The impact of necrotizing soft tissue infections on the lives of survivors: a qualitative study.

Purpose: Necrotizing soft tissue infections (NSTI) are potentially lethal infections marked by local tissue destruction and systemic sepsis, which require aggressive treatment. Survivors often face a long recovery trajectory. This study was initiated to increase understanding of the long-term impact of NSTI on health related quality of life (HRQoL), and how care may be improved.

Frailty Screening Practice in Specialized Burn Care-A Retrospective Multicentre Cohort Study.

Frailty can have a negative influence on outcomes in elderly patients after burn injuries. The Dutch hospitals have used a four-domain frailty screening instrument from the Dutch Safety Management System (DSMS) since 2012. However, its feasibility and validity have hardly been studied.

The Complexity of the Post-Burn Immune Response: An Overview of the Associated Local and Systemic Complications.

Burn injury induces a complex inflammatory response, both locally and systemically, and is not yet completely unravelled and understood. In order to enable the development of accurate treatment options, it is of paramount importance to fully understand post-burn immunology. Research in the last decades describes insights into the prolonged and excessive inflammatory response that could exist after both severe and milder burn trauma and that this response differs from that of none-burn acute trauma.

Burn injury characteristics, referral pattern, treatment (costs), and outcome in burn patients admitted to a hospital with or without a specialized Burn Centre (BURN-Pro).

Purpose: Data on the epidemiology, treatment, and outcome of burn patients treated at non-burn centre hospitals are not available. The primary aim was to compare the burn characteristics of patients admitted to a hospital with or without a specialized burn centre.

Methods: This multicentre, prospective, cohort study enrolled patients with burns admitted to a hospital without a burn centre and patients with < 10% total body surface area (TBSA) burned admitted to the burn centre.

The Effect of Burns on Children's Growth Trajectory: A Nationwide Cohort Study.

This study evaluates the short- and long-term effect of burns on children's height and weight, by comparing their pre and postburn growth trajectory. We invited children (≤17 years old), who sustained a burn requiring surgical treatment or admission at one of the Dutch burn centers in 2013 (n = 175). As well as children who sustained a severe burn, covering >10% of the total body surface area (TBSA), throughout 2009-2018 (n = 228).

Complications during Pregnancy after Abdominal Burn Scars: A Review.

Over the past decades, long-term sequelae of burns have gained increasing attention. Women of childbearing age, who sustained abdominal burns earlier in life, may have unmet information needs on scar-related complications they can expect during pregnancy. We performed a review of the literature to identify abdominal, foetal, and potential other complications during pregnancy in women with abdominal burn scars.

Microcalorimetry: A Novel Application to Measure In Vitro Phage Susceptibility of in Human Serum.

Infections involving antibiotic resistant () represent a major challenge to successful treatment. Further, although bacteriophages (phages) could be an alternative to antibiotics, there exists a lack of correlation in phage susceptibility results between conventional in vitro and in vivo assays. This discrepancy may hinder the potential implementation of bacteriophage therapy.

Full Skin Equivalent Models for Simulation of Burn Wound Healing, Exploring Skin Regeneration and Cytokine Response.

Healing of burn injury is a complex process that often leads to the development of functional and aesthetic complications. To study skin regeneration in more detail, organotypic skin models, such as full skin equivalents (FSEs) generated from dermal matrices, can be used. Here, FSEs were generated using de-epidermalized dermis (DED) and collagen matrices MatriDerm and Mucomaix.

Short-term and long-term increased mortality in elderly patients with burn injury: a national longitudinal cohort study.

Background: The population of elderly patients with burn injuries is growing. Insight into long-term mortality rates of elderly after burn injury and predictors affecting outcome is limited. This study aimed to provide this information.

The burden of disease of fatal and non-fatal burn injuries for the full spectrum of care in the Netherlands.

Background: A comprehensive overview of the burden of disease of burns for the full spectrum of care is not available. Therefore, we estimated the burden of disease of burns for the full spectrum in the Netherlands in 2018, and explored whether the burden of disease changed over the past 5 years (2014-2018).

Methods: Data were collected at four levels: general practice, emergency department, hospital, and mortality data.

Burn-injured skin is marked by a prolonged local acute inflammatory response of innate immune cells and pro-inflammatory cytokines.

The systemic and local immune response in burn patients is often extreme and derailed. As excessive inflammation can damage healthy tissues and slow down the healing process, modulation of inflammatory responses could limit complications and improve recovery. Due to its complexity, more detailed information on the immune effects of thermal injury is needed to improve patient outcomes.

Role of burn severity and posttraumatic stress symptoms in the co-occurrence of itch and neuropathic pain after burns: A longitudinal study.

Itch and pain are common after burns. Neuropathic mechanisms may underlie both modalities but remain not well-understood. This study aims to prospectively document neuropathic pain symptoms and to identify potential itch symptom profiles that differ regarding duration and co-occurrence with neuropathic pain which may inform underlying pathophysiological mechanisms and respond to different treatments.

Parent-Reported Health-Related Quality of Life of Pediatric Burn Patients 5 to 7 Years after Burn Injuries: A Multicenter Study.

Background:  Pediatric burns significantly impact the short-term health-related quality of life (HRQL) of children. Knowledge regarding the long-term impact is scarce. We therefore evaluated the parent-reported HRQL in pediatric burn patients 5 to 7 years after burns.

The Meek micrograft technique for burns; review on its outcomes: Searching for the superior skin grafting technique.

Introduction: Autologous split thickness skin grafting is the standard-of-care for the majority of deep dermal and full thickness burns: Meshed grafting is most commonly used. Patients with extensive burn injuries have limited donor site availability. Meek micrografting is a well-known technique to enable larger expansions.

Burn-Induced Local and Systemic Immune Response: Systematic Review and Meta-Analysis of Animal Studies.

Because burn injuries are often followed by a derailed immune response and excessive inflammation, a thorough understanding of the occurring reactions is key to preventing secondary complications. This systematic review, which includes 247 animal studies, shows the postburn response of 14 different immune cell types involved in immediate and long-term effects in both wound tissue and circulation. Peripheral blood neutrophil and monocyte numbers increased directly after burns, whereas thrombocyte numbers increased near the end of the first week.

Assessing Health-Related Quality of Life of Adult Patients with Intermediate Burns: The Added Value of an Itching and Cognition Item for the EQ-5D: A Retrospective Observational Study.

The EQ-5D is increasingly used to assess the health-related quality of life (HRQL) of adult patients with intermediate burns. However, this generic instrument may lack sensitivity, as important problems for burn patients, such as itching and cognition problems are not included in this instrument. This retrospective observational study investigates the value of adding an itching and cognition item to the EQ-5D-3L.

The Future of Burn Care From a Complexity Science Perspective.

Health care is undergoing a profound technological and digital transformation and has become increasingly complex. It is important for burns professionals and researchers to adapt to these developments which may require new ways of thinking and subsequent new strategies. As Einstein has put it: "We must learn to see the world anew.

Hydrosurgical and conventional debridement of burns: randomized clinical trial.

Background: Tangential excision of burned tissue followed by skin grafting is the cornerstone of burn surgery. Hydrosurgery has become popular for tangential excision, with the hypothesis that enhanced preservation of vital dermal tissue reduces scarring. The aim of this trial was to compare scar quality after hydrosurgical versus conventional debridement before split-skin grafting.

Scar formation from the perspective of complexity science: a new look at the biological system as a whole.

A burn wound is a complex systemic disease at multiple levels. Current knowledge of scar formation after burn injury has come from traditional biological and clinical studies. These are normally focused on just a small part of the entire process, which has limited our ability to sufficiently understand the underlying mechanisms and to predict systems behaviour.

Pre-Burn Health-Related Quality of Life: Patient and Partner Perspectives.

A proxy-assessment of health-related quality of life (HRQL) may be an alternative for burn patients who are medically unable to self-report shortly after being admitted to the hospital. This study examined the patient-partner agreement on the recalled pre-injury HRQL of burn patients. In a multi-centre study of 117 patient-partner pairs, the recalled pre-burn HRQL was assessed with the EQ-5D-3L + Cognition during the acute phase following the burns.

Bio-Psychological Predictors of Acute and Protracted Fatigue After Burns: A Longitudinal Study.

Objective: Fatigue after burns is often attributed to the hyperinflammatory and hypermetabolic response, while it may be best understood from a bio-psychological perspective, also involving the neuro-endocrine system. This longitudinal multi-center study examined the course of fatigue up to 18 months postburn. The contribution of bio-psychological factors, including burn severity, pain, and acute PTSD symptoms, to the course and persistence of fatigue was studied in a multifactorial model.

Sensitivity of the EQ-5D-5L for fatigue and cognitive problems and their added value in Q-fever patients.

Purpose: Measuring health-related quality of life (HRQoL) with the EQ-5D-5L might lack sensitivity for disease-specific health complaints. This cross-sectional study analyzed whether fatigue and cognitive problems are captured by the EQ-5D-5L in a Q-fever patient population with persistent fatigue/cognitive problems, and whether addition of fatigue/cognition improved the explained variance for HRQoL.

Methods: A Dutch sample of Q-fever patients filled out the EQ-5D-5L and EQ VAS, the fatigue subscale of the Checklist Individual Strength, and a cognition dimension in the EQ-5D-5L format.

Adding a fatigue item to the EQ-5D-5L improves its psychometric performance in the general population.

Background: Fatigue is a common and often disturbing sequela of serious chronic health conditions. In the widely applied HRQL instrument, the EQ-5D, this aspect is not included directly, for its assumed lack of additional information. We investigated the validity of this assumption by determining the gain-if any-of an additional fatigue item to the EQ-5D-5L in a general population sample.

The feasibility and reliability of frailty assessment tools applicable in acute in-hospital trauma patients: A systematic review.

Background: Assessing frailty in patients with an acute trauma can be challenging. To provide trustworthy results, tools should be feasible and reliable. This systematic review evaluated existing evidence on the feasibility and reliability of frailty assessment tools applied in acute in-hospital trauma patients.