Ethical Considerations for Acutely Injured and Future Burn Patients Who Smoke While on Home Oxygen Therapy.

Home oxygen therapy (HOT) is prescribed to patients with pulmonary dysfunction to improve survival and quality of life. However, ignition of oxygen can lead to burns with significant morbidity and mortality. Providers who routinely treat this patient population face an ethical issue: balancing the obligation to provide beneficial treatment to a patient with the responsibility to protect that patient from suffering avoidable burn injuries.

The impact of different co-morbidities on clinical outcomes and resource utilization in critically ill burn and surgical patients: A population-based analysis of social determinants of health.

Background: This study aims to establish the significance of social determinants of health and prevalent co-morbidities on multiple indicators for quality of care in patients admitted to the Burn and Surgical Intensive Care Unit (ICU).

Methods: We performed a retrospective analysis of population group data for patients admitted at the Burn and Surgical ICU from January 1, 2016, to November 18, 2019. The primary outcomes were length of hospital stay (LOS), mortality, 30-day readmission, and hospital charges.

Lower Extremity Pediatric Tissue Expansion: A Single Surgeon's 16-Year Experience.

Background: Tissue expansion is a well-established approach to soft tissue reconstruction in the pediatric population for lower extremity pathologies. Unfortunately, complication rates range from 19% to 40% in literature, including infection and implant extrusion, leading to delays in reconstruction. These challenges have prompted investigation toward categorizing risk factors for lower extremity tissue expander placement.

Treatment Delays in Nonsyndromic Craniosynostosis: A 30-Year Retrospective Case-Control Analysis of the Impact of Socioeconomic and Family Status on Access to Care.

Background: Patients with nonsyndromic craniosynostosis (NSC) generally undergo corrective surgery before 1 year of age to the mitigate morbidities and risks of delayed repair. The cohort of patients who receive primary corrective surgery after 1 year and factors associated with their gaps to care is poorly characterized in literature.

Methods: A nested case-control study was conducted for NSC patients who underwent primary corrective surgery at our institution and affiliates between 1992 and 2022.

Mentorship is Critical: An Analysis of the 2022 Plastic Surgery Match.

Background: As the second cycle impacted by COVID-19, the 2022 Plastic and Reconstructive Surgery (PRS) Match maintained virtual interviews while offering a modest lift of subinternship restrictions. The residency application process continues to evolve, with changes such as pass/fail United States Medical Licensing Examination Step 1 reporting prompting programs to reconsider metrics of applicant success. It is critical to address the impact of board scores, mentorship, and resource availability on a diverse applicant population in the PRS Match.

The Impact of Socioeconomic Factors on the 2022 Plastic Surgery Match.

Background: In 2022, the plastic and reconstructive surgery (PRS) match faced unprecedented system-wide transitions that have redefined conventional measures of applicant success. This challenges the equitable assessment of student competitiveness and diversity in the field.

Methods: A survey of demography, application content, and 2022 match outcomes was distributed to applicants to a single PRS residency program.

Public perception of household risks for pediatric burn injuries and assessment of management readiness.

Introduction: Children are uniquely vulnerable to injury because of near-complete dependence on caregivers. Unintentional injury is leading cause of death in children under the age of 14. Burns are one of the leading causes of accidental and preventable household injuries, with scald burns most common in younger children and flame burns in older ones.

USMLE Step 1 Pass/Fail is Here: Are Plastic Surgery Applicants Really Better Off?

Objective: As of January 26, 2022, the United States Medical Licensing Examination(USMLE) Step 1 score reporting will be changed from a numeric scoring system to pass/fail. Although the new scoring policy is expected to benefit medical students, there is concern that it will also amplify preexisting disadvantages and worsen disparities for students applying in the already-competitive plastic surgery match. Whether the reporting change will tangibly benefit applicants to plastic surgery has yet to be elucidated.

Differences in Applicant Perceptions of Virtual Interviews Between Integrated Plastic Surgery and Subspecialty Fellowship Applicants.

Objective: We aim to survey and compare integrated plastic surgery and plastic surgery subspecialty fellowship applicants on their experiences with virtual interviews and to determine if there are differences between them.

Design: An IRB-approved survey study was conducted using the Qualtrics platform.

Setting: The study was conducted at the Johns Hopkins University and the R Adams Cowley Shock Trauma Center in Baltimore Maryland.

Changes in Burn Surgery Operative Volume and Metrics due to COVID-19.

Due to COVID-19, hospitals underwent drastic changes to operating room policy to mitigate the spread of the disease. Given these unprecedented measures, we aimed to look at the changes in operative volume and metrics of the burn surgery service at our institution. A retrospective review was conducted for operative cases and metrics for the months of March to May for 2019, 2020, and 2021, which correspond with pre-COVID, early COVID (period without elective cases), and late COVID (period with resumed elective cases).

Outcomes of Patients with Burns Associated with Home Oxygen Therapy: An Institutional Retrospective Review.

Home oxygen therapy (HOT) burns carry high morbidity and mortality. Many patients are active smokers, which is the most frequent cause of oxygen ignition. We conducted a retrospective review at our institution to characterize demographics and outcomes in this patient population.

What Fuels the Fire: A Narrative Review of the Role Social Determinants of Health Play in Burn Injuries.

Social determinants of health (SDOH) are the conditions where people live, learn, work, and play that affect their health and quality of life. There has been an increasing focus on the SDOH in the field of medicine to both explain and address health outcomes. Both the risk of burn injuries and outcomes after burns have been found to be associated with multiple aspects of the SDOH.

Cross-Cultural Review of Sexuality, Relationships, and Body Image after Burns: Analysis of the BSHS-B.

Burn survivors are at risk for dissatisfaction with body image, relationships, and sexuality due to disfiguring changes secondary to the injury. This review compares available global data on BSHS-B psychosocial scores. Twenty-four studies were included in the final analysis encompassing 14 countries; significant differences were found in scores across all BSHS-B psychological sub-sections of affect, body image, interpersonal relationships, and sexuality.

Spiritual Healing: A Triple Scoping Review of the Impact of Spirituality on Burn Injuries, Wounds, and Critical Care.

Burn patients are unique because their recovery requires prolonged hospital admissions, often complicated by a myriad of medical and surgical complications as well as psychological and emotional challenges. Religion and spirituality have been linked to improved health outcomes in other medical fields. Our scoping review aimed to examine the available literature for evidence of the impact of spirituality on burns, complex wounds, and critical care to shed more light on the relationship between spirituality and the conditions treated by multidisciplinary burn center teams.

IgG Immune Complexes Inhibit Naïve T Cell Proliferation and Suppress Effector Function in Cytotoxic T Cells.

Elevated levels of circulating immune complexes are associated with autoimmunity and with worse prognoses in cancer. Here, we examined the effects of well-defined, soluble immune complexes (ICs) on human peripheral T cells. We demonstrate that IgG-ICs inhibit the proliferation and differentiation of a subset of naïve T cells but stimulate the division of another naïve-like T cell subset.