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.

scholarly journals The psychological impact of paediatric burn injuries: a systematic review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Alix Woolard ◽  
Nicole T. M. Hill ◽  
Matthew McQueen ◽  
Lisa Martin ◽  
Helen Milroy ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Traumatic Stress ◽  
Burn Injury ◽  
Clinical Care ◽  
Psychological Outcomes ◽  
Qualitative Studies ◽  
Burn Injuries ◽  
Burn Patients ◽  
Post Traumatic

Abstract Objective To review and synthesise qualitative literature regarding the psychological outcomes following paediatric burn injuries, and to determine if children and adolescents who experience a burn injury have elevated risk of psychopathology following the injury. Design Systematic review of quantitative and qualitative studies. Data sources Informit health, Medline, Embase, and PsycINFO were searched from January 2010 to December 2020. Data extraction and synthesis Two reviewers screened articles, and one reviewer extracted data (with cross-checking from another reviewer) from the included studies and assessed quality using an established tool. Narrative synthesis was used to synthesise the findings from the quantitative studies, and thematic synthesis was used to synthesise the findings of included qualitative studies. Results Searches yielded 1240 unique titles, with 130 retained for full-text screening. Forty-five studies from 17 countries were included. The psychological outcomes included in the studies were mental health diagnoses, medication for mental illness, depression, anxiety, stress, fear, post-traumatic stress, post-traumatic growth, emotional issues, self-harm, self-esteem, self-concept, stigmatisation, quality of life, level of disability, resilience, coping, and suicidality. Conclusions Our findings highlight paediatric burn patients as a particularly vulnerable population following a burn injury. Studies suggest elevated anxiety and traumatic stress symptoms, and higher rates of psychopathology in the long-term. Further research is recommended to determine the psychological outcomes in the other mental health domains highlighted in this review, as findings were mixed. Clinical care teams responsible for the aftercare of burn patients should involve psychological support for the children and families to improve outcomes.

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.

scholarly journals Epidemiological study of burn injury with special reference to its prevention- A Nine-year retrospective study from a tertiary care hospital of West Bengal, India

2015 ◽  
Vol 7 (1) ◽  
pp. 70-75 ◽  
Author(s):  
Shib Shankar Kuiri ◽  
Bikash Chandra Ghosh ◽  
Nilay Mandal ◽  
Mintu Mohan Nandi ◽  
Tusar Kanti Saradar ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Injury Risk ◽  
West Bengal ◽  
Burn Injury ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Burn Injuries ◽  
Care Hospital ◽  
Burn Patients ◽  
Age Group

Aims and Objectives: We conducted a retrospective analysis among 1984 burn patients to study the incidence, prevalence of burn injury, its various types and modes (actual event behind the burn injury), risk factors and to find out the preventive measures.Materials and Methods: The retrospective study was carried out among 1984 patients having burn injuries, admitted in a tertiary care hospital of West Bengal, India over a period of nine years. The sources of information were the admission registers and the patients' folders from the medical records department. The Ethical clearance was taken from the Institutional Ethical Committee. The information obtained included age, sex, whether accidental or suicidal, etiology of burn injury and particularly the mechanism of injury. Results: Females were mostly affected (83%) in comparison to males. Among the study population, most of the burn patients were in the age group of 21-30yrs i.e. 35.3%. The number of burn patients were less in number in the age group of 11-20yrs i.e. 7.3%. Most of the burn injuries (87%) were accidental. Suicidal burns occurred in 10% cases. Of which about 1/3rd of the cases were due to dowry related issues.  A significant number of teenagers also attempted suicides due to trivial reasons (e.g. failure in examination, quarrelling with parents). Gas oven related injuries occurred in 2.7% cases. Oil lamps (‘kupi’), candles and hurricane-lanterns, diyas were also responsible to some extent in rural India for flame burns(5%). Smoking related burn injuries occurred in 1.7% cases. Scald injuries occurred in 14% cases. Chemical injuries (0.3%) were due to spillage of unlabelled bottles of acid/alkali. Electrical burn injury occurred in 4.9% cases. Conclusion: Burn injury prevention is not easy, but to avoid the significant morbidity and mortality following injury we have to prevent it by any means. A coordinated and dedicated approach among social workers , medical and paramedical personnel, administrators can only minimize the incidence of burn.Asian Journal of Medical Sciences Vol.7(1) 2015 70-75

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 Considerations for pediatric burn sedation and analgesia

2017 ◽  
Vol 5 ◽  
Author(s):  
Alice Fagin ◽  
Tina L. Palmieri
Keyword(s):  
Pain Management ◽  
Burn Injury ◽  
Burn Injuries ◽  
Burn Patients ◽  
Injury Treatment ◽  
Sedation And Analgesia ◽  
Patients Experience ◽  
Medication Response

Abstract Burn patients experience anxiety and pain in the course of their injury, treatment, and recovery. Hence, treatment of anxiety and pain is paramount after burn injury. Children, in particular, pose challenges in anxiety and pain management due to their unique physiologic, psychologic, and anatomic status. Burn injuries further complicate pain management and sedation as such injuries can have effects on medication response and elimination. Burn injuries further complicate pain management and sedation as such injuries can have effects on medication response and elimination. The purpose of this review is to describe the challenges associated with management of anxiety, pain, and sedation in burned children and to describe the different options for treatment of anxiety and pain in burned children.

scholarly journals A rare Fusarium equiseti infection in a 53-year-old male with burn injury: A case report

2021 ◽  
Author(s):  
Tang Xuan Hai ◽  
Nguyen Thai Ngoc Minh ◽  
Do Ngoc Anh ◽  
Tran Ngoc Dung ◽  
Ngo Thi Minh Chau ◽  
...  
Keyword(s):  
Case Report ◽  
Susceptibility Testing ◽  
Burn Injury ◽  
Large Subunit ◽  
Antifungal Susceptibility ◽  
Herbal Product ◽  
Burn Injuries ◽  
Burn Patients ◽  
Fusarium Equiseti

Background and Purpose: Burn injuries are prone to infection caused by bacteria, fungi, or other pathogens. Fungal wound infection usually has non-specific clinical symptoms.Nevertheless, in some cases, the fungal burden is so substantial that can easily be seen by the naked eyes, but this phenomenon has rarely been reported with Fusarium. Case report: A 53-year-old patient with severe burn injury was admitted to the intensive care unit of the National Hospital of Burn, Ha Noi, Vietnam. His wound was dressed with a traditional herbal product before the hospital admission. On the 5th day after the admission, some white patches suspected of fungal colonies appeared on burn lesions where the herbal medicine was placed. Histological examination (Periodic acidSchiff) and culture of biopsy samples taken from those lesions revealed fungus that was identified as Fusarium equiseti after analysis of the internal transcribed spacer and D1/D2 region of the large subunit of the 28S rDNA. The isolated strain showed susceptibility to voriconazole but resistance to fluconazole, itraconazole, caspofungin,and amphotericin B in vitro. The patient received aggressive treatment, including IV voriconazole (400 mg daily from day five); however, he could not recover. Conclusion: Fusarium should be suspected in burn patients with white patches on lesions. Antifungal susceptibility testing is important since multidrug resistance is common among Fusarium strains.

scholarly journals The Effect of Early Tangential Excision and Split Thickness Skin Graft in Reducing Length of Stay in Burns Patients in Jakarta Islamic Hospital Cempaka Putih

2021 ◽  
Vol 8 (1) ◽  
pp. 15-20
Author(s):  
Gammaditya Adhibarata Winarno ◽  
Aditya Wardhana ◽  
Sanjaya Faisal Tanjunga ◽  
A. S Augiani ◽  
An’umillah Arini Zidna
Keyword(s):  
Length Of Stay ◽  
Skin Graft ◽  
Burn Injury ◽  
Study Groups ◽  
Cross Sectional Study ◽  
Burn Injuries ◽  
Split Thickness Skin Graft ◽  
Burn Patients ◽  
Cross Sectional ◽  
Thickness Skin

Introduction: Early tangential excision (TE) and split-thickness skin graft (STSG) have increased the outcome in burn patients treated at specialized burn centers. This study was conducted to compare the length of stay (LOS) in burn patients undergoing early TE & STSG and delayed TE & STSG. Method: This is a retrospective cross-sectional study including 42 patients with varied burn degrees, and TBSA admitted to Jakarta Islamic Hospital Cempaka Putih (JIHCP) Burn Unit. Patients were assigned to two study groups, the early TE & STSG group including 32 patients and the delayed TE & STSG group including 10 patients. All data were collected from the medical record and compared between two study groups. Result: The mean of LOS in a group with early TE & STSG was shorter (9.81±6.41 days) than LOS in the delayed TE & STSG group (15.80±5.67 days). The data of LOS between these groups were compared using an independent T-test. The LOS in the early TE & STSG group was significantly shorter than the delayed TE & STSG group (p=0.012). Conclusion: In patients with burn injuries, early TE & STSG is associated with a shorter length of stay than the delayed TE & STSG. Our study indicates that early excision within five days after burn injury is optimal to reduce the length of stay in burn patients.

scholarly journals Emergent Management of Thermal Burns in Emergency Rooms Saudi Arabia - A Review

2021 ◽  
pp. 266-272
Author(s):  
Hisham Mohammed Sonbul ◽  
Mohammed Ali Mohammed Alqahtani ◽  
Abdullah Mohammed Bajebair ◽  
Ali Abdallah A. Aljameely ◽  
Saud Ali Aloudah ◽  
...  
Keyword(s):  
Initial Step ◽  
Burn Injuries ◽  
Trauma Patients ◽  
Burn Patients ◽  
Emergency Rooms ◽  
Thermal Burns ◽  
Injuries And Wounds ◽  
Electric Burns ◽  
Serious Injuries

According to WHO statistics, over 300,000 people die each year by burns, and more dying from electric burns, scalds or other causes of burns. Burn injuries and wounds are typically fatal. And they can cause serious long-term implications for victims. The most important aspect in reducing the morbidity and mortality associated with burns is to prevent them. Exposure of tissue to an external high temperature source causes thermal burns. Burns that occur at greater temperatures or over longer periods of time cause deeper and more serious injuries. Because burn patients are the most common trauma patients, the initial step in treating them should be to assess and stabilize their airway, breathing, and circulation according to ATLS standards. Supportive care should include crystalloid resuscitation, blood composition, and potentially endotracheal intubation. In this review we will be looking at thermal burns epidemiology, etiology, pathophysiology and most importantly management.

scholarly journals A Review of Burn Patients Requiring Extracorporeal Membrane Oxygenation at a Burns Facility

2021 ◽  
Vol 2 (4) ◽  
pp. 293-300
Author(s):  
Stephen Frost ◽  
Liz Davies ◽  
Claire Porter ◽  
Avinash Deodhar ◽  
Reena Agarwal
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Burn Injury ◽  
Burn Injuries ◽  
Burn Patients ◽  
Review Of The Literature ◽  
Respiratory Compromise ◽  
Burn Care ◽  
Membrane Oxygenation ◽  
Regular Time ◽  
Major Burn

Respiratory compromise is a recognised sequelae of major burn injuries, and in rare instances requires extracorporeal membrane oxygenation (ECMO). Over a ten-year period, our hospital trust, an ECMO centre and burns facility, had five major burn patients requiring ECMO, whose burn injuries would normally be managed at trusts with higher levels of burn care. Three patients (60%) survived to hospital discharge, one (20%) died at our trust, and one patient died after repatriation. All patients required regular, time-intensive dressing changes from our specialist nursing team, beyond their regular duties. This review presents these patients, as well as a review of the literature on the use of ECMO in burn injury patients. A formal review of the overlap between the networks that cater to ECMO and burn patients is recommended.

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