Could Fibrin Sealants (TISSEEL) Be Effective in the Management of Burn Injuries? A Histopathological Study in Rats.

Burn injuries remain a major clinical problem worldwide, which require special management by experienced plastic surgeons. However, they cannot be available in every healthcare unit; consequently, there is a need for effective treatment options that could be utilized by a wide range of non-expert healthcare professionals. The aim of the present experimental study was to investigate the safety and efficacy of using a fibrin sealant (TISSEEL) compared to the conventional treatment with sulfadiazine on partial-thickness burn in a rat animal model.

The Effect of Diabetes Mellitus Severity on Foot & Ankle Burn Recovery.

Background: Diabetic patients often present with complex limb pathology, resulting in impaired sensation in the distal extremities making tactile injuries such as burns difficult to notice. We posit that poorly controlled diabetes mellitus, evidenced by increasing elevations in hemoglobin A1c, is associated with delayed wound healing and increased complications in burn patients.

Methods: The TriNetX Network, a database of 89 million patients across the U.

Establishing a Collaborative Genomic Repository for Adult Burn Survivors: A Burn Model System Feasibility Study.

In this study, we aimed to integrate a genetic repository with an existing longitudinal national burn database. We set out two primary objectives, namely (1) to develop standard operating procedures for genetic sample collection and storage, DNA isolation, and data integration into an existing multicenter database; and (2) to demonstrate the feasibility of correlating genetic variation to functional outcomes in a pilot study, using the catechol-O-methyltransferase (COMT) gene. Dubbed the worrier/warrior gene, COMT variants have been associated with varying phenotypes of post-traumatic stress, wellbeing, and resilience.

The 3rd Educational Course of the European Burns Association (EBA).

Abstracts of the plenary sessions, workshops, and poster presentations of the 3rd EBA Educational Course in Porto, Portugal, 17-18 October 2024.

Intelligent sequential degradation hydrogels by releasing bimetal-phenolic for enhanced diabetic wound healing.

Healing of diabetic wounds is significantly impeded by a complex environment comprising biofilm formation, excessive inflammation, and compromised angiogenic capacity, leading to a disordered physiological healing process. Restoration and maintenance of a normal and orderly healing process in diabetic wounds remain unmet therapeutic objectives. Herein, an innovative bimetal-phenolic network hydrogel system is designed with a concentric circular structure, enabling dual-drug delivery with differentiated release kinetics.

A prospective, historical-controlled evaluation of oliceridine for moderate or severe pain in patients with acute burn injuries (RELIEVE).

Oliceridine, a biased, selective opioid agonist, has shown a 3-fold preferential activation of the G-protein (i.e., analgesia) over β-arrestin pathway.

Evaluating Bard Gemini Pro and GPT-4 Vision Against Student Performance in Medical Visual Question Answering: Comparative Case Study.

Background: The rapid development of large language models (LLMs) such as OpenAI's ChatGPT has significantly impacted medical research and education. These models have shown potential in fields ranging from radiological imaging interpretation to medical licensing examination assistance. Recently, LLMs have been enhanced with image recognition capabilities.

What about the donor site morbidity - how invasive is the free latissimus dorsi flap?

Aims: The free latissimus dorsi muscle (LDM) flap represents a workhorse procedure in the field of trauma and plastic surgery. However, only a small number of studies have examined this large group of patients with regard to the morbidity of flap harvest. The aim of this prospective study was therefore to objectively investigate the morbidity of a free LDM flap.

Extracranial arteriovenous malformations: a 10-year experience at a German vascular anomaly center and evaluation of diagnostic imaging for endovascular therapy assessment.

Background: Arteriovenous malformations (AVMs) account for <3% of vascular anomalies. This study aims to present the 10-year experience of a German vascular anomaly center (VAC) with AVMs and evaluate diagnostic imaging for treatment-relevant information for minimally invasive therapy planning.

Material And Methods: A retrospective study including patients from the VAC database with AVMs was conducted.

Individualized surgical treatment using decellularized fish skin transplantation after enzymatic debridement: A two years retrospective analysis.

Over the past few years, treatment of burn injuries has evolved beyond primary surgical therapy with the development of enzymatic debridement and new types of skin replacement materials by providing complex personalized therapy concepts aimed at preserving and replacing the dermal layer of the skin. The aim of our study was to develop an individualized treatment algorithm for mixed depth burn wound and evaluate the outcomes of individualized combined treatment of mixed depth burn wounds with enzymatic debridement and decellularized fish skin. A total of 18 patients with a mean age of 34.

Evaluation of Papain-Urea for Enzymatic Debridement of Coagulation Zones Following Ablative Fractional Laser Treatment.

Background: Ablative fractional CO laser (10,600 nm) treatment creates an array of microscopic treatment zones composed of an ablation zone (AZ) surrounded by a denatured coagulation zone (CZ). The CZ is believed to play a functional role in skin tightening, posttreatment inflammation, and laser-assisted drug delivery. This study investigates the viability of enzymatic post-processing to remove the CZ without affecting the surrounding tissue.

Vasoactive Agents in Burn Patients - Perspectives on Angiotensin-II.

Severe burn injury poses significant clinical challenges, often necessitating the use of vasoactive agents to maintain perfusion. This narrative review explores the current landscape of vasoactive agents in acute burn shock resuscitation and severe burn-injured patients who develop septic shock, with a particular focus on the potential role of the novel vasoactive agent, synthetic angiotensin-II (AT-II), in these settings. While catecholamines and vasopressin remain cornerstone therapies, adverse effects, variable patient response, and a new understanding of burn injury pathophysiology highlight the potentially evolving role of vasoactive agents in these clinical scenarios.

Massage Therapy Utilization in Pediatric Acute Burns: A Retrospective Cohort Study.

Background: Patient-centered burn care extends beyond physical treatment to incorporate the management of the psychological impacts including stress, pain, and anxiety. This study explores the novel application of massage therapy (MT) in children with acute burns, assessing utilization and impact on pain and relaxation.

Methods: A retrospective review of 198 children with thermal injury admitted to an American Burn Association-verified pediatric burn center between January 2022 and July 2023 was conducted, excluding those requiring intensive care admission.

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.

A temporary hospital intensive care unit: a preparedness concept to increase intensive care capacity.

Introduction: Norway faced the possibility of the most significant strain on its intensive care capacity in decades during the COVID-19 pandemic. All Regional Health Authorities in Norway were instructed to prepare for an increase in Intensive Care Units (ICU) capacity demands. To address the surge in demand for critical care, a gymnasium within Haukeland University Hospital premises was planned to be used as a 20-bed temporary ICU.

Proteomic analysis illustrates the potential involvement of dysregulated ribosome-related pathways and disrupted metabolism during retinoic acid-induced cleft palate development.

Recent studies have unveiled disrupted metabolism in the progression of cleft palate (CP), a congenital anomaly characterized by defective fusion of facial structures. Nonetheless, the precise composition of this disrupted metabolism remains elusive, prompting us to identify these components and elucidate primary metabolic irregularities contributing to CP pathogenesis. We established a murine CP model by retinoic acid (RA) treatment and analyzed control and RA-treated embryonic palatal tissues by LC-MS-based proteomic approach.

The availability of common patient-reported outcome measures in hand surgery across Europe.

Many European healthcare systems emphasize value-based care to improve outcomes and control costs. Assessing function and satisfaction in hand surgery relies on patient reported outcome measures. This study evaluates the use of these outcome measures across Europe, focusing on diversity and language validation.

War at Sea: Burn Care Challenges-Past, Present and Future.

Throughout history, seafarers have been exposed to potential thermal injuries during naval warfare; however, injury prevention, including advances in personal protective equipment, has saved lives. Thankfully, burn injuries have decreased over time, which has resulted in a significant clinical skills gap. Ships with only Role 1 (no surgical capability) assets have worse outcomes after burn injury compared to those with Role 2 (surgical capability) assets.

Enteral Resuscitation: A Field-Expedient Treatment Strategy for Burn Shock during Wartime and in Other Austere Settings.

Burn injuries are a constant threat in war. Aspects of the modern battlefield increase the risk of burn injuries and pose challenges for early treatment. The initial resuscitation of a severely burn-injured patient often exceeds the resources available in front-line medical facilities.

Combat and Operational Stress Control: Application in a Burn Center.

Occupational therapy has been integral to the holistic recovery of soldiers since its origin. The positive psychosocial and physiological effects of occupation-based interventions, fundamental to the profession, have long justified its relevance to the military. As such, occupational therapy has been written into US Army doctrine as an integral component of the Combat and Operational Stress Control (COSC) program.

Pain Management during Bromelain-Based Enzymatic Debridement (NexoBrid) in a USA Adult Burn Center.

Outside the United States, bromelain-based enzymatic debridement (BBED) has become an effective tool for the removal of burn eschar. A primary concern with BBED is that it is a painful procedure requiring appropriate analgesia. The purpose of this study was to describe our experience using NexoBrid (NXB), with a particular focus on pain management.