Large Burns Research Articles

Sprayable, antimicrobial and immunoregulation hydrogel loading exosomes based on oxidized sodium alginate for efficient wound healing at skin graft donor sites and health detection

Skin grafting techniques are widely used for large burns, trauma, and various acute and chronic wounds, contributing greatly to the repair of traumatic tissue. However, donor site repair and regeneration are often neglected, resulting in infection and delayed healing. Therefore, it is crucial to reduce the rate of donor site infection and improve the speed and quality of healing. The low-oxidized sodium alginate (OSA) grafting ε-polylysine (OSA-g-EPL) prepared through the Schiff base reaction was used to load with mesenchymal stem cell exosomes (Exo), and crosslinked by Ca2+ to form a gel film (HAE) on the surface of the wound by spraying. EPL provided the hydrogel with good antimicrobial properties, and Exo promoted the polarization of the M2 macrophage, shortened the inflammatory phase of the wound and rapidly transitioned to the proliferation phase, thus accelerating the wound healing process and avoiding the transition to chronic wounds. The excellent electrical conductivity and sensing properties of the hydrogel could be used to monitor the behavioral activities of mice in real time to determine their wound recovery. Therefore, this strategy will provide a promising prospect for efficient and high-quality treatment of donor site wounds.

Assessing the generalizability of a National Burn Database to the United States pediatric burn injury population.

A national database is used to evaluate pediatric burn survivor outcomes, but the generalizability to the United States pediatric burn injury population is unclear, as only 60% of enrollees are U.S. residents. An increased understanding of population similarities and differences between residents of the United States and residents of Mexico treated in the United States within this database will help determine its ability to extrapolate. Assess the generalizability of a national burn database to the U.S. pediatric burn injury population. This retrospective cohort study analyzed pediatric enrollees in a burn database. Data were stratified into children who were residents of the United States or Mexico at time of injury and grouped by age into <5 years, 5-10 years, and >10 years. Not applicable. A total of 2043 children enrolled in the database from 1998 to 2020. Not applicable. Determination of similarities and differences between gender, injury etiology, total body surface area injured, length of stay, and place of injury between the two groups. Both groups showed an increased incidence of burn injury among males as they aged. In U.S.residents, the most frequent etiology in patients <5 years was scald (292 [53.6%]), followed by fire/flame (157 [28.8%]). In residents of Mexico, fire/flame burns were more frequent in all ages and electric burns were more common among children >5 years. In both groups, outdoor injuries became more common as children aged. Children from Mexico had larger burns and longer lengths of hospital stay than children from the United States across all ages. Differences between U.S. and Mexico groups were likely attributable to children with more severe burns being transferred to the United States for care, whereas those with low-severity burns were treated locally. This suggests that children from Mexico in the database were not representative of the pediatric burn injury population of the United States or Mexico more broadly and caution should be used before generalizations are made using this database.

Time since fire interacts with herbivore intake rates to control herbivore habitat occupancy.

Smaller grazers consistently show greater preference for recently burned patches than larger species. Energy optimization theory posits that this pattern is driven by small- versus large-bodied herbivores seeking to maximize energy intake by choosing high-quality recently burned grasses, or high-quantity unburned grasses, respectively. We propose that if burn preference is driven by an energy-maximization mechanism, then preference should change over time as grass regrows and progresses across the optimal feeding heights of herbivores of increasing body size. To test this, we used a camera trap array in the Serengeti National Park to quantify changes in the relative preference for burned patches of seven ruminant herbivore species. We compared observed patterns to simulation results from a grass production-herbivore patch selection model. Burn preference and herbivore body size scaled negatively for 6 months after fire, but this relationship disappeared after 7 months when smaller species stopped selecting burns, and larger herbivores selected burns after 10 months, in a reversal of classic grazer succession. Simulations recreated the former but not the latter relationship, suggesting that an energy-maximization mechanism can drive allometric scaling of burn preference immediately after fire, but over longer periods, grazer-driven feedbacks are required to explain large herbivore burn preferences.

Modeling the impacts of open biomass burning on regional O3 and PM2.5 in Southeast Asia considering light absorption and photochemical bleaching of Brown carbon

Open biomass burning in Southeast Asia has significant adverse impacts on air quality in the region and in downwind areas. These biomass burning events emit large amounts of light absorbing brown carbon (BrC). Once in the atmosphere, the light absorbing capacity of BrC is reduced by various oxidation processes. However, few modeling studies have been conducted to explicitly examine light absorption and bleaching on the prediction of ozone (O3) and fine particulate matter (PM2.5). In this study, a modified Community Multiscale Air Quality (CMAQ) model that explicitly tracks the concentrations of light absorbing and non-light absorbing organic aerosol components from different emission sources and the bleaching of BrC due to photooxidation and OH oxidation is applied to widespread open biomass burning events in March 2018 in Southeast Asia. Open biomass burning accounts for as much as 20–40 ppb (30–50%) of the maximum daily average 8-h ozone (MDA8 O3) and 40–120 μg m−3 (60–90%) of the daily average PM2.5 in the emission source regions. Compared to a simulation without BrC light absorption, the predicted MDA8 O3 and PM2.5 are as much as 16 ppb and 16 μg m−3 lower, respectively, than a simulation with light absorption. This confirms that neglecting the UV light absorption of BrC can lead to significant overpredictions of O3 and PM2.5 during the open biomass burning periods, which may lead to an overestimation of the adverse impacts of biomass burning on public health in Southeast Asia. The addition of BrC bleaching results in a 0.5–1% increase in MDA8 O3 and 1–5% increase in PM2.5 compared to the case without BrC bleaching. The results of this study indicate that light absorption by BrC needs to be considered in chemical transport modeling of large open biomass burning events. The BrC bleaching process is relatively slow and neglecting this process does not significantly change the predictions of MDA8 O3 and PM2.5 during open biomass burning.

Our experience of treatment of purulent arthritis in lower extremities after burn injury

BackgroundThe burn wound is directly affected by the general condition of the patient and also has a direct impact on the same leading to conditions pathology of the musculoskeletal system. Purulent arthritis is a pathological condition in which the joints of the body get inflamed as a result of bacterial infection.The aim of the present study was identification of purulent arthritis patients and to evaluate different surgical treatment in burn patients’ low extremities. Material and methodsDuring a 11-year period, 39 patients with burn injuries complicated by purulent arthritis of the joints of the lower extremities treated in the burn department of the Samarkand Center of Emergency Medical Care, Samarkand, Uzbekistan between 2010 and 2020 were enrolled in the present study. The diagnosis is made on the basis of a characteristic anamnesis. Blood tests confirming the presence of acute inflammation. The main diagnostic method purulent arthritis is puncture of the joint with subsequent examination of the punctate. All patients received comprehensive general and local treatment included necrotomy, necrectomy and 1 to 3 operations were performed to plastically close deep and large burn wounds. We performed an arthrotomy in 31 patients. In all cases, arthrotomy was performed as a planned surgical intervention. Unfortunately we performed amputation in 8 patients. ResultsIn the postoperative period, drainage of the joint cavity through the opening and wound, the application of paraphene to the surrounding tissues of the joints, massage, physical therapy, treatment physical physiotherapy exercises, laser application made it possible to achieve satisfactory results. ConclusionsThe described herein method of treatment of purulent arthritis of the lower extremities has improved treatment results, expanded survival rates, reduced probability of complications and disabilities.

An Epidemiological Survey of Hand Burn Injuries Admitted to a Large Burn Center in the New York City Metropolitan Area.

Hand form and function play a vital role in daily living, and even minor trauma can significantly impair quality of life. There is a current paucity of data regarding hand burn patient and injury characteristics, particularly in urban areas in the United States. As the field of hand surgery expands, a demographic understanding of patients with severe injury potentially requiring surgical management is imperative. The aim of this study was to define the epidemiological characteristics of burn injuries involving the hand that were admitted to a large New York City burn center. A retrospective review of the electronic health record was conducted to identify all patients admitted to our burn center with burn injury involving the hand from August 2020 to December 2023. Patient demographics, injury etiology and characteristics, and hospital course details were recorded and analyzed. We identified 96 admitted patients with 140 hand burn injuries, with a patient median age of 38 years. Female patients presented to the hospital significantly later after initial injury than male patients and were more likely to suffer from flame-related injury. The median length of stay for initial admission was 17.5 days, with longer length of stay associated with hypertension comorbidity. Patients experiencing homelessness demonstrated higher rates of psychiatric disorder, substance use, and current smoking. Length of follow-up was positively correlated with estimated household income. Compared to the general city population, the patient cohort was made up of a lower percentage of "White alone" and "Asian alone" race categories and higher percentage of persons experiencing homelessness. We report the clinical and social characteristics of burn patients with hand involvement admitted to a large urban burn center. Hand burn injuries have distinct risk factors and morbidity implications, and consideration for higher-risk groups is imperative for optimal prevention, acute management, and long-term support.

Nonlinear global flame response behaviors for triggering of combustion instabilities

Combustion instabilities result in large combustor acoustic amplitudes due to a feedback loop between exciting acoustic/hydrodynamic disturbances and flame response. This article addresses the global heat release properties required for a seemingly stable combustor to exhibit bi-stable behavior; that is, linearly stable but destabilized by a large enough disturbance amplitude, commonly referred to as “triggering” in the combustion instability literature. The global unsteady heat release rate is expanded up to fifth order in the source disturbance amplitude to capture triggering behaviors. For a system with linear damping, results show that under zero linear flame response, the third and fifth order non-linearity must satisfy very specific relationships in phase with no constraints on relative amplitudes. Extending this to non-zero linear flame response shows shifts in the phase relationship constraints. The analysis is applied to experimentally measured datasets from the literature showing its applicability. In addition, an example problem for an anchored, premixed flame is used with the constraints, to find the combination of control parameters where triggering is possible. The ultimate goal for the presented results is that it can be used to screen datasets (such as from single nozzle flame characterization experiments) and identify parametric spaces where triggering tendencies are the highest.

Innovative surgical management of large burn wounds in patients with elevated body weight to enhance team safety

Innovative surgical management of large burn wounds in patients with elevated body weight to enhance team safety

The influence of Muscle Wasting on Patient Outcomes among Burn Patients: A Burn Care Quality Platform Study.

The hypermetabolism that occurs after large burns leads to muscle wasting that can result in weakness, difficulty fighting infections, and other challenges to healing. Overall, rates of muscle wasting are not well established across burn centers. The Burn Care Quality Platform (BCQP), the largest available dataset on burn patients globally, was used to explore the rate of Muscle Wasting using data collected from more than 100 burn centers. "Muscle Wasting" was defined from relevant ICD codes (sarcopenia, muscle cachexia, protein malnutrition). Binomial and logistic regression were used to analyze the role of Muscle Wasting in burn mortality and other outcomes after controlling for demographic and comorbid characteristics. In total, the BCQP provided data from 84,438 adult and pediatric burn patients injured between 2000-2018. Only 2.6% (N=2,159) of the patients in the BCQP were diagnosed with having Muscle Wasting at some point during their admission. While Muscle Wasting was not associated with a statistically significant impact on mortality, it remained an independent predictor of inability to discharge to independent living, longer inpatient days, as well as an average of 10 additional surgical procedures (P<0.001 for all) as compared to patients who did not have Muscle Wasting. Muscle Wasting is an independent risk factor for several adverse outcomes in burn patients, but not mortality in the BCQP. Confidence in these findings would be improved with more accurate data collection, as the diagnosis of Muscle Wasting is likely under-reported, under-diagnosed, or both.

HOUSING TEMPERATURE ALTERS BURN INDUCED HYPERMETABOLISM IN MICE.

Mice used in biomedical research are typically housed at ambient temperatures (22-24 °C) below thermoneutrality (26-31 °C). This chronic cold stress triggers a hypermetabolic response that may limit the utility of mice in modeling hypermetabolism in response to burns. To evaluate the effect of housing temperature on burn-induced hypermetabolism, mice were randomly assigned to receive sham, small, or large scald burns. Mice recovered for 21 days in metabolic phenotyping cages at 24 °C or 30 °C. Regardless of sex or sham/burn treatment, mice housed at 24 °C had greater total energy expenditure (TEE, P < 0.001), which was largely attributable to greater basal energy expenditure (BEE) when compared to mice housed at 30 °C (P < 0.001). Thermoneutral housing (30 °C) altered adipose tissue mass in a sex-dependent manner. Compared to sham and small burn groups, large burns resulted in greater water vapor loss, regardless of housing temperature (P < 0.01). Compared to sham, large burns resulted in greater BEE and TEE in mice housed at 24 °C, however, this hypermetabolic response to large burns was blunted in female mice housed at 30 °C, and absent in male mice housed at 30 °C. Locomotion was significantly reduced in mice with large burns compared to sham and small burn groups, irrespective of sex or housing temperature (P < 0.05). Housing at 30 °C revealed sexual dimorphism in terms of the impact of burns on body mass and composition, where males with large burns displayed marked cachexia, whereas females did not. Collectively, this study demonstrates a sex-dependent role for housing temperature in influencing energetics and body composition in a rodent model of burn trauma.

Factors associated with delayed admission to the burn unit: A major burn center’s experience

BackgroundTimely admission to the burn unit is crucial. Ideal burn care requires prompt interventions such as wound and body temperature management, infection control, and fluid resuscitation to prevent complications like burn progression and infection. In this study, we identify specific factors and outcomes associated with delayed admission to a regional burn center. MethodsPatients admitted to a large urban burn center from January 2015 to December 2023 were retrospectively queried, with subsequent collection of demographic and outcome variables from chart review. Descriptive statistics, Welch’s t-tests of unequal variances, and Chi-square analysis were performed. Multiple logistic regression was performed to explore the association between delayed admission and ICU stay, ventilator requirements, and mortality. ResultsA total of 3137 patients were included in the study. Approximately 63.4 % of patients were admitted within 24 h, while 36.6 % had a significant delay in care of over 24 h after injury. Male patients were likely to experience delayed admission (39.0 vs. 31.8 %, p < 0.001). There was no significant difference in age between the two cohorts (38.6 vs. 39.7 years, p = 0.199). There was no significant difference in time to admission by racial background (p = 0.061). Total body surface area burned (TBSA) varied between the delayed and control cohorts (15.5±18.7 % vs. 8.2±12.9 %, p < 0.001). Patients who were single (p < 0.001) and lived alone (p = 0.011) were more likely to experience a delay in burn unit admission. Homelessness (p < 0.001), substance abuse disorder (p < 0.001), and uninsured status (p < 0.001) were also associated with delayed admission. In regression analysis when controlling for TBSA, delay in care was significantly associated with a greater requirement for ICU stay (p < 0.001) and mechanical ventilation (p = 0.021) but was not associated with increased mortality (p = 0.232). ConclusionSociodemographic variables such as homelessness, lack of social support, and substance abuse are associated with delayed burn unit admission. Knowledge of these factors can inform future interventions to improve outcomes for vulnerable patients, promoting better recovery and long-term outcomes after burn injury.

Evaluation of a National Sample of 16,671 Pediatric Burn Admissions: Identifying Predictors of Non-accidental Pediatric Burns

BackgroundBurn injuries remain one of the leading causes of injury and death in children. Studies have demonstrated a higher mortality for pediatric burns associated with non-accidental injury. Using data from a burn registry, our study aimed to discern potential factors associated with non-accidental burn injuries. MethodsWe utilized the American Burn Association database from 2016 to 2018, which collects data from over one hundred burn centers across the United States, to evaluate a large pediatric burn population. Patients aged ≤14 years were analyzed. The population was then divided into suspected non-accidental versus accidental burn injuries. A multivariable logistic regression model was utilized to evaluate for predictors of burn injuries. Additional models were used to assess the relationship between suspected non-accidental burn injury and mortality, intensive care unit (ICU) stay, and hospital length of stay. Results16,671 pediatric patients were included. Of those, 1228 (7.4%) patients suffered non-accidental burn injury. A majority of children who sustained non-accidental burn injury were younger, non-white, and sustained scald burns. The regression model demonstrated predictors for non-accidental burn injuries included younger age, Black race, chemical/corrosion burns, government insurance, and increased total body surface area (TBSA) burn. Overall mortality for the population was 0.5%. ConclusionThis evaluation of a national burn registry reveals differences in pediatric patients sustaining non-accidental burns compared to accidental burns. The findings in this study identify pediatric populations at risk for suspected non-accidental burn injuries which may assist in preparing the families for expectations after admission for a burn injury. Level of EvidenceIII.

Mapping PM2.5 Sources and Emission Management Options for Bishkek, Kyrgyzstan

Harsh winters, aging infrastructure, and the demand for modern amenities are major factors contributing to the deteriorating air quality in Bishkek. The city meets its winter heating energy needs through coal combustion at the central heating plant, heat-only boilers, and in situ heating equipment, while diesel and petrol fuel its transportation. Additional pollution sources include 30 km2 of industrial area, 16 large open combustion brick kilns, a vehicle fleet with an average age of more than 10 years, 7.5 km2 of quarries, and a landfill. The annual PM2.5 emission load for the airshed is approximately 5500 tons, resulting in an annual average concentration of 48 μg/m3. Wintertime daily averages range from 200 to 300 μg/m3. The meteorological and pollution modeling was conducted using a WRF–CAMx system to evaluate PM2.5 source contributions and to support scenario analysis. Proposed emissions management policies include shifting to clean fuels like gas and electricity for heating, restricting secondhand vehicle imports while promoting newer standard vehicles, enhancing public transport with newer buses, doubling waste collection efficiency, improving landfill management, encouraging greening, and maintaining road infrastructure to control dust emissions. Implementing these measures is expected to reduce PM2.5 levels by 50–70% in the mid- to long-term. A comprehensive plan for Bishkek should expand the ambient monitoring network with reference-grade and low-cost sensors to track air quality management progress and enhance public awareness.

Predictive analysis of lactate clearance on the prognosis of patients with large burns

Aims: To examine burn shock monitoring and the connection between lactate clearance and shock prognosis in individuals with severe burns. Materials and methods: This retrospective analysis comprised 100 patients with significant burns treated in our hospital between August 2017 and August 2021. The patients were split into two groups based on whether they survived or not: 50 cases each in the survival and death groups. Both groups had their blood lactate levels, partial pressure of oxygen, and other relevant indices tested. Analysis was done on the correlation between lactate level, lactate clearance, and death as well as the association between lactate clearance and prognosis at each time and point. Results: The lactate clearance rates at 6 h, 12 h, 24 h and 24 h in the survival group were greater than those in the death group, and the differences were significant (p &lt; 0.05). The lactate clearance rates at each time point were compared at a cut-off of 20%, and patients with 6 h and 12 h blood lactate clearance rates ≥20.0% had lower prognostic morbidity and mortality rates than those &lt;20.0%, with a significant difference (p &lt; 0.05). Conclusion: Lactate clearance is directly correlated with the prognosis of patients with severe burns, and survivors also have a high clearance rate. As a result, in patients with severe burns, lactate clearance monitoring during the shock phase can improve prognostic prediction and enable early treatment plan modification based on outcomes.

PANORAMA DA FISIOTERAPIA OFERTADA A PACIENTES COM SEQUELAS DE QUEIMADURA

Introduction: Burns are thermal, electrical, chemical or radioactive traumas that damage body tissues and can lead to death. Objective: To analyze the data and information collected in the system, referring to the quantity of physiotherapeutic care offered, by the SUS, to patients with burn sequelae, in Brazil, in the last 10 years. Materials and methods: Data were obtained from the DATASUS database. The collected data was organized in an Excel spreadsheet, displayed in graphs and analyzed based on scientific literature. Result: In Brazil, in the last 10 years, 97,685 physiotherapeutic services were offered to medium and large burn patients, through the SUS. The largest number of care for medium and large burn patients was concentrated in the northeast region of Brazil and the smallest number in the Central-West region. Conclusion: The study provided a broad overview of the physiotherapeutic care provided to patients with burns in Brazil over the last ten years.

Dioxin concentrations and congener distribution in biomass ash from small to large scale biomass combustion plants.

Biomass plays a pivotal role in global energy production, with a significant share allocated for industrial heat and power generation. The combustion of biomass generates biomass ash, which is widely utilized as a fertiliser. However, concerns arise regarding the presence of dioxins in biomass ash, which may limit its continued use. Dioxins are toxic compounds listed under the Stockholm Convention due to their persistence and detrimental effects on human health and the environment. This study investigates the dioxin content in biomass ashes produced in various combustion plants with a capacity of 1-50MWth in Estonia, where biomass is widely used for heating and power production. The research encompassed samples from nine biomass combustion plants with varying technical parameters considering both bottom and fly ash. Dioxin concentrations were determined for 7 polychlorinated dibenzo-p-dioxins (PCDDs), 10 polychlorinated dibenzofurans (PCDFs), and 12 dioxin-like PCBs (PCBs). The results indicate that dioxin TEQ content in all samples was well below the European Union's (EU) POP Regulation limit of 5µg TEQ/kg, with most values being at least tenfold lower. However, some samples failed to meet the EU Fertilising Products Regulation's threshold of 20ng TEQ/kg. Notably, fly ash exhibited higher dioxin concentrations than bottom ash. While PCBs were in significant concentrations, PCDDs dominated the overall dioxin TEQ content. This study provides essential insights into the dioxin content in biomass ash and its correlation with current EU regulatory limits. It also highlights the complex distribution of dioxin congeners, particularly PCBs, within biomass ash, emphasizing the continued research's importance.

The influence of fire mosaics on mammal occurrence in north-western Australia

BackgroundUnderstanding the relationship between fire and species habitat preferences is critical in an era of rapid environmental change. In northern Australia, large, intense, and frequent fires are thought to be a primary cause of mammal population declines, particularly through their influence on habitat suitability. Here, we used a large species presence database in combination with satellite-derived fire history data to assess the influence of fire attributes, including burn extent, frequency, and pyrodiversity, on the likelihood of occurrence of eight mammal species in north-west Western Australia.ResultsThe likelihood of occurrence declined for some species with an increasing proportion of recently burnt habitat and increased for most species with an increasing proportion of long unburnt habitat. The occurrence of six species was negatively correlated with increasing fire frequency, while the occurrence of four species was positively correlated with increasing pyrodiversity.ConclusionsOur results indicate that fire likely plays an important role in influencing mammal occurrence in the Pilbara and support previous research indicating that frequent large-scale burns have a mostly negative impact on small to medium-sized mammals in northern Australia. To improve mammal habitat suitability, land managers should aim to reduce the extent of large late dry season burns and increase the availability of mature spinifex grasslands.

Exercise and Heat Stress in Well-Healed Burn Survivors: Effects of Cooling Modalities on Thermal and Perceptual Responses.

Burn injuries that require grafting impair thermoregulation, which may dissuade individuals with such injuries from being physically active. We tested the hypothesis that cooling modalities attenuate core temperature elevations and perceptions of heat stress during physical activity in the heat among adults with well-healed burn injuries. Adults with no burn injuries (non-burned), 20-40% body surface area burn injuries (moderate burn), and > 40% body surface area burn injuries (large burn) performed 1 hour of moderate intensity exercise (2.5 ± 0.2 mph and 2% grade) on four different occasions in two environmental conditions (30 °C & 39 °C, 40% relative humidity). Within each environmental condition, we applied one of the following cooling modalities, random assigned, for each visit: no cooling (control), fan at 4 m/s (fan), water spray every 5 min (water spray; scaled to burn area size), or a combination of water spray + fan. In 30 °C, perceptual strain index (PeSI) was reduced in the non-burned and moderate burn groups with water spray + fan, whereas PeSI was reduced with all cooling modalities in the large burn group. The cooling modalities did not affect core temperature responses. In the 39 °C environment, water spray and water spray + fan attenuated the elevation in core temperature (p ≤ 0.007) only in the large burn group. In the moderate burn group, PeSI was decreased with water spray + fan (p = 0.017). In the large burn group, both water spray alone and water spray + fan (p ≤ 0.041) lowered PeSI. For both environments across burn groups, the applied cooling modalities were generally more effective at reducing indices of perceptual strain relative to indices of thermal strain (e.g., core temperature).

On the Analysis of Scale Effects of Flame Stabilization in Scramjet Combustors

Scale effects of flame stabilization in scramjet combustors at Mach 2.52 are investigated through experiments and numerical simulations based on two geometrically similar combustors. As the equivalence ratio increases, the combustion mode will change from Scram to Dual to Ram. However, the larger combustor has a delayed mode transition. The scale effects of flame stabilization are also reflected in the changes of heat release, precombustion shock train length, jet penetration depth, and reaction zone location. The combustion flowfields of different-scale combustors exhibit numerous differences under different combustion modes. However, after shortening the isolator of the proportionally scaled small-scale combustor, the combustion flowfield is closer to that of the large-scale combustor. Further analysis reveals the reason for the inconsistent scale effects of flame stabilization under different combustion modes. The probable reason is that the boundary layer, which does not change proportionally with the combustor scale, has different effects on the combustion under the three modes. Compared with the Scram and Ram modes, the scale effect in the Dual mode is the most significant because the strong interaction between heat release and the boundary layer amplifies the slight difference in the relative thickness of the boundary layer.

Effect of Low-Temperature Argon Plasma and Ultrasonic Cavitation on the Course of Burn Wound Healing

Background: Various physical phenomena come into use in medicine; however, to date, universal physical methods have not been developed to optimize the course of the wound healing at all treatment stages. In combustiology, the first stage of burn treatment is debridement; then it is important to create an optimal biological environment, normalize blood circulation, suppress pathogenic flora, and stimulate proliferative processes in the wound.Objective: To determine the effectiveness of low-temperature argon plasma (LTAP) and ultrasonic cavitation in deep burn wound treatment based on clinical observations and cytological findings.Materials and methods: We studied impression smears from burn wounds of 36 patients with deep burns of various etiologies who were treated using LTAP and ultrasonic cavitation in the Thermal Injuries Unit at the Saint Petersburg I.I. Dzhanelidze Research Institute of Emergency Medicine (Saint Petersburg, Russian Federation) between 2022 and 2023.Results: We found that cytogram findings in the study area changed from the inflammatory type to the regenerative-inflammatory one on day 3-7 when LTAP and ultrasonic cavitation were used, while such change in the control area was observed only after 10 days of treatment. Thanks to the use of LTAP and ultrasound after necrosectomy for deep dermal burns, the wound preparation for autologous skin grafting takes less time than it does with standard methods of local burn wound care. Ultrasonic cavitation should be used in cases of severe exudation and slough, whereas LTAP should be used when reparative processes in a burn wound slow down.Conclusions: Burn wound treatment using ultrasonic cavitation and LTAP enables to prepare the wound surface for autologous skin grafting with a high engraftment rate. The procedure allows to effectively and atraumatically debride the wound and suppress pathogenic microflora. Further research is planned in patients with large deep burn wounds.