Burns : journal of the International Society for Burn Injuries
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The use of in-vitro and ex-vivo models for the study of burn wound injuries is encouraged to reduce the animal burden in experimental burn research. However, few existing platforms enable the production of reproducible, locally confined thermal injuries at short durations in a high-throughput manner for both in-vitro and ex-vivo models. To address this gap, we established an automated high-throughput burn platform (HTBP) that provided accurate control over burn temperature, exposure time, and pressure application. ⋯ Moreover, we found that even a short exposure time of 200 msec caused a severe burn wound at 75 °C in a cell monolayer. In addition, we used the HTBP to generate burn injuries at different burn durations in ex-vivo porcine skin and showed that dermis discoloration was present in histologic sections after exposure to 100 °C for a short duration of 500 msec. Our work demonstrates that the HTBP can constitute an important tool for both in-vitro and ex-vivo research of mild and severe burn injuries in a tightly controlled setting and high-throughput manner.
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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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Patients with severe burns (≥20 % total body surface area [TBSA]) have specific and time sensitive needs on arrival to the burn centre. Burn care systems in Australia and New Zealand are organised differently during weekday business hours compared to overnight and weekends. The aims of this study were to compare the profile of adult patients with severe burns admitted during business hours with patients admitted out of hours and to quantify the association between time of admission and in-hospital outcomes in the Australian and New Zealand context. ⋯ These findings support current models of care in Australian and New Zealand burn centres, however further investigation is required. Nonetheless, given most severe burns patients arrive out of hours to burn the centre, it is plausible that out of hours availability of senior burn clinicians will improve patient care and safety resilience within burn care systems.
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Deep partial-thickness and full-thickness burn wounds often undergo tangential excision or escharectomy to expose healthy tissue, combined with skin grafting to promote wound healing. However, conventional tangential excision with the humby knife leads to inevitable damage to the dermis while excising burn tissue due to the lack of precision. Indeed, the preservation of dermal tissue is a key factor in determining wound healing and scar quality. The precision and tissue selectivity of the Versajet Hydrosurgical System has been established for excising burn tissue while preserving dermal tissue. In this study, we retrospectively compared the efficacy of "Hydrosurgical excision combined with skin grafting" and "Conventional tangential excision combined with skin grafting" in treating deep partial-thickness and full-thickness burn wounds to demonstrate that hydrosurgery improved the treatment of deep partial-thickness and full-thickness burns. ⋯ Hydrosurgical excision combined with skin grafting reduced intraoperative blood loss volume per unit area of grafted skin, improved scarring 1-year after injury, and did not increase the treatment costs per unit of burned area. This technique provides a novel alternative for managing deep partial-thickness and full-thickness burn wounds.