Burns : journal of the International Society for Burn Injuries
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One of the most important duties of the members of the treatment team is to pay attention to the mental, psychological, and social aspects of burn patients. One of the concerns of these patients during their stay in the hospital is the fear of rejection. The objective of this research is to examine the concept of 'fear of rejection' among patients hospitalized with burn injuries. ⋯ Based on the results of this study, it can be said that the fear of social rejection, characterized by an inability to perform roles and the visualization of a foggy future, significantly affects the psychological and physical health of burn patients, potentially delaying their recovery. Assisting these patients in reaching their fullest potential to contribute to society post-discharge, and fostering optimism for a promising future, constitute a paramount aspect of daily care and ongoing support.
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The overwhelming burden of burns in low-income (LIC) and low-middle-income (LMIC) countries has been well-documented. Though best global practice is for major burns to be treated in burn units, the prohibitive cost makes it difficult. In this article we attempt to present the improvement in outcome recorded over a period of 3 years as we transitioned from nursing our burns patients in the general surgical wards (Group A), then a separate cubicle within the wards (Group B) and then an isolated burn ward (Group C). ⋯ Most LICs and LMICs do not have functional health insurance schemes for burns patients and overall resources allocated for healthcare cannot support a state-of-the-art burn unit. Our report attempts to encourage such countries to adapt global practice to their economic reality. Minimal changes like an isolated burn ward, separate shower room for wound dressings, strict hygiene practices, and limiting visitor traffic may go a long way to improve burn patient outcome.
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If not accurately diagnosed and treated, postburn pathological scars, such as keloids and hypertrophic scars, can lead to negative clinical outcomes. However, differential diagnosis at the molecular level for postburn pathological scars remains limited. Using single-cell sequencing analysis, we investigated the genetic nuances of pathological scars at the cellular level. This study aimed to identify molecular diagnostic biomarkers to distinguish between postburn keloids and hypertrophic scars. ⋯ Single-cell sequencing analysis unveiled 29 and 30 cell clusters in keloids and hypertrophic scars, respectively, predominantly composed of fibroblasts. Bulk differential gene analysis showed 96 highly expressed genes and 69 lowly expressed genes in keloids compared to hypertrophic scars. By incorporating previous research, Gene Set Enrichment Analysis was conducted to select fibroblasts as the focus of research. According to the single-cell data, 301 genes were stably expressed in fibroblasts from both types of pathological scars. Consistently, Weighted Gene Co-expression Network Analysis revealed that the blue module genes were mostly hub genes associated with fibroblasts. After intersecting fibroblast-related genes in single-cell data, Weighted Gene Co-expression Network Analysis-hub module genes, and bulk differential expression genes, insulin-like growth factor binding protein 6 and tumour necrosis factor alpha-induced protein 6 were identified as key genes to distinguish keloids from hypertrophic scars, resulting in diagnostic accuracies of 1.0 and 0.75, respectively. Immunohistochemical Staining and Quantitative Reverse Transcription PCR revealed that the expression levels of tumour necrosis factor alpha induced protein 6 and insulin-like growth factor binding protein 6 were significantly lower in postburn keloids than in hypertrophic scars- CONCLUSIONS: Tumour necrosis factor alpha induced protein 6 and insulin-like growth factor binding protein 6, exhibiting high diagnostic accuracy, provide valuable guidance for the differential diagnosis and treatment of postburn pathological scars.
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Infections are the most frequent complication and cause of mortality in burn patients. We describe the epidemiology and outcomes of infections among deployed U.S. military personnel with burns. ⋯ Military personnel with burn injuries who developed infections were more severely injured with greater TBSA and inhalation injury. Improved understanding of risk factors for burn-related infections in combat casualties is critical for effective management.
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Timely admission to the burn unit is crucial. Ideal burn care requires prompt interventions such as wound and body temperature management, infection control, and fluid resuscitation to prevent complications like burn progression and infection. In this study, we identify specific factors and outcomes associated with delayed admission to a regional burn center. ⋯ Sociodemographic variables such as homelessness, lack of social support, and substance abuse are associated with delayed burn unit admission. Knowledge of these factors can inform future interventions to improve outcomes for vulnerable patients, promoting better recovery and long-term outcomes after burn injury.