Treatment of second to third-degree burns in a 2-day-old infant: A case report

Prevention and Treatment of Burn Scar Contracture: A Practical Review

Burn contracture affects close to one-third of all burn patients, leading to significant functional impairment and costs. Effective prevention and treatment strategies are necessary to decrease morbidity and unnecessary costs. This scoping review aimed to summarize prevention and treatment strategies used for management of burn scar contractures published in the literature since 2000. A comprehensive PubMed review was performed in October 2022 to identify methods of burn contracture prevention and treatments. Non-English, duplicate, and unavailable articles were excluded. Data were extracted including publication year, techniques, and outcomes. A total of 327 publications met criteria for inclusion. Most articles were published in 2011 (n = 22). Treatment strategies were discussed in 82.9% of studies, prevention in 16.5%, and both in 0.6%. The most common areas discussed included the upper extremity (n = 127) and neck (n = 102). Flaps were the most frequently used method (n = 208), followed by autografts (n = 89). Most preventative therapies were still in early stages of development. Burn contracture management requires a highly individualized approach with many available reconstructive techniques available. Further research is needed to improve prevention techniques and decrease morbidity and cost to patients.

Neonatal Burn Injuries Managed in a Neonatal Intensive Care Unit of a Tertiary Hospital in North-Central Nigeria

Introduction

Neonatal burn injuries are rare in clinical practice. This explains the many case reports of such injuries. This is a report of our experience in the management of neonatal burn injuries in our centre.

Materials and Methods

This is a retrospective study of neonatal burn injuries that were managed over an eight year period (2014-2022). The information that was retrieved from the case notes included the socio-demographic data, birth weight, weight at admission, type of injury, total burn surface area (TBSA), depth of burn injury, type of treatment, length of hospital stay and outcome of care. The data were then entered into the SPSS version 25 (IBM Corp., United States) software and analysed.

Results

We managed 11 neonates, five males and six females with a male: female (M: F) ratio of 1:1.2. Their age ranged from zero to 25 days with a median (IQR) of 2 (1 -15) days. Eight (72.7%) of them were one to two days old and eight (72.7%) were admitted as out born. Majority (81.8%) of the mothers were primiparous women. Nine (81.8%) of the injuries were as a result of hot water bath. Most (66.6%) of these baths were done by the grandmothers or mothers of the babies. The total burn surface area (TBSA) ranged from 1% to 62%, with a median (IQR) of 11 (7.5 - 19.0). None of the babies had skin grafting. The length of stay (LOS) ranged from six days to 25 days with a median (IQR) of 11.0 (7.0 - 16.0) days. Only one baby died giving a hospital mortality rate of 9.1%.

Conclusions

The commonest cause of neonatal burn injury in this series is scald injuries from hot water bath. Providing education about safe bathing to caregivers should be included in routine antenatal and postnatal instructions in order to prevent burns.

An update on stem cells applications in burn wound healing

Burn wounds have proven to be capable of having a long lasting devastating effects on human body. Conventional therapeutic approaches are not up to the mark as they are unable to completely heal the burn wound easily and effectively. Major pitfalls of these treatments include hypertrophic scarring, contracture and necrosis. Presence of these limitations in the current therapies necessitate the search for a better and more efficient cure. Regenerative potency of stem cells in burn wound healing outweigh the traditional treatment procedures. The use of multiple kinds of stem cells are gaining interest due to their enhanced healing efficiency. Distinctions of stem cells include better and faster burn wound healing, decreased inflammation levels, less scar progression and fibrosis on site. In this review, we have discussed the wound-healing process, present methods used for stem cells administration, methods of enhancing stem cells potency and human studies. Pre-clinical and the clinical studies focused on the treatment of thermal and radiation burns using stem cells from 2003 till the present time have been enlisted. Studies shows that the use of stem cells on burn wounds, whether alone or by the help of a scaffold significantly improves healing. Homing of the stem cells at the wound site results in the re-epithelialization, angiogenesis, granulation, inhibition of apoptosis, and regeneration of skin appendages together with reduced infection rate in the human studies. Several studies on animals have shown that stem cells can effectively promote wound healing. Although more research is needed to find out the effectiveness of this treatment in patients with severe burn wounds.