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Boersma-van Dam E, Spronk I, Hofland HWC, Van Loey NEE. Gender differences in relation to stigmatization and depressive symptoms after burns. Burns 2024; 50:1662-1670. [PMID: 38637258 DOI: 10.1016/j.burns.2024.03.022] [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: 06/30/2023] [Revised: 03/11/2024] [Accepted: 03/13/2024] [Indexed: 04/20/2024]
Abstract
OBJECTIVES The aim of this study was to investigate the moderating role of gender in the relationship between burn severity, perceived stigmatization and depressive symptoms at multiple time points postburn. MATERIALS AND METHODS This multi-center study included data from two cohorts. Cohort 1 consisted of 215 burn survivors, participating in a longitudinal study with measures at 3 and 12 months postburn. Cohort 2 consisted of 180 burn survivors cross-sectionally assessed at 5 - 7 years postburn. Both cohorts completed self-reported measures of perceived stigmatization and depressive symptoms. The number of acute surgeries (i.e., no surgery, 1 surgery or 2 or more surgeries) was used as indicator of burn severity. Relations between number of surgeries, depressive symptoms, and perceived stigmatization, including possible indirect effects, were evaluated with gender-specific path models. RESULTS In both men and women, number of surgical operations was related to higher levels of depressive symptoms and perceived stigmatization at 3 months after burn. In women, number of operations was still directly related to both constructs at 12 months after burn, which was cross-sectionally confirmed in the 5-7 years after burn cohort. In men, from 3 to 12 months after burn, depressive symptoms and perceived stigmatization were bidirectionally related, and, through these effects, number of surgeries was indirectly related to both outcomes. In the cross-sectional 5-7 years after burn cohort, number of operations was related to stigma but not to depressive symptoms of men. CONCLUSION Number of operations had a different effect on psychosocial adaptation of male and female burn survivors. In women, a persistent direct link from number of operations to both depressive symptoms and perceived stigmatization was found over time. In men, the effect of number of operations was most evident in the short-term, after which perceived stigmatization and depressive symptoms became interrelated. This indicates that burn severity remains a factor of significance in psychological adjustment in women, whereas in men, this significance seems to decrease over time.
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Affiliation(s)
- Elise Boersma-van Dam
- Department of Clinical Psychology, Utrecht University, Utrecht, the Netherlands; Association of Dutch Burn Centres, Beverwijk, the Netherlands.
| | - Inge Spronk
- Association of Dutch Burn Centres, Beverwijk, the Netherlands; Dutch Burns Foundation, Beverwijk, the Netherlands; Association of Dutch Burn Centres, Maasstad Hospital, Rotterdam, the Netherlands
| | | | - Nancy E E Van Loey
- Department of Clinical Psychology, Utrecht University, Utrecht, the Netherlands
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2
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Silva A, Marzo J, García Del Castillo JA. Relationship between quality of life, emotional symptomology and perceived emotional intelligence in a sample of burn victims. Burns 2024; 50:1330-1340. [PMID: 38494394 DOI: 10.1016/j.burns.2024.02.034] [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: 09/16/2022] [Revised: 02/16/2024] [Accepted: 02/27/2024] [Indexed: 03/19/2024]
Abstract
The main objective of this study is to analyse the association between Quality of Life (QOL), Emotional Symptomology and perceived Emotional Intelligence (EI) in burn patients. Additionally, it is intended determine the predictor models of QOL, and confirm the mediating effect of emotional symptomology between QOL and perceived EI. This is a transversal study developed in the Hospital da Prelada, Porto, Portugal, with a sample of 92 patients that were hospitalized in the Burn Unit and the Reconstructive Plastic Surgery Service. The assessment protocol consisted of a sociodemographic and clinical data sheet. To assess the perception of QOL of the burn patient it was used the Burn Specific Health Scale - Revised (BSHS-R), the emotional symptomology was measured by the Brief Symptom Inventory (BSI) and Trait Met-Mood Scale-24 (TMMS) was used to assess Emotional Intelligence (EI). The cross-sectional and correctional data were analysed through descriptive statistics, correlations, regressions and simple mediations. The results obtained suggest significant associations between QOL, perceived EI and Emotional Symptomology in burn patients. The results of the predictor models of the QOL domains encompass the Positive Symptom Distress Index (PSDI of Emotional Symptomology), where the total variance is explained mainly by the models of QOL Affect and Body Image 46% and Treatment 31%. The mediating effect of the PSDI in the relationship between QOL in the Affect and Body Image dimension and the Mood Repairs (MR) was also tested, having proved to have a total mediation (the Mood Repairs loses its contribution in the QOL model when the PSDI variable is introduced). This study underscores the importance of perceived Emotional Intelligence and its association with the burn impact in the different dimensions of QOL of the patients. The intention of this study is to alert health professionals for patient support in the search for strategies that aim for positive adaptation which promotes QOL and emotional adjustment of burn patients to their new condition.
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Affiliation(s)
- A Silva
- the Prelada Hospital and Doctorate from Miguel Hernández University of Elche in the Doctoral Program in Sport and Health, Spain.
| | - J Marzo
- Miguel Hernández University of Elche, Spain
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3
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Wojtyna E, Hyla M, Hachuła A. Pain of Threatened Self: Explicit and Implicit Self-Esteem, Cortisol Responses to a Social Threat and Pain Perception. J Clin Med 2024; 13:2705. [PMID: 38731234 PMCID: PMC11084546 DOI: 10.3390/jcm13092705] [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: 02/01/2024] [Revised: 04/12/2024] [Accepted: 04/21/2024] [Indexed: 05/13/2024] Open
Abstract
Background: Rejection, injustice, and exclusion from meaningful interpersonal relationships are often extremely painful and stress-generating experiences. This study aimed to define the role of explicit and implicit self-esteem in pain perception as a component of the physiological-psychological system that regulates the body's response to stress associated with the threat of social rejection. Methods: In total, 360 individuals participated in this study. The measurement of cortisol in saliva, the assessment of pain thresholds using thermal stimuli, the IAT to assess implicit self-esteem, and a questionnaire on global self-esteem and social pain were used. The study included three measurements: baseline and 15 and 45 min after the application of a laboratory socially threatening stimulus (the Trier Social Stress Test). Results: People experiencing chronic social pain (CSP) are more likely to have fragile self-esteem, higher pain thresholds, and tend to experience reduced pain tolerance in situations of acute social threat than people without CSP experience. In people with CSP and fragile self-esteem, after the introduction of a social threat, an increase in pain tolerance was observed along with a longer-lasting increase in cortisol levels. Conclusions: Fragile self-esteem, along with feelings of chronic exclusion, injustice, and rejection, may prolong stress reactions and produce a hypoalgesic effect.
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Affiliation(s)
- Ewa Wojtyna
- Institute of Medical Sciences, University of Opole, 45-040 Opole, Poland
| | - Magdalena Hyla
- Institute of Psychology, University of Silesia in Katowice, 40-007 Katowice, Poland;
| | - Aleksandra Hachuła
- Faculty of Psychology in Katowice, SWPS University, 40-326 Katowice, Poland;
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4
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Sharma Y, Jain P, Gottam SB, Sarkar A, Prasad N. Prospective Evaluation of Fractional Carbon Dioxide Laser Treatment of Mature Burn Scars, Post-traumatic Scars, and Post-acne Scars. Cureus 2024; 16:e58358. [PMID: 38756282 PMCID: PMC11096773 DOI: 10.7759/cureus.58358] [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] [Accepted: 04/15/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Annually, around 100 million patients worldwide acquire scars, some of which can cause significant problems. Various treatment interventions, such as topical scar creams, steroids, laser therapy, and surgery, have been developed to manage these scars. This study was conducted to evaluate the effectiveness of fractional CO2 laser treatment by assessing outcomes using the Patient Observer Scar Assessment Scale (POSAS) and clinical photographs. MATERIALS AND METHODS A total of 47 patients were included in the study, divided into three groups: a post-acne scar group with 14 patients, a post-burn scar group with 17 patients, and a post-traumatic scar group with 16 patients. Detailed histories were taken, and clinical examinations were performed and recorded on a prepared proforma. Aesthetic outcomes were evaluated based on clinical photographs, and total patient and observer scores were recorded using POSAS at baseline, and after one and three months. POSAS comprises two components: the observer scale (POSAS-O) and the patient scale (POSAS-P). Fractional CO2 laser treatments were performed in each group, with sessions repeated every four weeks for three consecutive sessions. Data were analyzed using the paired t-test for before-and-after comparisons in each study group. Welch's ANOVA test was used for comparisons among the three groups at a significance level of p=0.05, using MS Excel (Microsoft Corporation, Redmond, Washington) and IBM SPSS Statistics for Windows, Version 20 (Released 2011; IBM Corp., Armonk, New York). RESULTS The mean age for men was 26.38 ± 8.19 years and for women 22.21 ± 6.38 years. The study comprised 34 female patients (72.34%) and 13 male patients (27.66%). The mean POSAS observer and patient scales were recorded and compared for all three types of scars from baseline to three months. The mean percentage change in POSAS-O and POSAS-P (total score) in relation to different scar sites was recorded. The most significant difference in mean percentage change, statistically significant (p-value < 0.05), was observed for facial scars, followed by scars on the neck, and was minimal for scars on the hand, in both observer and patient groups. Even a single session of fractional CO2 laser therapy had profound effects on the overall quality of scars. CONCLUSION Fractional carbon dioxide laser therapy improves the quality of scars and produces significant improvements in skin texture, with better effects on post-traumatic scars than on post-burn and post-acne scars. Future studies are needed to better understand the mechanism of action and to optimize the doses and timing of therapy.
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Affiliation(s)
- Yasharth Sharma
- Plastic and Reconstructive Surgery, Moti Lal Nehru Medical College, Prayagraj, IND
| | - Pradeep Jain
- Plastic and Reconstructive Surgery, Banaras Hindu University, Varanasi, IND
| | - Suman Babu Gottam
- Plastic and Reconstructive Surgery, Banaras Hindu University, Varanasi, IND
| | - Arnab Sarkar
- Plastic and Reconstructive Surgery, Banaras Hindu University, Varanasi, IND
| | - Nikhil Prasad
- Plastic and Reconstructive Surgery, Banaras Hindu University, Varanasi, IND
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Wei H, Deng M, Ding R, Wei L, Yuan H. Macrophage β2-AR activation amplifies inflammation in wound healing by upregulating Trem1 via the cAMP/PKA/CREB pathway. Int Immunopharmacol 2024; 128:111463. [PMID: 38190789 DOI: 10.1016/j.intimp.2023.111463] [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: 10/18/2023] [Revised: 12/22/2023] [Accepted: 12/27/2023] [Indexed: 01/10/2024]
Abstract
BACKGROUND Inflammation is an important part of the wound healing process. The stress hormone epinephrine has been demonstrated to modulate the inflammatory response via its interaction with β2-adrenergic receptor (β2-AR). However, the precise molecular mechanism through which β2-AR exerts its influence on inflammation during the wound healing process remains an unresolved question. METHODS Transcriptome datasets of wound and macrophages from the GEO database were reanalyzed using bioinformatics. The role of β2-AR in wound healing was explored by a mouse hind paw plantar wound model, and histological analyses were performed to assess wound healing. In vivo and in vitro assays were performed to elucidate the role of β2-AR on the inflammatory response. Triggering receptor expressed on myeloid cells 1 (Trem1) was knocked down with siRNA on RAW cells and western blot and qPCR assays were performed. RESULTS Trem1 was upregulated within 24 h of wounding, and macrophage β2-AR activation also upregulated Trem1. In vivo experiments demonstrated that β2-AR agonists impaired wound healing, accompanied by upregulation of Trem1 and activation of cAMP/PKA/CREB pathway, as well as by a high level of pro-inflammatory cytokine production. In vitro experiments showed that macrophage β2-AR activation amplified LPS-induced inflammation, and knockdown of Trem1 reversed this effect. Using activator and inhibitor of cAMP, macrophage β2-AR activation was confirmed to upregulate Trem1 via the cAMP/PKA/CREB pathway. CONCLUSION Our study found that β2-AR agonists increase Trem1 expression in wounds, accompanied by amplification of the inflammatory response, impairing wound healing. β2-AR activation in RAW cells induces Trem1 upregulation via the cAMP/PKA/CREB pathway and amplifies LPS-induced inflammatory responses.
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Affiliation(s)
- Huawei Wei
- Department of Anesthesiology, Changzheng Hospital, Second Affiliated Hospital of Naval Medical University, Shanghai 200003, China
| | - Mengqiu Deng
- Department of Anesthesiology, Changzheng Hospital, Second Affiliated Hospital of Naval Medical University, Shanghai 200003, China
| | - Ruifeng Ding
- Department of Anesthesiology, Changzheng Hospital, Second Affiliated Hospital of Naval Medical University, Shanghai 200003, China
| | - Liangtian Wei
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, China
| | - Hongbin Yuan
- Department of Anesthesiology, Changzheng Hospital, Second Affiliated Hospital of Naval Medical University, Shanghai 200003, China.
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6
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Zaboli Mahdiabadi M, Farhadi B, Shahroudi P, Shahroudi P, Hekmati Pour N, Hojjati H, Najafi M, Farzan R, Salehi R. Prevalence of anxiety and its risk factors in burn patients: A systematic review and meta-analysis. Int Wound J 2024; 21:e14705. [PMID: 38353163 PMCID: PMC10865278 DOI: 10.1111/iwj.14705] [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: 12/09/2023] [Revised: 01/04/2024] [Accepted: 01/05/2024] [Indexed: 02/16/2024] Open
Abstract
The primary objective of this systematic review and meta-analysis was to ascertain the prevalence of anxiety and identify associated risk factors among individuals who have suffered burn injuries. We conducted a thorough and systematic search across various international electronic databases, including Scopus, PubMed and Web of Science, as well as Persian electronic databases like Iranmedex and the scientific information database (SID). Our search encompassed the period from the earliest available records up to 8 August 2023. We employed keywords derived from Medical Subject Headings (MeSH) such as "Prevalence", "Anxiety" and "Burns". In total, 2586 burn patients participated in 13 cross-sectional studies. The mean age of the participants was 32.88 (SD = 2.51). In a compilation of 13 studies, the documented overall occurrence rate of anxiety among burn patients stood at 16.1% (95% CI: 10.0% to 24.7%; I2 = 93.138%; p < 0.001). The outcomes of a meta-regression analysis, which examined the association between anxiety in burn patients and the year of publication, did not uncover any significant correlation (p = 0.442). Furthermore, there was a notable association between anxiety in burn patients and factors such as gender, TBSA affected, educational level and the types of burn injuries. Therefore, healthcare providers need to recognize the substantial prevalence of anxiety in burn patients as a fundamental consideration. This recognition should prompt a proactive approach toward early detection and timely intervention. Developing personalized intervention strategies tailored to each patient's unique risk factors and needs is paramount. These strategies may encompass a range of therapeutic options such as counselling, psychotherapy or consultations with mental health specialists.
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Affiliation(s)
| | - Bahar Farhadi
- School of MedicineIslamic Azad University, Mashhad BranchMashhadIran
| | - Parichehr Shahroudi
- Department of Pediatric NursingZeinab School of Nursing and Midwifery, Guilan University of Medical SciencesRashtIran
| | - Parinaz Shahroudi
- Department of Surgical TechnologyGuilan University of Medical SciencesRashtIran
| | - Nafiseh Hekmati Pour
- Department of NursingAliabad Katoul Branch, Islamic Azad UniversityAliabad KatoulIran
| | - Hamid Hojjati
- Nursing Research CenterGolestan University of Medical SciencesGorganIran
| | - Masoomeh Najafi
- Student Research CommitteeSchool of Nursing and Midwifery, Shahid Beheshti University of Medical SciencesTehranIran
| | - Ramyar Farzan
- Department of Plastic & Reconstructive SurgerySchool of Medicine, Guilan University of Medical SciencesRashtIran
| | - Reza Salehi
- Department of AnesthesiologySchool of Medicine, Iran University of Medical SciencesTehranIran
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Ahmadi AR, Wesson RN, Huang J, Harmon J, Burdick JF, Cameron AM, Sun Z. Induction of Skin Allograft Chimerism by Pharmacological Mobilization of Endogenous Bone Marrow-Derived Stem Cells. J Burn Care Res 2024; 45:234-241. [PMID: 37801462 PMCID: PMC10768753 DOI: 10.1093/jbcr/irad153] [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: 06/08/2023] [Indexed: 10/08/2023]
Abstract
Skin substitutes including allografts remain a standard therapeutic approach to promote healing of both acute and chronic large wounds. However, none have resulted in the regrowth of lost and damaged tissues and scarless wound healing. Here, we demonstrate skin allograft chimerism and repair through the mobilization of endogenous bone marrow-derived stem and immune cells in rats and swine. We show that pharmacological mobilization of bone marrow stem cells and immune cells into the circulation promotes host repopulation of skin allografts and restoration of the skin's normal architecture without scarring and minimal contracture. When skin allografts from DA rats are transplanted into GFP transgenic Lewis recipients with a combination of AMD3100 and low-dose FK506 (AF) therapy, host-derived GFP-positive cells repopulate and/or regenerate cellular components of skin grafts including epidermis and hair follicles and the grafts become donor-host chimeric skin. Using AF combination therapy, burn wounds with skin allografts were healed by newly regenerated chimeric skin with epidermal appendages and pigmentation and without contracture in swine.
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Affiliation(s)
- Ali R Ahmadi
- Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Russell N Wesson
- Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jinny Huang
- Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - John Harmon
- Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - James F Burdick
- Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Andrew M Cameron
- Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Zhaoli Sun
- Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
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8
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van de Warenburg MS, Munk EFL, Davies A, McBride CA, Edgar DW, Vehmeijer-Heeman MLAW, Young AE. Working Towards Holistic Scar Assessment and Improved Shared Decision Making in Global Burn Care. J Burn Care Res 2024; 45:112-119. [PMID: 37310702 PMCID: PMC10768758 DOI: 10.1093/jbcr/irad089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Indexed: 06/14/2023]
Abstract
Cutaneous burn scars impact various aspects of life. Scar treatment is mainly evaluated on scar characteristics. Consensus is needed on which other outcomes to capture, ensuring they are relevant to patients, clinicians, and researchers. The aim of this study was to identify, discuss and analyze outcomes related to cutaneous burn scarring, incorporating the voice of patients and views of healthcare professionals. For this, a Delphi process consisting of two survey rounds and a consensus meeting was initiated. Burn scar-related outcomes were identified from an existing comprehensive list of 100 outcomes by an international panel of patients, healthcare professionals and researchers. Fifty-nine outcomes were identified from the Delphi process as related to scarring (≥60% votes). Outcomes less impactful in relation to scar outcomes included psychosocial issues, sense of normality, understanding of treatment, costs and systemic issues. To represent a holistic assessment of outcomes related to cutaneous burn scarring, this Delphi process established a battery of outcomes currently included in scar quality assessment tools, and an expanded set of less frequently considered outcomes. Future work in this area must include the patient voice from developing countries. This is essential to identify globally applicable outcomes related to scarring.
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Affiliation(s)
- Milly S van de Warenburg
- Department of Plastic and Reconstructive Surgery, Radboud University Medical Centre, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Elleke F L Munk
- Department of Plastic and Reconstructive Surgery, Radboud University Medical Centre, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Anna Davies
- Translational Health Sciences, University of Bristol, Bristol, UK
| | - Craig A McBride
- Centre for Children’s Burns and Trauma Research, Child Health Research Centre, The University of Queensland, Brisbane, QLD, Australia
| | - Dale W Edgar
- State Adult Burn Unit, Fiona Stanley Hospital, Murdoch, Australia
- Burn Injury Research Node, The Institute for Health Research, The University of Notre Dame Australia, Fremantle, Australia
- Fiona Wood Foundation, Fiona Stanley Hospital, Murdoch, Australia
| | - Mariëlle L A W Vehmeijer-Heeman
- Department of Plastic and Reconstructive Surgery, Radboud University Medical Centre, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Amber E Young
- Centre for Surgical Research, Population Health Sciences, Bristol Medical School, Bristol University, Bristol, UK
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Zuo Y, Deng K, Tang F, Chen S, Liu D, Han Z, Shi K, Chen J, Li P, Zhou J, Liu C. A bibliometric study: Relevant studies on scar laser therapy since the 21st century. Int Wound J 2024; 21:e14410. [PMID: 37726970 PMCID: PMC10788465 DOI: 10.1111/iwj.14410] [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: 07/11/2023] [Revised: 09/01/2023] [Accepted: 09/10/2023] [Indexed: 09/21/2023] Open
Abstract
To summarise research studies on scar laser therapy since the 21st century using bibliometric methods, and to speculate on the possible development in the future. The literature about scar laser therapy in Web of Science database was searched. CiteSpace and VOSviewer were used to analyse main countries, institutions, journals,subject hotspots and trends, etc. A total of 884 papers have been published since the 21st century. These publications were written by 653 authors from 515 institutions in 58 countries. The United States published 287 papers in this field and ranks first. Laser in Surgery and Medicine is the most widely published journal, with Shumaker as the core author. The main keyword clustering includes terms such as combination therapy, wound healing, fractional photothermolysis, experience, scar formation, etc. CiteSpace and VOSviewer were used to sort out and summarise the countries, institutions, authors, journals, research hotspots and frontier topics of related literature about scar laser therapy since the 21st century. The current situation of its application and basic scientific research in clinical treatments were summarised briefly. This provides a new idea for the development and research of scar laser therapy in the future.
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Affiliation(s)
- Yiwei Zuo
- Department of Burn and Plastic Surgery, The Third Xiangya HospitalCentral South UniversityChangshaChina
| | - Kexin Deng
- Department of Burn and Plastic Surgery, The Third Xiangya HospitalCentral South UniversityChangshaChina
| | - Fengjie Tang
- Department of Burn and Plastic Surgery, The Third Xiangya HospitalCentral South UniversityChangshaChina
| | - Shuyue Chen
- Department of Burn and Plastic Surgery, The Third Xiangya HospitalCentral South UniversityChangshaChina
| | - Daisong Liu
- Department of Burn and Plastic Surgery, The Third Xiangya HospitalCentral South UniversityChangshaChina
| | - Zhaofei Han
- Department of Burn and Plastic Surgery, The Third Xiangya HospitalCentral South UniversityChangshaChina
| | - Ke Shi
- Department of Burn and Plastic Surgery, The Third Xiangya HospitalCentral South UniversityChangshaChina
| | - Jia Chen
- Department of Burn and Plastic Surgery, The Third Xiangya HospitalCentral South UniversityChangshaChina
| | - Ping Li
- Department of Burn and Plastic Surgery, The Third Xiangya HospitalCentral South UniversityChangshaChina
| | - Jianda Zhou
- Department of Burn and Plastic Surgery, The Third Xiangya HospitalCentral South UniversityChangshaChina
| | - Can Liu
- Department of Burn and Plastic Surgery, The Third Xiangya HospitalCentral South UniversityChangshaChina
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10
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Bandopadhyay A, Kapoor A, Kundu K, Jagtap M, Chattopadhyay D. Translation and validation of Hindi version of patient scar assessment scale in patients with postburn facial scar. J Cutan Aesthet Surg 2024; 17:55-59. [PMID: 38736860 PMCID: PMC11086925 DOI: 10.4103/jcas.jcas_11_22] [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] [Indexed: 05/14/2024] Open
Abstract
Background Patient scar assessment scale (PSAS) is a reliable and standard tool for assessment of scars by the observer and the patient. Till now the scale has not been translated to Hindi. The objective of the study was to translate and validate the PSAS to Hindi. Materials and Methods We did forward and backward translation of the English PSAS together with its validation. In total, 64 patients with postburn facial scars were included. The validation committee consisted of 6 bilingual members. Results The PSAS-Hindi showed good internal consistency with Cronbach's α of 0.86. Test-retest reliability showed good correlation with intra class coefficient being 0.94 (95% confidence interval: 0.83-0.97). Conclusion The PSAS was successfully translated to Hindi, and cross-cultural adaptation was made.
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Affiliation(s)
- Arkapal Bandopadhyay
- Department of Pharmacology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Akshay Kapoor
- Department of Burns and Plastic Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Kaustav Kundu
- Department of Psychiatry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Manish Jagtap
- Department of Burns and Plastic Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Debarati Chattopadhyay
- Department of Burns and Plastic Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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11
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Chen PJ, Huang CW, Lin HL, Chang CM. Depression, postburn disability & quality of life: The moderating roles of burn specific coping strategies. Burns 2023; 49:1886-1892. [PMID: 37821286 DOI: 10.1016/j.burns.2023.05.012] [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: 09/14/2022] [Revised: 03/13/2023] [Accepted: 05/06/2023] [Indexed: 10/13/2023]
Abstract
Depression has been associated with poorer postburn functional outcomes. However, whether or not certain burn specific coping strategies moderate the relationships remains unknown. Burn survivors from 2015 Formosa Fun Coast Water Park explosion were recruited in a 3-year follow-up study. Using Wave 1 data collected 1 year after discharge, we conducted multivariate regression analysis to assess the associations between depression and postburn disability and quality of life. We also performed moderation analysis to determine moderating effects of burn specific coping strategies on the associations. Our results found depression was significantly associated with worsening postburn disability and poorer quality of life. When demographic and burn related variables were accounted for, we found avoidance coping moderated the depression-disability relationship. Depression was significantly and positively correlated with disability at low and medium levels of avoidance but not high. Optimism/problem solving moderated the depression-quality of life relationship. Depression was significantly and negatively correlated with quality of life at low and medium levels of optimism/problem solving but not high. Our study provided evidence supporting early identification and intervention of depression in burn survivors to optimize functional outcomes. Such knowledge may provide insights into potential targets in rehabilitation in depressed burn survivors.
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Affiliation(s)
- Pei-Jung Chen
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience (IoPPN), King's College London, United Kingdom
| | - Chih-Wan Huang
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Huang-Li Lin
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Chia-Ming Chang
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
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12
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Villarreal E, Wolf SE, Golovko G, Bagby S, Wermine K, Gotewal S, Obi A, Corona K, Huang L, Keys P, Song J, El Ayadi A. Opioid prescription and opioid disorders in burns: A large database analysis from 1990 to 2019. Burns 2023; 49:1845-1853. [PMID: 37872016 DOI: 10.1016/j.burns.2023.09.013] [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: 11/22/2022] [Revised: 06/28/2023] [Accepted: 09/20/2023] [Indexed: 10/25/2023]
Abstract
BACKGROUND Opioids remain crucial in the management of burn pain. A comprehensive analysis of opioid use in burns and their complications has not been investigated. METHODS Data were collected from TriNetX, a large multicenter database with de-identified patient information. The population included patients prescribed opioids on or following burn injury from January 1st, 1990, to December 31st, 2019. Opioid prescription use was analyzed after cohort stratification by decades: 1990-1999, 2000-2009, and 2010-2019. Outcomes for opioid-related disorders, opioid dependence, opioid abuse, intentional self-harm, and mental and behavioral disorders from psychoactive substance use were investigated. RESULTS Hydrocodone was the most frequently prescribed opioid in 1990-1999 and 2000-2009, with oxycodone taking the lead in 2010-2019 (p < 0.0001). During 1990-1999, patients had a decreased risk of recorded opioid-related disorders (RR=0.52), opioid dependence (RR=0.46), opioid abuse (RR=0.55), mental and behavioral disorders (RR=0.88), and intentional self-harm (RR=0.37) when compared to 2000-2009. A comparison of the 2000-2009-2010-2019 cohorts showed an increased risk of recorded opioid-related disorders (RR= 1.91), opioid dependence (RR=1.56), opioid abuse (RR=1.67), mental and behavioral disorders (RR =1.73), and intentional self-harm (RR=2.02). CONCLUSIONS The risk of opioid-related disorders has nearly doubled since the year 2000 warranting precautions when prescribing pain medications to burn patients.
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Affiliation(s)
- Elvia Villarreal
- School of Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Steven E Wolf
- Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA
| | - George Golovko
- Department of Pharmacology, University of Texas Medical Branch, Galveston, TX, USA
| | - Shelby Bagby
- School of Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Kendall Wermine
- School of Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Sunny Gotewal
- School of Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Ann Obi
- School of Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Kassandra Corona
- School of Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Lyndon Huang
- School of Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Phillip Keys
- School of Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Juquan Song
- Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA
| | - Amina El Ayadi
- Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA.
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Abstract
Wound healing occurs as a response to disruption of the epidermis and dermis. It is an intricate and well-orchestrated response with the goal to restore skin integrity and function. However, in hundreds of millions of patients, skin wound healing results in abnormal scarring, including keloid lesions or hypertrophic scarring. Although the underlying mechanisms of hypertrophic scars and keloid lesions are not well defined, evidence suggests that the changes in the extracellular matrix are perpetuated by ongoing inflammation in susceptible individuals, resulting in a fibrotic phenotype. The lesions then become established, with ongoing deposition of excess disordered collagen. Not only can abnormal scarring be debilitating and painful, it can also cause functional impairment and profound changes in appearance, thereby substantially affecting patients' lives. Despite the vast demand on patient health and the medical society, very little progress has been made in the care of patients with abnormal scarring. To improve the outcome of pathological scarring, standardized and innovative approaches are required.
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Affiliation(s)
- Marc G Jeschke
- Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada.
| | - Fiona M Wood
- Burns Service of Western Australia, Fiona Stanley Hospital, Perth Children's Hospital, Perth, Western Australia, Australia
- Burn Injury Research Unit, University of Western Australia, Perth, Western Australia, Australia
| | - Esther Middelkoop
- Burn Center, Red Cross Hospital, Beverwijk, Netherlands
- Association of Dutch Burn Centers (ADBC), Beverwijk, Netherlands
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Movement Sciences (AMS) Institute, Amsterdam UMC, Amsterdam, Netherlands
| | - Ardeshir Bayat
- Medical Research Council Wound Healing Unit, Hair and Skin Research Lab, Division of Dermatology, Department of Medicine, University of Cape Town & Groote Schuur Hospital, Cape Town, South Africa
| | - Luc Teot
- Department of Plastic Surgery, Burns, Wound Healing, Montpellier University Hospital, Montpellier, France
| | - Rei Ogawa
- Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, Tokyo, Japan
| | - Gerd G Gauglitz
- Department of Dermatology and Allergy, Ludwig-Maximilian University Munich, Munich, Germany
- Haut- und Laserzentrum Glockenbach, Munich, Germany
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14
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Radzikowska-Büchner E, Łopuszyńska I, Flieger W, Tobiasz M, Maciejewski R, Flieger J. An Overview of Recent Developments in the Management of Burn Injuries. Int J Mol Sci 2023; 24:16357. [PMID: 38003548 PMCID: PMC10671630 DOI: 10.3390/ijms242216357] [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: 09/25/2023] [Revised: 11/09/2023] [Accepted: 11/13/2023] [Indexed: 11/26/2023] Open
Abstract
According to the World Health Organization (WHO), around 11 million people suffer from burns every year, and 180,000 die from them. A burn is a condition in which heat, chemical substances, an electrical current or other factors cause tissue damage. Burns mainly affect the skin, but can also affect deeper tissues such as bones or muscles. When burned, the skin loses its main functions, such as protection from the external environment, pathogens, evaporation and heat loss. Depending on the stage of the burn, the patient's condition and the cause of the burn, we need to choose the most appropriate treatment. Personalization and multidisciplinary collaboration are key to the successful management of burn patients. In this comprehensive review, we have collected and discussed the available treatment options, focusing on recent advances in topical treatments, wound cleansing, dressings, skin grafting, nutrition, pain and scar tissue management.
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Affiliation(s)
- Elżbieta Radzikowska-Büchner
- Department of Plastic, Reconstructive and Maxillary Surgery, National Medical Institute of the Ministry of the Interior and Administration, Wołoska 137 Street, 02-507 Warszawa, Poland;
| | - Inga Łopuszyńska
- Department of Plastic, Reconstructive and Maxillary Surgery, National Medical Institute of the Ministry of the Interior and Administration, Wołoska 137 Street, 02-507 Warszawa, Poland;
| | - Wojciech Flieger
- Department of Human Anatomy, Medical University of Lublin, Jaczewskiego 4 Street, 20-090 Lublin, Poland;
| | - Michał Tobiasz
- Department of Plastic Surgery, Reconstructive Surgery and Burn Treatment, Medical University of Lublin, Krasnystawska 52 Street, 21-010 Łęczna, Poland;
| | - Ryszard Maciejewski
- Faculty of Medicine, University of Warsaw, Żwirki i Wigury 101 Street, 02-089 Warszawa, Poland;
| | - Jolanta Flieger
- Department of Analytical Chemistry, Medical University of Lublin, Chodźki 4A Street, 20-093 Lublin, Poland
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15
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Farzan R, Hosseini SJ, Firooz M, Tabarian MS, Jamshidbeigi A, Samidoust P, Sarafi M, Mahdiabadi MZ, Ghorbani Vajargah P, Mollaei A, Karkhah S, Takasi P, Parvizi A, Haddadi S. Perceived stigmatisation and reliability of questionnaire in the survivors with burns wound: A systematic review and meta-analysis. Int Wound J 2023; 20:3391-3403. [PMID: 37016493 PMCID: PMC10502297 DOI: 10.1111/iwj.14176] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 03/18/2023] [Accepted: 03/21/2023] [Indexed: 04/06/2023] Open
Abstract
Perceived stigmatisation (PS) can cause different effects on burns survivors such as depression, low self-esteem, body image disturbance, and social anxiety. Current systematic review and meta-analysis aimed to determine the average PS among the burns survivor population and the average reliability of the PS questionnaire (PSQ). A comprehensive systematic search was conducted in various international electronic databases, such as Scopus, PubMed, Web of Science, and Persian electronic databases such as Iranmedex, and Scientific Information Database (SID) using keywords extracted from Medical Subject Headings such as "Stigmatisation", "Burns", "Reliability", and "Questionnaire" from the earliest to February 1, 2023. The COSMIN and the Joanna Briggs Institute (JBI) checklists were applied to evaluate the risk of bias. Data analysis was performed in STATA V.14 and JAMOVI v 2.3.24 software. The analysis consisted of two sections. Firstly, the overall weighted average of PS was calculated based on mean and standard deviation. Then, the reliability average of PSQ was calculated with the reliability generalisation method based on the alpha coefficient, questionnaire items, and sample size of each study. Finally, eight articles were included in the quantitative analysis. The results showed the weighted average of PS was 2.14 (ES: 2.14, 95%CI: 1.77-2.51, Z = 11.40, I2 :97.8%, P < 0.001). The average of PS in the factors of confused/staring behaviour, absence of friendly behaviour, and hostile behaviour was 2.36 (ES: 2.36, 95%CI: 2.05-2.67, Z = 14.86, I2 :92.7%, P < 0.001), 2.13 (ES: 2.13, 95%CI: 1.87-2.39, Z = 16.22, I2 :93.8%, P < 0.001) and 2.07 (ES: 2.07, 95%CI: 1.67-2.47, Z = 10.05, I2 :96.5%, P < 0.001), respectively. The analysis showed that the overall coefficient alpha of the PSQ was 0.88 (ES: 0.88, 95%CI: 0.851-0.910, Z = 58.7, I2 : 95.04%, P < 0.001). Also, the alpha coefficient of factors including confused/staring behaviour, absence of friendly behaviour, and hostile behaviour were 0.847 (ES: 0.847, 95%CI: 0.770-0.924, Z = 21.6, I2 :99.13%, P < 0.001), 0.860 (ES: 0.860, 95%CI: 0.808-0.912, Z = 32.4, I2 :98.02%, P < 0.001) and 0.899 (ES: 0.899, 95%CI: 0.829-0.968, Z = 21.33, I2 : 0.0%, P < 0.001), respectively. In sum, the current study showed that the average PS was 2.14 out of 5 points. Most survivors and parents reported confused/starring behaviour as a common perceived behaviour from different individuals. Also, the average reliability of PSQ was 0.88, and it had acceptable reliability. More studies are required to better judge the level of PS among different age groups. Also, the psychometric properties of PSQ in different cultures are an essential issue.
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Affiliation(s)
- Ramyar Farzan
- Department of Plastic & Reconstructive Surgery, School of MedicineGuilan University of Medical SciencesRashtIran
| | | | - Mahbobeh Firooz
- Department of NursingEsfarayen Faculty of Medical SciencesEsfarayenIran
| | | | - Amirreza Jamshidbeigi
- Student Research Committee, Faculty of Nursing and MidwiferyMashhad University of Medical SciencesMashhadIran
| | - Pirouz Samidoust
- Razi Clinical Research Development Unit, Razi HospitalGuilan University of Medical SciencesRashtIran
| | - Milad Sarafi
- Department of Vascular Surgery, Rasool‐e‐Akram HospitalIran University of Medical SciencesTehranIran
| | | | - Pooyan Ghorbani Vajargah
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Department of Medical‐Surgical Nursing, School of Nursing and MidwiferyGuilan University of Medical SciencesRashtIran
| | - Amirabbas Mollaei
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Department of Medical‐Surgical Nursing, School of Nursing and MidwiferyGuilan University of Medical SciencesRashtIran
| | - Samad Karkhah
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Department of Medical‐Surgical Nursing, School of Nursing and MidwiferyGuilan University of Medical SciencesRashtIran
| | - Poorya Takasi
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Department of Medical‐Surgical Nursing, School of Nursing and MidwiferyGuilan University of Medical SciencesRashtIran
| | - Arman Parvizi
- Anesthesiology Research Center, Department of Anesthesiology, Alzahra HospitalGuilan University of Medical SciencesRashtIran
| | - Soudabeh Haddadi
- Anesthesiology Research Center, Department of Anesthesiology, Alzahra HospitalGuilan University of Medical SciencesRashtIran
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16
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Mahmoudirad G, Nasiri A, Eslamialiabadi H. Response to Letter to the Editor: 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(2):452-458. J Burn Care Res 2023; 44:1262. [PMID: 37423713 DOI: 10.1093/jbcr/irad097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Affiliation(s)
- Gholamhosein Mahmoudirad
- Professor of Nursing, Department of Nursing, School of Nursing and Midwifery, Birjand University of Medical Sciences, Iran
| | - Ahmad Nasiri
- Professor of Nursing, Department of Nursing, School of Nursing and Midwifery, Birjand University of Medical Sciences, Iran
| | - Hassan Eslamialiabadi
- Assistant Professor of Nursing, Department of Nursing, Ferdows Faculty of Medical Sciences, Birjand University of Medical Sciences, Iran
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17
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Obaidi N, Keenan C, Chan RK. Burn Scar Management and Reconstructive Surgery. Surg Clin North Am 2023; 103:515-527. [PMID: 37149387 DOI: 10.1016/j.suc.2023.01.012] [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: 05/08/2023]
Abstract
This chapter highlights the importance of a comprehensive burn scar treatment plan in approaching a burn survivor. General concepts of burn scar physiology and a practical system to describe burn scars based on cause, biology, and symptoms are presented. Common scar management modalities including nonsurgical, surgical, and adjuvant therapies are further discussed.
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Affiliation(s)
- Noor Obaidi
- The Metis Foundation, 84 NorthEast 410 Loop, STE 325, San Antonio, TX 78216, USA
| | - Corey Keenan
- The Metis Foundation, 84 NorthEast 410 Loop, STE 325, San Antonio, TX 78216, USA
| | - Rodney K Chan
- The Metis Foundation, 84 NorthEast 410 Loop, STE 325, San Antonio, TX 78216, USA; United States Army Institute of Surgical Research, Fort Sam Houston, TX, USA.
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18
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Mehta K, Thrikutam N, Hoyte-Williams PE, Falk H, Nakarmi K, Stewart B. Epidemiology and Outcomes of Cooking- and Cookstove-Related Burn Injuries: A World Health Organization Global Burn Registry Report. J Burn Care Res 2023; 44:508-516. [PMID: 34850021 PMCID: PMC10413420 DOI: 10.1093/jbcr/irab166] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Indexed: 11/13/2022]
Abstract
Cooking- and cookstove-related burns (CSBs) comprise a large proportion of burn injuries globally, but there are limited data on cooking behavior patterns to inform prevention and advocacy. Therefore, we aimed to describe the epidemiology, risk factors, and outcomes of these injuries and highlight the potential of the World Health Organization (WHO) Global Burn Registry (GBR). Patients with cooking-related burns were identified in the WHO GBR. Patient demographics, cooking arrangement, injury characteristics, and outcomes were described and compared. Bivariate regression was performed to identify risk factors associated with CSBs. Analysis demonstrated that 25% of patients in the GBR sustained cooking-related burns (n = 1723). The cooking environment and cooking fuels used varied significantly by country income level ([electricity use: LIC 1.6 vs MIC 5.9 vs HIC 49.6%; P < .001] [kerosene use: LIC 5.7 vs MIC 10.4 vs HIC 0.0%; P < .001]). Of cooking-related burns, 22% were cookstove-related burns (CSBs; 311 burns). Patients with CSBs were more often female (65% vs 53%; P < .001). CSBs were significantly larger in TBSA size (30%, IQR 15-45 vs 15%, IQR 10-25; P < .001), had higher revised Baux scores (70, IQR 46-95 vs 28, IQR 10-25; P < .001) and more often resulted in death (41 vs 11%; P < .001) than other cooking burns. Patients with CSBs were more likely to be burned by fires (OR 4.74; 95% CI 2.99-7.54) and explosions (OR 2.91, 95% CI 2.03-4.18) than other cooking injuries. Kerosene had the highest odds of CSB compared to other cooking fuels (OR 2.37, 95% CI 1.52-3.69). In conclusion, CSBs specifically have different epidemiology than cooking-related burns. CSBs were more likely caused by structural factors (eg, explosion, fire) than behavioral factors (eg, accidental movements) when compared to other cooking burns. These differences suggest prevention interventions for CSBs may require distinctive efforts than typically deployed for cooking-related injuries, and necessarily involve cookstove design and safety regulations to prevent fires and explosions.
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Affiliation(s)
- Kajal Mehta
- Department of Surgery, University of Washington, Seattle, USA
| | | | - Paa Ekow Hoyte-Williams
- Department of Surgery, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Reconstructive Plastic Surgery and Burns Unit, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Henry Falk
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Kiran Nakarmi
- Department of Burns, Plastic, and Reconstructive Surgery, Kirtipur Hospital, Public Health Concern Trust-Nepal,Kathmandu, Nepal
| | - Barclay Stewart
- Division of Trauma, Burn, and Critical Care Surgery, Department of Surgery, University of Washington, UW Medicine Regional Burn Center, Seattle, USA
- Harborview Injury Prevention & Research Center, Seattle, Washington, USA
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19
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Mekeres GM, Buhaș CL, Csep AN, Beiușanu C, Andreescu G, Marian P, Cheregi CD, Fodor R, Manole F. The Importance of Psychometric and Physical Scales for the Evaluation of the Consequences of Scars-A Literature Review. Clin Pract 2023; 13:372-383. [PMID: 36961059 PMCID: PMC10037630 DOI: 10.3390/clinpract13020034] [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: 01/17/2023] [Revised: 02/22/2023] [Accepted: 03/01/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND Scars affect patients after trauma, burns, or surgical procedures and can generate both physical and psychosocial changes. The aesthetic damage represents the modification of a person's physical appearance, in its bodily integrity, causing numerous sufferings and determining social or economic consequences. The aim of this research is to evaluate the advantages and disadvantages offered by the available psychosocial and physical scar scales in assessing the physical, aesthetic, psychosocial, and juridical consequences of scars. This will aid to inform medical examiners about the most valued existing scales to allow them to select the most appropriate instrument to manage their patient. METHODS A broad search of relevant scientific studies on the psychosocial determinants of post-traumatic and surgical scars was conducted by using the following international database tools: PsycINFO, MedLine Social Science Index, Scopus, Web of Science, published from 1960 until 2022. RESULTS We analyzed 63 scientific studies to assess the advantages and limits of several psychometric and physical scar evaluation scales. CONCLUSIONS The researchers analyzed in this review highlight the advantages and limitation of existing instruments, evidencing the demand for future scar evaluation instruments and a scar-assessing algorithm that takes into account the physical, aesthetic, psychosocial, and legal consequences of scars.
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Affiliation(s)
- Gabriel Mihai Mekeres
- Doctoral School of Biomedical Sciences, University of Oradea, Faculty of Medicine and Pharmacy, 410087 Oradea, Romania
| | - Camelia Liana Buhaș
- Morphological Disciplines Department, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania
- Department of Legal Medicine, County Clinical Emergency Hospital of Oradea, 410169 Oradea, Romania
| | - Andrei Nicolae Csep
- Medical Disciplines Department, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania
| | - Corina Beiușanu
- Morphological Disciplines Department, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania
| | - Gineta Andreescu
- Morphological Disciplines Department, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania
| | - Paula Marian
- Medical Disciplines Department, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania
| | - Cornel Dragoș Cheregi
- Surgical Disciplines Department, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania
| | - Radu Fodor
- Doctoral School of Biomedical Sciences, University of Oradea, Faculty of Medicine and Pharmacy, 410087 Oradea, Romania
| | - Felicia Manole
- Surgical Disciplines Department, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania
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20
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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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21
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Salas-Gianini MA, Ahumada FV, Peruilh-Bagolini L, Highet PSM. Manejo quirúrgico de la hipopigmentación crónica post-quemadura. Revisión sistemática. REVISTA MÉDICA CLÍNICA LAS CONDES 2023. [DOI: 10.1016/j.rmclc.2023.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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22
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Chen J, Zhang D, Zhang J, Wang Y. Pathological changes in the brain after peripheral burns. BURNS & TRAUMA 2023; 11:tkac061. [PMID: 36865685 PMCID: PMC9972189 DOI: 10.1093/burnst/tkac061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 12/22/2022] [Indexed: 02/09/2023]
Abstract
Brain injuries are common complications in patients with thermal burns and are associated with unpleasant outcomes. In clinical settings, it was once believed that brain injuries were not major pathological processes after burn, at least in part due to the unavailability of specific clinical manifestations. Burn-related brain injuries have been studied for more than a century, but the underlying pathophysiology has not been completely clarified. This article reviews the pathological changes in the brain following peripheral burns at the anatomical, histological, cytological, molecular and cognitive levels. Therapeutic indications based on brain injury as well as future directions for research have been summarized and proposed.
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Affiliation(s)
- Jigang Chen
- Department of Burn and Plastic Surgery, Beijing Children’s Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Danfeng Zhang
- Department of Neurosurgery, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
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23
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Allahham A, Cooper MN, Fear MW, Martin L, Wood FM. Quality of life in paediatric burn patients with non-severe burns. Burns 2023; 49:220-232. [PMID: 35410696 DOI: 10.1016/j.burns.2022.03.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 02/28/2022] [Accepted: 03/16/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Burns are common worldwide, and the vast majority are non-severe burns of less than 20% of the total body surface area (TBSA). In Australia, paediatric burns account for a third of all burn admissions, thus understanding the quality-of-life outcomes after a non-severe burn in children is important. METHODS This retrospective cohort study describes a paediatric cohort from Western Australia with non-severe burns occurring between 2018 and 2020 and characterises the child's quality-of-life outcomes which is measured using the Paediatric quality of life survey (PedsQL). The PedsQL included a parent-report and child-report assessment, each with a physical function domain and a psychosocial function domain which comprised of an emotional, a social and a school category. RESULTS Data collected from 249 patients; 50.6% were male, 45.6% were toddlers. The most common cause was scald (48.19%), the majority had burns smaller than 5% TBSA (91.97%), and most included visible areas such as head, neck or hands (77.51%). The parent-report PedsQL scores were significantly different for both physical and psychosocial domains between the different age groups (p = 0.002, p = 0.001, respectively) and for burn cause (p = 0.004, p = 0.005, respectively). For child-reported scores we found evidence of an effect of burn cause across both domains that did not reach a statistical significance (p = 0.076, p = 0.078, respectively). The psychosocial functions in both the parent-report and the self-report were significantly different for the socioeconomic status groups (p = 0.015, p = 0.032, respectively). Quality of life scores were critically low in 16.46% of paediatric burn patients at three months after burn. CONCLUSION Parent-reported and child-reported psychosocial function was significantly poorer in higher socioeconomic groups, for older children and for those with flame burns. About 16% of patients had scores below the critical cut off. These data provide insight into the quality-of-life outcomes of paediatric patients with non-severe burns, allowing future studies to investigate burn prevention strategies and services to help paediatric burn patients in their recovery.
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Affiliation(s)
- Amira Allahham
- University of Western Australia, Burn Injury Research Unit, 35 Stirling Highway, Crawley, Western Australia 6009, Australia
| | - Matthew N Cooper
- Telethon Kids Institute, University of Western Australia, 15 Hospital Ave, Nedlands, Western Australia 6009, Australia
| | - Mark W Fear
- University of Western Australia, Burn Injury Research Unit, 35 Stirling Highway, Crawley, Western Australia 6009, Australia; Fiona Wood Foundation, 11 Robin Warren Dr, Murdoch, WA 6150, Australia
| | - Lisa Martin
- University of Western Australia, Burn Injury Research Unit, 35 Stirling Highway, Crawley, Western Australia 6009, Australia; Fiona Wood Foundation, 11 Robin Warren Dr, Murdoch, WA 6150, Australia.
| | - Fiona M Wood
- University of Western Australia, Burn Injury Research Unit, 35 Stirling Highway, Crawley, Western Australia 6009, Australia; Fiona Wood Foundation, 11 Robin Warren Dr, Murdoch, WA 6150, Australia; Burn Service of Western Australia, Fiona Stanley Hospital, MNH (B) Main Hospital, Level 4, Burns Unit, 102-118 Murdoch Drive, Murdoch, Western Australia 6150, Australia; Burns Unit, Perth Children's Hospital, 15 Hospital Ave, Nedlands, WA 6009 Australia.
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Alam MS, Ansari A, Ahsan I, Shafiq-Un-Nabi S, Md S, Shaik RA, Eid BG, Ahmad MZ, Ahmad J. Topical gel containing Polysiloxanes and hyaluronic acid for skin scar: Formulation design, characterization, and In vivo activity. J Cosmet Dermatol 2023; 22:1220-1232. [PMID: 36606411 DOI: 10.1111/jocd.15574] [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: 08/23/2022] [Revised: 11/21/2022] [Accepted: 12/06/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Scar formation is undesirable both cosmetically and functionally. It shows that silicone gel is effective in preventing and improving scars formed due to a wound formation after injury. OBJECTIVES This study investigates whether a silicone gel composition based on a novel concept of infusing a biologically active material such as hyaluronic acid and/or salts with various polysiloxane derivatives in a specific proportion to achieve desired viscosity range and their action has a synergistic beneficial effect on skin scar after injury. METHODS We have developed a topical gel utilizing a combination of emulsifiers, sodium hyaluronate, polysiloxane, and its derivatives. The method of preparation comprises mixing of aqueous phase dispersion and polysiloxanes blend under stirring at room temperature. RESULTS It results in the formation of a homogenous smooth gel formulation. The developed topical gel formulation was characterized for physicochemical properties, rheology, stability, and anti-scar activity in Wistar rats. It was found that the developed formulation system consists of desirable attributes for skin applications. In vivo investigation of developed polysiloxane gel formulation for anti-scar activity shown promising outcomes compared to marketed product (Kelo-cote scar gel). Furthermore, a histopathology study of healed skin tissues observed the formation of microscopic skin structures compared to the Kelo-cote scar gel. CONCLUSIONS It indicates that the combination of polysiloxanes and sodium hyaluronate resulting an improvement in anti-scar activity compared to the marketed product containing polysiloxanes alone.
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Affiliation(s)
- Md Shoaib Alam
- Research and Development, Jamjoom Pharmaceuticals, Jeddah, Saudi Arabia
| | - Arif Ansari
- Research and Development, Jamjoom Pharmaceuticals, Jeddah, Saudi Arabia
| | - Iftikhar Ahsan
- Research and Development, Jamjoom Pharmaceuticals, Jeddah, Saudi Arabia
| | | | - Shadab Md
- Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Rasheed A Shaik
- Department of Pharmacology & Toxicology, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Basma G Eid
- Department of Pharmacology & Toxicology, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammad Zaki Ahmad
- Department of Pharmaceutics, College of Pharmacy, Najran University, Najran, Saudi Arabia
| | - Javed Ahmad
- Department of Pharmaceutics, College of Pharmacy, Najran University, Najran, Saudi Arabia
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Dahm S, Lee G, Cleland H, Menezes H, Ng S. The use of carbon dioxide and intense pulsed light laser for the treatment of hypertrophic burn scars: A case series. Scars Burn Heal 2023; 9:20595131231202103. [PMID: 38022893 PMCID: PMC10655654 DOI: 10.1177/20595131231202103] [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] [Indexed: 12/01/2023] Open
Abstract
Introduction Hypertrophic scarring is a common and debilitating consequence of burn scars. While there is limited evidence for current treatment options, laser therapy has been shown to be effective, low risk and minimally invasive. This study assesses the use of carbon dioxide lasers and intense pulsed light devices in the treatment of hypertrophic burn scars. Methods In this case series, patients were recruited from a hypertrophic burn scar waitlist and completed a Patient and Observer Scar Assessment Scale prior to and six weeks after laser therapy. The Nordlys (intense pulsed light) and CO2RE (carbon dioxide) systems from Candela Medical were used, with a range of settings used depending on the assessment of the burn scar. The differences between scores were calculated for the total Patient and Observer Scar Assessment Scale score, pain, itch, colour, stiffness, thickness, irregularity and the overall opinion of the scar. Statistical analysis was completed using a paired, two-tailed student T test. Results A total of 31 patients were recruited for this trial with a range of scar locations, surface areas and mechanism of burn injury. The calculated difference in mean showed a significant reduction for the overall Patient and Observer Scar Assessment Scale score (1.93, p < 0.0001), pain (1.39, p = 0.0002), itch (1.84, p = 0.0002), colour (1.97, p < 0.0001), stiffness (2.47, p < 0.0001), thickness (2.1, p < 0.0001), irregularity (1.89, p < 0.0001) and overall opinion (1.58, p = 0.0003). Conclusion Current management options for hypertrophic scarring have limited evidence. Laser therapy presents a minimally invasive procedure that can be completed under topical anaesthetic and has shown to be effective following a single treatment of combined carbon dioxide laser and intense pulsed light device therapy. Lay Summary Many people will suffer a burn injury throughout their life and up to almost 3 out of 4 people with burn injuries will suffer from hypertrophic scars (a thickened, red and itchy scar). These scars cause distress both due to their appearance and their reduction of function, particularly over a joint or muscle. Laser therapy, in which different wave lengths of light (pulsed light) or gas (carbon dioxide) target the scar, has been found to be effective and have minimal side effects in the management of hypertrophic scars. While individual lasers have been assessed and found to be effective and low risk, the combined use of multiple lasers on the same scar has not been extensively studied. We studied the effectiveness of both light and gas laser therapies on hypertrophic scars. Patients with hypertrophic scars completed a questionnaire that focused on their perspective of their scar (pain, itch, stiffness, thickness, irregularity, overall opinion) prior to the treatment. The patients then underwent laser therapy (with local anaesthetic gel) with either pulsed light and/or carbon dioxide (gas) laser. The type of laser used was decided by the clinician performing the therapy depending on scar location and thickness. Patients then re-completed the subjective survey six weeks following the laser therapy, and the results compared. We learnt that laser therapy (both light, gas and a combination of both) are effective (and low risk) in reducing the subjective burden of the scar for the patient.
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Affiliation(s)
- Sophia Dahm
- Victorian Adult Burns Service, Alfred Hospital, Melbourne, Australia
| | - Geoffrey Lee
- Victorian Adult Burns Service, Alfred Hospital, Melbourne, Australia
| | - Heather Cleland
- Victorian Adult Burns Service, Alfred Hospital, Melbourne, Australia
| | - Hana Menezes
- Victorian Adult Burns Service, Alfred Hospital, Melbourne, Australia
| | - Sally Ng
- Victorian Adult Burns Service, Alfred Hospital, Melbourne, Australia
- Department of Plastic and Reconstructive Surgery, Austin Health, Melbourne, Australia
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Qiao Y, Zhang Q, Peng Y, Qiao X, Yan J, Wang B, Zhu Z, Li Z, Zhang Y. Effect of stem cell treatment on burn wounds: A systemic review and a meta-analysis. Int Wound J 2023; 20:8-17. [PMID: 35560869 PMCID: PMC9797938 DOI: 10.1111/iwj.13831] [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] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 04/19/2022] [Accepted: 04/21/2022] [Indexed: 01/07/2023] Open
Abstract
A meta-analysis was performed to evaluate the effect of stem cells treatment in managing burn wounds. A systematic literature search up to March 2022 incorporated 24 studies reported between 2013 and 2021 including 400 animals with burn wounds at the beginning of the study; 211 were using stem cells treatment, and 189 controlled. Statistical tools like the contentious method were used within a random or fixed-influence model to establish the mean difference (MD) with 95% confidence intervals (CIs) to evaluate the influence of stem cells treatment in managing burn wounds. Stem cells treatment had a significantly higher burn wound healing rate (MD, 15.18; 95% CI, 11.29-19.07, P < .001), higher blood vessel number (MD, 12.28; 95% CI, 10.06-14.51, P < .001), higher vascular endothelial growth factor (MD, 10.24; 95% CI, 7.19-13.29, P < .001), lower interleukin-1 level (MD, -98.48; 95% CI, -155.33 to -41.63, P < .001), and lower tumour necrosis factor α level (MD, -28.71; 95% CI, -46.65 to -10.76, P < .002) compared with control in animals' models with burn wounds. Stem cells treatment had a significantly higher burn wound healing rate, higher blood vessel number, higher vascular endothelial growth factor, lower interleukin-1 level, and lower tumour necrosis factor α level compared with control in animals' models with burn wounds. Further studies are required to validate these findings.
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Affiliation(s)
- Yating Qiao
- Department of Gastrointestinal SurgeryAffiliated Hospital of Hebei UniversityBoadingChina
| | - Qingrong Zhang
- Department of Burn and Plastic SurgeryAffiliated Hospital of Nantong UniversityNantongChina
| | - Ying Peng
- Department of Burn and Plastic SurgeryAffiliated Hospital of Nantong UniversityNantongChina
| | | | - Jun Yan
- Department of Burn and Plastic SurgeryAffiliated Hospital of Nantong UniversityNantongChina
| | - Bolin Wang
- Department of Burn and Plastic SurgeryAffiliated Hospital of Nantong UniversityNantongChina
| | - Zhihan Zhu
- Department of Burn and Plastic SurgeryAffiliated Hospital of Nantong UniversityNantongChina
| | - Zihan Li
- Department of Burn and Plastic SurgeryAffiliated Hospital of Nantong UniversityNantongChina
| | - Yi Zhang
- Department of Burn and Plastic SurgeryAffiliated Hospital of Nantong UniversityNantongChina
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Doomen MCHA, Rijpma D, Pijpe A, Meij-de Vries A, Niessen FB, Karaoglu S, de Vet HCW, Gevers T, van Zuijlen PPM. A clinimetric assessment of the validity and reliability of 3D technology for scar surface area measurement. Burns 2022; 49:583-594. [PMID: 36764836 DOI: 10.1016/j.burns.2022.12.008] [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: 11/11/2021] [Revised: 11/30/2022] [Accepted: 12/19/2022] [Indexed: 12/25/2022]
Abstract
INTRODUCTION The quality of scars has become an important outcome of burn care. Objective scar assessment through scar surface area measurement enables quantification of scar formation and evaluation of treatment efficacy. 3D technology has proven valid and reliable but often remains cumbersome, expensive, and time-consuming. 3D technology with depth sensors on mobile devices has become available and might surpass these limitations. This study provides a clinimetric assessment of the validity and reliability of a 3D system with a depth sensor for scar surface area measurement. METHODS A technology involving a depth sensor mounted on a mobile device was used. Images and analyses were made with a custom-made software application. A standardized one-keyframe image capturing procedure was followed. To assess validity, stickers with predefined dimensions (8.01 cm2 - 77.70 cm2) were imaged in a single observer setting on various body parts of healthy volunteers. To assess reliability, hypertrophic scars, keloids, and normotrophic scars were imaged and rated by two observers independently. Data are expressed as mean (+/-SD), Coefficient of Variation (CV), Intraclass Correlation Coefficients (ICC), and Limits of Agreements (LoA). RESULTS Eighty stickers placed on 20 healthy volunteers showed validity with CV between 0.62%- 1.67% for observer A and 0.75%- 1.19% for observer B. For the reliability study, 69 scars on 36 patients were included. Mean scar surface area ranged from 0.83 cm2 to 155.59 cm2. Mean scar surface area measurement was 13.83 cm2 (SD 23.06) for observer A and 13.59 cm2 (SD 23.31) for observer B. Adjusted interobserver CV for trained observers is estimated as 5.59%, with corresponding LoA = 0 ± 0.15 x mean surface area. Interobserver ICCs were 0.99-1.00. CONCLUSION This 3D technology with a depth sensor for measuring scar surface area provides valid and reliable data and thereby surpasses expensive and time-consuming 3D cameras.
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Affiliation(s)
- M C H A Doomen
- Burn Center, Red Cross Hospital, Beverwijk, the Netherlands; Association of Dutch Burn Centers, Beverwijk 1941 AJ, the Netherlands; Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Plastic Reconstructive and Hand Surgery, De Boelelaan 1117, Amsterdam, Netherlands; Amsterdam Movement Sciences, Tissue Function and Regeneration, Amsterdam, the Netherlands
| | - D Rijpma
- Burn Center, Red Cross Hospital, Beverwijk, the Netherlands; Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Plastic Reconstructive and Hand Surgery, De Boelelaan 1117, Amsterdam, Netherlands; Amsterdam Movement Sciences, Tissue Function and Regeneration, Amsterdam, the Netherlands.
| | - A Pijpe
- Burn Center, Red Cross Hospital, Beverwijk, the Netherlands; Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Plastic Reconstructive and Hand Surgery, De Boelelaan 1117, Amsterdam, Netherlands; Amsterdam Movement Sciences, Tissue Function and Regeneration, Amsterdam, the Netherlands
| | - A Meij-de Vries
- Burn Center, Red Cross Hospital, Beverwijk, the Netherlands; Department of Surgery, Red Cross Hospital, Beverwijk, the Netherlands; Amsterdam UMC location University of Amsterdam, Paediatric Surgical Centre, Emma Children's Hospital, Meibergdreef 9, Amsterdam, Netherlands
| | - F B Niessen
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Plastic Reconstructive and Hand Surgery, De Boelelaan 1117, Amsterdam, Netherlands
| | - S Karaoglu
- 3DUniversum, 1098 XH Amsterdam, the Netherlands
| | - H C W de Vet
- Amsterdam UMC location Vrije Universiteit Amsterdam, Epidemiology and Data Science, De Boelelaan1117, Amsterdam, the Netherlands
| | - T Gevers
- 3DUniversum, 1098 XH Amsterdam, the Netherlands
| | - P P M van Zuijlen
- Burn Center, Red Cross Hospital, Beverwijk, the Netherlands; Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Plastic Reconstructive and Hand Surgery, De Boelelaan 1117, Amsterdam, Netherlands; Amsterdam UMC location University of Amsterdam, Paediatric Surgical Centre, Emma Children's Hospital, Meibergdreef 9, Amsterdam, Netherlands; Department of Plastic, Reconstructive & Hand Surgery, Red Cross Hospital, Beverwijk, the Netherlands; Amsterdam Movement Sciences, Tissue Function and Regeneration, Amsterdam, the Netherlands.
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Prognostic Analysis of Skin Scar Loosening and Tissue-Expansive Autologous Skin Grafting in the Treatment of Skin Postburn Scars. J Craniofac Surg 2022:00001665-990000000-00509. [DOI: 10.1097/scs.0000000000009149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 10/11/2022] [Indexed: 12/23/2022] Open
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Vacuum and Electromagnetic Fields Treatment to Regenerate a Diffuse Mature Facial Scar Caused by Sulfuric Acid Assault. BIOENGINEERING (BASEL, SWITZERLAND) 2022; 9:bioengineering9120799. [PMID: 36551005 PMCID: PMC9774184 DOI: 10.3390/bioengineering9120799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/05/2022] [Accepted: 12/12/2022] [Indexed: 12/15/2022]
Abstract
Acid attacks are on the rise, and they cause extensive and deep burns, especially on the face. The treatments used to improve the aesthetic, functional and social impact of non-acid scars do not always prove useful for acid scars. This article reports the case of a woman with an extended, mature, acid facial scar, caused by sulfuric acid assault, treated with a recent new procedure that combines the application of vacuum and electromagnetic fields. Before and after the treatment, the aesthetic appearance, and motor function of the face and neck were evaluated, as well as the level of hydration, the amount of sebum, the elasticity, and the pH of the skin. The improvements highlighted after the treatment of the aesthetic and functional characteristics of the face and neck, and of the physical parameters of the skin seemed to indicate that this particular treatment induces tissue regeneration, even in the nerve component. However, it is evident that the rehabilitation pathways of facial wounds and scars must be personalized, and must include continuous psychological support for the patient.
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30
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Are burn patients satisfied with anesthesia in enzymatic debridement? Burns 2022; 48:2002-2003. [PMID: 36137883 DOI: 10.1016/j.burns.2022.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 09/13/2022] [Indexed: 11/22/2022]
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Lin Y, Lv W, Xu J, Jiang Y, Chen Z. Effectiveness of Cognitive Behavior Therapy Combined with Eye Movement Desensitization and Reprocessing on Psychological Problems and Life Quality in Patients' Postfacial Trauma. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:7822847. [PMID: 36118833 PMCID: PMC9473919 DOI: 10.1155/2022/7822847] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 08/22/2022] [Accepted: 08/26/2022] [Indexed: 11/22/2022]
Abstract
Objective To investigate the effectiveness of cognitive behavior therapy (CBT) combined with eye movement desensitization and reprocessing (EMDR) on the esteem, anxiety, depression, posttrauma stress disorder (PTSD), and posttraumatic growth in patients with facial trauma. Methods A total of 92 facial trauma patients in Wenzhou People's Hospital from January 2017 to December 2019 were enrolled in this study. The patients were randomly divided into control group (n = 46) and intervention group (n = 46). Both of the control group and the intervention group received routine treatment, while the intervention group further received CBT combined with EMDR. Questionnaires were used to explore and record the general patient information. The Self-Esteem Scale (SES), Self-Anxiety Scale (SAS), Self-Depression Scale (SDS), Posttraumatic Stress Disorder Checklist Civilian Version (PCL-C), Posttraumatic Growth Inventory (PTGI), and World Health Organization Quality of Life-brief (WHOQOL-BREF) scores between the two groups were compared. Results After CBT combined with EMDR intervention, the SDS and SAS scores in the intervention group were significantly decreased compared with the scores before intervention with statistically significance (P < 0.001). Furthermore, the PCL-C score in the intervention group showed significant decrease in comparison with the control group (P < 0.001), while the PTGI score in the intervention group was significantly higher than the control group (P < 0.001). The WHOQOL-BREF scores were increased after treatment in the two groups compared with the scores before treatment, and the scores in the intervention group were higher than those in the control group after treatment (P < 0.01). Conclusion Psychological intervention therapy can effectively alleviate the anxiety, depression, and PTSD and improve the life quality and the recovery of facial trauma patients.
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Affiliation(s)
- Yue Lin
- Department of Emergency, Wenzhou People's Hospital, Wenzhou, Zhejiang 325000, China
| | - Wang Lv
- Department of Emergency, Wenzhou People's Hospital, Wenzhou, Zhejiang 325000, China
| | - Jun Xu
- Department of Endoscopy Center, Wenzhou People's Hospital, Wenzhou, Zhejiang 325000, China
| | - Yingying Jiang
- Department of Emergency, Wenzhou People's Hospital, Wenzhou, Zhejiang 325000, China
| | - Zheyan Chen
- Department of Plastic Surgery, Wenzhou People's Hospital, Wenzhou, Zhejiang 325000, China
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Ding J, Chu F, Tang Y, Liu S, Zeng X, Yang Q, Ma X. Reconstruction of facial defects using a pre-expanded scalp flap: A description of the method used and outcomes of 43 patients. Front Surg 2022; 9:962737. [PMID: 36003283 PMCID: PMC9393413 DOI: 10.3389/fsurg.2022.962737] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 07/21/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundA technique for reconstructing facial units with matching colour, similar texture and sufficient contour is ideal for patients with various facial defects. The current report aimed to present the experience of the authors in facial reconstruction using pre-expanded scalp flaps combined with laser hair removal.MethodsFrom January 2014 to August 2021, 43 patients with different facial defects, such as post-burn scar and congenital nevus, were treated using this surgical technique that involved tissue expansion, scalp flap transfer and laser hair removal. Facial defects were artificially classified into three regions (forehead, n = 19; cheek, n = 15; and lips and chin, n = 9). Pedicle delaying and division were performed in patients who underwent reconstruction with pedicled flaps.ResultsOf the included patients, one presented with haematoma, one with infection and three had distal necrosis after expanded scalp flap transfer. The donor site was primarily closed in all patients. Further, all patients were successfully treated without major complications. The texture, colour and contour of the scalp flap after laser hair removal matched well with the surrounding skin tissues at 2–30-month follow-up.ConclusionReconstruction using pre-expanded scalp flaps combined with laser hair removal is an effective and reliable option for facial reconstruction with excellent colour and texture match.
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Affiliation(s)
- Jianke Ding
- Department of Plastic and Reconstructive Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Feifei Chu
- Department of Plastic and Reconstructive Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Yinke Tang
- Department of Plastic and Reconstructive Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Shiqiang Liu
- Department of Burn and Plastic Surgery, PLA No. 983 Hospital, Tianjin, China
| | - Xianhui Zeng
- Department of Plastic and Reconstructive Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Qing Yang
- Department of Plastic and Reconstructive Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Xianjie Ma
- Department of Plastic and Reconstructive Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
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Yatagai N, Hasegawa T, Kyotani K, Noda T, Amano R, Saito I, Arimoto S, Takeda D, Kakei Y, Akashi M. Exploratory clinical trial to evaluate the efficacy and safety of carbon dioxide paste in healthy people. Medicine (Baltimore) 2022; 101:e29511. [PMID: 35866800 PMCID: PMC9302358 DOI: 10.1097/md.0000000000029511] [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: 01/04/2023] Open
Abstract
INTRODUCTION Scarring and pain are postoperative complications in patients after head and neck cancer treatment; however, there is no effective treatment. These complications are affected by local blood flow disorders, and it is well known that the transcutaneous application of carbon dioxide (CO2) improves local blood flow. Previously, we have shown that the transcutaneous application of carbon dioxide causes absorption of CO2 and increase the oxygen (O2) pressure in the treated tissue; it is expected that the application of CO2 may reduce scarring and pain caused by cancer treatment. We newly introduced the CO2 paste as a new CO2 application method, which does not need to use CO2 gas directly. In this study, we aimed to apply of CO2 paste to healthy people and to investigate its usefulness, safety and feasibility by analysing the increase in blood flow and frequency of adverse events. METHODS We applied carbon dioxide paste to skin over the sternocleidomastoid and gastrocnemius muscles of eight healthy volunteers. The changes in blood flow before and after the CO2 paste application using dynamic MRI, and changes in the vital signs were evaluated. RESULTS In the neck area and middle layer of the lower leg, the signal intensity (SI) significantly increased 60 seconds after application. In the surface layer of the lower leg, the SI was significantly increased 60 and 300 seconds after paste application. Although mild heat was noted after the paste application, no obvious adverse events occurred. CONCLUSION We demonstrated the increase in SI by dynamic MRI at the site of the carbon dioxide paste application, which indicates the paste application is effective in improving the blood flow.
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Affiliation(s)
- Nanae Yatagai
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Takumi Hasegawa
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
- *Correspondence: Takumi Hasegawa, Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan (e-mail: )
| | - Katsusuke Kyotani
- Center for Radiology and Radiation Oncology, Kobe University Hospital, Kobe, Japan
| | - Tomohiro Noda
- Center for Radiology and Radiation Oncology, Kobe University Hospital, Kobe, Japan
| | - Rika Amano
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Izumi Saito
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Satomi Arimoto
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Daisuke Takeda
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Yasumasa Kakei
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Masaya Akashi
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
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Chen Z, Zhang M, Xie S, Zhang X, Tang S, Zhang C, Li H. Global burden of thermal burns, 1990-2017: Unbalanced distributions and temporal trends assessed from the Global Burden of Disease Study 2017. Burns 2022; 48:915-925. [PMID: 34916089 DOI: 10.1016/j.burns.2021.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 07/28/2021] [Accepted: 08/02/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Many studies demonstrate that being burned has both physical and psychological sequelae that affect quality of life. Further, these effects may be more prevalent in some regions and populations. We sought to access the unbalanced distributions and temporal trends concerning the health burden of thermal burns. METHODS Data were collected from the Global Burden of Disease Study 2017, and the disability-adjusted life year (DALY)1 was used as a measure of health burden. Linear regression was used to evaluate the relationship between the age-standardized DALY rate and socio-demographic index.2 Joinpoint regression analysis and comparison line charts were all applied to assess the temporal trends of burns. RESULTS The age-standardized DALY rate of global thermal burns decreased by 43.7%, from 197 (95% CI: 152-228) per 100,000 in 1990 to 111 (95% CI: 93-129) per 100,000 in 2017. The burden was borne mainly by children 1-4 years of age and people over 80 years. Socio-demographic index was negatively correlated with the age-standardized DALY rate. In low-middle and low socio-demographic index regions, the decreasing trends were slower than other regions with an average annual percentage change of -2.1% (95% CI: -2.2 to -2.0) and -2.1% (95% CI: -2.1 to -2.0), respectively. Among six geographical regions, Africa presented the highest age-standardized DALY rates of 352 (95% CI: 275-410) per 100,000 in 1990 and 208 (95% CI: 175-236) per 100,000 in 2017, and also the slowest average decreasing trend, with an average annual percentage change of -1.9% (95% CI: -2 to -1.8). CONCLUSIONS The global burden of thermal burns shows a downward trend from 1990 to 2017, and regions with lower socio-demographic index and Africa show greater burdens and smaller downward trends.
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Affiliation(s)
- Zeshan Chen
- Department of Plastic Surgery and Burn Center, The Second Affiliated Hospital, Shantou University Medical College, North Dongxia Road, Shantou 515041, Guangdong Province, China
| | - Mingjun Zhang
- Department of Plastic Surgery and Burn Center, The Second Affiliated Hospital, Shantou University Medical College, North Dongxia Road, Shantou 515041, Guangdong Province, China
| | - Sitian Xie
- Department of Plastic Surgery and Burn Center, The Second Affiliated Hospital, Shantou University Medical College, North Dongxia Road, Shantou 515041, Guangdong Province, China
| | - Xiang Zhang
- Department of Wound Repair and Dermatologic Surgery, Taihe Hospital, Hubei University of Medicine, 32 South Renmin Road, Shiyan 442000, Hubei Province, China
| | - Shijie Tang
- Department of Plastic Surgery and Burn Center, The Second Affiliated Hospital, Shantou University Medical College, North Dongxia Road, Shantou 515041, Guangdong Province, China
| | - Cuiping Zhang
- Research Center for Tissue Repair and Regeneration Affiliated to the Medical Innovation Research Department and Fourth Medical Center of PLA General Hospital, Beijing 100048, China
| | - Haihong Li
- Department of Plastic Surgery and Burn Center, The Second Affiliated Hospital, Shantou University Medical College, North Dongxia Road, Shantou 515041, Guangdong Province, China
- Department of Wound Repair and Dermatologic Surgery, Taihe Hospital, Hubei University of Medicine, 32 South Renmin Road, Shiyan 442000, Hubei Province, China
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De Decker I, De Graeve L, Hoeksema H, Monstrey S, Verbelen J, De Coninck P, Vanlerberghe E, Claes KEY. Enzymatic debridement: past, present, and future. Acta Chir Belg 2022; 122:279-295. [PMID: 35440290 DOI: 10.1080/00015458.2022.2068746] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
INTRODUCTION Early surgical debridement of the deep second and third-degree burns is still the standard of care (SOC) to prepare the wound bed for skin grafting. However, this technique has some drawbacks that explain the growing interest in enzymatic debridement as an alternative. In this article, we provide a historic overview as well as the current state-of-the-art and future prospective of this type of non-surgical debridement. MATERIALS AND METHODS A narrative review of the available literature was conducted using a systematic search. RESULTS A total of 32 articles were included. The only enzyme mixture still used nowadays for burn eschar removal is bromelain-based. There is increasing evidence that this type of enzymatic debridement is a powerful tool to selectively remove the eschar in deep burns, thereby reducing the need for autologous skin grafting compared to surgical SOC. Moreover, off-label use of enzymatic debridement with NexoBrid® (facial, pediatric, and >15%TBSA burns) has proven to be effective and safe. CONCLUSION There is increasing evidence that bedside administered NexoBrid®, preferably under regional anesthesia, is a powerful tool for selective burn eschar removal. However, the clinical wound bed evaluation post-NexoBrid® procedure in relation to the optimal treatment decision-conservative treatment vs. surgery-is not yet completely elucidated. More high-quality prospective clinical trials are necessary to compare enzymatic debridement of objectively confirmed deep burns with the current standard treatment and assess the effectiveness of the eschar removal, the need for surgery, the healing time of such wounds, and the long-term scar quality.
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Affiliation(s)
| | - Liesl De Graeve
- Department of Plastic Surgery, Ghent University Hospital, Ghent, Belgium
| | - Henk Hoeksema
- Burn Center, Ghent University Hospital, Ghent, Belgium
- Department of Plastic Surgery, Ghent University Hospital, Ghent, Belgium
| | - Stan Monstrey
- Burn Center, Ghent University Hospital, Ghent, Belgium
- Department of Plastic Surgery, Ghent University Hospital, Ghent, Belgium
| | | | | | | | - Karel E. Y. Claes
- Burn Center, Ghent University Hospital, Ghent, Belgium
- Department of Plastic Surgery, Ghent University Hospital, Ghent, Belgium
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Paggiaro AO, Paggiaro PBS, Fernandes RAQ, Freitas NO, Carvalho VF, Gemperli R. Posttraumatic stress disorder in burn patient: A systematic review. J Plast Reconstr Aesthet Surg 2022; 75:1586-1595. [PMID: 35361563 DOI: 10.1016/j.bjps.2022.02.052] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 02/13/2022] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Burns often cause severe physical and mental suffering and can become a trigger for the development of permanent psychological diseases, even after wound healing. Posttraumatic stress disorder (PTSD) is one such disorder, which involves the re-experiencing of many symptoms provoked by a previous traumatic situation. METHOD This study is a systematic review of interventions used to reduce or prevent PTSD symptoms in burn victims. We included randomized clinical trials that described therapeutic interventions for the prevention of PTSD in burn patients. The search was conducted in the databases EMBASE and PUBMED/Medline between 2009 and 2020, and the main variables evaluated were%TBSA, age, number of hospitalization days, type of intervention, follow-up time and results. The analysis of the bias risk was carried out according to the guidance in the Cochrane Handbook for Bias Risk Assessment. RESULTS Eight clinical trials were selected: three of them were performed in children, and five involved adults. The most common bias risks were related to participant/researcher blinding and loss of follow-up. Two interventions were identified: a pharmacological intervention and a psychological intervention. Medications (sertraline and propanolol) were not effective in reducing stress symptoms. Four studies used cognitive-behavioral therapies, which achieved the best results for PTSD improvement in burn patients. Hypnosis and an informational education program were also evaluated and did not show success in reducing PTSD. CONCLUSION Cognitive-behavioral therapies may work to reduce PTSD symptoms in burn patients, and when they are adopted early by burn units, they may improve the psychological condition of burn patients.
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Affiliation(s)
- André Oliveira Paggiaro
- Plastic Surgery Department- São Paulo University- Rua Eneas de Carvalho, 255, São Paulo, SP, Brazil Zip code: 05403-010; Nursing Post Graduation- Guarulhos University- Praça Tereza Cristina, 229, Centro - Guarulhos, SP, Brazil Zip code: 07023-070.
| | | | - Rosa Aurea Quintela Fernandes
- Nursing Post Graduation- Guarulhos University- Praça Tereza Cristina, 229, Centro - Guarulhos, SP, Brazil Zip code: 07023-070
| | - Noelle Oliveira Freitas
- Nursing Post Graduation- Guarulhos University- Praça Tereza Cristina, 229, Centro - Guarulhos, SP, Brazil Zip code: 07023-070
| | - Viviane Fernandes Carvalho
- Nursing Post Graduation- Guarulhos University- Praça Tereza Cristina, 229, Centro - Guarulhos, SP, Brazil Zip code: 07023-070
| | - Rolf Gemperli
- Plastic Surgery Department- São Paulo University- Rua Eneas de Carvalho, 255, São Paulo, SP, Brazil Zip code: 05403-010
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Shepherd L, Beveridge A. A tiered approach to inpatient psychosocial screening in an adult UK burns service. Burns 2022; 48:698-702. [PMID: 34120780 DOI: 10.1016/j.burns.2021.05.017] [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: 11/23/2020] [Revised: 05/19/2021] [Accepted: 05/28/2021] [Indexed: 12/15/2022]
Abstract
National guidance in the UK advises that psychosocial screening is completed for all inpatients admitted to burns services for over 24 h. Acceptable methods of psychosocial screening have been nationally agreed. However, little is known about how different services conduct psychosocial screening. Moreover, data related to validity and reliability are lacking. This paper describes a tiered approach to inpatient psychosocial screening in a UK adult burns service and considers implications for services. Data collected over a seven-year period was analysed retrospectively. Of 891 patients, almost half (48%; n = 431) were screened face-to-face by a graduate level assistant psychologist. Almost one quarter (23%, n = 205) were screened face-to-face by a qualified clinical psychologist. Around a fifth (22%, n = 193) were screened indirectly through psychological discussions at multi-disciplinary team meetings with a member of the burns clinical psychology team present. A minority of patients were screened face-to-face by liaison psychiatry, or by both liaison psychiatry and a clinical psychologist. Screening and delivery of low-level psychological interventions by a graduate level assistant psychologist appeared to protect resources of qualified clinical psychologists for the most distressed patients. Results highlight the value and cost-effectiveness of a tiered approach to psychosocial screening and in guiding subsequent intervention. Future study is needed in relation to inpatient psychosocial screening and its validity and reliability. Investigating the predictive value of screening methods in identifying those with longer-term psychological difficulties would also be important clinically.
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Affiliation(s)
- L Shepherd
- Nottingham University Hospitals NHS Trust, Department of Clinical Psychology & Neuropsychology, Queens Medical Centre Campus, Derby Road, Nottingham NG7 2UH, United Kingdom.
| | - A Beveridge
- Nottingham University Hospitals NHS Trust, Department of Clinical Psychology & Neuropsychology, Queens Medical Centre Campus, Derby Road, Nottingham NG7 2UH, United Kingdom
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Self-reported health measures in burn survivors undergoing burn surgery following acute hospitalization: A burn model system national database investigation. Burns 2022; 49:688-700. [PMID: 35718573 DOI: 10.1016/j.burns.2022.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 03/28/2022] [Accepted: 05/09/2022] [Indexed: 11/02/2022]
Abstract
INTRODUCTION Health Related Quality of Life (HRQoL) surveys such as PROMIS-29 may facilitate shared decision-making regarding surgery after burn injury. We aimed to examine whether scar revision and contracture release surgery after index hospitalization was associated with differences in HRQoL. METHODS Patient and PROMIS-29 Profile v2.0 data were extracted from the Burn Model System (BMS) at 6-, 12-, and 24-months after burn. PROMIS-29 measures 7 health-related domains. Linear regression was performed to identify associations between independent burn patient variables (e.g. scar-related surgery) and PROMIS-29 scores. Socio-demographic and injury variables were analyzed using logistic regression to determine the likelihood of undergoing burn-related surgery. RESULTS Of 727 participants, 201 (27.6%) underwent ≥ 1 scar/contracture operation within 24 months of injury. Number of operations at index hospital admission and range of motion (ROM) deficit at discharge were correlated with an increased likelihood of undergoing subsequent scar/contracture surgery (p < 0.05). Participants undergoing scar/contracture surgery and those that were Medicaid insured reported significantly worse HRQoL for PROMIS domains: anxiety, depression, and fatigue (p < 0.05). CONCLUSIONS After adjusting for burn severity and available confounders, participants who underwent scar-related burn reconstructive surgery after index hospitalization reported overall worse Health-Related Quality of Life (HRQoL) in multiple domains.
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Moore C, Clover J, Gibson L. Evaluating parental knowledge of pediatric burns first aid in Ireland and the effectiveness of an educational intervention improving knowledge. Burns 2022; 48:672-682. [PMID: 34696953 DOI: 10.1016/j.burns.2021.05.022] [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: 11/04/2020] [Revised: 04/15/2021] [Accepted: 05/24/2021] [Indexed: 12/15/2022]
Abstract
AIM Burns represent a large portion of injuries attending emergency departments each year, with children accounting for the biggest proportion. Appropriate first aid has been shown to help improve the outcome of burns, and decrease the need for surgical intervention. Several studies outside of Ireland demonstrate inadequate parental knowledge of burns first aid, but few evaluated interventions to improve knowledge. Consequently our aim was to assess parental/caregiver knowledge in Ireland, and determine if knowledge levels could be raised following a short educational video intervention. METHODS An educational video based on current European and British best practice guidelines was produced and shown to parents/caregivers waiting in the Pediatric Outpatients Department after a previously validated pre-intervention questionnaire was completed. A post intervention questionnaire was completed following the video. Questionnaires assessed demographics, previous experience and included scenarios to test parental knowledge. RESULTS 112 parents/caregivers (81.3% female (n = 91), 18.8% male (n = 21)) were questioned. Baseline knowledge was found to be poor overall, however this significantly improved with a simple educational video (pre-score 31.9%, post-test mean score knowledge 92.1%). Pre- and post-test scores showed a statistical significance (x2 = 71.117, P < 0.001, 95% CI).No other variables analysed were shown to be statistically significant predictors of pre- or post-test scores (all p > 0.05). CONCLUSION The study found poor parental knowledge of burns first aid in Ireland and shows the use of an educational video was effective in raising knowledge levels.
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Affiliation(s)
| | - James Clover
- University College Cork, Ireland; Cork University Hospital, Cork, Ireland.
| | - Louise Gibson
- University College Cork, Ireland; Cork University Hospital, Cork, Ireland.
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Ozbasli E, Takmaz O, Albayrak N, Gungor Md M. Cosmetic Outcome of Robotic Surgery Compared to Laparoscopic Surgery for Benign Gynecologic Disease. JSLS 2022; 26:JSLS.2021.00081. [PMID: 35509304 PMCID: PMC9033169 DOI: 10.4293/jsls.2021.00081] [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] [Indexed: 11/22/2022] Open
Abstract
Background and Objectives: This study was designed to compare patients who have undergone conventional laparoscopic surgery with those who undergone multiport robot-assisted laparoscopic surgery for benign gynecological diseases regarding cosmetic results, patient satisfaction, and quality of life. Methods: Sixty-four patients who underwent either robot-assisted or conventional laparoscopic surgery for benign gynecological diseases from July 1, 2019 to March 31, 2020 at Acibadem Mehmet Ali Aydinlar University Hospital were enrolled. Patients were evaluated using the Patient and Observer Scar Assessment Scale, visual analog scale for cosmetic satisfaction, body image questionnaire, and 12-item Short Form Survey six months postoperatively. Results: The median patient assessment scale and observer assessment scale (general) values were significantly higher in the robotic group than in the laparoscopic group. The mean body image questionnaire (cosmetic section) and visual analog scale values were significantly higher in the laparoscopic group than in the robotic group. No significant differences in body image scale, body image questionnaire 9–10, and 12-item Short Form Survey values were observed between the groups. The number of patients with previous surgical history was significantly higher in the laparoscopic group than in the robotic group. Conclusion: Although esthetic concerns are not a priority consideration when deciding an appropriate surgical method, the higher cosmetic satisfaction rate in the laparoscopic group than in the robotic group suggests that cosmetic results should be discussed with patients after evaluating other factors.
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Affiliation(s)
- Esra Ozbasli
- Department of Obstetrics and Gynecology, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey
| | - Ozguc Takmaz
- Department of Obstetrics and Gynecology, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey
| | - Nazlı Albayrak
- Department of Obstetrics and Gynecology, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey
| | - Mete Gungor Md
- Department of Obstetrics and Gynecology, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey
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Look me in the eyes! A pre-registered eye-tracking study investigating visual attention and affective reactions to faces with a visible difference. Body Image 2022; 40:67-77. [PMID: 34864605 DOI: 10.1016/j.bodyim.2021.10.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 10/29/2021] [Accepted: 10/31/2021] [Indexed: 12/28/2022]
Abstract
This research aims to determine how disfigurement alters visual attention paid to faces and to examine whether such a potential modified pattern of visual attention to faces with visible difference was associated, in turn, with perceiver's stigmatizing affective reactions. A pilot study (N = 38) and a pre-registered experimental eye-tracking study (N = 89) were conducted. First, the visual explorations of faces with and without disfigurement were compared. The association of these visual explorations with affective reactions were investigated next. Findings suggest that disfigurement impacts visual attention toward faces; attention is not merely attracted to the disfigured area but it is also diverted particularly from the eye area. Disfigurement also eases disgust-related, surprise-related, anxiety-related, and, to a lesser extent, hostility-related affective states. Exploratory interaction effects between attention to the eyes and to the disfigured part of the face revealed a hybrid effect on disgust-related affect and an increase in surprise-related affect when participants fixated more upon the disfigured area and fixated less upon the eyes. Thus, perceiver's attention is captured by disfigurement and also diverted from face internal features which seems to play a role in the affective reactions elicited.
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Romanowski KS, Sen S. Wound Healing in Older Adults With Severe Burns: Clinical Treatment Considerations and Challenges. BURNS OPEN 2022; 6:57-64. [PMID: 35571008 PMCID: PMC9104500 DOI: 10.1016/j.burnso.2022.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Background: The older adult population continues to rapidly expand in number, with a projection by the United States (US) Census Bureau that there will be more individuals older than > 65 years (77.0 million) than those younger than < 18 years (76.5 million) by 2034. This review provides an overview of aging as it relates to wound healing and burn injuries in older adult patients, summarizes current treatment practices, and addresses the key challenges and considerations for treating severe burn injuries in this specific patient population. Materials and methods: A narrative literature search was conducted, focusing on recent primary literature on burns and wound healing in elderly patients. Results: Studies showed that the aging process results in both physiologic (eg, nutritional and metabolic status) and anatomic changes (eg, thinning dermis) that contribute to a reduced capacity to recover from burn-injury trauma compared with younger patients. Owing to impaired vision, decreased coordination, comorbidities, and medication-induced side effects, older adults (ie, > 65 years) are susceptible to severe burn injury (deep-partial thickness and full-thickness), which is associated with significant morbidity and mortality. Conclusion: A better understanding of the effects of age-related changes regarding wound healing in older adult patients who incur severe burn injuries may provide insight into clinical strategies to improve outcomes among this population.
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Brewin M, Docherty S, Heaslip V, Breheny K, Pleat J, Rhodes S. Early Laser for Burn Scars (ELABS): protocol for a multi-centre randomised, controlled trial of both the effectiveness and cost-effectiveness of the treatment of hypertrophic burn scars with Pulsed Dye Laser and standard care compared to standard care alone [version 1; peer review: 2 approved]. NIHR OPEN RESEARCH 2022; 2:1. [PMID: 35392303 PMCID: PMC7612584 DOI: 10.3310/nihropenres.13234.1] [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] [Accepted: 11/09/2021] [Indexed: 11/22/2022]
Abstract
This paper outlines the protocol for a study that is being carried out at multiple centres across the UK in the next three years. It is a Research for Patient Benefit (RfPB) study funded by the National Institute for Healthcare Research (NIHR). The aim is to assess the effectiveness of treating hypertrophic burns scars with pulsed dye laser (PDL) at an early stage of scar formation. The objective is to improve Quality of Life for the patient by improving both the appearance and quality of burn scarring, as well as reducing its psychological impact. This is a parallel-arm randomised, controlled trial to compare PDL and standard care against standard care alone. The difference is measured between baseline and six-month follow-up. Recruits are within three months of healing from a burn injury; with wounds showing a defined potential for hypertrophic scarring. A total of 120 patients are recruited in a multi-centre study; with randomisation in a 1:1 allocation to each arm. The treatment arm receives 3 PDL treatments at six-week intervals in addition to standard care, whereas the control arm receives standard care alone. The primary outcome is the patient-rated part of the Patient and Observer Scar Scale (POSAS). Psychological and psycho-social impact is evaluated using the CARe burn scale (UWE, Bristol) and Quality Adjusted Life Years (QALY) is determined using the Short-Form Health Survey (SF-12). The study evaluates both the cost-effectiveness through an economic analysis and the patient-reported experience of the treatment by phone interviews.
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Affiliation(s)
- Mark Brewin
- Burns & Plastics, Salisbury NHS Foundation Trust, Salisbury, Wiltshire, SP2 8BJ, UK
| | | | | | | | - Jonathon Pleat
- Burns & Plastics, North Bristol NHS Trust, Bristol, BS10 5NB, UK
| | - Shelley Rhodes
- Exeter Clinical Trials Unit, University of Exeter, Exeter, EX4 4SB, UK
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Rajput RJ. Hair Transplant for Eyebrow Restoration. Indian J Plast Surg 2022; 54:489-494. [PMID: 34984090 PMCID: PMC8719974 DOI: 10.1055/s-0041-1739253] [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] [Indexed: 11/04/2022] Open
Abstract
Eyebrow restoration can be best done with individual single hair follicles grafts harvested by FUE. Understanding the male and female eyebrow allows us to plan an aesthetic reconstruction, requiring 70 to 120 grafts. Selection of donor hair, angle of placement, alignment and direction within the rows influences the results, as does scarring and perfusion of the skin. Details of planning, technique, anesthesia and postoperative care, as well as drawbacks of older methods, are discussed in the article.
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Mehta K, Arega H, Smith NL, Li K, Gause E, Lee J, Stewart B. Gender-based disparities in burn injuries, care and outcomes: A World Health Organization (WHO) Global Burn Registry cohort study. Am J Surg 2022; 223:157-163. [PMID: 34330521 PMCID: PMC8688305 DOI: 10.1016/j.amjsurg.2021.07.041] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 05/14/2021] [Accepted: 07/19/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND We aimed to describe the gender-based disparities in burn injury patterns, care received, and mortality across national income levels. METHODS In the WHO Global Burn Registry (GBR), we compared patient demographics, injury characteristics, care and outcomes by sex using Chi-square statistics. Logistic regression was used to identify the associations of patient sex with surgical treatment and in-hospital mortality. RESULTS Among 6431 burn patients (38 % female; 62 % male), females less frequently received surgical treatment during index hospitalization (49 % vs 56 %, p < 0.001), and more frequently died in-hospital (26 % vs 16 %, p < 0.001) than males. Odds of in in-hospital death was 2.16 (95 % CI: 1.73-2.71) times higher among females compared to males in middle-income countries. CONCLUSIONS Across national income levels, there appears to be important gender-based disparities among burn injury epidemiology, treatment received and outcomes that require redress. Multinational registries can be utilized to track and to evaluate initiatives to reduce gender disparities at national, regional and global levels.
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Affiliation(s)
- Kajal Mehta
- Department of Surgery, University of Washington, Seattle, WA, USA
| | - Hana Arega
- School of Public Health, University of Washington, Seattle, WA, USA
| | | | - Kathleen Li
- Krieger School of Arts & Sciences, The Johns Hopkins University, Baltimore, MD, USA
| | - Emma Gause
- Harborview Injury Prevention & Research Center, Seattle, WA, USA
| | - Joohee Lee
- Public Health Concern Trust-Nepal, Kathmandu, Nepal
| | - Barclay Stewart
- Harborview Injury Prevention & Research Center, Seattle, WA, USA; Department of Surgery, University of Washington, Seattle, WA, USA
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Yaseen U, Ahmed S, Ahmed M. Beard Reconstruction. Int J Trichology 2021; 13:4-8. [PMID: 34934294 PMCID: PMC8647705 DOI: 10.4103/ijt.ijt_40_19] [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: 05/08/2019] [Revised: 03/18/2020] [Accepted: 07/17/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction: Loss of beard can occur due to many reasons. As beard has huge cosmetic importance, loss of beard can be psychologically traumatic. Beard can be absent from puberty, called as congenital absence of beard. Beard loss can be secondary to dermatological conditions such as nodulocystic acne. In our setting, the most common cause of loss of beard is burn injury. There are many treatment options such as surgical excision of scar, flaps Z/W plasty, and hair transplantation to reconstruct the beard. We present the follicular unit extraction (FUE) method of beard reconstruction. Aim: The aim of our study was to describe the evaluation of the results using FUE method for beard reconstruction. Materials and Methods: We did a study in twenty male patients. Any patient having alopecia areata were ruled out of the study. Fifteen patients had postburn loss, three had postacne scarring, and two patients had congenital absence of beard. We evaluated all patients thoroughly by calculating the density of beard over the normal areas of beard, evaluating the elasticity of skin, preoperative photography, and doing dermatoscopy. Areas were marked. FUE was used for harvesting the grafts as a limited number of grafts were needed to complete the surgery. In the recipient area, adrenaline was avoided in patients of scarring alopecia. In cases of congenital absence of hair, 1:200,000 adrenaline was used to minimize bleeding. Grafts were placed. Results were noted after 1 year. Results: All patients followed up properly for 1 year. Growth started 3 months postoperatively and continued till 1 year postoperatively. Density was good in cases with congenital absence of hair. In cases of scarring alopecia, multiple sessions were needed to provide adequate density. Results were graded as “very good,” “good,” and “poor.” Eleven patients had “very good” result, eight had “good,” and one had “poor” result. Nineteen patients were satisfied with the final result, and one patient was dissatisfied with the result. Conclusion: FUE is the ideal method of reconstructing beard loss. Proper preoperative evaluation, preparation, planning, and proper surgical technique produce the best possible result.
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Affiliation(s)
- Ummer Yaseen
- Assistant Professor, Department of Dermatology, Government Medical College, Anantnag, Jammu and Kashmir, India
| | - Shabir Ahmed
- Associate Professor, Department of Dermatology, Government Medical College, Anantnag, Jammu and Kashmir, India
| | - Muzaffar Ahmed
- Senior Resident, Department of Dermatology, Government Medical College, Anantnag, Jammu and Kashmir, India
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Woolard A, Hill NTM, McQueen M, Martin L, Milroy H, Wood FM, Bullman I, Lin A. The psychological impact of paediatric burn injuries: a systematic review. BMC Public Health 2021; 21:2281. [PMID: 34906121 PMCID: PMC8670283 DOI: 10.1186/s12889-021-12296-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 11/23/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To review and synthesise qualitative literature regarding the psychological outcomes following paediatric burn injuries, and to determine if children and adolescents who experience a burn injury have elevated risk of psychopathology following the injury. DESIGN Systematic review of quantitative and qualitative studies. DATA SOURCES Informit health, Medline, Embase, and PsycINFO were searched from January 2010 to December 2020. DATA EXTRACTION AND SYNTHESIS Two reviewers screened articles, and one reviewer extracted data (with cross-checking from another reviewer) from the included studies and assessed quality using an established tool. Narrative synthesis was used to synthesise the findings from the quantitative studies, and thematic synthesis was used to synthesise the findings of included qualitative studies. RESULTS Searches yielded 1240 unique titles, with 130 retained for full-text screening. Forty-five studies from 17 countries were included. The psychological outcomes included in the studies were mental health diagnoses, medication for mental illness, depression, anxiety, stress, fear, post-traumatic stress, post-traumatic growth, emotional issues, self-harm, self-esteem, self-concept, stigmatisation, quality of life, level of disability, resilience, coping, and suicidality. CONCLUSIONS Our findings highlight paediatric burn patients as a particularly vulnerable population following a burn injury. Studies suggest elevated anxiety and traumatic stress symptoms, and higher rates of psychopathology in the long-term. Further research is recommended to determine the psychological outcomes in the other mental health domains highlighted in this review, as findings were mixed. Clinical care teams responsible for the aftercare of burn patients should involve psychological support for the children and families to improve outcomes.
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Affiliation(s)
- Alix Woolard
- Telethon Kids Institute, Perth Children's Hospital, 15 Hospital Avenue, Nedlands, Australia.
- The University of Western Australia, Perth, Australia.
| | - Nicole T M Hill
- Telethon Kids Institute, Perth Children's Hospital, 15 Hospital Avenue, Nedlands, Australia
| | - Matthew McQueen
- Telethon Kids Institute, Perth Children's Hospital, 15 Hospital Avenue, Nedlands, Australia
| | - Lisa Martin
- Fiona Wood Foundation, Perth, Australia; Child and Adolescent Health Service, Perth Children's Hospital, University of Western Australia, Perth, Western Australia, Australia
| | - Helen Milroy
- The University of Western Australia, Perth, Australia
| | | | - Indijah Bullman
- Telethon Kids Institute, Perth Children's Hospital, 15 Hospital Avenue, Nedlands, Australia
| | - Ashleigh Lin
- Telethon Kids Institute, Perth Children's Hospital, 15 Hospital Avenue, Nedlands, Australia
- The University of Western Australia, Perth, Australia
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Bayuo J, Wong FKY, Chung LYF. Effects of a nurse-led transitional burns rehabilitation programme (4Cs-TBuRP) for adult burn survivors: protocol for a randomised controlled trial. Trials 2021; 22:698. [PMID: 34645512 PMCID: PMC8511287 DOI: 10.1186/s13063-021-05679-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 10/01/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Transitioning from the burn unit to the home/community can be chaotic with limited professional support. Some adult burn survivors may face varied concerns leading to poor outcomes in the early post-discharge period with limited access to professional help. Based on these, a nurse-led transitional burns rehabilitation programme has been developed and the current trial aims to ascertain its effects as well as explore the implementation process. METHODS A single-centre, double-arm randomised controlled trial with a process evaluation phase will be utilised for this study. All adult burn survivors aged ≥ 18 years with burn size ≥ 10% total burn surface area at the site during the study period will be screened for eligibility at least 72 h to discharge. A sample size of 150 will be block randomised to treatment (receiving the nurse-led transitional care programme and routine post-discharge service) and control groups (receiving routine post-discharge service). The nurse-led transitional care programme comprises of predischarge and follow-up phases with the delivery of bundle of holistic interventions lasting for 8 weeks. There are three timelines for data collection: baseline, immediate post intervention, and 4 weeks post-intervention. DISCUSSION The findings from this study can potentially inform the development and organisation of post-discharge care and affirm the need for ongoing comprehensive home-based care for burn survivors and their families TRIAL REGISTRATION: ClinicalTrials.gov NCT04517721 . Registered on 20 August 2020.
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Affiliation(s)
- Jonathan Bayuo
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
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Durant F, Whited JL. Finding Solutions for Fibrosis: Understanding the Innate Mechanisms Used by Super-Regenerator Vertebrates to Combat Scarring. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2021; 8:e2100407. [PMID: 34032013 PMCID: PMC8336523 DOI: 10.1002/advs.202100407] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/12/2021] [Indexed: 05/08/2023]
Abstract
Soft tissue fibrosis and cutaneous scarring represent massive clinical burdens to millions of patients per year and the therapeutic options available are currently quite limited. Despite what is known about the process of fibrosis in mammals, novel approaches for combating fibrosis and scarring are necessary. It is hypothesized that scarring has evolved as a solution to maximize healing speed to reduce fluid loss and infection. This hypothesis, however, is complicated by regenerative animals, which have arguably the most remarkable healing abilities and are capable of scar-free healing. This review explores the differences observed between adult mammalian healing that typically results in fibrosis versus healing in regenerative animals that heal scarlessly. Each stage of wound healing is surveyed in depth from the perspective of many regenerative and fibrotic healers so as to identify the most important molecular and physiological variances along the way to disparate injury repair outcomes. Understanding how these powerful model systems accomplish the feat of scar-free healing may provide critical therapeutic approaches to the treatment or prevention of fibrosis.
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Affiliation(s)
- Fallon Durant
- Department of Stem Cell and Regenerative BiologyHarvard UniversityCambridgeMA02138USA
| | - Jessica L. Whited
- Department of Stem Cell and Regenerative BiologyHarvard UniversityCambridgeMA02138USA
- The Harvard Stem Cell InstituteCambridgeMA02138USA
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Froutan R, Saberi A, Ahmadabadi A, Mazlom SR. The Effect of a Recreational Therapy Program on the Pain Anxiety and Quality of Life of Patients with Burn Injuries: A Randomized Clinical Trial. J Burn Care Res 2021; 43:381-388. [PMID: 34329456 DOI: 10.1093/jbcr/irab153] [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: 11/14/2022]
Abstract
Pain anxiety and dysfunction are among the most prevalent complications of burns, impacting the quality of life of patients with burn injuries. As a non-pharmaceutical approach, recreational therapy can be effective in reducing the complications of burns. This study aimed to examine the effect of a recreational therapy program on the pain anxiety and quality of life of patients with burn injuries. This controlled randomized clinical trial was conducted on 58 patients admitted to the burn center of XXX. These patients were randomly allocated to the intervention and control group. The intervention group received a recreational therapy program three sessions a week, for two weeks. The control group performed routine daily activities. As the main variable of the study, the Burn Specific Pain Anxiety Scale and Burn Specific Health Scale-Brief were completed for both groups before and two weeks after the intervention. After controlling confounders, the pain anxiety score in the intervention group was significantly lower than in the control group (p = 0.002). The total quality of life score was significantly higher in the intervention group than the control group (p = 0.001). In addition, the intervention significantly increased the scores of quality of life in the physical (p< 0.001), emotional (p = 0.009), and social (p< 0.001) dimensions. As it reduces pain anxiety and promotes the quality of life of patients with burn injuries, this recreational therapy program is recommended for promoting the mental health and quality of life of these patients.
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Affiliation(s)
- Razieh Froutan
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran / Department of Medical Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abolfazl Saberi
- Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Ahmadabadi
- Surgical Oncology Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Reza Mazlom
- Instructor of Nursing, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
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