Publications by authors named "Naiem Moiemen"

Severe thermal injury significantly impacts upon hemostasis and is associated with classical changes to the circulating platelet count with a nadir followed by a rebound thrombocytosis at days ~3 and ~15 post-injury, respectively. To date, few studies have assessed platelet function following thermal injury as platelet tests often require large quantities of blood, are not representative of normal platelet pathophysiology, and are usually dependent on a normal platelet count. The purpose of this study was to measure platelet thrombus formation using a whole blood flow chip-based system following thermal injury and to study how platelet counts may impact upon the measurement.

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  • Acetic acid shows potential as an alternative to antibiotics for treating burn wounds, but its effectiveness is limited by its poor material properties for retention and site specificity.
  • In this study, acetic acid was used as both a gelling agent and an antimicrobial component in alginate fluid gels, with the microstructure depending on the concentration of acetic acid.
  • The resulting fluid gels exhibited improved sprayability and long-lasting surface retention, while maintaining antimicrobial effectiveness against common pathogens.
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Neutrophil extracellular traps (NETs) have a dual role in the innate immune response to thermal injuries. NETs provide an early line of defence against infection. However, excessive NETosis can mediate the pathogenesis of immunothrombosis, disseminated intravascular coagulation (DIC) and multiple organ failure (MOF) in sepsis.

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Background: Traumatic and thermal injuries result in a state of systemic immune suppression, yet the mechanisms that underlie its development are poorly understood. Released from injured muscle and lysed red blood cells, heme is a damage associated molecular pattern with potent immune modulatory properties. Here, we measured plasma concentrations of total heme in over 200 traumatic and thermally-injured patients in order to examine its relationship with clinical outcomes and post-injury immune suppression.

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Background: Dermal scaffolds have created a paradigm shift for burn and wound management by providing improved healing and less scarring, while improving cosmesis and functionality. Dermal regeneration template (DRT) is a bilayer membrane for dermal regeneration developed by Yannas and Burke in the 1980s. The aim of this review is to summarize clinical evidence for dermal scaffolds focusing on DRT for the management and reconstruction of burn injuries and complex wounds.

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  • Laser therapy is an effective treatment for pediatric burn scars, with studies indicating that the timing of therapy plays a crucial role in the outcome, particularly suggesting that early intervention (within 12 months) yields better results than later treatment.
  • A comprehensive meta-analysis of seven studies involving 467 patients showed significant improvements in scar assessment metrics (VSS and POSAS) and scar attributes like vascularity and height following laser therapy.
  • Non-ablative lasers were found to be the most beneficial type, outperforming other laser types in enhancing scar characteristics and overall effectiveness.
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Background: Burn damage to skin often results in scarring; however in some individuals the failure of normal wound-healing processes results in excessive scar tissue formation, termed 'hypertrophic scarring'. The most commonly used method for the prevention and treatment of hypertrophic scarring is pressure-garment therapy (PGT). PGT is considered standard care globally; however, there is continued uncertainty around its effectiveness.

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Over several decades, skin substitutes have become an essential tool in acute burn surgery, particularly in major burns, where scarce donor tissues can limit the availability of autografts. This systematic review aimed to assess the efficacy, complication rates, and long-term outcomes of acellular dermal substitutes in acute burns and compare these to conventional skin grafting methods of coverage. A search of PubMed, Web of Science, and CENTRAL for appropriate randomized controlled trials (RCTs), non-randomized trials, and observational studies was conducted.

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  • * Eleven studies involving 491 patients were analyzed, revealing that laser therapy significantly improved various scar characteristics, with better outcomes after 12 months post-injury and when using pulse dye lasers.
  • * Results highlight the importance of treatment timing and laser choice, while also indicating variability among studies, suggesting further research is needed to better understand scar outcomes.
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Introduction: Despite of recent advancement in the burns wound management, burn wound infection (BWI) is still one of the major cause of burns mortality. Patients who survive their burns injury still suffers from BWI related complication like delayed wound healing and poor scarring. BWI has been treated by application of topical antimicrobial agents or systemic antibiotics.

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Background: Burn injuries are the fourth most common type of trauma and are associated with substantial morbidity and mortality. The impact of burn injury is clinically significant as burn injuries often give rise to exuberant scarring. Hypertrophic scarring (HTS) is a particular concern as up to 70% of burns patients develop HTS.

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Dermal substitutes are well established in the reconstructive ladder. MatriDerm® (Dr. Otto Suwelack Skin & Health Care AG, Billerbeck, Germany) is a single-layer dermal substitute composed of a bovine collagen (type I, III, and V) and elastin hydrolysate, that allows for immediate split-thickness skin grafting (SSG).

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Objective: Accurate wound assessment is crucial for determining the progression of healing and guides treatment strategies. Portable wound assessment devices can be useful in providing an accurate evaluation in the community where most cases are treated. The objective of this review was to compare the performance of various portable wound assessment techniques used for wound healing assessment described in the literature.

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Background: A European response plan to burn mass casualty incidents has been jointly developed by the European Commission and the European Burn Association. Upon request for assistance by an affected country, the plan outlines a mechanism for coordinated international assistance, aiming to alleviate the burden of care in the affected country and to offer adequate specialized care to all patients who can benefit from it. To that aim, Burn Assessment Teams are deployed to assess and triage patients.

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Background: Glutamine is thought to have beneficial effects on the metabolic and stress response to severe injury. Clinical trials involving patients with burns and other critically ill patients have shown conflicting results regarding the benefits and risks of glutamine supplementation.

Methods: In a double-blind, randomized, placebo-controlled trial, we assigned patients with deep second- or third-degree burns (affecting ≥10% to ≥20% of total body-surface area, depending on age) within 72 hours after hospital admission to receive 0.

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Background: Burn care is centralized in highly specialized burn centers in Europe. These centers are of limited capacity and may be overwhelmed by a sudden surge in case of a burn mass casualty incident. Prior incidents in Europe and abroad have sustained high standards of care through well-orchestrated responses to share the burden of care in several burn centers.

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Burn injuries have decreased markedly in high-income countries while the incidence of burns remains high in Low- and Middle-Income Countries (LMICs) where more than 90% of burns are thought to occur. However, the cause of burns in LMIC is poorly documented. The aim was to document the causes of severe burns and the changes over time.

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Background: Emerging evidence suggests that the pathophysiological impact of acute burn injuries may have chronic health consequences. We conducted a systematic review and meta-analysis to investigate the association between burn injuries and long-term mortality in patients surviving to initial discharge from hospital.

Methods: Medline and Embase databases were searched on 22 October 2021.

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Background: Major thermal injury induces a complex pathophysiological state characterized by burn shock and hypercatabolism. Steroids are used to modulate these post-injury responses. However, the effects of steroids on acute post-burn outcomes remain unclear.

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Background Of The Study: Acute kidney injury (AKI) is a common complication in critically ill burn patients and is associated with a number of serious adverse outcomes. The clinical decision-making process related to the management of AKI in burn patients is complex and has not been sufficiently standardized. The main aim of this study was to explore the diagnostic approach and clinician's attitudes toward the management of AKI and RRT in burn patients around the world.

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Objective: Paediatric burn injuries present physical and psychosocial effects for children and their parents, including disruption to family life. Some burns services in the UK enable parents to administer dressing changes at home to reduce the number of hospital visits. To date, there is no research on parents' experiences of administering dressing changes.

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Background: Burn injuries are a leading cause of morbidity and disability, with the burden of disease being disproportionately higher in low- and middle-income countries (LMIC). Burn prevention programmes have led to significant reductions in the incidence of burns in high-income countries. However, a previous systematic review published in 2015 highlighted that implementation and evaluation of similar programmes has been limited in LMIC.

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Objective: Following paediatric burn injury, dressings are initially changed in outpatient clinics, necessitating regular visits with substantial burden for parents, children and services. This can potentially be lessened if some parents go on to administer dressing changes for their child at home. However, a lack of data regarding support for parent-administered dressing changes is present.

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