Search

Introduction: Classic heat stroke is a severe trauma which can lead to multi-organ dysfunctions and is associated with a high mortality. Case presentation: In this case report we present a 73-year-old patient with a classic heat stroke. His initial core body temperature was over 42 °C and he had a GCS of 3. Due to severe burn injuries the patient was transferred to a specialized burn center. The patient developed different organ failures and showed a prolonged course on the intensive care unit. Although the patient demonstrated different impaired organ systems, he recovered completely after receiving painstaking supportive therapy. Conclusions: This is a rare case of a patient who fully recovered after a heat stroke with a temperature over 42 °C and severe sequelae. [ABSTRACT FROM AUTHOR]

Individuals with severe burn injuries may develop depression, yet knowledge about psychological risk factors for depression following trauma is limited. This study investigated the prospective impact and interplay of prior depression and trauma-related cognitive processes (posttraumatic negative appraisals and trauma-related rumination) to depressive symptoms between 6 and 24 months after burn injury. Taiwanese adult survivors of burn (N = 118) participated in surveys immediately post-burn and at 6-, 12-, and 24-months follow-up. Participants were 7 5% men, with an average age of 41.8 years and an average of TBSA of 18.3%. A total of 8.5%, 5.9%, and 4.2% met criteria for probable major depression at 6, 12, and 24 months post-burn, respectively. The prevalence increased to 23.7%, 11.0%, and 5.9% using the cutoff on the PHQ-9. Prior depression and trauma-related cognitive processes immediately post-burn explained 13.5%, 20.5%, and 18.6% of the variance in depressive symptoms at 6, 12, and 24 months post-burn, respectively. Posttraumatic negative appraisals strongly predicted depressive symptoms post-burn across follow-ups. Moreover, posttraumatic negative appraisals significantly mediated the effect of prior depression on subsequent depressive symptoms across follow-ups. Prior depression significantly moderated the effect of trauma-related rumination on depressive symptoms at 6 months post-burn. Our results are the first to demonstrate the role and interplay of prior depression and trauma-related cognitive processes in post-burn depression. Findings highlight that pre-and post-trauma psychological factors jointly affect depression following trauma, broadening the applicability of cognitive theories of PTSD. • This study examined the contribution effect of early psychological risk factors to post-burn depressive symptoms. • Depression is relatively common at 6 months post-burn and then gradually decreased. • Posttraumatic negative appraisals strongly predicted depressive symptoms between 6 and 24 months post-burn. • Posttraumatic negative appraisals mediated the effect of prior depression on long-term depressive symptoms after burn. [ABSTRACT FROM AUTHOR]

Objective: This study attempts to examine long-term pain medication usage after burn injury and its association with functional and psychosocial outcomes. Design: This is a multicenter retrospective cohort study utilizing the Burn Model System National Longitudinal Database. Participants injured from 2015 to 2021 were divided into two groups, those taking and not taking prescription pain medication at 12 mos after injury. Regression analyses examined associations between pain medication use and outcomes at 12 mos, adjusting for demographics, burn size, length of hospital stay, and preinjury pain medication use and employment status. Outcomes included VR-12 Physical and Mental Component Summary scores Patient-Reported Outcomes Measurement Information System Anxiety and Depression scores, Satisfaction with Life Scale, and employment status. Results: Of 358 participants analyzed, prescription pain medication use was associated with worse outcomes at 12 mos: Physical Component Summary (β = -7.11, P < 0.001), Mental Component Summary (β = -6.01, P < 0.001), and Patient-Reported Outcomes Measurement Information System Depression (β =4.88, P < 0.001) and Anxiety (β = 6.16, P < 0.001). Satisfaction with Life Scale was not significantly associated with pain medication use (P = 0.069) and those taking pain medication were 52% less likely to be employed at 12 mos (P = 0.035). Conclusions: There is a significant association between prescription pain medication use and worse physical, mental, and employment outcomes at 12 mos after burn injury. [ABSTRACT FROM AUTHOR]

Purpose: Nowadays, it is largely accepted that albumin should not be used in hypoalbuminemia or for nutritional purpose. The most discussed indication of albumin at present is the resuscitation in shock states, especially distributive shocks such as septic shock. The main evidence-based indication is also liver disease. In this review, we provided updated evidence-based instruction for definite and potential indications of albumin administration in clinical practice, with appropriate dosing and duration. Methods: Data collection was carried out until November 2023 by search of electronic databases including PubMed, Google Scholar, Scopus, and Web of Science. GRADE system has been used to determine the quality of evidence and strength of recommendations for each albumin indication. Results: A total of 165 relevant studies were included in this review. Fluid replacement in plasmapheresis and liver diseases, including hepatorenal syndrome, spontaneous bacterial peritonitis, and large-volume paracentesis, have a moderate to high quality of evidence and a strong recommendation for administering albumin. Moreover, albumin is used as a second-line and adjunctive to crystalloids for fluid resuscitation in hypovolemic shock, sepsis and septic shock, severe burns, toxic epidermal necrolysis, intradialytic hypotension, ovarian hyperstimulation syndrome, major surgery, non-traumatic brain injury, extracorporeal membrane oxygenation, acute respiratory distress syndrome, and severe and refractory edema with hypoalbuminemia has a low to moderate quality of evidence and weak recommendation to use. Also, in modest volume paracentesis, severe hyponatremia in cirrhosis has a low to moderate quality of evidence and a weak recommendation. Conclusion: Albumin administration is most indicated in management of cirrhosis complications. Fluid resuscitation or treatment of severe and refractory edema, especially in patients with hypoalbuminemia and not responding to other treatments, is another rational use for albumin. Implementation of evidence-based guidelines in hospitals can be an effective measure to reduce inappropriate uses of albumin. [ABSTRACT FROM AUTHOR]

Background: Inflammation is the hallmark of critical illness and triggers the neuro-endocrine stress response and an oxidative stress. Acute inflammation is initially essential for patient's survival. However, ongoing or exaggerated inflammation, due to persistent organ dysfunction, immune dysfunction or poor inflammation resolution, is associated to subsequent hypermetabolism and hypercatabolism that severely impact short and long-term functional status, autonomy, as well as health-related costs. Modulation of inflammation is thus tempting, with the goal to improve the short- and long-term outcomes of critically ill patients. Findings: Inflammation can be modulated by nutritional strategies (including the timing of enteral nutrition initiation, the provision of some specific macronutrients or micronutrients, the use of probiotics) and metabolic treatments. The most interesting strategies seem to be n-3 polyunsaturated fatty acids, vitamin D, antioxidant micronutrients and propranolol, given their safety, their accessibility for clinical use, and their benefits in clinical studies in the specific context of critical care. However, the optimal doses, timing and route of administration are still unknown for most of them. Furthermore, their use in the recovery phase is not well studied and defined. Conclusion: The rationale to use strategies of inflammation modulation is obvious, based on critical illness pathophysiology and based on the increasingly described effects of some nutritional and pharmacological strategies. Regretfully, there isn't always substantial proof from clinical research regarding the positive impacts directly brought about by inflammation modulation. Some arguments come from studies performed in severe burn patients, but such results should be transposed to non-burn patients with caution. Further studies are needed to explore how the modulation of inflammation can improve the long-term outcomes after a critical illness. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: This study aimed to assess the methods used for ripening fruits by sellers and to examine the knowledge regarding the health risks associated with the use of calcium carbide (CaC2) among both fruit sellers and consumers in Ado-Ekiti. Methods: The study employed a cross-sectional design, utilizing a semi-structured questionnaire administered in major markets within Ado-Ekiti. Knowledge levels were categorized into good (> 70% score), fair (50–69% score), and poor (< 50% score). One way Analysis of variance (ANOVA) and Independent sample t-test was used to indicate knowledge score difference with respect to socio demographic characteristics. Results: The study involved 357 consumers and 20 fruit sellers, with a majority being females (54.9% of consumers; 80.0% of sellers) and aged predominantly between 18–27 years and 28–39 years. The findings revealed that the use of CaC2 (50%) and natural ripening methods (100%) were common among fruit sellers. Sellers cited cancer (60%), bacterial infections (35%), and chest tightness (15%) as associated risks with CaC2 usage. Similarly, consumers expressed concerns about consuming CaC2-ripened fruits, attributing risks such as abdominal burns (70%), cancer (70.6%), and diarrhoea (67.3%). A significant proportion of sellers (90%) exhibited poor knowledge regarding the risks associated with CaC2, while 24.6% of consumers demonstrated fair knowledge on the subject. Conclusion: The study identified common fruit ripening practices among sellers. Fruit sellers showed poor knowledge, while consumers displayed fair to poor understanding of health risks linked to calcium carbide use in artificial fruit ripening. [ABSTRACT FROM AUTHOR]

INTRODUCTION: With advancements in laser technology, urologists have been able to treat urinary calculi more efficiently by increasing the energy delivered to the stone. With increases in power used, there is an increase in temperatures generated during laser lithotripsy. The aim of this study was to evaluate the thermal dose and temperatures generated with four laser settings at a standardized power in a high-fidelity, anatomic model. METHODS: Using high-fidelity, 3D-printed hydrogel models of a pelvicalyceal collecting system with a synthetic BegoStone implanted in the renal pelvis, surgical simulation of ureteroscopic laser lithotripsy was performed with the Moses 2.0 holmium laser. At a standard power (40 W) and irrigation pressure (100 cm H2O), we evaluated operator duty cycle (ODC) variations with different time-on intervals at four different laser settings. Temperature was measured at two separate locations: at the stone and ureteropelvic junction. RESULTS: Greater cumulative thermal doses and maximal temperatures were achieved with greater ODCs and longer laser activation periods. There were statistically significant differences between the thermal doses and temperature profiles of the laser settings evaluated. Temperatures were greater closer to the tip of the laser fiber. CONCLUSIONS: Laser energy and frequency play an important role in the thermal loads delivered during laser lithotripsy. Urologists must perform laser lithotripsy cautiously when aggressively treating large renal pelvis stones, as dangerous temperatures can be reached. To reduce the risk of causing thermal tissue injury, urologists should consider reducing their ODC and laser-on time. [ABSTRACT FROM AUTHOR]

Background: There is no standardized practice in pediatric pain assessment with burn injuries in the outpatient clinic setting. Objective: This review aims to identify reliable, validated tools to measure pain in the pediatric burn clinic population. Methods: The literature search for this integrative review was conducted using the databases of PubMed, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Cochrane, and Embase from 2011 to 2023. Quality and relevance were appraised using the Johns Hopkins Nursing Evidence-Based Practice Model. Reporting was done according to a Preferred Reporting Items for Systemic Reviews and Meta-Analysis checklist. Results: Fourteen articles and two clinical practice guidelines met inclusion criteria and were included in this review. Conclusion: The Pain Observation Scale for Young Children and the COMFORT Behavior Scale tools have shown good reliability and construct validity and can be safely used to measure background and procedural pain in daily burn practice. Further research on reliable, validated pain assessment techniques in the pediatric burn population is needed. [ABSTRACT FROM AUTHOR]

Introduction: Fire is one of the greatest discoveries in the history of mankind. It fully transforms the way of living of humans. But just like a double edged sword it also affects the human life in a negative way. Fire is easy and dangerous weapon in kitchen to be used for suicide for females in developing country like India. Due to this, thermal burn is a big problem and have significant share in medico-legal autopsies. Aim and objective: The aim of present study is to provide a brief analysis of thermal burn mortality across all age group brought in the mortuary of GRMC, Gwalior and to study the various medico-legal aspects of fatal thermal burn cases. Material & Method: This is a retrospective analysis of 82 cases of thermal burns which were brought for medicolegal autopsy at Forensic Medicine & Toxicology department in Gajra Raja Medical College, Gwalior (Madhya Pradesh) during the whole year. The data was complied, tabulated and analysed statistically. Results: 3.6% of total medico-legal autopsies are of thermal burn. Most of the thermal burn cases fall in the age group of 21-30years. 57.3% victims are female.81.1% of the victims are married. Most of the victims (64.6%) showed total body surface area involvement between 71-100%. Most of the cases (39%) survived for 7 days or more. Most common cause of death (74.4%) in this study is Septicaemia. About 69.5% of thermal burn cases were accidental manner. Conclusion: In most of the cases thermal burn is totally preventable and manageable. Education at school level plays a key role. Most of the accidental thermal burns can be avoided if, people know the proper safety measures for using fuels for cooking. [ABSTRACT FROM AUTHOR]

Cultured epidermal autograft, JACE®, was introduced into the Japanese national health insurance system in 2009 and has been used in more than 1000 cases of extensive burns. The aim of this study was to investigate whether the use of JACE® contributes to survival rate in extensive burns. In this study, 119 cases were selected from 3990 cases in Tokyo Burn Unit Association registry data from 2009 to 2023, excluding cases with less than 40% total body surface area, cases of deaths within 4 weeks and cases with unknown length of hospital stay. In total, 25 patients treated with JACE® were selected and matched with another 25 patients who did not receive JACE® using propensity score matching. The results showed that patients treated with JACE® had a significantly higher survival rate than did those who were not treated with JACE® at all time points between 6 and 9 weeks post‐injury. In addition, there was no significant difference in length of hospital stay between the groups. These results suggest that the use of JACE® in patients with extensive burns contributes to patient survival and does not prolong hospital stay. [ABSTRACT FROM AUTHOR]

Copyright of Anaesthesiologie & Intensivmedizin is the property of DGAI e.V. - Deutsche Gesellschaft fur Anasthesiologie und Intensivmedizin e.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Unintentional injuries disproportionately impact American Indian and Alaska Native (AI/AN) populations. Developing effective and culturally tailored data collection and intervention programs requires an understanding of past prevention efforts in AI/AN communities, but limited peer-reviewed literature on the topic is available. This scoping review aims to summarize efforts that have been published in the Primary Care Provider newsletter, a source of gray literature available through the Indian Health Service. Methods: The research team obtained all injury related articles in the Provider newsletter and excluded those that did not describe an unintentional injury prevention effort. Included articles were organized chronologically and by topic, and outcomes were described in a data abstraction form. Results: A total of 247 articles from the Provider newsletter were screened, and 68 were included in this review. The most number of articles were published in 2007 (n = 15). Many focused not specifically on one tribal community but on the AI/AN community as a whole (n = 27), while others reported that certain tribes were the focus of study but did not identify tribes by name (n = 24). The following is a list of 14 tribal communities explicitly mentioned: Omaha, Cherokee, Ute, Yakama, Chippewa, Apache, Ho-Chunk, The Crow Tribe, Tohono O'odham Nation, Fort Mojave Tribe, Chemehuevi Tribe, The Rosebud Tribe, Navajo, and The Pueblo of Jemez. Published unintentional injury prevention efforts have covered the following 7 topics in AI/AN communities: falls, motor vehicle crashes, poisonings, improving data, burns, children, and other. Conclusion: This scoping review makes available and searchable information on injury prevention work conducted in and for AI/AN communities that is not currently found in the peer-reviewed literature. [ABSTRACT FROM AUTHOR]

The article discusses research which examined trends and factors associated with opioid use for pediatric pain management in emergency departments (ED) in the U.S. from 2011 to 2020 using the National Hospital Ambulatory Medical Care Survey data. The study analyzed primary outcome of treatment with opioid during ED visit by race, ethnicity, age group, sex, ambulance arrival, payor, geographic region, triage category, pain level, type of painful condition and five-year time lapse intervals.

Self-harm behaviors (performed with either lethal and non-lethal intentions) are common, especially among individuals suffering from mood disorders, and the reasons individuals self-harm vary both by person and by the type of behavior. Understanding these variations may help clinicians determine levels of risk more accurately. To understand whether culture and gender are associated with the likelihood of engaging in specific self-harm behaviors and whether the intention (lethal, ambivalent, non-lethal) of these behaviors vary with culture and gender. 2826 individuals took part in an international multilingual online depression/suicidality screening study and reported at least one instance of self-harm in the past year. Participants were grouped into six broad cultural categories (Latin America, South Asia, Russian, Western English, Chinese, Arab). 3-way (culture x gender x intent) interactions were observed for several self-harm behaviors (overdosing, self-burning, asphyxiating, poisoning, and jumping from heights), suggesting that individuals engage in each of these behaviors with different intentions depending on gender and culture. Cultures and genders likewise differed in the likelihood of engaging in several self-harm behaviors. Clinicians should consider culture and gender when assessing for suicide risk, as similar self-harming behaviors may reflect different intentions depending on an individual's culture and gender. [ABSTRACT FROM AUTHOR]

The purposes for performing negative pressure wound therapy (NPWT) in severe burns are diverse, but few reports comprehensively discussing its indications and methods have been published. We included patients with a ≥30% total burn area. There were 4 patients, and a total of 9 NPWT were performed. The therapy sites were the upper extremity (n = 2), the elbow (n = 1), the dorsum of the hand (n = 5), and the knee (n = 1). The purposes of the therapy were bridge-to-skin grafting (n = 5), dressing the artificial dermis (n = 1), therapy for bolstering the autograft (n = 1), bridge-to-flap surgery (n = 1), and covering the flap (n = 1). The devices used were bedside wall suction (n = 5) and dedicated device (n = 3). Therapy was converted to wall aspiration after use of the dedicated device in 1 case. NPWT is an effective option in severe burn treatment. For each purpose, it is necessary to consider the device used, negative pressure setting, starting date, frequency of dressing changes, and period of therapy. NPWT in severe burns also has the advantage of prioritizing life-prolonging treatment. If strict control of negative pressure is required, a dedicated device should be used rather than wall suction. [ABSTRACT FROM AUTHOR]

Background: There is a high incidence of burns in China and the sequelae of post-burn scar growth, disfigurement, and other body image disorders can cause serious psychological distress to burns patients, and negatively affecting the patient's dignity. However, there is limited knowledge relating to the dignity of burns patients. Aim: To investigate the factors that affect dignity in burns patients. Design: Cross-sectional study. Participants and research context: We recruited 323 burn patients from the burn unit of a tertiary care hospital. The Patient Dignity Scale, Burn Specific Health Scale-Brief, Hospital Anxiety and Depression Scale were used to assess burn patients' dignity, quality of life, anxiety, and depression, respectively. 18 sociodemographic variables were included in the questionnaire. Ethical considerations: Before the data were collected, the study protocol was reviewed and approved by the Ethics Committee of the Guangzhou Red Cross Hospital of Jinan University (Reference: 2022-149-02) and all patients provided and signed informed consent forms. Findings: This study included 323 burns patients; of these, 26 (8%) had a mild loss of dignity, 94 (29.1%) had a moderate loss of dignity, 125 (38.7%) had a severe loss of dignity, and 78 (24.1%) had a very severe loss of dignity. The main factors that influence the loss of dignity in burns patients, including the department in which the patient was treated after their burns, gender, the clinical stage of the burn, quality-of-life, depression, resident medical insurance, the cause of the burn, and the burn site. Conclusions: In most cases, the loss of dignity after burn injury is serious. Clinical health care professionals can provide personalized whole-life dignity care for patients by considering the factors that affect the dignity of burns patients, developing targeted dignity management programs, and implementing individualized interventions to maintain dignity, thus helping burns injury patients return to social life and work. [ABSTRACT FROM AUTHOR]

Scalp and forehead region reconstruction is a complex clinical area, typically necessitated by conditions like skin cancers, intracranial lesions, trauma and burns. Various reconstructive techniques exist, from primary closure upscaling to free tissue transfer. Reconstructive options are largely determined by the size and location of the defects, as well as other factors such as age and comorbidities. Preserving natural hair patterns and utilising native scalp tissue, whenever possible, are essential for achieving aesthetic success. This article provides a concise overview of scalp wound reconstruction, emphasising the advantages and limitations of each option. [ABSTRACT FROM AUTHOR]

Background: Despite the relative importance, the prevalence of workplace safety and health issues in hospital food service workers is not well studied. This study describes the epidemiology of work-related injuries and occupational diseases among hospital food service workers (FSWs) in a tertiary hospital in Singapore. Methods: Using a total population sampling approach, a cross-sectional self-administered questionnaire was distributed to all FSWs employed at a major tertiary hospital in Singapore. Results: The response rate was 98.4% (n = 125). The overall prevalence of workplace injuries and musculoskeletal symptoms was 35% (n = 43) and 53% (n = 65) respectively. The most common workplace injuries were cuts/lacerations (35.8%), muscle strain (25.4%) and burns (19.4%). The prevalence of workplace injuries among staff performing food preparation duties was higher at 56.3% as compared to 21.6% among staff with no food preparation duties (p < 0.01). The prevalence of workplace injuries among staff performing cooking duties was also higher at 47.5%, compared to 29.3% among staff with no cooking duties (p = 0.05). Staff performing food preparation duties had a higher prevalence of musculoskeletal symptoms at 66.7% as compared to 44.6% among staff with no food preparation duties (p = 0.02). Obese staff had a higher prevalence of musculoskeletal symptoms at 78.9%, compared to overweight staff at 53.8% and staff with normal weight at 43.1% (p = 0.03). Conclusion: FSWs with jobs involving cooking and preparation of food, and those with obesity, are at higher risk of sustaining workplace injuries or musculoskeletal symptoms. Targeted interventions should be implemented for injury prevention and to mitigate these risks. [ABSTRACT FROM AUTHOR]

Background: The efficacy and safety of cefiderocol in ICU patients with difficult-to-treat resistance (DTR) non-fermenting Gram-negative bacteria (Nf-GNB) are not as well-established. Consequently, we conducted a cohort study to compare Cefiderocol with the Best Available Therapy (BAT) in ICU patients. Methods: We included adult patients from 9 different ICUs, including a burn ICU unit, from 2019 to 2023 treated with Cefiderocol for DTR Nf-GNB isolated from the blood or lungs. We matched each patient at a 1:2 ratio based on the same DTR Nf-GBN isolated pathogen, and when possible, within the same type of ICU (burn unit or not). The primary endpoint of the study was the clinical cure at 15 days, with secondary endpoints including clinical cure at 30 days, relapse, and in-ICU mortality. For each outcome, adjusted odds ratios were estimated using bidirectional stepwise regression in a final model, which included 13 preselected confounders. Results: We included 27 patients with cefiderocol, matched with 54 patients receiving the BAT. Four patients were not exactly matched on the type of ICU unit. Characteristics were comparable between groups, mostly male with a Charlson Comorbidity Index of 3 [1–5], and 28% had immunosuppression. Cefiderocol patients were most likely to have higher number of antibiotic lines. The main DTR Nf-GNB identified was Pseudomonas aeruginosa (81.5%), followed by Acinetobater baumanii (14.8%) and Stenotrophomonas maltophilia (3.7%). Pneumonia was the identified infection in 21 (78.8%) patients in the Cefiderocol group and in 51 (94.4%) patients in the BAT group (p = 0.054). Clinical cure at 15 and 30-day and the in-ICU mortality was comparable between groups, however relapse was higher in the cefiderocol group (8-29.6% vs. 4-7.4%;aOR 10.06[1.96;51.53]) Conclusion: Cefiderocol did not show an improvement in clinical cure or mortality rates compared to BAT in the treatment of DTR Nf-GNB, but it was associated with a higher relapse rate. Key points: What was known: •The use of cefiderocol remains debated and under-evaluated in patients admitted to the ICU. What this article tells us: •In a cohort of 27 patient with cefiderocol treatment, compared with 54 patients treated with best available therapy, no difference was observed compared regarding the 15 and 30-day clinical cure, and in ICU mortality. •However, a higher risk of relapse was observed in the cefiderocol group: 29% vs. 7%. [ABSTRACT FROM AUTHOR]

Wounds pose significant challenges to public health, primarily due to the loss of the mechanical integrity and barrier function of the skin and impaired angiogenesis, causing physical morbidities and psychological trauma to affect patients. Reconstructing the vasculature of the wound bed is crucial for promoting wound healing, reducing scar formation and enhancing the quality of life for patients. The development of pro‐angiogenic skin substitutes has emerged as a promising strategy to facilitate vascularization and expedite the healing process of burn wounds. This review provides an overview of the various types of skin substitutes employed in wound healing, explicitly emphasising those designed to enhance angiogenesis. Synthetic scaffolds, biological matrices and tissue‐engineered constructs incorporating stem cells and primary cells, cell‐derived extracellular vesicles (EVs), pro‐angiogenic growth factors and peptides, as well as gene therapy‐based skin substitutes are thoroughly examined. The review summarises the existing challenges, future directions and potential innovations in pro‐angiogenic dressing for skin substitutes. It highlights the need for continued research to develop new technologies and combine multiple strategies and factors, and to overcome obstacles and advance the field, ultimately leading to improved outcomes for wound patients. [ABSTRACT FROM AUTHOR]

BACKGROUND: Although ambient temperature has been linked with injury incidence, there have been few nationwide studies to quantify the temperature-related risk and burden of cause-specific injury hospitalizations. Additionally, the impact of human-induced climate change to injury burden remains unknown. OBJECTIVES: Our objectives are to examine the associations between ambient temperature and injury hospitalizations from various causes and to quantify the contribution of human-induced warming to the heat-related burden. METHODS: We collected injury hospitalization data from a nationwide hospital-based registry in China during 2000–2019. Using a time-stratified case-crossover design, we investigated the associations between daily mean temperature (°C) and cause-specific injury hospitalizations. We also quantified the burden of heat-related injuries under the scenarios with and without anthropogenic forcing, using the Detection and Attribution Model Intercomparison Project to assess the contribution of human-induced warming. RESULTS: Our study included a total of 988,087 patients with hospitalization records for injuries. Overall, compared to the temperature at minimum risk of hospitalization (-12:1°C), the relative risk of hospitalization at extreme hot temperature (30.8°C, 97.5th percentile) was 1.18 [95% confidence interval (CI): 1.14, 1.22], with an approximately linear association between temperature and hospitalization. Vulnerability to heat-related injuries was more pronounced among males, young (<18 years of age) or middle-aged (45–64 years of age) individuals, and those living in the North. The heatrelated attributable fraction increased from 23.2% in the 2000s to 23.6% in the 2010s, with a corresponding increase in the contribution of humaninduced change over time. In the 2010s, the heat-related attributable fractions for specific causes of injury ranged from 12.4% to 54.4%, with humaninduced change accounting for 6.7% to 10.6% of the burden. DISCUSSION: This nationwide study presents new evidence of significant associations between temperature and cause-specific injury hospitalizations in China and highlights the increasing contribution of human-induced warming to the injury burden. [ABSTRACT FROM AUTHOR]

Background: The percentage of total body surface area (%TBSA) burned and burn depth provide valuable information on burn injury severity. Objective: This study investigated the concordance between The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM) codes and expert burn clinicians in assessing burn injury severity. Method: We conducted a retrospective population-based review of all patients who sustained a burn injury between July 1, 2009, and June 30, 2019, requiring admission into a specialist burn service across Australia and New Zealand. The %TBSA burned (including the percentage of full thickness burns) recorded by expert burn clinicians within the Burns Registry of Australia and New Zealand (BRANZ) were compared to ICD-10-AM coding. Results: 20,642 cases (71.5%) with ICD-10-AM code data were recorded. Overall, kappa scores (95% confidence interval [CI]) for burn size ranged from 0.64 (95% CI 0.63–0.66) to 0.86 (95% CI 0.78–0.94) indicating substantial to almost perfect agreement across all %TBSA groups. When stratified by depth, the lowest agreement was observed for < 10% TBSA and < 10% full thickness (kappa 0.03; 95% CI 0.02–0.04) and the highest agreement was observed for burns of ≥ 90% TBSA and ≥ 90% full thickness (kappa 0.72; 95% CI 0.58–0.85). Conclusion: Overall, there was substantial agreement between the BRANZ and ICD-10-AM coded data for %TBSA classification. When %TBSA classification was stratified by burn depth, greater agreement was observed for larger and deeper burns compared with smaller and superficial burns. Implications: Greater consistency in the classification of burns is needed. [ABSTRACT FROM AUTHOR]

Objective: We aim to report on the Laser-Sclerosing Foam Hybrid Treatment (LSFHT) and its outcomes when used on patients with great saphenous vein (GSV) insufficiency. Methods: This was a single center retrospective cohort study on patients with GSV insufficiency that were treated with the LSFHT technique, a surgical procedure that comprises the use of both sclerosing foam and endovenous ablation and avoids the use of tumescent anesthesia. Occlusion rates and complications were reported. Results: 139 legs from 106 patients were operated, achieving a 100% occlusion rate, while only a small burn and 2 popliteal vein thrombosis cases occurred. Conclusion: The study suggests that the LSFHT is a feasible fast procedure that proved both effective and safe for the treatment of GSV insufficiency. [ABSTRACT FROM AUTHOR]

Preservation and restoration of hand function after burn injuries are challenging yet imperative. This study aimed to assess the curative effect of a composite skin graft over an acellular dermal matrix (ADM) and a thick split‐thickness skin graft (STSG) for treating deep burns on the hand. Patients who met the inclusion criteria at the First Affiliated Hospital of Wenzhou Medical University between September 2011 and January 2020 were retrospectively identified from the operative register. We investigated patient characteristics, time from operation to the start of active motion exercise, take rates of skin graft 7 days post‐surgery, donor site recovery, complications and days to complete healing. Patients were followed up for 12 months to evaluate scar quality using the Vancouver Scar Scale (VSS) and hand function through total active motion (TAM) and the Jebsen–Taylor Hand Function Test (JTHFT). A total of 38 patients (52 hands) who received thin STSG on top of the ADM or thick STSG were included. The location of the donor sites was significantly different between Group A (thick STSG) and Group B (thin STSG + ADM) (p = 0.03). There were no statistical differences in age, gender, underlying disease, cause of burn, burn area, dominant hand, patients with two hands operated on and time from burn to surgery between the two groups (p > 0.05). The time from operation to the start of active motion exercise, take rates of skin graft 7 days post‐surgery and days to complete healing were not significantly different between Group A and Group B (p > 0.05). The rate of donor sites requiring skin grafting was lower in Group B than in Group A (22.2% vs. 100%, p < 0.001). There were no statistically significant differences in complications between the groups (p = 0.12). Moreover, 12 months postoperatively, the pliability subscore in the VSS was significantly lower in Group A than in Group B (p = 0.01). However, there were no statistically significant differences in vascularity (p = 0.42), pigmentation (p = 0.31) and height subscores (p = 0.13). The TAM and JTHFT results revealed no statistically significant differences between the two groups (p = 0.22 and 0.06, respectively). The ADM combined with thin STSG is a valuable approach for treating deep and extensive hand burns with low donor site morbidity. It has a good appearance and function in patients with hand burns, especially in patients with limited donor sites. [ABSTRACT FROM AUTHOR]

Objective: Burn injuries pose a heightened risk of infection, which is primarily responsible for increased morbidity and mortality. Factors such as extensive skin damage and compromised immunity exacerbate this vulnerability. Pseudomonas aeruginosa and Staphylococcus aureus are frequently identified in burns, with Gram-negative Pseudomonas aeruginosa often resistant to antibacterial agents. While Flaminal, an alginate-based wound dressing (Flen Health, Belgium), aids wound healing, its antibacterial effects are limited compared with 1% silver sulfadiazine (1% SSD). In contrast, Prontosan Wound Gel X, a betaine and polyhexanide-based hydrogel (B. Braun Medical AG, Switzerland), has been shown to effectively combat various microbes and promotes wound healing. Method: In this study, two research cohorts were retrospectively established (control group: patients receiving standard of care with the alginate-based wound dressing; intervention group: patients receiving the polyhexanide hydrogel wound dressing), comprising patients admitted to a burn centre between 2019 and 2022. Patients were eligible when continuous wound treatment with either of the two wound dressings was performed. Laser Doppler imaging (LDI) scans were conducted. Regions of interest (ROIs) were selected based on LDI scans and divided into healing time categories. Wound swabs were collected and the presence of Pseudomonas aeruginosa and Staphylococcus aureus was documented. Bacterial load was evaluated using a semiquantitative scale. Wound healing was recorded. Results: The control group consisted of 31 patients with 93 ROIs, while the intervention group had 67 ROIs involving 29 patients. Both groups exhibited similar proportions of healing time categories (p>0.05). The polyhexanide hydrogel dressing outperformed the alginate-based dressing in antiseptic efficacy by significantly reducing the incidence of Pseudomonas aeruginosa- and Staphylococcus aureus-positive cultures in patients' wounds. Wound healing time for conservative treatment was comparable between groups. Conclusion: In this study, the polyhexanide hydrogel dressing minimised Pseudomonas aeruginosa and Staphylococcus aureus colonisation in burn wounds, demonstrating strong antibacterial properties, emphasising its potential to minimise infections in burn injuries. [ABSTRACT FROM AUTHOR]

Introduction: Luminal esophageal temperature (LET) monitoring during atrial fibrillation (AF) ablation is widely used to reduce the incidence of endoscopically detected esophageal lesion (EDEL). We sought to assess whether specific patterns of LET variation are associated with EDEL. Methods: A high‐fidelity multisensor probe was used to record LET in AF patients undergoing radiofrequency ablation (RFA) or cryoballoon ablation (CBA). Explainable machine learning and SHapley Additive exPlanations (SHAP) analysis were used to predict EDEL and assess feature importance. Results: A total of 94 patients (38.3% persistent AF, 71.3% male, 72 RFA, and 22 CBA) were included. EDEL was detected in 11 patients (10 RFA and one CBA). In the RFA group, the highest LET recorded was similar between patients with and without EDEL (40.6 [40.1–41]°C vs. 40.2 [39.1–40.9]°C; p =.313), however, the rate of LET rise for the highest recorded peak was higher (0.08 [0.03–0.12]°C/s vs. 0.02 [0.01–0.05]°C/s; p =.033), and the area under the curve (AUC) for the highest peak was smaller (412.5 [206.8–634.1] vs. 588.6 [380.4–861.1]; p =.047) in patients who had EDEL. In case of CBA, the patient with EDEL had a faster LET decline (0.12 vs. 0.07 [0.02–0.14]°C/s), and a smaller AUC for the lowest trough (2491.3 vs. 2629.3 [1712.6–5283.2]). SHAP analysis revealed that a rate of LET change higher than 0.05°C/s and an AUC less than 600 were more predictive of EDEL in RFA. Conclusion: The rate of LET change and AUC for the recorded temperature predicted EDEL, whereas absolute peak temperatures did not. [ABSTRACT FROM AUTHOR]

RSDL® (Reactive Skin Decontamination Lotion) Kit is approved for decontaminating chemical warfare agents and T-2 fungal toxins. This work aimed to investigate the efficacy of RSDL or water irrigation for sulfuric acid dermal decontamination against untreated control in rabbit models. Rabbits were randomly assigned to Groups 1 (no decontamination), 2 (water) or 3 (RSDL) and exposed to sulfuric acid (0.1 mL/3-4 cm²) for 30 seconds Decontaminants remained on-site for 2 minutes. Decontamination efficacy with RSDL and water were similar. Wound pH was higher and erythema persisted longer after decontamination versus control. Oedema developed by Day 3 and resolved by Day 15 in all groups. Necrosis started by Day 3, and all wounds had necrosis by Day 21. Wound areas following decontamination were significantly smaller than controls. Microscopically, all wounds in all groups had full-thickness epidermal and dermal necrosis. In summary, RSDL and water were similarly effective in reducing wound size and increasing wound pH by Day 3 compared to controls. Histopathology data demonstrated similar tissue injury across all groups and showed no signs of wound healing after exposure RSDL was a reliable decontamination method in the absence of immediate access to water. [ABSTRACT FROM AUTHOR]

Background/Objective : Hydroxocobalamin is indicated for cyanide poisoning and its package insert states it should be given "without delay". We sought to evaluate time to administration and clinical characteristics when hydroxocobalamin was administered in a quaternary care academic medical center. Methods : All hydroxocobalamin administrations from January 1, 2007 to December 31, 2018 were analyzed. Data points recorded were: carboxyhemoglobin, cyanide and methemoglobin levels, hospital time and course, time and dose of hydroxocobalamin administration, lactate and bicarbonate levels, initial and nadir pH, initial heart rate, and initial and lowest systolic blood pressure. Results : Fifty-six cases were identified. One case was excluded as hydroxocobalamin was administered for nitroprusside toxicity. Among 55 cases analyzed, 93% (n = 51) were adults. Median hospital length of stay was 4.3 days (IQR 2.5 to 12). Burn, inhalation injury, and smoke inhalation were 80% of admitting diagnoses. Median time to hydroxocobalamin administration was 208 minutes (IQR 62.5 to 330). Eleven of 55 cases died. Hydroxocobalamin was given within 60 minutes of arrival in 12 cases, of which 3 died. All adults received 5 g of hydroxocobalamin. Time to hydroxocobalamin administration was longer in death cases [median: 221 minutes (IQR 119 to 594)] vs survivors [median: 184.5 minutes (IQR 62.8 to 315)]. Seventeen cases had cyanide levels drawn, with 9 being measurable, but none were toxic. Conclusions : Significant delay in hydroxocobalamin administration was seen in this study. Cases that resulted in death had significantly longer times to hydroxocobalamin administration. Further studies are warranted to identify reasons for delays in hydroxocobalamin administration. [ABSTRACT FROM AUTHOR]

Air medical providers are responsible for the care of an incredibly diverse patient population. When it is time to transport a patient, providers must be prepared for complex situations, each requiring different skills, medications, and critical thinking. Scene flights will have providers landing and providing care in the prehospital setting where an interfacility transport requires the patient to be taken from one hospital to another. Specialty flights require special equipment, personnel, and aircraft preparedness to be completed. The case studies provided within this article highlight the complexity and diversity that is encountered each shift at Allegheny LifeFlight. [ABSTRACT FROM AUTHOR]

Objective: Accurate assessment of burn depth and burn wound healing potential is essential to determine early treatments. Infrared thermography (IRT) is a non-invasive and objective tool to do this. This systematic review evaluated the accuracy of IRT to determine burn wound healing potential. Method: This systematic review and meta-analysis used MEDLINE, EMBASE, CINAHL, PEDro, DiTA and CENTRAL databases. IRT data were extracted from primary studies and categorised into four cells (i.e., true positives, false positives, true negatives and false negatives). Subgroup analysis was performed according to methods used to capture thermal images. Results: The search strategy identified 2727 publications; however, 15 articles were selected for review and 11 for meta-analysis. In our meta-analysis, the accuracy of IRT was 84.8% (63% sensitivity and 81.9% specificity). Conclusion: IRT is a moderately accurate tool to identify burn depth and healing potential. Thus, IRT should be used carefully for evaluating burn wounds. Declaration of interest: The authors have no conflicts of interest to declare. [ABSTRACT FROM AUTHOR]

Objective: Wormwood (Artemisia absinthium L.) is a valuable medicinal plant that has been used for the wound healing since ancient times. Hydrogel dressings are often preferred for wound care in treatment. In this study, the effects of chit osanbased hydrogel dressings containing wormwood were investigated in rats with a burn wound model for the first time. Material-Method: Certain phenolic compounds in wormwood extracts were detected by LC-MS/MS and antioxidant activities were calculated using the DPPH. The antibacterial activity of the dressings was tested using the disk diffusion method. Tissues taken from 48 female Sprague-Dawley rats were histopathologically examined at days 3rd and 21st. Skin tissue Il-1α, Il-6, TNF-α and Il-10 levels were measured using ELISA. All data obtained from histopathological examination and cytokine levels were statistically evaluated. Results: Fifteen phenolic compounds were quantitatively determined in wormwood extracts. The antioxidant activities of high-, medium-, and low-dose wormwood extracts were 91.1% ± 0.054, 89.6% ± 0.012 and 84.1% ± 0.02, respectively. The hydrogel dressings showed no antibacterial activity against S. aureus (ATCC 29213) or P. aeruginosa (ATCC 27853). Granulation tissue formation, collagen increase, and regular scar appearance were higher in all three wormwood groups. Wound contraction was completed and remodeling phase started at day 21st, especially in the high-dose wormwood treatment group. Tissue cytokine levels were determined in pg/ml in all groups. Conclusion: It was determined that A. absinthium L. can promote wound healing through various mechanisms of action and shows immunomodulatory effects, and is appropriate for use as a wound dressing in the form of a chitosan -based hydrogel. [ABSTRACT FROM AUTHOR]

The study screened the occurrence of VanA,VanB,Vanc genes in Staph aureus vancomycin-resistant isolates recovered in Hilla -hospitals. From various clinical samples, 160 isolates from patients between July and November of 2022 were included in the search. Among these samples are (65) burn samples, (55) urine samples, and (40) samples from Blood. 40 (or 25%) of the 160 isolates were Staph aureus. Characterization of the VanA, VanB, and VanC genes in Staph aureus isolates obtained from various specimens is the main goal of the work. The RESULTS of samples were obtained from a variety of clinical specimens, including 20 (40.625%) burn swabs, 10 (25%) urine samples, and 10 (34.375%) blood. Staph aureus was resistant to Cefepime (91.7%), Piperacillin (73.3%), and Ceftazidime (71.7%), although little relationship was detected with Aztreonam resistance (35%). 40 isolates were used for antibiotic sensitivity test (AST). Only 18.3% and 15% of isolates, respectively, were resistant to meropenem and imipenem. Fluoroquinolone resistance to lomefloxacin, ciprofloxacin, ofloxacin, and levofloxacin was 51.7%, 48.3%, 35%), and 30%, respectively. While the most prevalent vancomycin resistance genes were found in 40 isolates of S. aureus and were discovered by VanC 40 (100%), VanA 20 (100%), and VanB28 (70%), according to the current investigation.In Conclusion :The PCR-reaction method was discovered to be an easy-to- use tool for detecting staph aureus by pcr that can be regularly used for identifying staph aureus and detection the molecular resistance apparatuses to vancomycin in staph aureus by VanA, VanB, VanC), efflux systems plays To choose the best antibiotics, prevent the establishment of resistant strains, and create novel antimicrobial. medications, it is beneficial to research the particular resistance mechanisms vancomycin to staph aureus. [ABSTRACT FROM AUTHOR]

Burn injuries result in localised tissue damage and precipitate systemic responses; routine clinical treatments, which typically include metabolic nutritional support and anti‐infection therapies, do not yield optimal outcomes. Therefore, we aimed to systematically evaluate the effects of ulinastatin on wound infection and healing in patients with burns to provide reliable evidence‐based recommendations for burn treatment. An electronic search of the Web of Science, PubMed, Cochrane Library, Embase, Wanfang, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure databases, supplemented by manual searches, was conducted from database inception to October 2023 to collect randomised controlled trials (RCTs) assessing the efficacy of ulinastatin for the treatment of burns. Two researchers screened all retrieved articles according to the inclusion and exclusion criteria; the included studies were evaluated for quality, and the relevant data were extracted. Stata 17.0 software was employed for data analysis. Overall, 8 RCTs with 803 patients were included, with 404 and 399 in the ulinastatin and conventional treatment groups, respectively. The analysis revealed that wound infections (odds ratio [OR] = 0.08, 95% CI: 0.02–0.35, p = 0.001) and complications (OR = 0.21, 95% CI: 0.10–0.42, p < 0.001) were significantly lower, and wound healing time (standardised mean differences [SMD] = −1.31, 95% CI: −2.05 to −0.57, p = 0.001) was significantly shorter, in the ulinastatin groups than in the control group. This meta‐analysis revealed that ulinastatin can effectively reduce the incidence of wound infections and complications and significantly shorten the duration of wound healing in patients with burns, thereby promoting early recovery in these patients. [ABSTRACT FROM AUTHOR]

Non-accidental trauma (NAT) is a major cause of morbidity and mortality for children around the world and most significantly impacts children under one year of age. Prompt and comprehensive treatment of these children relies on a high index of suspicion from any medical provider that treats pediatric patients. This review discusses those most at risk for experiencing NAT, and common initial presentations, to assist providers in the identification of potential victims. In addition, this review provides guidance on the recommended workup for these patients so that the full extent of associated injuries may be identified and the appropriate healthcare team may be assembled. [ABSTRACT FROM AUTHOR]

Objective: The effective assessment of wounds, both acute and hard-to-heal, is an important component in the delivery by wound care practitioners of efficacious wound care for patients. Improved wound diagnosis, optimising wound treatment regimens, and enhanced prevention of wounds aid in providing patients with a better quality of life (QoL). There is significant potential for the use of artificial intelligence (AI) in health-related areas such as wound care. However, AI-based systems remain to be developed to a point where they can be used clinically to deliver high-quality wound care. We have carried out a narrative review of the development and use of AI in the diagnosis, assessment and treatment of hard-to-heal wounds. We retrieved 145 articles from several online databases and other online resources, and 81 of them were included in this narrative review. Our review shows that AI application in wound care offers benefits in the assessment/diagnosis, monitoring and treatment of acute and hard-to-heal wounds. As well as offering patients the potential of improved QoL, AI may also enable better use of healthcare resources. [ABSTRACT FROM AUTHOR]

Introduction: Burn injuries represent a prevalent concern among children, often resulting in irreversible complications. Hence, this study aimed to investigate the epidemiology and severity of burns in children under 12 years of age admitted to Imam Khomeini Hospital in Ilam from 2015 to 2019. Material & Methods: This retrospective descriptive study examined the medical records of 150 children under 12 years old admitted to Imam Khomeini Hospital in Ilam with burn injuries between 2015 and 2019. Data were collected through chart reviews and interviews with the patients' families, and analyzed using SPSS v-19. Results: The majority of burn cases occurred in children under three years old (61.3%, 92 individuals), with more than half being boys (55.3%, 83 individuals). Second-degree burns accounted for 87.3% (131 individuals) of cases, with approximately 80% (120 individuals) involving burns covering 1-20% of the body surface area. Hot liquids were the leading cause of burns (79.9%, 119 individuals), and 84% (126 individuals) of burns occurred in enclosed spaces. Only 18.7% (122 individuals) of cases required hospitalization, with no fatalities reported. Conclusion: Preventive measures targeting young children, particularly those under three years old, and boys, given their active nature, are crucial in reducing burn incidents. Additionally, addressing factors such as the availability of combustible materials, particularly hot liquids, through educational programs can significantly contribute to burn prevention efforts. [ABSTRACT FROM AUTHOR]

This case involves a 30-year-old female who suffered extensive facial burns as an outcome of a horrific assault. The patient subsequently underwent 2 surgeries with the ultimate goal of reducing the cosmetic, physical, and thus mental burden the assault caused. The technique of choice was the novel trapezius fasciocutaneous flap for burn reconstruction of the neck. It is discussed that while this technique is still deemed a novel procedure, its unique characteristics make it an excellent choice for cases similar to this one. While this approach has not been widely popularized in the treatment of patients with burn contracture requiring reconstruction, the donor site characteristics and ideal functionality make the trapezius fasciocutaneous flap such an excellent choice. This particular type of graft yields a hidden donor site, contains rich vascularity with physical qualities similar to those of facial skin, specifically in regard to thickness, color, and texture, and ultimately produces the most ideal cometic outcome. Further, the wide arc of rotation unique to this flap allows for better manipulation and mobility at the transplanted location. While the anatomic implications are very relevant to head and neck surgery, this method also produces exemplary cosmetic outcomes when compared to other graft procedures. [ABSTRACT FROM AUTHOR]

A commentary on the 2024 article "Affect, Values and Problems Assessing Decision-Making Capacity," by J. Hawkins is presented. It examines how Hawkins' two additional criteria in determining decision-making capacity might be applied to the case of Dax Cowart, a patient who suffered burns and repeatedly expressed his wish to be permitted to die. It also cites that Dax's case has provoked bioethical debate for several decades.

In the article, the author discusses the criteria for identifying wound infection and other topics like the creation of a clinical framework specific to wound infection and the different types of wound like arterial leg ulcers, diabetic foot ulcers, and venous leg ulcers.

Pediatric burn injuries are a critical medical condition that triggers a series of ongoing multifactorial stressors that affect both children and their families. To inform healthcare research and clinical practice, this study aimed to understand and describe the perceptions and experiences of the parents of burn-injured children during hospital stay. Forty-six parents (thirty-eight mothers) of forty-six children (eighteen girls) with a mean age of 2.28 years (SD = 1.52) answered ten open-ended questions. This qualitative study was conducted in a referral hospital in the northern region of Portugal. Qualitative data were analyzed using an inductive content analysis. Five key themes emerged from the data analysis: diving into the crisis of the child burn injury, being together and in good hands, becoming aware of an uncertain future, enhancing supportive care and environment, and finding ways to guide parents. Qualitative findings underlined the pressing need for integrated care within this context. Parents were significantly burdened and distressed during the inpatient phase. These parents should be included in the integrated care plan starting from admission. Understanding and addressing parents' healthcare needs and psychosocial adjustment difficulties is paramount to the development of future intervention programs and the delivery of suitable integrated healthcare. [ABSTRACT FROM AUTHOR]

Sarah Jane Palmer describes the powerful impact diet can have on the capability of a wound to heal itself. A wide range of nutrients can improve healing, yet malnutrition in everyday diet, regardless of a person's weight, can significantly delay or prevent healing. This article explores wound types, such as chronic wounds and burns, and discusses immunonutrition. [ABSTRACT FROM AUTHOR]

The most common type of burn among children is scalding burn. This study aims to reveal child abuse and neglect as a specific etiological factor that specific to our country, traditional teapot- and teacup-related scalding burns. Burn cases that admitted to our Burn Center were investigated, and among these, 72 cases suffering from scalding burns were included in the study. The interview forms issued upon admission of these cases were evaluated in detail. Out of 148 scalding burn cases, 48.6% were related to the use of traditional teapots and teacups. After a detailed assessment, all cases were considered neglect-related burns. As a result of considering the role of traditional teapots and teacups in pediatric injuries in our country, parents and caregivers should be warned about these types of injuries. Also, physicians must determine the possibility of child abuse or neglect in all pediatric burn cases. [ABSTRACT FROM AUTHOR]

Deep burns sequelae involving the upper limb are challenging even for experienced surgeons, mainly because local reconstructive options and donor sites are often compromised. The use of free flaps for this type of reconstruction remains difficult due to the small recipient vessel diameter and tendency to vasospasm. Moreover, pediatric cases bring the challenge to another level. We present the case of a 13-year-old girl presenting major retractile sequelae of the upper left limb, including complete wrist immobilization combining wrist hyper-extension, ulnar deviation deformity, and a ulno-carpal dislocation. She was referred to our department where a two-stage reconstruction was performed using a pre-expanded free deep inferior epigastric artery perforator (DIEP) flap. The first surgery consisted of placing two kidney-shaped expanders in a subfascial plane in the hypogastric region. Four months later, after a bi-weekly expansion, an excision of the scar tissue, and the DIEP flap transfer were completed. At the 12-month follow-up evaluation, both aesthetic and functional results were satisfactory, with a good contour and regained mobility of the wrist. [ABSTRACT FROM AUTHOR]

La réparation des tissus mous de la partie distale de la jambe constitue un défi pour le chirurgien. L'objectif de notre travail est d'évaluer l'intérêt du lambeau plantaire médial dans la réparation des pertes de substance du quart distal de la jambe, en mettant le point sur les avantages et les inconvénients de cette technique. Nous avons mené une étude rétrospective étalée sur 4 ans au sein du service de Chirurgie Plastique, Réparatrice et des Brûlés de l'Hôpital Militaire d'Instruction Mohammed V de Rabat incluant 8 patients admis pour couverture d'une perte de substance du quart distal de la jambe par un lambeau plantaire médial. Huit patients ont été inclus, 5 hommes et 3 femmes avec une moyenne d'âge de 45,5 ans, l'origine traumatique a présenté l'étiologie la plus fréquente. Tous les patients ont bénéficié d'une couverture par un lambeau plantaire médial. Les résultats fonctionnels et esthétiques étaient très bons avec un faible taux de complications. Le lambeau plantaire médial ne doit plus être réservé à la couverture des pertes de substance du pied uniquement, mais il doit être intégré dans l'arsenal thérapeutique de reconstruction des défects du quart distal de la jambe. Soft tissue repair of the distal leg is a challenge for the surgeon. The objective of our work is to evaluate the interest of medial plantar flaps in the repair of soft tissue loss in the distal quarter of the leg, by highlighting the advantages and disadvantages of this technique. We conducted a retrospective study over 4 years in the Department of Plastic, Reconstructive and Burn Surgery of the Mohammed V Military Teaching Hospital of Rabat, including 8 patients admitted for coverage of a distal quarter of the leg with a medial plantar flap. Eight patients were included, 5 men and 3 women with an average age of 45.5 years. All patients received coverage with a medial plantar flap. The functional and aesthetic results were very good with a low complication rate. The medial plantar flap should no longer be reserved for covering loss of substance of the foot only, but should be integrated into the therapeutic arsenal of reconstruction of the distal quarter of the leg. [ABSTRACT FROM AUTHOR]

Background and Aim: The prevalence of fluoroquinolone resistance among Pseudomonas aeruginosa isolates, particularly in burn wound infections, has been increasing. The primary cause of ciprofloxacin resistance is attributed to genetic alterations in the quinolone resistance determinant region (QRDR). In this study, we evaluated the antimicrobial resistance profile and QRDR gene mutations in both ciprofloxacin-resistant and non-resistant strains of P. aeruginosa derived from burn wound patients. Materials and Methods: A total of 300 samples were collected from patients with burn wound infections in Guilan, Iran. The isolates were identified as P. aeruginosa, and drug susceptibility tests were conducted using the agar disk diffusion method. DNA extraction and polymerase chain reaction (PCR) analysis were performed for the amplification and sequencing of gyrA, gyrB, parC, and parE genes in the QRDR region. Results: Resistance to Tobramycin, Gentamicin, Piperacillin, Ciprofloxacin, Ceftazidime, and Amikacin was observed in 59.32%, 55.08%, 51.69%, 50.84%, 30.50%, and 26.27% of the isolates, respectively. Forty-two (35.59%) isolates were multidrug- resistant (MDR). The sequencing results in the QRDR region showed that the majority of mutations were in the gyrA gene, with 85.71% of these mutations being the substitution of threonine with isoleucine (Thr-83 Ile) in ciprofloxacinresistant strains. Conclusion: The results of this study indicate that mutations in the gyrA (gyrase gene) are a significant mechanism of resistance to fluoroquinolones. Identifying these mutations can aid in the detection of fluoroquinolone-resistant isolates and simplify treatment challenges by selecting the appropriate antibiotic. [ABSTRACT FROM AUTHOR]

This case study series outlines the use of Novosorb biodegradable temporising matrix (BTM, PolyNovo, Australia) in the management of 22 patients, each with a complex wound who attended the vascular department in the University Hospital Limerick between 2021 and 2023. The majority of patients presented with acute conditions (e.g. necrotising fasciitis, crush injuries, compartment syndrome) that initially required high dependency level care. The majority of wounds (21/22, 95%) affected the leg or foot, and one wound was on the chest wall. Each patient had a significant complex wound and, in many cases, was complicated further by the patients' medical condition and comorbidities, which had the potential to cause problematic and delayed healing. The BTM was applied following debridement, as required, and provided a stable base for secondary wound healing or skin grafting, as needed. Of the patients: 12 (54%) healed completely; one (4%) progressed towards complete vascularisation with the BTM in situ; two (9%) underwent major amputations despite successful application of the BTM to lower limb wounds; and one (4%) returned to theatre to have retained clips removed. The remaining six (27%) patients failed to heal completely following BTM application. Ischaemia, infection, vasculitis and underlying osteomyelitis were limiting factors in achieving limb salvage or healing. Declaration of interest: The authors have no conflicts of interest to declare. [ABSTRACT FROM AUTHOR]

Copyright of Health & Society is the property of Instituto de Ensino e Pesquisa Periodicojs and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The emerging evidence has indicated the role of microRNAs (miRNA) in various physiological or pathological processes. Also, documents have suggested that exercise, by affecting miRNA regulation, may enhance burn wound healing. The current study aims to systematically review the role of exercise in regulating miRNAs related to burn wound healing to provide potential therapeutic targets. A comprehensive, systematic search was performed in different international electronic databases, such as Embase, PubMed and Google Scholar search engine, Science Direct, ProQuest and Ovid using keywords extracted from Medical Subject Headings from 2010 to September 2023. The keywords, including 'exercise' AND 'burn wound' AND 'microRNA' and finally, six cases were achieved. Evidence has indicated that exercise may promote the healing of burn wounds by regulating certain miRNAs. Studies have found that exercise regulates the expression of miRNAs such as mir‐155, miR‐21, let‐7a, miR‐146a, miR‐122 and mir‐210 in burn wound tissue, which regulate inflammation and angiogenesis. These findings suggest that miRNAs may play a role in the positive effect of exercise on burn wound healing. However, further research is needed to understand the mechanisms involved fully. [ABSTRACT FROM AUTHOR]