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Bebbington E, Miles J, Young A, van Baar ME, Bernal N, Brekke RL, van Dammen L, Elmasry M, Inoue Y, McMullen KA, Paton L, Thamm OC, Tracy LM, Zia N, Singer Y, Dunn K. Exploring the similarities and differences of burn registers globally: Results from a data dictionary comparison study. Burns 2024; 50:850-865. [PMID: 38267291 DOI: 10.1016/j.burns.2024.01.004] [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: 07/15/2023] [Revised: 12/08/2023] [Accepted: 01/10/2024] [Indexed: 01/26/2024]
Abstract
INTRODUCTION Pooling and comparing data from the existing global network of burn registers represents a powerful, yet untapped, opportunity to improve burn prevention and care. There have been no studies investigating whether registers are sufficiently similar to allow data comparisons. It is also not known what differences exist that could bias analyses. Understanding this information is essential prior to any future data sharing. The aim of this project was to compare the variables collected in countrywide and intercountry burn registers to understand their similarities and differences. METHODS Register custodians were invited to participate and share their data dictionaries. Inclusion and exclusion criteria were compared to understand each register population. Descriptive statistics were calculated for the number of unique variables. Variables were classified into themes. Definition, method, timing of measurement, and response options were compared for a sample of register concepts. RESULTS 13 burn registries participated in the study. Inclusion criteria varied between registers. Median number of variables per register was 94 (range 28 - 890), of which 24% (range 4.8 - 100%) were required to be collected. Six themes (patient information, admission details, injury, inpatient, outpatient, other) and 41 subthemes were identified. Register concepts of age and timing of injury show similarities in data collection. Intent, mechanism, inhalational injury, infection, and patient death show greater variation in measurement. CONCLUSIONS We found some commonalities between registers and some differences. Commonalities would assist in any future efforts to pool and compare data between registers. Differences between registers could introduce selection and measurement bias, which needs to be addressed in any strategy aiming to facilitate burn register data sharing. We recommend the development of common data elements used in an international minimum data set for burn injuries, including standard definitions and methods of measurement, as the next step in achieving burn register data sharing.
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Affiliation(s)
- Emily Bebbington
- Centre for Mental Health and Society, Bangor University, Wrexham Academic Unit, Technology Park, Wrexham LL13 7YP, UK.
| | - Joanna Miles
- Plastic and Reconstructive Surgery Department, Norfolk and Norwich University Hospital, Colney Lane, Norwich NR4 7UY, UK
| | - Amber Young
- Bristol Centre for Surgical Research, Bristol Medical School, Department of Population Health Sciences, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK
| | - Margriet E van Baar
- Dutch Burn Repository R3, Association of Dutch Burn Centres, Maasstad Hospital, Maasstadweg 21, 3079 DZ Rotterdam, the Netherlands
| | - Nicole Bernal
- The Ohio State University Wexner Medical Center, 410 W 10th Ave, Columbus, OH 43235, USA; Burn Care Quality Platform, American Burn Association, 311 S. Wacker Drive, Suite 950, Chicago, IL, USA
| | - Ragnvald Ljones Brekke
- Norwegian Burn Registry, Norwegian National Burn Center, Haukeland University Hospital, Haukelandsveien 22, 5009 Bergen, Norway
| | - Lotte van Dammen
- Burn Centres Outcomes Registry The Netherlands, Dutch Burns Foundation, Zeestraat 29, 1941 AJ Beverwijk, the Netherlands
| | - Moustafa Elmasry
- Burn Unit Database, Swedish Burn Register, Department of Hand Surgery, Plastic Surgery and Burns, Linköping University, Linköping, Sweden
| | - Yoshiaki Inoue
- Japanese Burn Register, Japanese Society for Burn Injuries, Shunkosha Inc. Lambdax Building, 2-4-12 Ohkubo, Shinjuku-ku, Tokyo 169-0072, Japan
| | - Kara A McMullen
- Burn Model System, Burn Model System National Data and Statistical Center, Department of Rehabilitation Medicine, University of Washington, Box 354237, Seattle, WA 98195-4237, USA
| | - Lia Paton
- Care of Burns in Scotland, National Managed Clinical Network, NHS National Services Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh EH12 9EB, UK
| | - Oliver C Thamm
- German Burn Registry, German Society for Burn Treatment (DGV), Luisenstrasse 58-59, 10117 Berlin, Germany; University of Witten/Herdecke, Alfred-Herrenhausen-Strasse 50, 58455 Witten, Germany
| | - Lincoln M Tracy
- School of Public Health & Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Nukhba Zia
- South Asia Burn Registry, Johns Hopkins International Injury Research Unit, Department of International Health, Health Systems Program, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Yvonne Singer
- School of Nursing and Midwifery, Griffith University, Nathan Campus, 170 Kessels Road, Brisbane, QLD, Australia
| | - Ken Dunn
- Burn Care Informatics Group, NHS, UK
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Salemans RFC, van Uden D, van Baar ME, Haanstra TM, van Schie CHM, van Zuijlen PPM, Lucas Y, Scholten-Jaegers SMHJ, Meij-de Vries A, Wood FM, Edgar DW, Spronk I, van der Vlies CH. Timing of surgery in acute deep partial-thickness burns: A study protocol. PLoS One 2024; 19:e0299809. [PMID: 38466683 PMCID: PMC10927102 DOI: 10.1371/journal.pone.0299809] [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: 11/13/2023] [Accepted: 02/14/2024] [Indexed: 03/13/2024] Open
Abstract
For deep partial-thickness burns no consensus on the optimal treatment has been reached due to conflicting study outcomes with low quality evidence. Treatment options in high- and middle-income countries include conservative treatment with delayed excision and grafting if needed; and early excision and grafting. The majority of timing of surgery studies focus on survival rather than on quality of life. This study protocol describes a study that aims to compare long-term scar quality, clinical outcomes, and patient-reported outcomes between the treatment options. A multicentre prospective study will be conducted in the three Dutch burn centres (Rotterdam, Beverwijk, and Groningen). All adult patients with acute deep-partial thickness burns, based on healing potential with Laser Doppler Imaging, are eligible for inclusion. During a nine-month baseline period, standard practice will be monitored. This includes conservative treatment with dressings and topical agents, and excision and grafting of residual defects if needed 14-21 days post-burn. The subsequent nine months, early surgery is advocated, involving excision and grafting in the first week to ten days post-burn. The primary outcome compared between the two groups is long-term scar quality assessed by the Patient and Observer Scar Assessment Scale 3.0 twelve months after discharge. Secondary outcomes include clinical outcomes and patient-reported outcomes like quality of life and return to work. The aim of the study is to assess long-term scar quality in deep partial-thickness burns after conservative treatment with delayed excision and grafting if needed, compared to early excision and grafting. Adding to the ongoing debate on the optimal treatment of these burns. The broad range of studied outcomes will be used for the development of a decision aid for deep partial-thickness burns, to fully inform patients at the point of consent to surgery and support optimal person-centred care.
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Affiliation(s)
- Roos F. C. Salemans
- Trauma Research Unit Department of Surgery, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands
- Burn Centre, Maasstad Hospital, Rotterdam, the Netherlands
| | | | - Margriet E. van Baar
- Association of Dutch Burn Centres, Maasstad Hospital, Rotterdam, the Netherlands
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | - Tjitske M. Haanstra
- Department of Dermal Therapy, Faculty of Health, Nutrition & Sport, The Hague University of Applied Sciences, The Hague, the Netherlands
- Dutch Burns Foundation, Beverwijk, the Netherlands
- Research Group Relational Care, Centre of Expertise Health Innovation, The Hague University of Applied Sciences, The Hague, the Netherlands
| | | | - Paul P. M. van Zuijlen
- Burn Centre, Red Cross Hospital, Beverwijk, the Netherlands
- Department of Plastic and Reconstructive Surgery, Red Cross Hospital, Beverwijk, the Netherlands
- Department of Plastic Reconstructive and Hand Surgery, Amsterdam Movement Sciences Institute, Amsterdam UMC, Location VUmc, Amsterdam, the Netherlands
- Paediatric Surgical Centre, Emma’s Children’s Hospital, Amsterdam UMC, Location AMC, Amsterdam, the Netherlands
| | - Ymke Lucas
- Burn Centre, Maasstad Hospital, Rotterdam, the Netherlands
| | | | - Annebeth Meij-de Vries
- Burn Centre, Red Cross Hospital, Beverwijk, the Netherlands
- Paediatric Surgical Centre, Emma’s Children’s Hospital, Amsterdam UMC, Location AMC, Amsterdam, the Netherlands
- Department of Surgery, Red Cross Hospital, Beverwijk, the Netherlands
| | - Fiona M. Wood
- Fiona Wood Foundation, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
- State Adult Burn Unit, Fiona Stanley Hospital, South Metropolitan Health Service, Murdoch, Western Australia, Australia
| | - Dale W. Edgar
- Fiona Wood Foundation, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
- State Adult Burn Unit, Fiona Stanley Hospital, South Metropolitan Health Service, Murdoch, Western Australia, Australia
- Institute for Health Research, Burn Injury Research Node, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
- Burn Injury Research Unit, Faculty of Medicine and Dentistry, University of Western Australia, Crawley, Western Australia, Australia
- Safety and Quality Unit, Armadale Kalamunda Group Health Service, East Metropolitan Health Service, Mt Nasura, Western Australia, Australia
| | - Inge Spronk
- Burn Centre, Maasstad Hospital, Rotterdam, the Netherlands
- Association of Dutch Burn Centres, Maasstad Hospital, Rotterdam, the Netherlands
- Department of Dermal Therapy, Faculty of Health, Nutrition & Sport, The Hague University of Applied Sciences, The Hague, the Netherlands
- Research Group Relational Care, Centre of Expertise Health Innovation, The Hague University of Applied Sciences, The Hague, the Netherlands
| | - Cornelis H. van der Vlies
- Trauma Research Unit Department of Surgery, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands
- Department of Trauma and Burn Surgery, Maasstad Hospital, Rotterdam, the Netherlands
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Shokre ES, Mohammed SEM, Elhapashy HMM, Elsharkawy NB, Ramadan OME, Abdelaziz EM. The effectiveness of the psychosocial empowerment program in early adjustment among adult burn survivors. BMC Nurs 2024; 23:45. [PMID: 38225570 PMCID: PMC10790373 DOI: 10.1186/s12912-024-01700-x] [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: 12/02/2023] [Accepted: 01/01/2024] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND Burns constitute a major global health challenge, causing not only physical trauma, but also significant psychosocial and emotional disturbances. The complexity of these injuries requires comprehensive rehabilitation programs that address both the physical and psychosocial aspects of recovery. Despite advances in medical care, there is a lack of standardized, accessible, and sustainable psychosocial interventions for burn survivors, particularly in the transition from hospital to home. This study aimed to develop and evaluate a nurse-led psychosocial empowerment intervention for early adjustment among burn survivors after hospital discharge. METHODS The study adopted a quasi-experimental framework. A convenient sample of 80 adult burn survivors was randomly divided into an intervention group, receiving the psychosocial empowerment program, and a control group, continuing standard care from November 2022 to May 2023. The effectiveness of the program was evaluated using various tools that measure satisfaction with appearance, coping abilities, and symptoms of post-traumatic stress disorder (PTSD). The intervention focused on enhancing resilience, self-efficacy, and adaptive coping, through targeted skill building in stress management, adaptability to coping, social reintegration, emotion regulation, and problem-solving. RESULTS Participants in the intervention group demonstrated significant improvements in body image satisfaction, coping abilities, and symptoms of PTSD compared to the control group. CONCLUSIONS The psychosocial empowerment program effectively addressed the psychosocial needs of burn survivors and enhanced their early adjustment after hospital discharge. The findings highlight the critical role of psychosocial support in the rehabilitation of burn survivors and underscore the need to integrate such interventions into standard post-discharge care. Future research should focus on the long-term effects of these interventions and their applicability in diverse settings.
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Affiliation(s)
- Evon S Shokre
- Department of Psychiatric Mental Health Nursing, Faculty of Nursing, Fayoum University, Fayoum, Egypt.
| | | | | | - Nadia Bassuoni Elsharkawy
- College of Nursing, Jouf University, Sakaka, 72388, Saudi Arabia
- Department of Maternal and New-born Health Nursing, Faculty of Nursing, Cairo University, Cairo, 11562, Egypt
| | - Osama Mohamed Elsayed Ramadan
- College of Nursing, Jouf University, Sakaka, 72388, Saudi Arabia
- Department of Paediatric Nursing, Faculty of Nursing, Cairo University, Cairo, 11562, Egypt
| | - Enas Mahrous Abdelaziz
- College of Nursing, Jouf University, Sakaka, 72388, Saudi Arabia
- Department of Psychiatric Mental Health Nursing, Faculty of Nursing, Cairo University, Cairo, 11562, Egypt
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Ahmed S, Hussain R, Khan A, Batool SA, Mughal A, Nawaz MH, Irfan M, Wadood A, Avcu E, Rehman MAU. 3D Printing Assisted Fabrication of Copper-Silver Mesoporous Bioactive Glass Nanoparticles Reinforced Sodium Alginate/Poly(vinyl alcohol) Based Composite Scaffolds: Designed for Skin Tissue Engineering. ACS APPLIED BIO MATERIALS 2023; 6:5052-5066. [PMID: 37857344 DOI: 10.1021/acsabm.3c00726] [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] [Indexed: 10/21/2023]
Abstract
Additive manufacturing (also known as 3D printing) is a promising method for producing patient-specific implants. In the present study, sodium alginate (Na-ALG)/poly(vinyl alcohol) (PVA) polymer blends of varying ratios (1:0, 3:1, 1:1, and 1:3) were used to produce tailored-designed skin scaffolds using a 3D bioprinter. Samples of skin scaffolds were printed at 20 layers with a layer height of 0.15 mm using a needle with an inner diameter of 330 μm while maintaining the extrusion speed, extrusion width, and fill density at 10 mm/s, 0.2 mm, and 85%, respectively. The Na-ALG/PVA blend with a 3:1 ratio showed the best printability due to its good viscosity and minimal nozzle leakage, allowing for the fabrication of skin scaffolds with high fidelity and the desired morphological characteristics. Then, copper-silver doped mesoporous bioactive glass nanoparticles (Cu-Ag MBGNs) were incorporated into the Na-ALG/PVA blend (which had already been prepared by using a Na-ALG:PVA ratio of 3:1) in order to obtain therapeutic (angiogenic and antibacterial) effects. The fabricated Na-ALG/PVA/Cu-Ag MBGNs biocomposite scaffolds with dimensions of 20 mm× 20 × 3 mm3 and pore size of 400 ± 60 μm exhibited a promising fidelity. The presence of chemical bonds attributed to Na-ALG, PVA, and Cu-Ag MBGNs and the uniform distribution of Na, C, and O elements within the microstructure of the scaffolds were confirmed by EDX, SEM, and FTIR analyses. The scaffolds were hydrophilic and exhibited proper swelling and degradation behavior for skin tissue engineering. According to the inhibition halo test, the scaffolds exhibited strong antibacterial activity against Staphylococcus aureus and Escherichia coli. The cytocompatibility to human-derived fibroblast cells was confirmed by the WST-8 assay and in vivo Chorioallantoic Membrane Assay. In addition, Na-ALG/PVA/Cu-Ag MBGNs showed angiogenic potential, exhibiting favorable wound healing properties.
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Affiliation(s)
- Sheraz Ahmed
- Department of Materials Science & Engineering, Institute of Space Technology, Islamabad 44000, Pakistan
| | - Rabia Hussain
- Department of Materials Science & Engineering, Institute of Space Technology, Islamabad 44000, Pakistan
| | - Ahmad Khan
- Department of Materials Science & Engineering, Institute of Space Technology, Islamabad 44000, Pakistan
| | - Syeda Ammara Batool
- Department of Materials Science & Engineering, Institute of Space Technology, Islamabad 44000, Pakistan
| | - Awab Mughal
- Department of Materials Science & Engineering, Institute of Space Technology, Islamabad 44000, Pakistan
| | - Muhammad Haseeb Nawaz
- Department of Materials Science & Engineering, Institute of Space Technology, Islamabad 44000, Pakistan
| | - Muhammad Irfan
- School of Chemical and Materials Engineering, National University of Science & Technology, Islamabad 44000, Pakistan
| | - Abdul Wadood
- Department of Materials Science & Engineering, Institute of Space Technology, Islamabad 44000, Pakistan
| | - Egemen Avcu
- Department of Mechanical Engineering, Institute of Natural and Applied Sciences, Kocaeli University, Kocaeli 41001, Turkey
- Department of Machine and Metal Technologies, Ford Otosan Ihsaniye Automotive Vocational School, Kocaeli University, Kocaeli 41650, Turkey
| | - Muhammad Atiq Ur Rehman
- Department of Materials Science & Engineering, Institute of Space Technology, Islamabad 44000, Pakistan
- Centre of Excellence in Biomaterials and Tissue Engineering, Government College University, Lahore, 54000, Pakistan
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