Severely burned patients exhibit increased nutritional requirements and are at high risk of developing sepsis. Selenium is an essential trace element supporting antioxidant and anti-inflammatory pathways, mediated by incorporation into selenoproteins. The selenium status may affect sepsis risk in burn injury.

Working in burn units has its unique challenges and may increase the rate of depression, anxiety, and burnout in burn care staff. We aimed to estimate the rate of depression, anxiety, and burnout among the members of the burn care team.

Pruritus, a common symptom of burn wounds, arises from skin tissue damage and abnormal tissue healing. Chronic post-burn pruritus (CPBP) is defined as itching that persists for six weeks or more. The brain mechanisms underlying CPBP are not understood adequately. This study aims to explore abnormal brain function in CPBP patients and identify potential pathogenesis of pruritus.

Burn trauma induces hypermetabolism and alters thermoregulation resulting in elevated body temperature. Because patients with burns are prone to heat loss and hypothermia, maintaining physiologic body temperature is important. However, optimal target temperature is widely unknown because thermoregulation of burn trauma has mainly been studied in the previous century, when treatment concepts differed from current era. The aim of this study was to investigate current thermal management of burn treatment and to investigate the discrepancies between classical concepts of thermoregulation in burn trauma and current practice of temperature management. A paper-based survey was conducted in burn centres in Germany, Austria, and German-speaking Switzerland. Participants were asked for expected temperatures, temperature goals, and thermal management of severely burned patients. Results were evaluated for adults and children. 37 of 38 approached burn centres participated in this survey. 59 % expected that adults with burn trauma would develop hyperthermia (>37.5 °C) but only 27 % expected hyperthermia in children (>38 °C). The average target body temperature was 37.1 °C for adults and 36.9 °C for children. Adults below 35.7 °C and children below 36.0 °C were assessed to be hypothermic. Temperatures above 38.8 °C in adults and 38.7 °C in children raised suspicion for sepsis. Antipyretic treatment was assumed to be justified at temperatures above 39.1 °C in adults and 38.5 °C in children. Although the most common warming method was to increase ambient temperature, 89 % of all participants felt their wellbeing was affected by an increased ambient temperature and 68 % were concerned about temperature-related negative effects. Although 57 % of the responding centres had established a standard operating procedure for thermal management, only 41 % considered the available literature to be very relevant in daily practice and 89 % criticized the lack of guidelines. Limit and target temperatures in European burn centres are heterogeneous. Classic concepts of thermal management in burn care are not universally adopted. A majority of the centers expresses the need for specific guidelines. The basis for this should be multicentre clinical trials on temperature management in burn trauma.

To examine the characteristics and outcomes of myocardial infarction (MI) among burn patients.

To share our 20-year experience in major burn management and the impact of a newly implemented burn protocol since 2015 at Tri-Service General Hospital (TSGH).

Oral commissure stenosis and lower eyelid ectropion from burns are functionally impairing and challenging to treat. Evaluation of various treatment modalities is limited by a lack of preclinical models. Described is a method for inducing controlled, titratable oral commissure and lower eyelid burns in swine for future treatment research.

Many research-based burn models rely on creating homogenous burns that are subsequently studied and treated. However, the majority of burn wounds sustained - and in particular those that are combat-related - are heterogeneous in nature, with varying degrees of severity intermixed throughout the entire wound, creating a complex debridement and overall treatment plan. The purpose of this study was to develop a clinically relevant heterogeneous porcine burn wound model.

Ablative fractional carbon dioxide laser (AFCO2L) is widely used as a treatment for hypertrophic burn scars. This study aimed to evaluate clinician and patient-reported outcomes after AFCO2L treatment, safety, and identify factors influencing outcomes.

Collecting patient-reported outcome measures (PROMs) has been a longstanding priority for the Burns Registry of Australia and New Zealand (BRANZ). An earlier pilot of hospital-led PROM collection encountered low participation rates and high loss to follow-up, indicating consideration for an alternative model was warranted.

Whilst wound repair in severe burns has received substantial research attention, non-severe burns (<20 % total body surface area) remain relatively understudied, despite causing considerable physiological impact and constituting most of the hospital admissions for burns. Early prediction of healing outcomes would decrease financial and patient burden, and aid in preventing long-term complications from poor wound healing. Lipids have been implicated in inflammation and tissue repair and may play essential roles in burn wound healing. In this study, plasma samples were collected from 20 non-severe burn patients over six weeks from admission, including surgery, and analysed by liquid chromatography-tandem mass spectrometry and nuclear magnetic resonance spectroscopy to identify 850 lipids and 112 lipoproteins. Orthogonal projections to latent structures-discriminant analysis was performed to identify changes associated with re-epithelialisation and delayed re-epithelisation. We demonstrated that the lipid and lipoprotein profiles at admission could predict re-epithelisation outcomes at two weeks post-surgery, and that these discriminatory profiles were maintained up to six weeks post-surgery. Inflammatory markers GlycB and C-reactive protein indicated divergent systemic responses to the burn injury at admission. Triacylglycerols, diacylglycerols and low-density lipoprotein subfractions were associated with re-epithelisation (p-value <0.02, Cliff's delta >0.7), whilst high-density lipoprotein subfractions, phosphatidylinositols, phosphatidylcholines, and phosphatidylserines were associated with delayed wound closure at two weeks post-surgery (p-value <0.01, Cliff's delta <-0.7). Further model validation will potentially lead to personalised intervention strategies to reduce the risk of chronic complications post-burn injury.

Pediatric burn injuries are often associated with significant morbidity, and require specialized care. The primary advantage of Wireless Micro Current Stimulation (WMCS) is the ability to deliver electric current without direct contact with the wound, which is particularly advantageous in the pediatric population and in those with wounds over multiple areas or over sensitive regions.

Burn injuries present a significant challenge globally, particularly in low- and middle-income countries (LMICs) where access to standard intravenous (IV) fluid resuscitation is often limited. In such austere settings, the feasibility of enteral resuscitation via oral rehydration solution (ORS) as an alternative to burn resuscitation is a critical consideration. We aimed to investigate the barriers and facilitators perceived by burn care providers in Nepal trained to use an enteral resuscitation protocol.

Blood loss during burn surgery significantly contributes to morbidity and mortality. Tranexamic acid (TXA), an antifibrinolytic agent, is hypothesized to reduce intraoperative bleeding. This double-blinded, randomized clinical trial aimed to assess the efficacy of systemic TXA in severe burn patients (total body surface area [TBSA] > 20 %) undergoing surgery. The study evaluated the impact of TXA on surgical bleeding, operating room (OR) time, intravenous (IV) fluid requirements, length of hospital stay (LOS), and overall patient outcomes. A total of 94 patients, with equal distribution in age, sex, and TBSA, were randomly assigned into two groups (47 each). We administered TXA as a 10 mg/kg loading dose followed by a 1 mg/kg/h infusion during surgery. Results demonstrated significant reductions in blood loss (P = 0.043), total IV fluid volume (P = 0.021), OR time (P = 0.002), LOS (P = 0.0001), and transfusions (P = 0.024) in the TXA group. Notably, women and patients without inhalation injuries exhibited better responses to TXA treatment, and graft survival was lower in the TXA group. The study concludes that IV TXA administration during burn surgery can reduce bleeding, minimize IV fluid and blood transfusion needs, and shorten surgery duration, enhancing overall surgical outcomes.

Access to healthcare and insurance coverage are associated with quality of life, morbidity, and mortality outcomes. However, most studies have only focused on same-admission and short-term outcomes due to the lack of national longitudinal datalthere are limited data on this topic in the burn literature. Our aim was to determine the effect of insurance status on long-term outcomes in a national sample of burn patients.

Despite progress in medical and surgical treatments of wounds, bioactive compounds still offer an effective and safe approach to accelerate wound healing (WH). In this review, recent results of studies on WH by essential oils (EOs) and their terpenoids are reported. Mechanisms of action of these substances and their possible use in drug delivery systems (DDSs) for WH are discussed. EOs of 38 species from 16 families have been evaluated for their potential to treat wounds. Lamiaceae was the most representative family with 10 species, followed by Myrtaceae and Asteraceae. EOs improve WH by acting as anti-inflammatory, antioxidant, and antimicrobial agents. Some other EOs were involved by increasing expression of transforming growth factor (TGF), inhibition of several factors, including plasminogen activator inhibitor-1 (PAI-1), substitution of type III collagen by type I collagen, and up-regulation of insulin-like growth factor-1 (IGF-1), fibroblast growth factor 2 (FGF-2), and vascular endothelial growth factor (VEGF). These mechanisms improved repair of cells and increased proliferation. Alternatively, DDSs based on nanomaterials (NMs) used to carry EOs for WH are mainly based on nanoparticles (NPs), microparticles (MPs) and scaffolds. There is much evidence that EOs can promote WH. Advancement of nanotechnology in recent years has contributed to improving use of EO with DDSs in WH management. However, some limitations need to be addressed to achieve the translation of this technology into clinical applications for wound treatment.

Literature examining the impact of obesity on burn injury remains mixed. Previous examination of the National Burn Repository, now the BCQP, in obesity-related burn research is limited. The aim of this work was to provide an assessment of the BCQP dataset to examine the effect of obesity on burn-related outcomes.

The aim of this study was to explore the effect and mechanism of formononetin (FMNT) in thermal-injured fibroblast proliferation, apoptosis, and oxidative stress. After thermal injury, human skin fibroblast (HSF) cells showed inhibited proliferation, migration, extracellular matrix (ECM) synthesis; and increased apoptosis, reactive oxygen species (ROS) production, and inflammation. Specifically, after thermal injury, cell viability, migration distance, and protein levels of collagen I, collagen III, α-SMA, MMP1, and MMP3 were reduced; cell apoptosis rate and TUNEL-positive cell numbers were increased; the levels of Bax and cleaved caspase-3 were elevated, while Bcl-2 level was reduced. Moreover, the thermally injured HSF cells showed increased levels of ROS, MDA, LDH, TNF-α, and IL-1β, and decreased GSH, SOD, GSH-Px, and CAT. FMNT levels can partially eliminate the effects of thermal injury on HSF cells, as shown by promoting thermally injured HSF cell proliferation and migration, and inhibiting cell apoptosis, ROS production, and inflammation. FMNT exerted no significant effect on normal HSF cells. Additionally, the levels of the P13K/AKT/mTOR signaling-related proteins (p-P13K, p-AKT, and p-mTOR) were reduced in thermally injured HSF cells, whereas FMNT could promote p-P13K, p-AKT, and p-mTOR levels. FMNT can partially alleviate the thermal injury-induced inhibition of fibroblast proliferation and migration; FMNT also inhibited the apoptosis, ROS level, and inflammation in thermal-injured cells. The effects of FMNT may be mediated by regulating the P13K/AKT/mTOR pathway.