterKashan University of Medical SciencesKashanIran
| | - Negin Letafatkar
- School of MedicineGuilan University of Medical SciencesRashtIran
| | - Alireza Feizkhah
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Department of Medical PhysicsSchool of Medicine, Guilan University of Medical SciencesRashtIran
| | - Mahsa Sadeghi
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
| | - Mojdeh Esmailzadeh
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
| | | | - Mohammadreza Mobayen
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
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Al-Samydai A, Abu Hajleh MN, Mayyas A, Al-Mamoori F, Al-Tawalbe DM, Alqaraleh M, Mousa MA, Aladwan H, Alazab B, Selwadi D, Othman FA, Zaazouee MS, Ragab KM, Al-Halaseh L. Ethnopharmacological Study of Medicinal Plants Used in the Treatment of Skin Burns in the Arab World. J Burn Care Res 2023; 44:1216-1222. [PMID: 36864698 DOI: 10.1093/jbcr/irad030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
Traditional healers are often practiced in rural areas owing to cultural beliefs and are known to provide various forms of healthcare and home remedies. Patients in the Mediterranean region rely on traditional medicine to cure a variety of health concerns, like skin burns. This study was conducted to identify the various practices used by traditional healers for treating skin burns. The survey was conducted in 18 Arab countries, including Syria, Iraq, Jordan, Saudi Arabia, Egypt, United Arab Emirates, Algeria, Bahrain, Palestine, Kuwait, Oman, Qatar, Lebanon, Yemen, Tunisia, Oman, Morocco, and Sudan. Between September 2020 and July 2021, an online questionnaire was administered to 7530 participants from 12 Asian and 5 African countries. The survey was designed to gather information from common medicinal plant users and herbalists on their practices as specialists in using various herbal and medicinal plant products for diagnosis and treatment. Among the participants, 2260 had a scientific background in plant application, and the study included one phytotherapeutic professional. The crude-extraction technique was favored, by Arabic folk, for plant preparation over the maceration and decoction method. Olive oil was the most commonly used product among participants as an anti-inflammation and for scar reduction. Aloe vera, olive oil, sesame, Ceretonia siliqua, lavender, potato, cucumber, shea butter, and wheat flour are used as crude drugs to reduce pain because of their analgesic and cooling effects. The present study is the first database of medicinal plants with burn-healing properties conducted in Arab countries. These plants can be employed in the search for new bioactive substances through pharmacochemical investigations, as well as in the development of new formulations containing a combination of these plants.
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Affiliation(s)
- Ali Al-Samydai
- Pharmacological and Diagnostic Research Centre, Faculty of Pharmacy, Al-Ahliyya Amman University, Amman, Jordan
| | - Maha N Abu Hajleh
- Department of Cosmetic Science, Pharmacological and Diagnostic Research Centre, Faculty of Allied Medical Sciences, Al-Ahliyya Amman University, Amman, Jordan
| | - Amal Mayyas
- Faculty of Health Science, Pharmacy Department, American University of Madaba, Madaba, Jordan
| | - Farah Al-Mamoori
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Zarqa University, Zarqa, Jordan
| | - Deniz M Al-Tawalbe
- Department of Medicinal Chemistry and Pharmacognosy, Faculty of Pharmacy, Yarmouk University, Irbid, Jordan
| | - Moath Alqaraleh
- Pharmacological and Diagnostic Research Centre, Faculty of Pharmacy, Al-Ahliyya Amman University, Amman, Jordan
| | - Mohamad Ak Mousa
- Pharmacological and Diagnostic Research Centre, Faculty of Pharmacy, Al-Ahliyya Amman University, Amman, Jordan
| | - Hala Aladwan
- Faculty of Pharmacy, The University of Jordan, Amman, Jordan
| | - Badi'ah Alazab
- Faculty of Pharmacy, The University of Jordan, Amman, Jordan
| | - Dana Selwadi
- Faculty of Pharmacy, The University of Jordan, Amman, Jordan
| | | | | | | | - Lidia Al-Halaseh
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Mutah University, Al-Karak, Jordan
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Khanipour M, Lajevardi L, Taghizadeh G, Azad A, Ghorbani H. Effects of an Occupation-Based Intervention on Hand and Upper Extremity Function, Daily Activities, and Quality of Life in People With Burn Injuries: A Randomized Controlled Trial. Am J Occup Ther 2023; 77:7705205090. [PMID: 37851587 DOI: 10.5014/ajot.2023.050115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023] Open
Abstract
IMPORTANCE Occupational performance and function are affected in people with burn injuries to the hand and upper extremity; this can lead to the development of some disabilities and endanger quality of life. OBJECTIVE To investigate the effects of occupation-based intervention on hand and upper extremity function, daily activities, and quality of life in people with burn injuries. DESIGN Randomized controlled trial. SETTING Specialized burn hospital in Iran. PARTICIPANTS Patients (N = 20) with burn injuries to the hand and upper extremity. INTERVENTIONS The control group received only traditional rehabilitation, and the intervention group received traditional rehabilitation and took part in the Cognitive Orientation to daily Occupational Performance (CO-OP) protocol (18 sessions, 45 min/day, for both groups). MEASURES Assessments included the CO-OP; Michigan Hand Outcomes Questionnaire; Shortened Disabilities of the Arm, Shoulder and Hand Questionnaire; Modified Barthel Index; World Health Organization Quality-of-Life Scale-Brief; a visual analogue scale; measurements with a goniometer and dynamometer; and the figure-of-eight method. These evaluations were conducted with both groups before the rehabilitation program commenced and at Wk 2, 6, and 14 (follow-up). RESULTS The results showed that there were notable changes in all the study variables except edema in both groups. However, these changes (p [V] ≤ .05) were not statistically significant between the two groups. CONCLUSIONS AND RELEVANCE According to the results, the occupation-based interventions are as effective as traditional therapeutic interventions for the improvement of hand and upper extremity function, ability to perform daily activities, and quality of life in people with burn injuries. What This Article Adds: The CO-OP protocol, as an occupation-based intervention, can improve hand performance, ability to perform daily activities, and quality of life in people with burn injuries, and thus it can be useful in rehabilitation clinics.
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Affiliation(s)
- Mahnoosh Khanipour
- Mahnoosh Khanipour, MSc, is Instructor, Department of Occupational Therapy, School of Paramedical Sciences, Zanjan University of Medical Sciences, Zanjan, Islamic Republic of Iran;
| | - Laleh Lajevardi
- Laleh Lajevardi, PhD, is Associate Professor, Department of Occupational Therapy, Rehabilitation Research Center, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Ghorban Taghizadeh
- Ghorban Taghizadeh, PhD, is Associate Professor, Department of Occupational Therapy, Rehabilitation Research Center, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Akram Azad
- Akram Azad, PhD, is Associate Professor, Department of Occupational Therapy, Rehabilitation Research Center, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Hooman Ghorbani
- Hooman Ghorbani, MSc, is Occupational Therapy Practitioner, Department of Occupational Therapy, Shahid Motahhari Specialized Burn Hospital, Tehran, Islamic Republic of Iran
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Gokaltun AA, Fan L, Mazzaferro L, Byrne D, Yarmush ML, Dai T, Asatekin A, Usta OB. Supramolecular hybrid hydrogels as rapidly on-demand dissoluble, self-healing, and biocompatible burn dressings. Bioact Mater 2023; 25:415-429. [PMID: 37056249 PMCID: PMC10087110 DOI: 10.1016/j.bioactmat.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 08/15/2022] [Accepted: 09/05/2022] [Indexed: 11/02/2022] Open
Abstract
Despite decades of efforts, state-of-the-art synthetic burn dressings to treat partial-thickness burns are still far from ideal. Current dressings adhere to the wound and necessitate debridement. This work describes the first "supramolecular hybrid hydrogel (SHH)" burn dressing that is biocompatible, self-healable, and on-demand dissoluble for easy and trauma-free removal, prepared by a simple, fast, and scalable method. These SHHs leverage the interactions of a custom-designed cationic copolymer via host-guest chemistry with cucurbit[7]uril and electrostatic interactions with clay nanosheets coated with an anionic polymer to achieve enhanced mechanical properties and fast on-demand dissolution. The SHHs show high mechanical strength (>50 kPa), self-heal rapidly in ∼1 min, and dissolve quickly (4-6 min) using an amantadine hydrochloride (AH) solution that breaks the supramolecular interactions in the SHHs. Neither the SHHs nor the AH solution has any adverse effects on human dermal fibroblasts or epidermal keratinocytes in vitro. The SHHs also do not elicit any significant cytokine response in vitro. Furthermore, in vivo murine experiments show no immune or inflammatory cell infiltration in the subcutaneous tissue and no change in circulatory cytokines compared to sham controls. Thus, these SHHs present excellent burn dressing candidates to reduce the time of pain and time associated with dressing changes.
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Affiliation(s)
- A. Aslihan Gokaltun
- Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St., Boston, MA, 02114, USA
- Shriners Hospitals for Children, 51 Blossom St., Boston, MA, 02114, USA
- Department of Chemical and Biological Engineering, Tufts University, 4 Colby St., Medford, MA, 02474, USA
- Department of Chemical Engineering, Hacettepe University, 06532, Beytepe, Ankara, Turkey
| | - Letao Fan
- Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St., Boston, MA, 02114, USA
- Shriners Hospitals for Children, 51 Blossom St., Boston, MA, 02114, USA
| | - Luca Mazzaferro
- Department of Chemical and Biological Engineering, Tufts University, 4 Colby St., Medford, MA, 02474, USA
| | - Delaney Byrne
- Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St., Boston, MA, 02114, USA
- Shriners Hospitals for Children, 51 Blossom St., Boston, MA, 02114, USA
| | - Martin L. Yarmush
- Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St., Boston, MA, 02114, USA
- Shriners Hospitals for Children, 51 Blossom St., Boston, MA, 02114, USA
- Department of Biomedical Engineering, Rutgers University, 599 Taylor Rd., Piscataway, NJ, 08854, USA
| | - Tianhong Dai
- Wellman Center for Photomedicine, Massachusetts General Hospital, Department of Dermatology, Harvard Medical School, 50 Blossom Street, Boston, MA, 02114, USA
| | - Ayse Asatekin
- Department of Chemical and Biological Engineering, Tufts University, 4 Colby St., Medford, MA, 02474, USA
| | - O. Berk Usta
- Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St., Boston, MA, 02114, USA
- Shriners Hospitals for Children, 51 Blossom St., Boston, MA, 02114, USA
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22
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Deribe Z, Desta D. Pattern, Cause of Childhood Burn injuries and their Management Outcome At Jimma Medical Center, Jimma Zone, Oromia Region, Southwest Ethiopia. Clin Cosmet Investig Dermatol 2023; 16:1505-1514. [PMID: 37337570 PMCID: PMC10277001 DOI: 10.2147/ccid.s411693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 06/08/2023] [Indexed: 06/21/2023]
Abstract
Purpose Burn injuries are prevalent worldwide, especially in developing countries; and there are significant pediatric burn injuries in Ethiopia. This study was performed to analyze the pattern, cause, and management outcome of burn injuries in Jimma Medical Center. Methods A hospital‑based retrospective cross‑sectional study was conducted at Jimma university medical center burn unit. Data were collected through chart review of pediatric patients aged 0 to 14 years who were admitted to the burn unit with a burn injury. A total of 92 hospitalized children were studied from Jan 1, 2020 to Dec 31, 2021 GC. Data were analyzed using SPSS version 25. The statistical significance was determined using odds ratio (OR) with a 95% confidence interval (CI) and the corresponding P-value of less than 0.05. Results The majority of the patients were males (52.2%). Scald burn was the most common cause of burn in 57(62.0%). The TBSA of majority of the patients (52.2%) was found to be between 11% and 20%. After adjusting for possible confounders in the multivariate analysis, preexisting illness and time of presentation to care were found to have a statistically significant association with the outcome of burn at discharge (P= 0.007) (P= 0.021) respectively. Conclusion The most common cause of burn in our setup was scald burn; upper extremities were also the most affected site. According to our study, the factors associated with the outcome of burn injury were preexisting illness and late presentation to health facilities.
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Affiliation(s)
- Zekarias Deribe
- Department of Surgery, Faculty of Medical Science, Jimma Medical Center, Jimma, Ethiopia
| | - Diliab Desta
- Department of Anatomy, Faculty of Medical Science, Jimma University, Jimma, Ethiopia
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23
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Li X, Xu M, Geng Z, Liu Y. Functional hydrogels for the repair and regeneration of tissue defects. Front Bioeng Biotechnol 2023; 11:1190171. [PMID: 37260829 PMCID: PMC10227617 DOI: 10.3389/fbioe.2023.1190171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 05/03/2023] [Indexed: 06/02/2023] Open
Abstract
Tissue defects can be accompanied by functional impairments that affect the health and quality of life of patients. Hydrogels are three-dimensional (3D) hydrophilic polymer networks that can be used as bionic functional tissues to fill or repair damaged tissue as a promising therapeutic strategy in the field of tissue engineering and regenerative medicine. This paper summarises and discusses four outstanding advantages of hydrogels and their applications and advances in the repair and regeneration of tissue defects. First, hydrogels have physicochemical properties similar to the extracellular matrix of natural tissues, providing a good microenvironment for cell proliferation, migration and differentiation. Second, hydrogels have excellent shape adaptation and tissue adhesion properties, allowing them to be applied to a wide range of irregularly shaped tissue defects and to adhere well to the defect for sustained and efficient repair function. Third, the hydrogel is an intelligent delivery system capable of releasing therapeutic agents on demand. Hydrogels are capable of delivering therapeutic reagents and releasing therapeutic substances with temporal and spatial precision depending on the site and state of the defect. Fourth, hydrogels are self-healing and can maintain their integrity when damaged. We then describe the application and research progress of functional hydrogels in the repair and regeneration of defects in bone, cartilage, skin, muscle and nerve tissues. Finally, we discuss the challenges faced by hydrogels in the field of tissue regeneration and provide an outlook on their future trends.
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24
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Salhi N, El Guourrami O, Rouas L, Moussaid S, Moutawalli A, Benkhouili FZ, Ameggouz M, Alshahrani MM, Al Awadh AA, Bouyahya A, Faouzi MEA, Cherrah Y. Evaluation of the Wound Healing Potential of Cynara humilis Extracts in the Treatment of Skin Burns. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2023; 2023:5855948. [PMID: 37114146 PMCID: PMC10129424 DOI: 10.1155/2023/5855948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 03/03/2023] [Accepted: 04/06/2023] [Indexed: 04/29/2023]
Abstract
Cynara humilis is traditionally used to treat skin burns and microbial infections. However, experimental studies on this plant are rare. Furthermore, the aim of this study was to investigate the effects of Cynara humilis, a Moroccan herbal remedy, on the healing of deep second-degree burns in rats with a silver sulfadiazine group. This research was also carried out to confirm if C. humilis had antibacterial capabilities. Under typical burn procedures, each rat received a deep second-degree burn on the upper back. The burns were treated regularly with control groups (control and control VH), silver sulfadiazine (SDD) in group 3, C. humilis ethanolic extract (CHEE) in group 4, and C. humilis aqueous extract (CHAE) in group 5. Throughout the treatment, digital photography was used to measure rat responses to the treatment until day 18. After the scar biopsy at the end of the study, histological parameters (inflammatory cells, collagen, epithelialization, fibrosis, and granulation tissue) were assessed. Using the well technique, the antibacterial activity of the extracts was tested against Staphylococcus aureus CIP 483, Bacillus subtilis CIP 5262, Escherichia coli CIP 53126, Pseudomonas aeruginosa CIP 82118, and Salmonella enterica CIP 8039, and the results showed important activities of the ethanolic and aqueous extracts against the five species tested with MICs of 2 and 4 mg/mL, respectively. In the aqueous extract group, the wound healed faster. In addition, the healing rate in the C. humilis extracts (CHEA and CHEE) group was faster than in the silver sulfadiazine and control groups. In the C. humilis group, maximum wound surface recovery was observed at the same time, as it was not noted in the silver sulfadiazine group. Pathologically, epithelialization was more marked in wounds treated with C. humilis extracts (CHE). Angiogenesis and inflammatory cells were considerably lower in the CHE group than in the silver and other control groups. However, elastic fibers were considerable in the CHE-treated group. In histological examination, the C. humilis group had a low incidence of angiogenesis and inflammation, indicating that this group had less wound scarring. Collagen and burn wound healing were both faster in the C. humilis group. The findings of this study suggest that C. humilis, as indicated by traditional medicine, is a promising natural source for the management of wound healing.
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Affiliation(s)
- Najoua Salhi
- Pharmacoepidemiology and Pharmacoeconomics Research Team, Laboratory of Pharmacology and Toxicology, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
| | - Otman El Guourrami
- Laboratory of Analytical Chemistry and Bromatology, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
| | - Lamiae Rouas
- Laboratory of Anatomy Cytology, Faculty of Medicine and Pharmacy, Children's Hospital, Mohammed V University in Rabat, Rabat, Morocco
| | - Siham Moussaid
- Laboratory of Plant, Animal and Agro Industry Productions, Faculty of Science, Ibn Tofail University, B.P 133, Kenitra 1400, Morocco
| | - Amina Moutawalli
- Department of Drug Sciences, Laboratory of Medicinal Chemistry, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
| | - Fatima Zahra Benkhouili
- Department of Drug Sciences, Laboratory of Medicinal Chemistry, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
| | - Mouna Ameggouz
- Laboratory of Analytical Chemistry and Bromatology, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
| | - Mohammed Merae Alshahrani
- Department of Clinical Laboratory Sciences, Faculty of Applied Medical Sciences, Najran University, Najran 61441, Saudi Arabia
| | - Ahmed Abdullah Al Awadh
- Department of Clinical Laboratory Sciences, Faculty of Applied Medical Sciences, Najran University, Najran 61441, Saudi Arabia
| | - Abdelhakim Bouyahya
- Laboratory of Human Pathologies Biology, Faculty of Sciences, Department of Biology, Mohammed V University in Rabat, Rabat, Morocco
| | - My El Abbes Faouzi
- Biopharmaceutical and Toxicological Analysis Research Team, Laboratory of Pharmacology and Toxicology, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
| | - Yahya Cherrah
- Pharmacoepidemiology and Pharmacoeconomics Research Team, Laboratory of Pharmacology and Toxicology, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
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25
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Eslamialiabadi H, Nasiri A, Mahmoudirad G. Iranian Men's Sexual Life Issues After Their Wives' Burn: A Qualitative Content Analysis Study. J Burn Care Res 2023; 44:452-458. [PMID: 35983920 DOI: 10.1093/jbcr/irac117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Indexed: 11/13/2022]
Abstract
Physical and psychological complications of burn injuries reduce the victims' sexual quality of life and challenge their partners' sexual satisfaction. There is no information about men's sexual issues and behaviors. Previous studies did not address the impact of women's burns on their husbands' sexual lives. Therefore, this qualitative study aimed to characterize the sexual experiences of Iranian men after their wives' burns. The study was performed on 16 men with surviving spouses of major burn using criterion-based purposive sampling. Semistructured interviews were analyzed using a qualitative content analysis approach. The results showed men's sexual issues with three main themes and eight subthemes: 1) sexual desire restrictors (annoying scars, imposing roles, and wives' sexual coldness), 2) degradation of marital sex (reduced frequency of sexual intercourses, temptation of extramarital affairs), and 3) effort to maintain sex (sexual self-sacrifice, sexual pretending, sexual precautions). According to men's experiences, female sexual coldness, temptation for extramarital affairs, and sexual pretense were related to couples' poor knowledge of sexual discourse. Thus, health professionals can use context-oriented educational program to promote the couples' sexual knowledge and health after burns.
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Affiliation(s)
| | - Ahmad Nasiri
- Nursing and Midwifery School, Birjand University of Medical Sciences, Iran
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26
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Banga AT, Westgarth-Taylor C, Grieve A. The epidemiology of paediatric burn injuries in Johannesburg, South Africa. J Pediatr Surg 2023; 58:287-292. [PMID: 36473740 DOI: 10.1016/j.jpedsurg.2022.10.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 10/11/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Children remain the most common victim of burns in Sub-Saharan Africa. This study describes the epidemiology of paediatric burn injury among patients admitted to Chris Hani Baragwanath Academic Hospital. METHODS Hospital based cross-sectional, prospective study. RESULTS 509 patients were admitted to the unit over a 12-month period, with 482 patients included for baseline analysis. 50% of admitted patients were between 15 and 47 months with a median age of 25 months. 58% of participants were male. The predominant mechanism of injury was scalding (84%), in the winter season (32%). The most common site of burn was upper limb (75%). 63% of all admissions received first aid. Among those who received first aid, a described first aid method was provided in 74% of the cases. 226 out of 482 participants (47%) provided sociodemographic information. Access to basic amenities was high, with most admissions coming from households with access to electricity (91%). 90% of caregivers held at least a high school leaving certificate. Migrant caregivers made 19% of the caregivers, which was four times the proportion of foreign nationals counted in the national census. Most admissions (79%) were referrals from other centres as opposed to walk-ins. Severe burns were associated with thermal mechanism of injury, multiple burn sites, and receiving first aid prior to admission. CONCLUSION Children under two years of age and children of minority groups are at greatest risk for burn injury and should therefore be targeted for injury prevention strategies and education on appropriate first aid. LEVEL OF EVIDENCE According to the Journal of pediatric Surgery, this research corresponds to Level II evidence as a prospective study with less than 80% follow-up.
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Affiliation(s)
- Agatha T Banga
- Department of Paediatric Surgery & Child Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.
| | | | - Andrew Grieve
- Nelson Mandela Children's Hospital, Johannesburg, South Africa
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Emergency Care for Burn Patients-A Single-Center Report. J Pers Med 2023; 13:jpm13020238. [PMID: 36836472 PMCID: PMC9959911 DOI: 10.3390/jpm13020238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/25/2023] [Accepted: 01/27/2023] [Indexed: 02/03/2023] Open
Abstract
Burns, one of the main public health problems, lead to significant mortality and morbidity. Epidemiological studies regarding burn patients in Romania are scarce. The aim of this study is to identify the burn etiology, demographics, clinical characteristics, and outcomes in patients requiring treatment in a regional burn unit. DESIGN We performed a retrospective observational study of 2021. PATIENTS All patients admitted to our six-bed intensive care unit (ICU) were included. INTERVENTIONS The following data were collected for further analysis: demographics, burn pattern (etiology, size, depth, affected body region), type of ventilation, ABSI (Abbreviated Burn Severity Index) score, comorbidities, bioumoral parameters, and hospitalization days. RESULTS There were 93 burned patients included in our study that were divided into two groups: alive patients' group (63.4%) and deceased patients' group (36.6%). The mean age was 55.80 ± 17.16 (SD). There were 65.6% male patients, and 39.8% of the patients were admitted by transfer from another hospital. Further, 59 patients presented third-degree burns, from which 32.3% died. Burns affecting >37% of the total body surface area (TBSA) were noticed in 30 patients. The most vulnerable regions of the body were the trunk (p = 0.003), the legs (p = 0.004), the neck (p = 0.011), and the arms (p = 0.020). Inhalation injury was found in 60.2% of the patients. The risk of death in a patient with an ABSI score > 9 points was 72 times higher. Comorbidities were present in 44.1% of the patients. We observed a median LOS (length of stay) of 23 days and an ICU-LOS of 11 days. Logistic regression analysis showed that admission protein, creatinkinase, and leukocytes were independent risk factors for mortality. The general mortality rate was 36.6%. CONCLUSION A thermal factor was responsible for the vast majority of burns, 94.6% of cases being accidents. Extensive and full-thickness burns, burns affecting the arms, inhalation injuries, the need for mechanical ventilation, and a high ABSI score represent important risk factors for mortality. Considering the results, it appears that prompt correction of protein, creatinkinase, and leukocytes levels may contribute to improvement in severe burn patients' outcomes.
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28
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Ke Y, Ye L, Zhu P, Zhu Z. The clinical characteristics and microbiological investigation of pediatric burn patients with wound infections in a tertiary hospital in Ningbo, China: A ten-year retrospective study. Front Microbiol 2023; 13:1034099. [PMID: 36699578 PMCID: PMC9868836 DOI: 10.3389/fmicb.2022.1034099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 12/13/2022] [Indexed: 01/12/2023] Open
Abstract
Burn is one of the leading causes of death and disability in children worldwide, and wound infection is an excellent challenge in burn treatment. We performed a retrospective review of pediatric burn patients with wound infections to reveal their clinical data and investigate pathogens' distribution and drug resistance patterns to provide references for treatment. As a result, 330 pediatric burn patients with wound infections were identified; 65.8% (217/330) were < 2 years old. Most of the injuries were scalded and involved <10% total body surface area in size (TBSA), mainly causing II-degree burn and II + III-degree burn. Three hundred and fifty nine strains of pathogens were isolated, the primary pathogens were Staphylococcus aureus (45.4%) and Pseudomonas aeruginosa (18.7%). Both S. aureus and P. aeruginosa isolated from 2012 to 2016 were more likely to be multi-resistant than those isolated from 2017 to 2021, as they were significantly associated with resistance to ≥4 Clinical and Laboratory Standard Institute (CLSI) classes (p = 0.040 and 0.006, respectively). In conclusion, children aged <2 years old were the main pediatric burn patients with wound infections. The primary bacteria isolated from the wound were S. aureus and P. aeruginosa, with a decreasing tendency of multi-resistance.
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Affiliation(s)
- Yefang Ke
- Department of Clinical Laboratory, Ningbo Women and Children’s Hospital, Ningbo, Zhejiang, China
| | - Lina Ye
- Department of Clinical Laboratory, Ningbo Women and Children’s Hospital, Ningbo, Zhejiang, China
| | - Pan Zhu
- Neonatal Intensive Care Unit, Ningbo Women and Children’s Hospital, Ningbo, Zhejiang, China
| | - Zhe Zhu
- Department of Blood Transfusion, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejiang, China,*Correspondence: Zhe Zhu,
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29
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Jorgensen AM, Mahajan N, Atala A, Murphy SV. Advances in Skin Tissue Engineering and Regenerative Medicine. J Burn Care Res 2023; 44:S33-S41. [PMID: 36567474 PMCID: PMC9790899 DOI: 10.1093/jbcr/irac126] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
There are an estimated 500,000 patients treated with full-thickness wounds in the United States every year. Fire-related burn injuries are among the most common and devastating types of wounds that require advanced clinical treatment. Autologous split-thickness skin grafting is the clinical gold standard for the treatment of large burn wounds. However, skin grafting has several limitations, particularly in large burn wounds, where there may be a limited area of non-wounded skin to use for grafting. Non-cellular dermal substitutes have been developed but have their own challenges; they are expensive to produce, may require immunosuppression depending on design and allogenic cell inclusion. There is a need for more advanced treatments for devastating burns and wounds. This manuscript provides a brief overview of some recent advances in wound care, including the use of advanced biomaterials, cell-based therapies for wound healing, biological skin substitutes, biological scaffolds, spray on skin and skin bioprinting. Finally, we provide insight into the future of wound care and technological areas that need to be addressed to support the development and incorporation of these technologies.
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Affiliation(s)
- Adam M Jorgensen
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Winston Salem, North Carolina, USA
| | - Naresh Mahajan
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Winston Salem, North Carolina, USA
| | - Anthony Atala
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Winston Salem, North Carolina, USA
| | - Sean V Murphy
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Winston Salem, North Carolina, USA
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30
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Salendo J, Ximenes J, Soares A, Guest G, Hagander L. Acute burn care and outcomes at the Hospital Nacional Guido Valadares (HNGV), Timor-Leste: A 7-year retrospective study. Medicine (Baltimore) 2022; 101:e32113. [PMID: 36550901 PMCID: PMC9771211 DOI: 10.1097/md.0000000000032113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The purpose of this study was to describe the epidemiology of patients presenting with acute burns and undergoing admission at Hospital Nacional Guido Valadares (HNGV) in Dili, Timor-Leste in the period 2013 to 2019. HNGV is the only tertiary referral hospital in Timor-Leste. This was a retrospective study involving all acute burn patients admitted to the surgical wards of HNGV from 2013 to 2019. The data was collected from patient charts and hospital medical archives. Data were reviewed and analyzed statistically in terms of age, gender, residence, cause, total body surface area (TBSA), burns depth, length of stay (LOS), and mortality. The outcomes were analyzed using logistic regression. Over the 7-year period, there were 288 acute burn patients admitted to the surgical wards of HNGV. Most patients were children (55%), male (65%) and from the capital city of Dili or surrounding areas (59%). The most common cause of burns in children was scalds and the most common cause among adults was flames. Of the admitted patients 59% had burns affecting >10% of the TBSA and 41% had full thickness burns. The median LOS was 17 days (1-143) and the average mortality for admitted burn patients in HNGV was 5.6% (annual mortality 0-17%). The odds ratio for extended LOS was 1.9 (95% confidence interval 1.1-3.2) in female compared with male patients. The odds ratio for mortality was 14.6 (95% confidence interval 2.7-80.6) in the older adults when compared with younger adults. Higher TBSA, full thickness burns, and flame burns were also significantly associated with longer LOS and higher mortality. Children and male patients were disproportionately overrepresented among patients admitted to HNGV, while female patients had longer LOS and older adults had more severe injury and a higher risk of mortality. Establishment of a national program for the prevention of burns is essential.
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Affiliation(s)
- Junius Salendo
- Institute of Tropical Medicine and International Health Charité, Universitätsmedizin Berlin, Berlin, Germany
- Global Health, Royal Australasian College of Surgeons, Melbourne, Victoria, Australia
| | - Joao Ximenes
- Hospital Nacional Guido Valadares, Dili, Timor-Leste
| | - Alito Soares
- Hospital Nacional Guido Valadares, Dili, Timor-Leste
| | - Glenn Guest
- Epworth Geelong Hospital and Department of Clinical and Biomedical Sciences, Deakin University, Geelong, Victoria, Australia
| | - Lars Hagander
- Department of Clinical Sciences in Lund, Pediatric Surgery, Skåne University Hospital in Lund, Faculty of Medicine, Lund University, Lund, Sweden
- * Correspondence: Lars Hagander, Department of Clinical Sciences in Lund, Pediatric Surgery, Skåne University Hospital in Lund, Faculty of Medicine, Lund University, Lund, Sweden (e-mail: )
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Puvanachandra P, Ssesumugabo C, Balugaba BE, Ivers R, Kobusingye O, Peden M. The epidemiology and characteristics of injuries to under 5's in a secondary city in Uganda: a retrospective review of hospital data. Int J Inj Contr Saf Promot 2022; 29:550-555. [PMID: 35797975 DOI: 10.1080/17457300.2022.2089686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Child injuries are largely preventable yet cause significant mortality and morbidity globally. Injury data from low-income countries is limited for children under the age of 5 and therefore the current understanding of the magnitude of injuries in this age group is low. Hospital-based registries are one mechanism by which injury data can be gathered. This paper presents findings from a retrospective hospital record review of 4 hospitals in Jinja, a rural setting in Uganda, involving the extraction of data for children under the age of 5-years who sustained an injury during a 6-month period in 2019. A total of 225 injury cases were retrieved from the hospitals. Over half (57.3%) of the events occurred among males. The majority (92%) suffered one injury per injury event. Most of the injuries occurred among those aged 13 to 24 months (32.9%). Burns (32%) and cuts (20%) were the most common cause of injury. This study presents a hospital-based analysis of injuries amongst under 5's in rural Uganda. It provides information on the characteristics of children entering healthcare facilities in Uganda and highlights the burden of paediatric injuries in the hospital setting.
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Affiliation(s)
- P Puvanachandra
- The George Institute for Global Health, UK, Imperial College London, London, UK
| | - C Ssesumugabo
- School of Public Health, Makerere School of Public Health, Kampala, Uganda
| | - B E Balugaba
- School of Public Health, Makerere School of Public Health, Kampala, Uganda
| | - R Ivers
- School of Population Health, University of New South Wales, Sydney, Australia
| | - O Kobusingye
- School of Public Health, Makerere School of Public Health, Kampala, Uganda
| | - M Peden
- The George Institute for Global Health, UK, Imperial College London, London, UK
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Histopathological Evaluation of the Healing Process of Standardized Skin Burns in Rabbits: Assessment of a Natural Product with Honey and Essential Oils. J Clin Med 2022; 11:jcm11216417. [DOI: 10.3390/jcm11216417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/16/2022] [Accepted: 10/27/2022] [Indexed: 11/16/2022] Open
Abstract
Skin burns are one of the most difficult medical problems. Recently, studies have been directed towards development of natural products in order to identify effective and safe remedies. In the present study, we evaluated the efficacy of a natural composite (formulated from honey and essential oils) compared with MEBO® (0.25% β-sitosterol) and DERMAZIN® creams (1% silver-sulfadiazine) in the treatment of thermally induced skin burns. For this purpose, four burn-wounds were created on the back of male New Zealand rabbits (n = 10) using a thermal stamp under the effect of general anesthesia. Each wound represents one of the following groups: non-treated, natural composite-cream, MEBO®-cream, and silver-sulfadiazine treated groups, respectively. Treatments were applied once a day topically until one of these wounds appeared to be healed grossly. The non-treated group received no treatment. Grossly, skin burns have been healed after 28 days of the treatment in all groups except of the non-treated group. The healing efficacy of the natural composite, MEBO® and silver-sulfadiazine creams was quite similar macroscopically. However, microscopically, the epidermal layer of the composite-cream treated group was more mature than those of both MEBO® and silver-sulfadiazine creams treated groups. In conclusion, the tested composite may be a promising effective and inexpensive treatment of skin burns.
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Adane MM, Admasie A, Shibabaw T. Prevalence and risk factors of cooking-related burn injury among under-five-years old children in a resource-limited setting: a community-based cross-sectional study in Northwest Ethiopia. Int J Inj Contr Saf Promot 2022; 30:220-231. [PMID: 36137170 DOI: 10.1080/17457300.2022.2125534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Cooking-related child burn injury causes a greater health burden in low-and-middle-income countries. Therefore, a community-based cross-sectional study was conducted among 5830 under-five-years old children in a resource-limited community in Northwest Ethiopia to determine the prevalence and risk factors of this child health problem. Data were collected by trained nurses using a questionnaire and the logistic regression analysis method was applied to identify factors linked with burn injury. Injury prevalence was 6.2% (95% CI:5.5-6.8); and this burden was linked with several risk factors such as lower literacy status of caretakers [AOR = 2.21 (95% CI:1.05-4.67)], overcrowding [AOR = 2.35(95% CI:1.25-4.43], lack of separate kitchen [AOR =2.19 (95% CI:1.56-3.07)], using traditional cookstove [AOR = 2.04 (95% CI:1.23-3.36)], and lack of child supervision [AOR = 2.27 (95% CI:1.63-3.17)]. In conclusion, children experience a high burden of burn injury. Thus, stakeholders should work to reduce child burn injury by modifying the aforementioned risk factors.
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Affiliation(s)
- Mesafint Molla Adane
- Department of Environmental Health, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Amha Admasie
- Department of Environmental Health, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Tebkew Shibabaw
- Department of Environmental Health, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Yakupu A, Zhang J, Dong W, Song F, Dong J, Lu S. The epidemiological characteristic and trends of burns globally. BMC Public Health 2022; 22:1596. [PMID: 35996116 PMCID: PMC9396832 DOI: 10.1186/s12889-022-13887-2] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 07/18/2022] [Indexed: 11/10/2022] Open
Abstract
Background Burns is a type of injury, caused by unintentional exposure to substances of high temperature, including hot liquid, solid, and objects radiating heat energy, placing a high burden not only on patients’ families but also on national healthcare systems globally. It is difficult for policymakers and clinicians to formulate targeted management strategies for burns because data on current epidemiological patterns worldwide are lacking. Methods Data on burns were obtained from the Global Burden of Disease (GBD) 2019 Study. The incidence, disability-adjusted life years (DALYs), and deaths of burns in 204 countries and regions from 1990 to 2019 were calculated and stratified by sex, age, geographical location, and sociodemographic index (SDI). The estimated annual percentage change (EAPC) of incidence, DALYs, and deaths was calculated to evaluate the temporal trends. All analyses were performed using R software, version 4.1.1, with 2-sided P-values < .05 indicating a statistically significant difference. Results A total of 8,378,122 new cases (95% UI, 6,531,887–10,363,109cases) of burns were identified globally in 2019, which is almost evenly split between men and women, and most of the new cases were concentrated in the 10–19-year age group. Besides, burns account for 111,292 deaths (95% UI, 132,392–88,188) globally in 2019, most of which were concentrated in those aged 1–4 years. The burden of burns measured in DALYs was 7,460,448.65 (95% UI, 5,794,505.89–9,478,717.81) in 2019, of which 67% and 33% could be attributed to YLLs and YLDs, respectively. The EAPC of incidence, DALYs, and deaths were negative, the age-standardized rate (ASR) of incidence, DALYs, and deaths were considered to be decreasing in most of the regions, and the EAPCs were negatively correlated with SDI levels, universal health coverage (UHC), and gross domestic product (GDP). Conclusion Globally, the age-standardized rates of burn incidence, DALYs, and mortality, as well as the number of burn DALYs and death cases will continuously decrease, but the number of new burn cases has an increasing tendency globally. In addition, the EAPCs of burns in incidence, DALYs, and deaths indicated that the burden of burns was considered to be decreasing in most of the regions. And from the relationship of EAPCs with SDI, UHC index, and GDP, indicate that prevention burns not only depend on health spending per capita but also depend on the education level per capita and healthcare system performance, but it does not mean higher health spending corresponds to higher UHC index, which needs high efficiency of translating health spending into individuals health gains. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13887-2.
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Affiliation(s)
- Aobuliaximu Yakupu
- Wound Healing Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Burn, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jie Zhang
- Department of Burn, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei Dong
- Wound Healing Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Burn, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fei Song
- Wound Healing Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Burn, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiaoyun Dong
- Wound Healing Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. .,Department of Burn, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. .,Shanghai Burn Institute, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, No. 197 Ruijin Er Road, Shanghai, 200025, China.
| | - Shuliang Lu
- Wound Healing Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. .,Department of Burn, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. .,Shanghai Burn Institute, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, No. 197 Ruijin Er Road, Shanghai, 200025, China.
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Comparing Peak Burn Injury Times and Characteristics in Australia and New Zealand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159578. [PMID: 35954935 PMCID: PMC9368485 DOI: 10.3390/ijerph19159578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 08/01/2022] [Accepted: 08/02/2022] [Indexed: 11/16/2022]
Abstract
Burns are a leading cause of morbidity and mortality worldwide. Understanding when and how burns occur, as well as the differences between countries, would aid prevention efforts. A review of burn injuries occurring between July 2009 and June 2021 was undertaken using data from the Burns Registry of Australia and New Zealand. Peak injury times were identified on a country-by-country basis. Variations in demographic and injury event profiles between countries were compared using descriptive statistics. There were 26,925 admissions recorded across the two countries (23,323 for Australia; 3602 for New Zealand). The greatest number of injuries occurred between 6 PM to 7 PM in Australia (1871, 8.0%) and between 5 PM to 6 PM in New Zealand (280, 7.8%). In both countries, scalds accounted for the greatest proportion of injuries during peak times (988, 45.8%), but a greater proportion of young children (under three years) sustained burns during New Zealand’s peak times. The number of burn injuries associated with the preparation and/or consumption of food offers an opportunity for a targeted prevention program that may yield benefits across the two countries. Age- and mechanism-related differences in the profile of burn-injured patients need to be considered when developing and implementing such a program.
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Comparative Effects of Recove® and Nitrofurazone 0.2% on the Treatment of First and Second-Degree Burns: a Double-Blind Randomized Clinical Trial. World J Plast Surg 2022; 11:55-62. [PMID: 36694677 PMCID: PMC9840760 DOI: 10.52547/wjps.11.3.55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022] Open
Abstract
Background Burns are among the major health challenges of all societies and more than any other trauma incur physical, mental, social, and economic burdens on the patient and society. This study was conducted to assess whether Recove® burn ointment is capable of alleviating the pain, preventing the formation of new blisters and controlling the microbial contamination of the wound. Methods We, therefore, compared its efficacy to nitrofurazone 0.2% cream. This randomized clinical trial was conducted on individuals who had two burn injuries in their body at the same time in the Motahari Burn Hospital, Tehran Province, from June to October 2016. Sampling was carried out with a non-random method using available samples. The intervention in experimental and control groups was Recove® and nitrofurazone, respectively. The effect of interventions on pain relief, the formation of new blisters and prevention of infection at the burn wound were evaluated. In our double-blind study, blindness was applied to the patients and the person evaluating the outcomes. Results Both Recove® and nitrofurazone interventions significantly alleviated pain (P < 0.01), but Recove ®showed more effectiveness (P=0.01). Similarly, in terms of new blister formation, the experimental group receiving Recove® showed less new blister formation over 24 hours after treatment compared to nitrofurazone group (P=0.03) and with respect to antimicrobial activity, there was no significant difference between Recove® and nitrofurazone (P=0.12). Conclusion Recove® was effective on pain reduction, prevention of new blisters formation as well as infection. Therefore, it seems that Recove® could be considered as a new and efficient treatment for burn.
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Tusiime M, Musoke D, Muneza F, Mutto M, Kobusingye O. Prevalence, risk factors and perceptions of caregivers on burns among children under 5 years in Kisenyi slum, Kampala, Uganda. Inj Epidemiol 2022; 9:18. [PMID: 35689273 PMCID: PMC9188101 DOI: 10.1186/s40621-022-00382-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 05/31/2022] [Indexed: 11/20/2022] Open
Abstract
Background Globally, burn related deaths are disproportionately higher among children below 5 years of age compared to other age groups. Although rarely fatal, most burns in this group occur within homes specifically in kitchens. This study assessed the prevalence, risk factors and perceptions of caregivers regarding burns among children under 5 years in an urban slum in Kampala, Uganda.
Methods The study used an analytic cross-sectional design with quantitative and qualitative techniques. Quantitative data were collected using a structured questionnaire and observational checklist, while qualitative data involved use of a key informant interview guide. A total of 426 children were involved in the study, while 6 key informants namely an adult mother, teenage mother, community health worker, health practitioner, father and local leader were interviewed. A modified Poisson regression model was used to determine the correlates of burn injuries, prevalence rate ratios and 95% confidence intervals, while thematic analysis was used for qualitative data. Results The prevalence of burns among under-fives was 32%, highest among those aged 24 to 35 months (39%), and least in those below 12 months (10%). Children with single parents (adj PR = 1.56 95% CI 1.07–2.29) and those from households in the middle and least poor wealth quintile (adj.PR = 1.72; 95% CI 1.02–2.89 and adj.PR = 1.77; 95% CI 1.02–3.05, respectively) were more likely to get burns compared to their counterparts in other quintiles. In households where flammables were safely stored, children were less likely to suffer from burn injuries (adj.PR = 0.61; 95% CI 0.44–0.83). Congestion, negligence of caregivers, and use of charcoal stoves/open cooking were the commonest determinants of burns. Although many caregivers offered first aid to burn patients, inadequate knowledge of proper care was noted. Crawling children were perceived as being at highest risk of burns. Conclusion The prevalence of burns among children under 5 years was high, with several household hazards identified. Health education, household modification and applicable public health law enforcement are recommended to reduce hazards and minimise burn risks among children.
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Affiliation(s)
- Marcia Tusiime
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda.
| | - David Musoke
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Fiston Muneza
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Milton Mutto
- Chronic Trauma, Injury and Disability Program (TRIAD), School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda.,Pincer Training and Research Institute, Kampala, Uganda
| | - Olive Kobusingye
- Chronic Trauma, Injury and Disability Program (TRIAD), School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
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Kruchevsky D, Levanon S, Givon A, Bodas M, Ramon Y, Ullmann Y, Zeltzer AA. Burns During Coronavirus Disease 19 Lockdown: a Multi-Center Retrospective Study in Israel. J Burn Care Res 2022; 44:75-80. [PMID: 35666996 PMCID: PMC9214151 DOI: 10.1093/jbcr/irac078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Indexed: 01/11/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic forced many countries into lockdowns to limit the spread of infection. Israel's containment measures included school closures, mobility restrictions, and workforce reductions. Our study evaluated the effect of COVID-19 on the occurrence and patterns of burn injuries. The study data was obtained via retrospective chart review of burn patients treated between March 15, 2020 and April 30, 2020, namely the period of strict national lockdown. This data was compared against data from paralleling periods between 2017 and 2019. A total of 686 patients were treated for burn injuries in the two study periods. Age group analysis revealed an increased ratio of pediatric patients aged 0-3 years during the lockdown (55.91% vs 40.79%, P = .002). In contrast, there were fewer patients presenting with burn injuries in the 7-16 and 17-29 age groups (9.66% vs 3.15%, P = .017; 16.46% vs 7.09%, P = .007, respectively). During both study periods, scald injuries were the most common burn etiology and burn injuries occurred most often at home. This predominance was further pronounced during the lockdown (71.65% vs 58.68%, P = .007; 90.55% vs 74.60%, P = .0001, respectively). The lockdown period underlined the danger faced by pediatric patients in their household environment. This danger was possibly compounded by an improper level of adult supervision as parents transitioned to remote work. These findings can educate us about factors that render burn injuries more likely not only during lockdowns, but also during regular times, thus shaping the development of burn prevention practices.
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Affiliation(s)
- Dani Kruchevsky
- Address correspondence to Dani Kruchevsky, MD, Rambam Health Care Campus, HaAliya HaShniya St 8, Haifa 31096, Israel.
| | - Shir Levanon
- Rappaport Faculty of Medicine, Technion Institute, Haifa, Israel
| | - Adi Givon
- Israel National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Health Policy Research, Tel Hashomer, Israel
| | - Moran Bodas
- Israel National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Health Policy Research, Tel Hashomer, Israel,School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Yitzchak Ramon
- Plastic & Reconstructive Surgery Department, Rambam Health Care Campus, Haifa, Israel
| | - Yehuda Ullmann
- Plastic & Reconstructive Surgery Department, Rambam Health Care Campus, Haifa, Israel
| | - Assaf A Zeltzer
- Plastic & Reconstructive Surgery Department, Rambam Health Care Campus, Haifa, Israel,Rappaport Faculty of Medicine, Technion Institute, Haifa, Israel
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Melquíades da Rocha BDF, Bochnia MF, Ioris RA, Damin R, de Araujo Santos Nigro MV, Nisihara RM. The impact of social isolation by COVID-19 on the epidemiological and clinical profiles of the burn patients. A retrospective study. Burns 2022; 48:976-983. [PMID: 35361496 PMCID: PMC8882480 DOI: 10.1016/j.burns.2022.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 02/17/2022] [Accepted: 02/21/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Social isolation, imposed by the COVID-19 pandemic, may imply changes in the clinical-demographic and epidemiological profiles of burn trauma victims. OBJECTIVE Evaluate the changes in the epidemiological profile of patients with burns that resulted in hospitalization during the social isolation period due to the COVID-19 pandemic, comparing with the same period in the previous year. METHODS The medical records of burn patients who were hospitalized in our Burn Center during the local confinement period (March 18th to August 31st, 2020) and during the same period in 2019 were analyzed. Data on demographic, clinical and hospitalization aspects were studied. RESULTS 470 patients were evaluated. In the pediatric population, a significant increase in the number of cases up to 2 years old (P = 0.0003), median of %TBSA (P = 0.037), full-thickness burns (P < 0.0001), involvement of hands (P = 0.024), debridement (P = 0.046) and grafting (P = 0.032) procedures, and higher scores of severity (P < 0.0001) were noted. In the adult population, it was only observed an increase in the burn-hospitalization interval (P = 0.029). CONCLUSION The pediatric population was heavily impacted by the imposed period of social isolation, presenting a greater severity of burns. In contrast, the epidemiology of burns for the adult population was slightly altered during the pandemic period.
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Affiliation(s)
| | - Mateus Franzoni Bochnia
- Mackenzie Evangelical School of Medicine Paraná, Curitiba, Brazil. Rua Padre Anchieta, 2770, 80730-000 Curitiba, Brazil
| | - Rafael Augusto Ioris
- Plastic Surgery Department and Burn Center, Hospital Universitário Evangélico Mackenzie, Alameda Augusto Stellfeld, 1908, 80730-150 Curitiba, Brazil
| | - Renata Damin
- Plastic Surgery Department and Burn Center, Hospital Universitário Evangélico Mackenzie, Alameda Augusto Stellfeld, 1908, 80730-150 Curitiba, Brazil
| | | | - Renato Mitsunori Nisihara
- Mackenzie Evangelical School of Medicine Paraná, Curitiba, Brazil. Rua Padre Anchieta, 2770, 80730-000 Curitiba, Brazil,Correspondence to: Rua Padre Anchieta, 2770, 80730-000 Curitiba, Paraná, Brazil
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Resilience and Psychological Distress among Burn Survivors. Burns 2022; 49:670-677. [PMID: 35842271 DOI: 10.1016/j.burns.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 04/27/2022] [Accepted: 05/03/2022] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Burn is one of the highly occurring injuries worldwide. In case of an acid attack, survivors are considered an embarrassing element for the family. In other words, survivors' dignity is judged by the scars on their faces and bodies. Burn survivors experience physical pain of wounds, along with unseen psychological agony. Here, resilience is the most captivating phenomenon that can lead the survivor to normalcy in life after experiencing such traumas. The current study is aimed to explore the role of resilience in the psychological distress of burn survivors. METHOD 160 burn survivors were selected with an age bracket of 18-78 years from indoor hospital settings. To explore resilience, Urdu translated version of the Connor-Davidson Resilience Scale (CD-RISC) by Naz (2011) was used and for symptoms of psychological distress, Urdu version of Depression Anxiety Stress Scale- 21 (DASS-21) by Aslam and Kamal (2017). was also used. The data were analyzed via SPSS 23. RESULTS Findings revealed that there is a significant negative relationship between resilience and psychological distress among burn survivors. Moreover, resilience predicted psychological distress. A significant difference was found between types of burn on depression and anxiety. Furthermore, the relationship between resilience to stress and depression is moderated by age of the burn survivor at the time of the incidence. A significant negative relationship between age with psychological distress among burn survivors was observed. The treatment period was associated positively with resilience and negatively with stress among burn survivors. Results also revealed no significant gender difference. However, a significant difference was found between types of burn on depression and anxiety. CONCLUSION The findings of current study would be helpful for the medical professionals, mental healthcare providers, and policymakers who can help to develop and implement rehabilitation programs and mental health demands for the said population and can initiate and plan resilience promoting programs that would help promote adaptive coping to deal with trauma.
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Iyer C, Soletti AB. Lived Experiences of Adult Burn Survivors with Post-Burn Contractures. SOCIAL WORK IN PUBLIC HEALTH 2022; 37:209-223. [PMID: 34797206 DOI: 10.1080/19371918.2021.1997862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The article documents the life changes and challenges that are experienced by individuals who suffer from burns with long-lasting injury, and what are the available support mechanisms for these individuals. The experiences are drawn from a qualitative phenomenological inquiry conducted at a leading facility for burns treatment in Navi Mumbai, where people from across the country can access free non-cosmetic corrective surgery for burn-related contracture. In-depth interviews have been conducted with nine participants and three key informants. Burns are commonly experienced as a disabling phenomenon, with the repercussions being experienced in the activities of daily living, finances, social roles, and social participation. We have noted, not only the changes in physical and emotional self but also the difficulty in accepting the changed self. Traversing and negotiating the fragmented healthcare system has been a baffling experience that is riddled with expensive, complex, and protracted treatment procedures. The uncertainty around the prognosis and treatment are sources of distress for the participants and their families. The paper concludes by indicating the need and scope for social work interventions in the lived experiences of adult burn survivors.
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Affiliation(s)
- Chetana Iyer
- Center for Health and Mental Health, School of Social Work, Tata Institute of Social Sciences, Mumbai, India
| | - Asha Banu Soletti
- Center for Health and Mental Health, School of Social Work, Tata Institute of Social Sciences, Mumbai, India
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Pieptu V, Moscalu R, Mihai A, Moscalu M, Pieptu D, Azoicăi D. Epidemiology of hospitalized burns in Romania: A 10-year study on 92,333 patients. Burns 2022; 48:420-431. [PMID: 34670711 DOI: 10.1016/j.burns.2021.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 05/19/2021] [Accepted: 05/26/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND No epidemiological information is available of the number of burns treated in the past 30 years in Romania. The aim of the present study is to investigate the extent of burn injuries in Romania, as well as to detect and analyze the essential epidemiological characteristics. METHODS A comprehensive retrospective study was conducted over a period of 10 years (1.01.2006 to 31.12.2015). Patient-related data were obtained from the Diagnosis-related group (DRG) Center of National School of Public Health, Management and Professional Development, which is the only official national structure that collects and manages data concerning all the hospitalized patients in Romania. RESULTS Included in this study were all 92,333 patients with burn injury as the main International Classification of Diseases (ICD-10) code of discharge from Romanian hospitals. The data was analyzed using SPSS V.24, IBM Statistics Package. The annual number of burns decreased gradually from 10,547 in 2006 to 7313 in 2015, reaching statistical significance (p = 0.001). The incidence decreased from 47 cases per 100,000 in 2006 to 36.93 per 100,000 in 2015. The seasonal evolution showed that the number of burns increases in July-August (8.8% and 9.1% of annual burns). The mean length of stay (LoS) was 10.59 days, with the highest value in 2012 (11.00) and the lowest in 2014 (10.30). The median LoS and the mean LoS values during the 10 years period have a plateau-type evolution, with no tendency for improvement. We found a significant correlation (r = 0.708, p = 0.0118) between increased mortality and the year of study. CONCLUSIONS This is the first nationwide epidemiological study concerning hospitalized burns in Romania. It provides insight in demographical characteristics but also uncovers a worrying trend of increasing mortality rates, which requires further investigation. This study cannot make any reference to the severity of burns (surface and depth) or towards major burns events which unfolded during the studied period, due to lack of data. Consequently, it should raise awareness towards policymakers and caregivers that for a durable burns management strategy in Romania, it would be extremely useful to implement a national burn registry.
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Affiliation(s)
- V Pieptu
- Department of Plastic and Reconstructive Surgery, Grigore T Popa University of Medicine and Pharmacy Iasi, Romania.
| | - R Moscalu
- The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
| | - A Mihai
- Department of Plastic and Reconstructive Surgery, Grigore T Popa University of Medicine and Pharmacy Iasi, Romania.
| | - M Moscalu
- Department of Informatics and Biostatistics, Grigore T Popa University of Medicine and Pharmacy Iasi, Romania.
| | - D Pieptu
- Department of Plastic and Reconstructive Surgery, Grigore T Popa University of Medicine and Pharmacy Iasi, Romania.
| | - D Azoicăi
- Department of Epidemiology, Grigore T Popa University of Medicine and Pharmacy Iasi, Romania.
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Gunsmaa G, Shono A, Price PE, Kondo M, Hebron C, Potokar T, Ichikawa M. Parental acceptance and willingness to pay for a newly designed kitchen rack to reduce paediatric burns. Burns 2022; 48:381-389. [PMID: 34092419 DOI: 10.1016/j.burns.2021.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 05/07/2021] [Accepted: 05/10/2021] [Indexed: 12/14/2022]
Abstract
The majority of pediatric burns in Mongolia occur within the home, particularly in the spaces dedicated to cooking. This makes home environment modification a priority for injury prevention. Many of these injuries are caused by electric appliances used in traditional tent-like dwellings (called a ger). In the present study, we designed and provided a context appropriate kitchen rack to 50 households with children aged 0-3 years living in gers and investigated parental views on the acceptability of the rack and willingness-to-pay (WTP) through face-to-face structured individual and group interviews and the contingent valuation method. We used the DCchoice package of R to estimate the median WTP and its 95% confidence interval by the household income, previous experience of childhood burn injury, and the number of children in the household. There was a total of 89 children aged <5 years in the 50 households, with a total of 59 burn experiences since birth including 29 treated at inpatient facilities. The median WTP was MNT 106,000 (about USD 37). The WTP appeared to be higher for the households with a higher income, more severe child burn experiences, and a greater number of children in the household. In the group interviews conducted after 4-6 weeks of routine use, the participants indicated that the use of the rack had resulted in a less stressful cooking environment, and the kitchen rack was described as a positive contribution to the reduction of risk to their young children. Whilst there were some suggestions for minor modifications, the rack was well accepted as a means of child burn prevention by the parents of infants and toddlers in Mongolia.
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Affiliation(s)
- Gerelmaa Gunsmaa
- Department of Global Public Health, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
| | - Aiko Shono
- Laboratory of Social Pharmacy and Regulatory Science, Showa Pharmaceutical University, Tokyo, Japan
| | - Patricia E Price
- Centre for Global Burn Injury Policy and Research, College of Human and Health Sciences, Swansea University, Swansea, UK; Interburns, Swansea, UK
| | - Masahide Kondo
- Department of Health Care Policy and Health Economics, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Caitlin Hebron
- Centre for Global Burn Injury Policy and Research, College of Human and Health Sciences, Swansea University, Swansea, UK
| | - Tom Potokar
- Centre for Global Burn Injury Policy and Research, College of Human and Health Sciences, Swansea University, Swansea, UK; Interburns, Swansea, UK
| | - Masao Ichikawa
- Department of Global Public Health, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
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44
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Boukani LM, Kheirjou R, Khosroshahi RF, Khosroshahi AF. Experimental Repairing of the Defect of Rat Full-Thickness Burn with Cell-Engineered Structure. REGENERATIVE ENGINEERING AND TRANSLATIONAL MEDICINE 2022. [DOI: 10.1007/s40883-022-00249-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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45
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Sandora N, Fitria NA, Kusuma TR, Winarno GA, Tanjunga SF, Wardhana A. Amnion bilayer for dressing and graft replacement for delayed grafting of full-thickness burns; A study in a rat model. PLoS One 2022; 17:e0262007. [PMID: 35061768 PMCID: PMC8782387 DOI: 10.1371/journal.pone.0262007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 12/15/2021] [Indexed: 11/19/2022] Open
Abstract
Burn is a common case in developing countries, with over half of fire-related deaths reported in Southeast Asia and full-thickness burns as a high mortality risk. Human amnion has been used as a wound dressing for centuries. In this study, a decellularised amnion overlaid with fibrin, “amnion bilayer (AB),” was used as a dressing immediately after burn and as a graft to replace the scar in Sprague-Dawley rats subjected to full-thickness burn model. The aim was to observe whether amnion bilayer can reduce damages in third-grade burn when skin replacement is deemed impossible. The burn was induced using an electrical solder, heated for 5 mins, and contacted on the rat’s bare skin for 20 s. AB was applied as a (i) dressing immediately after induction and graft after eschar removal. Two groups (n = 6) were compared: AB and Sofra-Tulle ®, the National Hospital of Indonesia (NHI) protocol. Sections were stained with hematoxylin and eosin and Masson trichrome stains. Immunohistochemistry labelling was used to indicate scars (α-smooth muscle actin [α-SMA] and collagen-1) and angiogenesis (von Willebrand factor). Also, the macrophages inflammatory protein-3α (MIP-3α) indicates an early inflammatory process. The post dressing of the AB group demonstrated hair follicle remains and adipose tissue development. The NHI group appeared with a denatured matrix. Complete healing was seen in the AB group after 28 days with skin appendages similar to normal, while the NHI group showed no appendages in the centre of the actively inflamed area. The α-SMA was found in both groups. Collagen-1 was highly expressed in the NHI group, which led to a scar. Angiogenesis was found more in the AB group. The AB group had shown the capacity to accelerate complete healing and recover skin appendages better than the current protocol.
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Affiliation(s)
- Normalina Sandora
- Faculty of Medicine, Universitas Riau, Pekanbaru, Indonesia
- Indonesian Medical Education and Research Institute (IMERI), Jakarta, Indonesia
| | - Nur Amalina Fitria
- Indonesian Medical Education and Research Institute (IMERI), Jakarta, Indonesia
| | - Tyas Rahmah Kusuma
- Indonesian Medical Education and Research Institute (IMERI), Jakarta, Indonesia
| | - Gammaditya Adhibarata Winarno
- Burn Unit, Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
- Department of Surgery, Plastic and Reconstructive Surgery Division, Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
| | - Sanjaya Faisal Tanjunga
- Burn Unit, Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
- Department of Surgery, Plastic and Reconstructive Surgery Division, Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
| | - Aditya Wardhana
- Burn Unit, Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
- Department of Surgery, Plastic and Reconstructive Surgery Division, Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
- Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- * E-mail:
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46
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Marcondes P, Rosas GH, González MEL, Queiroz AAAD, Marques PS. Poly(vinyl alcohol)/poly(glycerol) dendrimer hydrogel mediated green synthesis of silver nanoparticles. POLIMEROS 2022. [DOI: 10.1590/0104-1428.20220025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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47
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Jordan KC, Di Gennaro JL, von Saint André-von Arnim A, Stewart BT. Global trends in pediatric burn injuries and care capacity from the World Health Organization Global Burn Registry. Front Pediatr 2022; 10:954995. [PMID: 35928690 PMCID: PMC9343701 DOI: 10.3389/fped.2022.954995] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 06/27/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Burn injuries are a major cause of death and disability globally. The World Health Organization (WHO) launched the Global Burn Registry (GBR) to improve understanding of burn injuries worldwide, identify prevention targets, and benchmark acute care. We aimed to describe the epidemiology, risk factors, and outcomes of children with burns to demonstrate the GBR's utility and inform needs for pediatric burn prevention and treatment. METHODS We performed descriptive analyses of children age ≤ 18 years in the WHO GBR. We also described facility-level capacity. Data were extracted in September of 2021. RESULTS There were 8,640 pediatric and adult entries from 20 countries. Of these, 3,649 (42%) were children (0-18 years old) from predominantly middle-income countries. The mean age was 5.3 years and 60% were boys. Children aged 1-5 years comprised 62% (n = 2,279) of the cohort and mainly presented with scald burns (80%), followed by flame burns (14%). Children >5 years (n = 1,219) more frequently sustained flame burns (52%) followed by scald burns (29%). More than half of pediatric patients (52%) sustained a major burn (≥15% total body surface area) and 48% received surgery for wound closure during the index hospitalization. Older children had more severe injuries and required more surgery. Despite the frequency of severe injuries, critical care capacity was reported as "limited" for 23% of pediatric patients. CONCLUSIONS Children represent a large proportion of people with burn injuries globally and often sustain major injuries that require critical and surgical intervention. However, critical care capacity is limited at contributing centers and should be a priority for healthcare system development to avert preventable death and disability. This analysis demonstrates that the GBR has the potential to highlight key epidemiological characteristics and hospital capacity for pediatric burn patients. To improve global burn care, addressing barriers to GBR participation in low- and low-middle-income countries would allow for greater representation from a diversity of countries, regions, and burn care facilities.
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Affiliation(s)
- Kelly C Jordan
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, WA, United States
| | - Jane L Di Gennaro
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, WA, United States
| | - Amélie von Saint André-von Arnim
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, WA, United States.,Department of Global Health, University of Washington, Seattle, WA, United States
| | - Barclay T Stewart
- Division of Trauma, Burn, and Critical Care Surgery, Department of Surgery, University of Washington, Seattle, WA, United States
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48
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Acute burn care in resource-limited settings: a cohort study on treatment and outcomes in a rural hospital referral center in Tanzania. Burns 2022; 48:1966-1979. [DOI: 10.1016/j.burns.2022.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 12/10/2021] [Accepted: 01/18/2022] [Indexed: 11/23/2022]
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49
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Baiee H, Obaid E. Epidemiological and clinical characteristics of burn injuries among hospitalized patients in Babylon Province. MEDICAL JOURNAL OF BABYLON 2022. [DOI: 10.4103/mjbl.mjbl_70_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Davies P, Davies AK, Kirkham JJ, Young AE. Secondary analysis of data from a core outcome set for burns demonstrated the need for involvement of lower income countries. J Clin Epidemiol 2021; 144:56-71. [PMID: 34906674 PMCID: PMC9094759 DOI: 10.1016/j.jclinepi.2021.12.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 11/17/2021] [Accepted: 12/07/2021] [Indexed: 11/08/2022]
Abstract
Objective To compare the views of participants from different income-status countries on outcome selection for a burn care Core Outcome Set (COS). Methods A retrospective analysis of data collected during a two round Delphi survey to prioritise the most important outcomes in burn care research. Results There was considerable agreement between participants from low- and middle-income countries (LMICs) and high-income countries (HICs) across outcomes. The groups agreed on 91% of 88 outcomes in round 1 and 92% of 100 in round 2. In cases of discordance, the consensus of participants from LMICs was to include the outcome and for participants from HICs to exclude. There was also considerable agreement between the groups for the top-ten ranking outcomes. Discordance in outcome prioritisation gives an insight into the different values clinicians from LMICs place on outcomes compared to those from HICs. Limitations of the study were that outcome rankings from international patients were not available. Healthcare professionals from LMICs were not involved in the final consensus meeting. Conclusion COS developers should consider the need for a COS to be global at protocol stage. Global COS should include equal representation from both LMICs and HICs at all stages of development.
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Affiliation(s)
- P Davies
- Bristol Centre for Surgical Research, Bristol Biomedical Research Centre, Population Health Sciences, University of Bristol, United Kingdom
| | - A K Davies
- Centre for Academic Child Health, University of Bristol, United Kingdom
| | - J J Kirkham
- Centre for Biostatistics, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
| | - A E Young
- Bristol Centre for Surgical Research, Bristol Biomedical Research Centre, Population Health Sciences, University of Bristol, United Kingdom.
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