Burns : journal of the International Society for Burn Injuries
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Understand the availability of human resources, infrastructure and medical equipment and perceived improvement helps to address interventions to improve burn care. ⋯ A variety of factors, including a low HDI, delayed hospital presentation e.g. due to prior care by non-physicians and lack of equipment seem to worsen the outcome. Introduction of an intensive care unit and communal education are perceived to be important steps in improving health care in burns.
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Our objective was to compare the outcomes of full thickness skin grafts versus split thickness skin grafts in paediatric hand burn patients. A systematic review and meta-analysis were carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Guidelines, and an electronic search was conducted to identify all Randomised Controlled Trials and non-randomised studies comparing the outcomes of full thickness skin grafts versus split thickness skin grafts in paediatric hand burn patients. Primary outcomes included development of post-graft contracture and the necessity for surgical release. ⋯ However, split thickness skin grafts, showed to be superior in scar, aesthetic, and colour assessments, and less hair growth was observed for split thickness skin grafts. No significant difference was seen in sensation and donor or recipient site complaints. Overall, full thickness skin grafts are a better alternative for paediatric hand burns than split thickness skin transplants because they are linked with reduced post-graft contracture and the requirement for surgical release.
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Blast injuries have a variety of mechanisms, with some cases resulting in immediate death and others resulting in burns as a fourth type of blast injury when the energy of the explosion is relatively low. We reported in 2020, as an incidental result, that burns caused by explosions had a higher survival rate than usual burns caused by other mechanisms. The present study confirmed whether or not burns caused by explosions had higher survival rates than those caused by other mechanisms using the Japan Trauma Data Bank (JTDB), a leading nationwide trauma registry in Japan. ⋯ The survival rate of patients with burns induced by explosions was higher than that of common burn cases according to analyses based on a burn grade of AIS98 among burn cases without common trauma. Multivariate analyses also showed that explosion burns had a significantly better outcome than those induced by other causes.
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Review
Nerve growth factor and burn wound healing: Update of molecular interactions with skin cells.
Burn wound healing is a very intricate and complex process that conventionally includes three interrelated and overlapping stages of hemostasis/inflammation, proliferation and remodeling. This review aims to explore the molecular interactions of NGF with the most prominent cell types in the skin and their respective secretory products during wound healing, particularly burn wound healing. Different types of cells such as, nerve cells, endothelial cells, mast cells, macrophages, neutrophils, keratinocytes and fibroblasts all come into play through a plethora of cytokines and growth factors including nerve growth factor (NGF). ⋯ In the remodeling phase, NGF regulates fibroblasts and induces their differentiation into myofibroblasts ultimately leading to wound contracture. In addition, NGF stimulates melanocytes and enhances hair growth and pigmentation. Such data depict the mechanisms of action of NGF implicated in the various stages of the healing process and support its applicability as a new targeted therapeutic molecule effective in burn wound healing but with some limitations.
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The aim of this study was to create a Finnish scar assessment scale by translating and evaluating the psychometric properties of the Patient Scar Assessment Scale (PSAS), a part of the Patient and Observer Scar Assessment Scale (POSAS), with burn patients to enable its use in burn care. ⋯ The PSAS was successfully translated and culturally adapted into Finnish and the newly translated version has good validity and reproducibility for assessing mature burn scars.