Evaluating Burn Recovery Outcomes in Children with Neurodevelopmental Symptoms

2021 ◽  
Author(s):  
Farzin Sadeq ◽  
Alexa Riobueno-Naylor ◽  
Matthew A DePamphilis ◽  
Martha Lydon ◽  
Robert L Sheridan ◽  
...  
Keyword(s):  
Behavioral Problems ◽  
Burn Injury ◽  
Burn Injuries ◽  
Learning Problems ◽  
Post Discharge ◽  
Recovery Curves ◽  
Burn Prevention ◽  
Parents And Children ◽  
Injury Recovery

Abstract Neurodevelopmental symptoms (NS) including attention and behavioral problems, developmental delays, intellectual disabilities and learning problems are prevalent in children with burn injuries. The presence of NS may predispose children to poorer burn injury recovery outcomes compared to children without these symptoms (non-NS). The Multi-Center Benchmarking Study (MCBS) monitored recovery outcomes in children with burn injuries in real time utilizing the Burn Outcomes Questionnaire (BOQ). The objective of this study was to retrospectively assess the long term burn recovery outcomes in NS patients versus non-NS patients from the MCBS population. This study assessed parent-reported BOQ outcomes in a sample of 563 patients aged 5 to 18 years who were admitted for burn injuries to a pediatric burn center. A subsample of patients had reported NS (n=181). Analyses compared BOQ outcomes within the NS subsample and the non-NS subsample (n=382) across three longitudinal points post-discharge. The prevalence rate of NS was 32.1% in the full sample. Findings revealed statistically significant improvement in the recovery curves in all five BOQ subscales for the non-NS group and all subscales except for Compliance for the NS group across all longitudinal points. When compared to non-NS patients, NS patients had significantly poorer burn recovery outcomes on the Satisfaction and Compliance subscales. Although it is important to educate all clinicians, parents, and children on burn prevention efforts, targeted education is necessary for children with NS since they may be at greater risk for burn injury as well as worse recovery outcomes.

Severe Burn Injuries and Their Long-Term Implications

2014 ◽  
Author(s):  
Eva C Diaz ◽  
Celeste C Finnerty ◽  
David N Herndon
Keyword(s):  
Burn Injury ◽  
Recombinant Human Growth Hormone ◽  
Human Growth ◽  
Adverse Outcomes ◽  
Burn Injuries ◽  
Endocrine Function ◽  
Growth Delay ◽  
Negative Effects ◽  
Severe Burn Injuries

Burn injury is notable for the degree and duration of pathophysiological alterations that it induces. Burn triggers profound changes in metabolism, immune function, and endocrine function, leading to a host of negative effects, including catabolism of muscle and bone and insulin resistance. These changes may persist or evolve for years after the injury has occurred, delaying recovery. This chapter discusses all of these consequences of burn injury, along with other adverse outcomes, specifically growth delay in children and hypertrophic scarring. Particular attention is placed on what is known about the mechanisms underlying each of these pathological changes and, in some cases, current practice in their management. A description is also provided of some of the pharmacologic (i.e. oxandrolone and recombinant human growth hormone) and non-pharmacologic (i.e. exercise therapy) approaches that hold promise in the treatment of burn injury and its consequences.

scholarly journals Effect of small molecular weight soybean protein-derived peptide supplementation on attenuating burn injury-induced inflammation and accelerating wound healing in a rat model

RSC Advances ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. 1247-1259 ◽  
Author(s):  
Fen Zhao ◽  
Wei Liu ◽  
Yonghui Yu ◽  
Xinqi Liu ◽  
Huinan Yin ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Wound Healing ◽  
Rat Model ◽  
Burn Injury ◽  
Soybean Protein ◽  
Burn Injuries ◽  
Small Molecular Weight

The populations most afflicted by burn injuries have limited abilities to support the significant specialized requirements and costs for acute and long-term burn injury care.

scholarly journals Neuronal Plasticity Associated with Burn Injury and Its Relevance for Perception and Management of Pain in Burn Patients

2000 ◽  
Vol 5 (3) ◽  
pp. 205-213
Author(s):  
Terence J Coderre ◽  
Manon Choinière
Keyword(s):  
Neuronal Plasticity ◽  
Pain Perception ◽  
Burn Injury ◽  
Clinical Care ◽  
Strong Support ◽  
Burn Injuries ◽  
Burn Patients ◽  
Pain Mechanisms ◽  
Gate Control Theory

Through the introduction of the gate control theory and various subsequent works, Ronald Melzack has inspired many investigators worldwide to realize two important facts about pain. First, incoming pain messages are subject to both negative and positive modulation, which significantly affect its perception. Second, the progression of knowledge about the basic mechanisms underlying persistent and chronic pain is critically dependent on the increased understanding of the complexity of the symptoms experienced by pain patients. The present paper examines these two very important issues in an effort to understand better the mechanisms that underlie the pain suffered by burn patients. The physiological responses to burn injury involve many different mediators and mechanisms, all of which contribute to pain perception and development of neuronal plasticity underlying short and long term changes in pain sensitivity. While experimental burn injuries in humans and animals are typically well controlled and mild, in burn victims, the severity is much more variable, and clinical care involves repeated traumas and manipulations of the injured sites. Recurrent inputs from damaged and redamaged tissue impinge on a nervous system that becomes an active participant in the initiation of changes in sensory perception and maintenance of long term sensory disturbances. Recently acquired experimental evidence on postburn hyperalgesia, central hyperexcitability and changes in opioid sensitivity provides strong support that burn patients need an analgesic approach aimed at preventing or reducing the 'neural' memory of pain, including the use of more than one treatment modality. Burn injuries offer a unique opportunity to combine experimental and clinical research to understand pain mechanisms better. Over the years, Ronald Melzack has insisted that one of the most laudable enterprises in research is to span the gap between these two often separate worlds.

547 Long-term Outcomes of Chemical Burn Injuries: A Burn Model System National Database Study

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S113-S114
Author(s):  
Gabrielle G Grant ◽  
Olivia Stockly ◽  
Audrey E Wolfe ◽  
Steven E Wolf ◽  
Jeffrey C Schneider ◽  
...  
Keyword(s):  
Employment Status ◽  
Satisfaction With Life ◽  
Burn Injury ◽  
Burn Injuries ◽  
National Database ◽  
Chemical Burn ◽  
Long Term Outcomes ◽  
Chemical Injuries ◽  
Fire Flame

Abstract Introduction Information on long-term outcomes following chemical burn injury is sparse. This study aims to examine whether or not there are differences in long-term outcomes for individuals with chemical burn injuries compared to those with fire/flame injuries. Methods Data from the Burn Model System (BMS) National Database (1997–2019) were used for analysis. Demographic and clinical characteristics of adult burn survivors with chemical injuries and fire/flame injuries were compared. Regression analyses for the Mental Health Composite Scale (MCS) and the Physical Health Composite Scale (PCS) of the Short Form Health Survey-12, employment status, and Satisfaction with Life Scale (SWLS) were conducted at 12 and 24 months post-burn, adjusting for age, gender, race, and burn size. Results A total of 2,522 database participants (96 with chemical burns; 2,426 with fire/flame injuries) were included in the analyses. Those with chemical injuries had smaller burn sizes, shorter hospital stays, and fewer ventilator days (p< 0.0001, p=0.0034, and p=0.0005, respectively). Chemical burn survivors were more likely to be employed at the time of the burn (p< 0.0001), to have sustained an employment-related injury (p< 0.0001), and to have been discharged to their own home following their acute stay (p< 0.0001). No significant differences in the MCS, PCS, employment status or SWLS were found at either 12 or 24 months post-burn between groups in the regression analyses. Conclusions Chemical burn injuries were not found to have a significant difference on mental health, physical health, employment status, and satisfaction with life outcomes compared to fire/flame injuries. However, the effects of chemical burn injury on long-term outcomes may be difficult to detect due to the relatively small sample size of this population. Applicability of Research to Practice Further investigation is needed to better understand long-term outcomes following chemical injuries. Individuals with chemical burn injuries may require more specific assessment tools to improve how these types of injuries are studied.

58 The Homelessness Crisis and Burn Injuries: A Cohort Study

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S38-S39
Author(s):  
Sebastian Q Vrouwe ◽  
Maxwell B Johnson ◽  
Christopher H Pham ◽  
Christianne J Lane ◽  
Warren L Garner ◽  
...  
Keyword(s):  
Cohort Study ◽  
Burn Injury ◽  
Care Facility ◽  
Burn Injuries ◽  
High Risk Population ◽  
Burn Prevention ◽  
Stable Housing ◽  
Lower Socioeconomic ◽  
Adult Inpatient ◽  
Using Data

Abstract Introduction Many metropolitan areas face a growing homelessness crisis. Lower socioeconomic status has been shown to be a consistent risk factor for burn injury; however, only a limited number of studies have specifically examined homeless burn patients. The purpose of this study is to characterize the demographics and outcomes of homeless patients who sustain burn injuries and compare them to a cohort of domiciled patients in a large, metropolitan city. Methods A retrospective cohort study was performed at an ABA-verified center located in a major metropolitan area. Consecutive acute burn admissions in adults from June 1, 2015 to December 31, 2018 were included. Prevalence was estimated using data from the regional homeless count. Comparisons of demographics, burn characteristics, clinical outcomes, and disposition were made between patients categorized homeless or domiciled at the time of their injury. Results Of 881 admissions, 751 (85%) had stable housing, and 130 (15%) were homeless. The mean prevalence rate of burn injury requiring hospitalization for homeless adults was estimated at 88 per 100,000 persons. Homeless patients had a significantly larger median burn size (7% vs 5%, p< 0.05), characterized by a greater rate of flame burns (68% vs 42%, p< 0.001). For the homeless, rates of assault and self-inflicted injury were four- (18% vs 4%, p< 0.001) and two-fold higher (9% vs 4%, p< 0.001), respectively. Homeless patients had higher rates of mental illness (32% vs 12%, p< 0.001) and substance abuse (88% vs 22%, p< 0.001), and were less likely to follow-up as outpatients (54% vs 87%, p< 0.001). There were no significant differences in mortality. Homeless patients had a longer median length of stay (LOS, 11 days vs 7 days, p< 0.001), but there were no significant differences in LOS per %TBSA. Homeless patients had more complex discharge dispositions and were more frequently discharged to a recuperative care facility than domiciled patients (27% vs. 1%, p< 0.001). Conclusions Homeless patients comprised a significant subset of our adult inpatient population, with an estimated five-fold greater rate of burn injury requiring hospitalization compared to the national average. These patients sustained larger burn injuries with greater rates of assault or self-inflicted injury. Applicability of Research to Practice Homeless individuals should be considered a high-risk population for burn injury. This distinction serves as a call to action for the development of burn prevention strategies.

Palliative Care in Burn and Thermal Injury

2019 ◽  
pp. 119-134
Author(s):  
Alisa Savetamal ◽  
Kristin Edwards
Keyword(s):  
Substance Abuse ◽  
Palliative Care ◽  
Burn Injury ◽  
Burn Injuries ◽  
The Other ◽  
Psychosocial Needs ◽  
Care Services ◽  
Valuable Adjunct ◽  
Palliative Care Services

Burn injury can be a life-changing event for many patients, requiring prolonged hospitalization, multiple operative procedures, and extensive physical rehabilitation after hospital discharge. For the burn team, the challenges of caring for burn injuries are compounded by the psychosocial needs of the patients, many of whom have underlying medical, psychiatric, or substance abuse problems or some combination of all of these. Integrating palliative care services into the burn team is a valuable adjunct for the patients, families, and care teams involved in burn injury. Palliative care provides a framework for considering not only the acute needs of the burn patient but also the other underlying issues that may affect the patient’s hospital course, recovery, and long-term goals.

Fireworks and Seafood Boils: The Epidemiology of Burns in Louisiana

2019 ◽  
Author(s):  
Dylan M Johnson ◽  
Levi J White ◽  
Jameson Gilstrap ◽  
Tracee C Short
Keyword(s):  
Burn Injury ◽  
Burn Injuries ◽  
Severe Injuries ◽  
Burn Center ◽  
Burn Prevention ◽  
Temporal Relationships ◽  
Total Incidence ◽  
Demographical Data ◽  
Epidemiological Trends ◽  
Outpatient Settings

Abstract Epidemiological trends provide a means for targeting efforts in burn prevention. There have been but few regional-specific studies concerning burns in the southern United States. This study describes burn injury trends experienced by a single burn center in Louisiana. We also investigate the temporal relationships of several activities informally known for having a high risk for burn injury among local providers. Data were retrospectively extracted from the records of all patients treated for burn injuries at the regional burn center from 2012 to 2018 in both inpatient and outpatient settings. Demographical data and burn injury characteristics were noted. A total of 6,498 patients were included (1,593 inpatient, 4,905 outpatient). The most common burn etiologies were scald and flame, with flame being associated with more severe injuries. Overall incidence was disproportionally high in males and children less than 4 years of age. Total incidence was highest in Caucasians, though African Americans held the highest annual incidence rate specific to this population. The most common situation at the time of burn injury involved the consumption or preparation of food or beverages. Significant variation was observed in the rates of different injury situations throughout the year. Notably, burns related to seafood, heating, and firework activity occurred more often during crawfish season, colder months, and the months of January and July, respectively. In addition to establishing preliminary trends, these data may be useful in guiding the development of future evidence-based prevention efforts to target the most detrimental burn injuries in this population.

748 The Calm After the Storm? Burn Injury Incidence Following Hurricanes and Tropical Storms

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S207-S207
Author(s):  
Alexander Zirulnik ◽  
Dan Neal ◽  
Joshua S Carson
Keyword(s):  
Burn Injury ◽  
Public Awareness ◽  
The State ◽  
Burn Injuries ◽  
Injury Incidence ◽  
Storm Events ◽  
Burn Prevention ◽  
Regional Center ◽  
Weather Events ◽  
Before And After

Abstract Introduction In recent years, we have noted a pattern of a surges in burn admissions occurring in the wake of some of the larger storm events occurring in our region. Many injuries incurred in the activities related to the storms’ aftermath— accelerate related burns from burning debris, generator explosions, and electrical repair burns. It is suspected that conditions created by larger storms may increase the population-wide risk for burn injuries for some time after the storm itself. If trues, this would suggest a need for more concerted burn prevention efforts in the wake of major natural disasters. The purpose of this study was to identify whether there is indeed a predictable surge in burn injuries relationships between seasonal variation and burn injuries in one catchment area of a regional center. We hypothesize that there is an underlying association between significant storms and an increased number of burn-related injuries before and after storms. Methods Using a retrospective approach, we examined burn center admission data from 2007–2018 (N=4,637) to include burns in the week prior to and three weeks after hurricane or tropical storm events (a storm window) in our state. This dataset only examined burns in which patients were admitted greater than 20 hours to exclude any confounding follow-up visits. Results Using Poisson regression to evaluate the effect of the storm window has on the number of daily admissions, there was found to be no significant association in respect to daily case totals (p=.165) when comparing across all years in respect to storm windows. When examining data from 2017 and 2018; years in which severe storms (category 4+) hit the state of Florida, there was found to be a significant increase in the number of daily burn admissions during the storm window by about 39% (p=0.039) as compared to 2015 when no storms hit the state. Conclusions It is hypothesized that a significant association of injuries were found in later years due to the ever-increasing intensity of storms hitting the state. Public awareness should be directed to the dangers of burns and related injuries in the wake of major weather events, i.e. before and after storms. In addition, further studies should examine the relationships between injuries and weather-related events. Applicability of Research to Practice Awareness of a tendency for burn injuries and admissions to surge after major storms could be used to improve the timing and content of burn prevention response to these incidents.

A burn prevention program as a long-term investment: trends in burn injuries among Jews and Bedouin children in Israel

Burns ◽  
2000 ◽  
Vol 26 (2) ◽  
pp. 171-177 ◽  
Author(s):  
E Shani ◽  
S.A Bahar-Fuchs ◽  
I Abu-Hammad ◽  
M Friger ◽  
L Rosenberg
Keyword(s):  
Prevention Program ◽  
Burn Injuries ◽  
Burn Prevention

scholarly journals The Phenomenon of Community Reintegration for Veterans with Burn Injury: Supportive Communities and Future-Oriented Thinking

2019 ◽  
Author(s):  
Sarah J Murray ◽  
Leopoldo C Cancio
Keyword(s):  
Posttraumatic Growth ◽  
Peer Support ◽  
Meaning In Life ◽  
Military Service ◽  
Burn Injury ◽  
Qualitative Inquiry ◽  
Burn Injuries ◽  
Community Reintegration ◽  
Burn Survivors

Abstract Combat missions in the Middle East have resulted in approximately 52,000 U.S. veterans who have been wounded in action, with 10% of whom suffered burn injuries. More than 90% of the wounded survived, but many were unable to return to military service. The purpose of this study was to investigate the factors that impacted reintegration of veterans with combat burn injuries. Using a mixed-methods approach and analysis, we asked veterans with combat burns “What was your experience reintegrating into the civilian community?” Additionally, we administered the Community Reintegration of Injured Service Members (CRIS) tool to measure the current level of reintegration. Six veterans with combat burn injury identified two major themes: supportive communities and future-oriented thinking. Supportive communities are defined as communities that are veteran-specific, provide long-term burn/injury care, are financially beneficial, and support hobbies, education, and work opportunities. Future-oriented thinking is defined as thinking in which a veteran experiences a turning point in recovery, has a desire to serve others, develops new meaning in life, and experiences posttraumatic growth. In both themes, peer support was a key component. Community reintegration was enhanced by future-oriented thinking and a supportive community, both of which can be buoyed by peer support. These findings are similar to other studies noting the importance of peer support for veterans. Studies of civilians burn survivors describe similar reintegration issues. These two factors may also be applicable to those survivors. Further qualitative inquiry into peer support in the burn community at large may reveal more actionable evidence which could enable burn survivors to meet the long-term goal of community reintegration.

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