Burns : journal of the International Society for Burn Injuries
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Despite the multitude of preventative methods, postburn hand contractures are poorly controlled and often require surgery. However, there is no consensus on which hand reconstruction technique is most efficacious. This systematic review aims to compare the efficacy of available postburn hand contracture reconstruction techniques over the long term and to evaluate the quality of current literature. Effectiveness is assessed with functional improvement, increase of skin surface area, and scar quality/enhanced cosmesis. ⋯ No consensus remains on the superiority of a single reconstruction technique. Meticulous preoperative planning and intensive rehabilitation are vital. A stepwise approach, considering individual patient and contracture characteristics and the limitations of each technique, should be followed. Well-designed and conducted future studies, utilizing reliable and validated contracture description methods and outcome assessment, are now imperative.
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Advancements in resuscitative care and burn surgery have improved survival rates after extensive burn injuries, shifting focus to enhancing the quality of survival. Conventional treatment with split-thickness skin grafts (STSG) presents limitations such as donor-site morbidity, limited availability in extensive burn injuries, and hypertrophic scarring. Tissue engineering aims to address these drawbacks by developing optimal skin substitutes. This systematic review aims to provide an overview of the current applications of cultured cells in burn surgery, encompassing diverse approaches and addressing existing challenges to enhance burn wound management and improve patient outcomes. ⋯ Results are promising, though standardization of cultured skin substitutes and robust clinical trials with larger populations and appropriate comparators are still lacking.
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Randomized Controlled Trial
Potential therapeutic effects of topical recombinant human erythropoietin on burn wound healing: A preliminary randomized double-blind controlled clinical trial.
Burn injuries can cause significant mortality and morbidity. This study aimed to evaluate the efficiency of topical recombinant human erythropoietin (rhEPO) on enhancing burn wound healing. ⋯ At the second follow-up visit, all parameters were significantly lower in the rhEPO group compared with the control group except for itchiness. The results of the next two follow-up sessions were also the same. The total value of the modified Vancouver Scar Scale (VSS) at days 5, 7, and 14 was significantly lower in the rhEPO group compared with the routine of care group. Trial Registry Date: 2022-03-02, Trial Registry number: IRCT20190810044500N23 CONCLUSIONS: The results of the present study suggested that topical rhEPO is a potential option in burn wounds and patient satisfaction, without causing intolerable side effects.
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Demographic data reveal a correlative relationship between facial burns and profoundly impaired dental health, while inhalation injury correlates with a high Periodontal Screening and Recording Index, both of which significantly reduce quality of life for the burn injury patient. Despite these facts, few if any burn centers surveyed in the U. S. or Germany enlist specialized services and well-defined follow-up protocols for patients who might well be at risk. ⋯ Thermal injury patterns to perioral-related and dental structures is increasingly being recognized. This review delineates current burn-related dental health pathology and when available the underlying causation. These findings may help guide future research as well as therapeutic strategies to improve dental health and outcome for our patients.
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Randomized Controlled Trial
Illusory movements for immobile patients with extensive burns (IMMOBILE): A randomized, controlled, cross-over trial.
Patients who have sustained extensive burns frequently exhibit substantial damage to skeletal muscle and associated complications. The rehabilitation of these patients can be challenging due to the nature of the injury and the subsequent complications. Nevertheless, there is a possibility that functional proprioceptive stimulation (illusory movements) may facilitate effective rehabilitation in patients with limited physiotherapy options. Nevertheless, this approach has yet to be tested in patients with burn injuries. ⋯ Compared to physical therapy alone, two daily sessions of functional proprioceptive stimulation in addition to usual physical therapy in patients with extensive burns did not change energy expenditure, insulin sensitivity, nitrogen balance, or energy substrate oxidation. At cellular level, the intervention improved the capacity of aerobic phosphorylation in skeletal muscle mitochondria. Clinical effects remain to be demonstrated in adequately powered trials.