Enoxaparin 40mg Twice Daily with Peak Anti-Xa Adjustments is Safe and Necessary to Achieve Therapeutic Chemoprophylaxis in Burn-Injured Patients.

Burn injury results in hypercoagulability and an increased venous thromboembolism risk. However, the most effective chemoprophylaxis for burn-injured patients has yet to be elucidated. Therefore, this study aims to identify the safety and efficacy of a burn center's venous thromboembolism protocol modification which increased the dose of enoxaparin from 40mg daily to 40mg twice daily with peak anti-Xa level adjustments.

Plasma Inclusive Resuscitation Is Not Associated With Transfusion-Related Acute Lung Injury Under Updated Guidelines.

Introduction: Plasma inclusive resuscitation (PIR) uses fresh frozen plasma as an adjunct to crystalloid in the management of burn shock and has potential benefits over other colloids. Yet, safety concerns for transfusion-related acute lung injury (TRALI) exist. The aim of this study evaluated the association between TRALI and PIR in a cohort of severely burn-injured patients using the updated Canadian Blood Services Consensus definitions.

Venous Thromboembolism Incidence, Risk Factors, and Prophylaxis in Burn Patients: a National Trauma Database Study.

Comprehensive studies on the incidence, risk factors, and prophylactic measures related to venous thromboembolism (VTE) are lacking in burn care. This study characterizes VTE risk and existing prevention measures to improve and inform overall patient care in the field of burn care on a national scale. The US National Trauma Data Bank (NTDB) was queried from 2007 to 2021 to identify burn-injured patients.

Addressing Burn Hypertrophic Scar Symptoms Earlier: Laser Scar Revision May Begin as Early as 3-6 Months After Injury.

Objectives: Fractional ablative CO laser (FLSR) is used to treat hypertrophic scars (HTSs) resulting from burn injuries, which are characterized by factors, such as erythema, contracture, thickness, and symptoms of pain and itch. Traditionally, waiting a year after injury for scar maturation before starting laser treatment has been recommended; however, the potential benefits of earlier intervention have gained popularity. Still, the optimal timing for beginning laser intervention in patients with HTSs remains uncertain.

Treatment of hypopigmented burn hypertrophic scars with short-term topical tacrolimus does not lead to repigmentation.

Objectives: Dyschromia is an understudied aspect of hypertrophic scar (HTS). The use of topical tacrolimus has successfully shown repigmentation in vitiligo patients through promotion of melanogenesis and melanocyte proliferation. It was hypothesized that HTSs treated with topical tacrolimus would have increased repigmentation compared to controls.

Rete ridges are decreased in dyschromic burn hypertrophic scar: A histological study.

Dyschromic hypertrophic scar (HTS) is a common sequelae of burn injury, however, its mechanism has not been elucidated. This work is a histological study of these scars with a focus on rete ridges. Rete ridges are important for normal skin physiology, and their absence or presence may hold mechanistic significance in post-burn HTS dyschromia.

The First 24 Hours: Burn Shock Resuscitation and Early Complications.

Resuscitation is required for the management of patients with severe thermal injury. Some of the initial pathophysiologic events following burn injury include an exaggerated inflammatory state, injury to the endothelium, and increased capillary permeability, which all culminate in shock. Understanding these processes is critical to the effective management of patients with burn injuries.

Human Performance Optimization: A Framework for the Military Health System.

The Department of Defense (DoD) is increasingly dependent on highly technological weapon systems, but the human is still at the heart of our war-fighting efforts. In order to maintain an effective fighting force, we must optimize and sustain human performance, which is defined as the successful completion of a specified task within an available performance capacity that meets or exceeds the mission demands. When health and performance are optimized and sustained, the costs of warfighter care and disability compensation are reduced and the quality of life is enhanced.

Scar Management and Dyschromia: A Summary Report from the 2021 American Burn Association State of the Science Meeting.

Burn scars, and in particular, hypertrophic scars, are a challenging yet common outcome for survivors of burn injuries. In 2021, the American Burn Association brought together experts in burn care and research to discuss critical topics related to burns, including burn scars, at its State of the Science conference. Clinicians and researchers with burn scar expertise, as well as burn patients, industry representatives, and other interested stakeholders met to discuss issues related to burn scars and discuss priorities for future burn scar research.

Intra-abdominal Pressure Monitoring During Negative Pressure Wound Therapy in the Open Abdomen.

Introduction: Negative pressure wound therapy (NPWT) is commonly used in open abdomen management, where there may be a simultaneous need for prevention of abdominal hypertension, tamponade of hemorrhage, and continuous fascial tension. The regional pressure dynamics of vacuum dressings are poorly understood.

Methods: Three duroc swine underwent mid-line laparotomy and application of vacuum open abdomen dressing, with and without sponge packing.

Compounded Cerium Nitrate-Silver Sulfadiazine Cream is Safe and Effective for the Treatment of Burn Wounds: A Burn Center's 4-Year Experience.

Wound infections and sepsis are significant causes of morbidity after burn injury and can be alleviated by early excision and grafting. In situations that preclude early surgery, topical agents allow for a safer delay. Cerium nitrate compounded with silver sulfadiazine (Ce-SSD) is a burn cream that provides broad antibacterial activity, forms a temporary barrier, and promotes re-epithelialization.

Prevalence and risk factors for acute stress disorder and posttraumatic stress disorder after burn injury.

Background: Psychological consequences of burn injury can be profound. Acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) are known sequelae, but routine identification is challenging. This study aims to identify patient characteristics associated with outpatient positive screens.

Representation Matters: An Assessment of Diversity in Current Major Textbooks on Burn Care.

Ethnic and gender disparities in healthcare have been well described. Increasing attention is paid to representative diversity in the images and educational resources used during medical training. Nearly 40% of the population of the United States identifies as a person of color, and patients of color reflect 41% of the total burn population seen in the United States.

Initial Experience Combining Negative Pressure Wound Therapy With Autologous Skin Cell Suspension and Meshed Autografts.

The success of autologous split-thickness skin grafts (STSGs) in the treatment of full-thickness burns is often dependent on the dressing used to secure it. Tie-over bolsters have been used traditionally; however, they can be uncomfortable for patients and preclude grafting large areas in one definitive operation. Negative pressure wound therapy (NPWT) is used as an alternative to bolster dressings and may afford additional wound healing benefits.