Burn Injury Outcomes Research Articles

Pediatric burn injury at home in 30 years: A road to future prevention

IntroductionInjury prevention is valuable for pediatric burns at home. To develop future target of prevention, we aimed to elucidate characteristics and chronological changes of pediatric burn injuries at home in urban areas. Patients and MethodsWe conducted a retrospective observational study using the database of the Tokyo Burn Unit Association, which comprises 14 tertiary burn centers, the Tokyo Fire Department, Tokyo Medical Association, and the Tokyo city government. We included pediatric patients aged ≤15 years who had a burn injury at home in the last 30 years and divided them into five groups at 6-year intervals. We compared the mechanism, severity, and outcome of burn injuries between the groups. ResultsWe included 1092 pediatric patients, with no significant chronological changes in the incidence of burn injuries at home (approximately 200 patients in each 6-year period). The median age was 1 year in all the groups. Flame burns decreased from 7.7% to 1.6%, whereas scald burns remained at >80%. The burn area decreased from 10 (5–16) %total body surface area (%TBSA) to 7 (3–11) %TBSA. The length of hospital stay was reduced from 6 to 2 days, and in-hospital mortality was 0.4%–0.5% in the last decade. ConclusionsThe incidence of flame burns and burn area decreased over time with improving clinical outcomes in pediatric burns. The number of scald burns remained the same over time; thus, further social intervention is needed to prevent scald burns.

Comparative Analysis of Burn Injuries in Toddler and Preschool Children: Implications for Triage and Outcome Assessment.

This study aims to compare the demographic, clinical characteristics, and outcomes of burn injuries in toddler and preschool children, and to validate the American Burn Association (ABA) Burn Triage Decision Matrix in the Turkish pediatric population. A retrospective analysis was conducted on 684 pediatric burn patients (494 toddlers, 190 preschoolers) admitted to our burn center over a 5-year period. Variables including gender, burn etiology, burn area, depth, treatment modalities, complications, length of hospital stay, and mortality were analyzed. The performance of the ABA Burn Triage Decision Matrix was evaluated in both groups. Scalding was the predominant cause of burns in both groups, with a significant difference in the involvement of anterior trunk (p = 0.027). The mean Total Body Surface Area (TBSA) was comparable between the groups (p = 0.286). There was no significant difference in mortality rates (p = 0.385), treatment modalities, and complications. The ABA Burn Triage Decision Matrix demonstrated consistency in triaging the severity of burn injuries, with a notable discrepancy observed in the moderate risk category of toddler group. This study highlights the distinct characteristics and outcomes of burn injuries in different pediatric age groups. The ABA Burn Triage Decision Matrix's validation suggests its utility in enhancing triage accuracy and resource allocation in pediatric populations, especially in disaster-prone regions.

Prognostic Scores for Mortality in Invasive Mechanically Ventilated Burn Patients.

Managing burn patients is a challenge requiring a multidisciplinary team with the ability to predict complications and act early to avoid them. There are few studies characterizing the population of critically ill burn patients in need of ventilatory support. This study aimed to describe the population of burn patients in need of invasive mechanical ventilation supportand assess in-hospital mortality and the factors associated with it. A longitudinal retrospective study was conducted, including burn patients admitted to a tertiary hospital burn unit over five consecutive years, who required invasive mechanical ventilation support during their hospitalization. Demographic data, comorbidities, characteristics of the injury scene, etiology, and characteristics of the burn were collected.Length of mechanical ventilation and hospitalization as well as mortality rate were evaluated.The determination of mortality predictors and the prognostic performance of mortality prediction scores were analyzed. A one-year follow-up was performed to evaluate the survival of discharged patients. A total of 141 patients were included in this study; 68.1% patients were malewith a median age of 58 years. The mean percentage of total body surface area (TBSA) burned was 24.5%. Home incidents were the most frequent, and fire was the most common cause of burns (80.9% of patients). The mean Abbreviated Burn Severity Index Score (ABSI) was 7.83, with an area under the curve in receiver operating characteristic curve (ROC) analysis (AUC_ROC) of 0.725; the mean Belgium Outcome of Burn Injury (BOBI) score was 3.45, with AUC_ROC of 0.740 and mean R-Baux of 89.1 and AUC_ROC of 0.834. The mean duration of invasive mechanical ventilation was 16.9±19.3 days. Age (p<0.001), length of mechanical ventilation (p<0.001), length of hospitalization (p<0.001), higher degree of burn (p=0.001), TBSA (p=0.040), and the presence of buttock burn (0.006) were associated with mortality in this sample. In-hospital mortality was 29.8%. The survival group had a 12% death rate at one-year follow-up, mostly in the first three months after discharge. Age, duration of mechanical ventilation, length of hospitalization, higher degree of burn, TBSA, and the presence of buttock burn were associated with mortality in this sample. R-Baux score was the most accurate test score to predict mortality in this challenging group of patients.

The Efficacy of Onion Extract on the Prevention or Treatment of Scars: A Systemic Review.

Scars are common and debilitating outcomes of burn injury, with no current consensus regarding the gold standard in scar management. Non-invasive interventions such as silicone gels are popular adjuvant treatments due to ease of application. Onion extract (OE) has been proposed as a potential scar treatment modality due to its anti-microbial and anti-inflammatory properties. A systematic search of the literature was conducted using PubMed, Scopus, and Cochrane for articles published between January 2000 and December 2021. Inclusion criteria were studies: (a) involved OE gel or OE treatment, and (b) those assessing scar prevention or treatment outcomes. Patient and physician reported scar outcomes after treatment and adverse effects were recorded. A total of 21 articles were included in the final review. Five studies found statistically significant improvements in overall scores and individual VSS components in the OE treatment group compared to the silicone groups. Several studies found combined treatment of OE with other topical treatment modalities such as triamcinolone or silicone gel produced significant improvements in scar symptoms. In this review, reported adverse effects were minimal, often consisting of self-resolving pruritus, irritation, and erythema. This review supports OE's potential utility in scar prevention and treatment. Most studies reported minimal adverse events with OE application and significant benefits in specific scar characteristics. Further research is needed to investigate scar outcomes after treatment with OE with larger sample sizes and a follow up period greater than a year.

Factors Influencing Surgical Care and Outcome of Pediatric Burn Injuries and the Use of Synthetic Skin Substitutes

Abstract Burn trauma is one of the most common causes of inpatient treatment in children and is associated with severe physical and psychological consequences. Synthetic skin substitutes are designed to reduce the risk of infection, minimize wound pain, and reduce the frequency of dressing changes. However, data regarding premature detachment of these materials is scarce. The aim of this study was to identify factors associated with early detachment and subsequent consequences for surgical treatment. A retrospective analysis of 392 children with superficial and deep partial thickness burns undergoing inpatient treatment with the application of a skin substitute (Suprathel) was performed. Patient age, wound localization and progression, as well as burned total body surface area (TBSA%) were investigated as possible risk factors for early detachment of wound dressings and surgical intervention. Premature material detachment was significantly associated with burn localization (P &amp;lt; .001) and correlated with burn depth progression (r = 0.23, &amp;lt;0.001) and patient age (r = 0.22, &amp;lt;0.001). Surgical revision after material detachment was required in 13% of patients. Patient age and burn localization seem to increase the risk of premature material detachment. In addition, we observed increased premature detachment of Suprathel® in areas that elicited higher wound progression rates. Identifying these areas might prove pivotal in the improvement of pediatric burn trauma management.

Evaluating Burn Injuries at the University of Sierra Leone Teaching Hospitals Complex, Freetown

Background: As with most low- and middle-income countries (LMICs), burns are a major public health problem in Sierra Leone, yet they are poorly studied. This retrospective study of burn injuries at the Connaught Hospital unit of the University of Sierra Leone Teaching Hospitals Complex aims to bridge this gap by examining the patterns and outcomes of burn injuries over a two-year period and comparing these findings with previous studies from the same region. Methods: A total of 146 patients were included in the study over a two-year period from January 1, 2021, to December 31, 2022. Results: The 146 patients seen during the study period represented an average rate of 1.39 cases per week. The median age was 3.9 years (range: 2 months to 56 years) with 59.4% male involvement. Eighty percent suffered from scalds, mostly from hot water. The modal percentage of Total Body Surface Area (%TBSA) affected was 10% (range: 1–75%), and 68.1% had superficial partial thickness burns. The %TBSA of scalds was significantly smaller than that of flame burns. The most common complication was anaemia. Conclusions: Burns continue to pose a significant challenge in Sierra Leone and the situation has not changed significantly over the past decade. There is a need to institute burn preventive measures in the country and to have dedicated functioning burns units to address this common public health problem.

The Epidemiology and Outcomes of Perineal and Genital Burn Injury in Low- and Middle- Income Countries: A Global Burn Registry Study

IntroductionThe epidemiology, care, and outcomes of perineal and genital burns (PG) in high-income countries have been previously described, but an analysis of this topic in LMICs has yet to be performed. We use the World Health Organization’s Global Burn Registry to fill this gap. MethodsThe GBR was searched from inception to November 2023 to identify all burn patients, excluding cases from high-income countries. Demographics and mechanism of injury were retrieved. Primary outcomes were length of hospital stay (LOHS), surgical intervention, discharge with physical impairment, and mortality. A multivariate regression analysis was performed controlling for burnt total body surface area (TBSA), age, sex, inhalation injury, mechanism of burn and care center characteristics. ResultsOf 9041 patients identified, 1213 (13.4 %) had PG burns with 136 (1.6 %) isolated to the PG region. PG patients had higher TBSA (p < 0.001) and more inhalation injury (p < 0.001). They had better access to rehabilitation and lower access to theater space for burns (p < 0.001). Multivariable analysis showed that PG patients had longer LOHS (p = 0.001), greater mortality (p < 0.001), were less likely to undergo surgery (p = 0.01) or be discharged home with physical impairment (p = 0.03). ConclusionSimilarities and differences exist between high- and low/middle-income countries in terms of the patterns of injury, care, and recovery in patients with PG burns. The longer LOHS and higher mortality among PG patients, previously reported in high-income countries, are verified. This highlights the importance of greater vigilance when caring for such patients.

Associations of Diabetes and Hyperglycaemia with Extent and Outcomes of Acute Burn Injuries.

Severe burns may induce hyperglycaemia in the absence of diabetes, but how glucose trajectories relate to burns outcomes is unclear. To assess incidence of hyperglycaemia following acute burn injury, and associations with diabetes history and length of stay (LOS). Retrospective cohort study of adults admitted with acute burns to tertiary centres. Blood glucose level (BGL), hyperglycaemic episodes (BGL ≥ 11.1 mmol/L) and hyperglycaemic days were recorded. Stress hyperglycaemia was defined as BGL ≥ 11.1 mmol/L without a diabetes history. A total of 30 participants had a diabetes history and 260 did not. Participants with known diabetes had higher mean BGLs (9.7 vs. 9.0 mmol/L, p < 0.001), more hyperglycaemic episodes (28.0 vs. 17.2%, p < 0.001) and hyperglycaemic days (51 vs. 21%, p < 0.001), compared to those without diabetes, despite smaller burns (total body surface area 1.0 vs. 14.8%, p < 0.001). Fourteen participants with stress hyperglycaemia had similar BGLs (at admission 10.3 vs. 11.5 mmol/L; during inpatient stay 9.9 vs. 9.8 mmol/L), more severe burns (15.6% vs. 1.0% TBSA) and longer LOS (18 vs. 7 days, p < 0.001) compared to participants with known diabetes. Extent of burns, having NGT nutrition, age, having inpatient BGL monitoring in the setting of diabetes, or having inpatient BGL monitoring in the absence of diabetes were associated with longer LOS. In participants with known diabetes, small burn injuries were associated with hyperglycaemia. Stress hyperglycaemia can be triggered by major burn injuries, with early and sustained elevation of BGLs. Further research is warranted to improve inpatient management of BGL in patients with acute burn injury.

2 Differential Transcriptomic Responses Among Burn Injury Outcomes Related to Morality and Hospital Length of Stay

2 Differential Transcriptomic Responses Among Burn Injury Outcomes Related to Morality and Hospital Length of Stay

Neighborhood child opportunity is associated with hospital length of stay following pediatric burn injury

IntroductionPediatric burns are associated with socioeconomic disadvantage and lead to significant morbidity. The Child Opportunity Index (COI) is a well-validated measure of neighborhood characteristics associated with healthy child development. We sought to evaluate the relationship between COI and outcomes of burn injuries in children. MethodsWe performed a single-institution retrospective review of pediatric (<16 years) burn admissions between 2015 and 2019. Based on United States residential zip codes, patients were stratified into national COI quintiles. We performed a multivariate Poisson regression analysis to determine the association between COI and increased length of stay. Results2095 pediatric burn admissions occurred over the study period. Most children admitted were from very low (n = 644, 33.2 %) and low (n = 566, 29.2 %) COI neighborhoods. The proportion of non-Hispanic Black patients was significantly higher in neighborhoods with very low (44.5 %) compared to others (low:28.8 % vs. moderate:11.9 % vs. high:10.5 % vs. very high:4.3 %) (p < 0.01). Hospital length of stay was significantly longer in patients from very low COI neighborhoods (3.6 ± 4.1 vs. 3.2 ± 4.9 vs. 3.3 ± 4.8 vs. 2.8 ± 3.5 vs. 3.2 ± 8.1) (p = 0.02). On multivariate regression analysis, living in very high COI neighborhoods was associated with significantly decreased hospital length of stay (IRR: 0.51; 95 % CI: 0.45–0.56). ConclusionChildren from neighborhoods with significant socioeconomic disadvantage, as measured by the Child Opportunity Index, had a significantly higher incidence of burn injuries resulting in hospital admissions and longer hospital length of stay. Public health interventions focused on neighborhood-level drivers of childhood development are needed to decrease the incidence and reduce hospital costs in pediatric burns. Type of studyRetrospective study Level of evidenceLevel III

Cold burn injuries in the United Kingdom: A five-year cohort study of patients presenting to a regional burn unit

AimsTo assess the aetiology, management and outcomes of cold burn injuries presenting to a regional burn unit in the United Kingdom. MethodsRetrospective cohort study of consecutive patients over a five-year period (2018-22). ResultsSixty-two patients (M:F 34:38; median age 23.5 years) were identified. The most common aetiology was aerosol (n=28, 45.2%). Seven (11.5%) injuries were sustained during a social media or peer ‘challenge’ and nineteen (31.2%) were self-harm, of whom five (26.3%) were inpatients on a mental health ward at the time of injury. All ‘challenge’ and self-harm injuries were caused by aerosol. ‘Challenge’ injury patients were younger than those with self-harm (p=.007) and non-intentional injuries (p<.001). A greater proportion of self-harm injuries were in female patients compared to non-intentional injuries (p<.001). Median TBSA was 0.35% (IQR 0.3). Most burns were superficial partial-thickness (n=35, 56.5%), followed by deep-dermal (n=18, 29.0%), full-thickness (n=8, 12.9%), and superficial (n=1, 1.6%). The upper limb was most frequently affected (n=35, 56.5%). Aetiology and whether a non-intentional, ‘challenge’ or self-harm injury did not affect TBSA (p=0.776 & p=0.364) or depth (p=0.353 & p=0.381). Five (8.1%) patients underwent autografting. The median time to healing was 17 days (range 7-45, IQR 22.75). Follow-up ranged from 1-173 weeks. ConclusionsThe incidence of cold burns has increased when compared with previous literature. A disproportionate number of cold burns are self-inflicted using aerosols, either as self-harm or due to social media or peer ‘challenges’. Other emerging aetiologies include non-intentional skin contact with nitrous oxide containers during its recreational use.

Approach to burn treatment in the rural emergency department.

To outline an approach to the assessment and initial management of patients with burns in the rural emergency department setting. Three mnemonics are presented that can be used for both the assessment and the initial management of patients with burns in rural settings. Current and local guidelines compiled by a plastic surgeon were reviewed to develop a systematic approach to the treatment of patients with burns. PubMed and other databases were also searched for current literature on emergency care of patients with burns. Burn injuries are a common reason for presentation to the emergency department. However, the care of patients with these injuries can vary substantially depending on geographic location, provider training, and hospital resources. Classification of burns, fluid resuscitation guidelines, dressings and wound care, indications for referral, and pain management are discussed. Using a systematic approach may help improve burn injury outcomes for patients and provide practitioners with a step-by-step framework for the management of patients with burns in rural settings.

Outcome of burn injury and its associated factors among burn patients attending public hospitals in North Showa Zone, Ethiopia: A cross-sectional study.

Burn injury is a major contributor to morbidity and mortality in developing countries. In Ethiopia, the outcome of burn injuries and associated factors among burn patients were not clearly described. To assess the outcome of burn injuries and its associated factors among burn patients attending public hospitals in the North, showa Zone, Ethiopia. An institution-based cross-sectional study was conducted among 420 burn patients in public hospitals of the North showa, zone. Systematic random sampling was used to select study participants. Structured checklists were used to extract data from burn patients' medical records. Data was entered using Epi-Data version 4.6. Data was analyzed using SPSS version 25. A p- value of ≤ 0.05 in the multivariable logistic regression was used to declare a significant association. In this study, the prevalence of discharges with complications was 40.9% (95% CI: 36.5-45.6). The odds of developing complications among patients having pre-hospital intervention were nearly four times the odds of not having the intervention (AOR = 3.8, 95% CI, 1.11-13.25). The odds of developing complications among patients having scalds were four times the odds of not having scalds (AOR = 4.3, 95% CI, 1.52-12.32). A patient who received fluid and electrolytes was 76% less likely to develop the outcome of burn injury discharged with burn complications. Patients with TBSA less than 20% were 66% less likely to be discharged with complications compared to patients with TBSA greater than 20%.: This study demonstrates a significantly higher level of outcome for patients with burn injuries who were discharged with complications, leading to death and other bad outcomes. Therefore, stakeholder would more emphasis in health education on prevention of burn injuries, first aid treatment of burn, treatment of the cause of burns, and providing fluid and electrolytes.

A comparative study of the predictive value of four models for death in patients with severe burns

ObjectiveTo assess the prognostic value of the Ryan score, Belgian Outcome of Burn Injury (BOBI) score,revised Baux (rBaux) score, and a new model (a Logit(P)-based scoring method created in 2020) for predicting mortality risk in patients with extremely severe burns and to conduct a comparative analysis. MethodsA retrospective analysis was conducted on 599 burn patients who met the inclusion criteria and were admitted to the burn unit of the First Affiliated Hospital of Nanchang University from 2017 to 2022. Relevant information was collected, and receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA) were plotted for each of the four models in assessing mortality in these burn patients using both age-stratified and unstratified forms. The ROC curve section was further compared with the area under the curve (AUC), optimal cutoff value, as well as its sensitivity and specificity. Additionally, the quality of the AUC was assessed using the Delong test. ResultAmong the patients who met the inclusion criteria, 532 were in the survival group and 67 in the death group. Irrespective of age stratification, the novel model exhibited superior performance with an AUC of 0.868 (95% CI: 0.838–0.894) among all four models predicting mortality risk in included patients, and also demonstrated better AUC quality than other models; the calibration curves showed that the accuracy of all four models was good; the DCA curves showed that the clinical utility of the novel model and rBuax score were better. In the comparison of four scoring models across different age groups, the new model demonstrated the largest AUC in both 0–19 years (0.954, 95% CI 0.914–0.979) and 20–59 years groups (0.838, 95% CI 0.793–0.877), while rBuax score exhibited the highest AUC in ≥ 60 years group (0.708, 95% CI of 0.602–0.800). The calibration curves showed that the four models exhibited greater accuracy within the age range of 20–59 years, while the DCA curves indicated that both the novel model and rBuax score scale displayed better prediction in both the 20–59 and ≥ 60 years groups. ConclusionsAll four models demonstrate accurate and effective prognostication for patients with severe burns. Both the novel model and rBaux score exhibit enhanced prediction utility. In terms of the model itself alone, the new model is not simpler than, for example, the rBaux score, and whether it can be applied clinicallyinvolves further study.

Changing Epidemiology and Outcome of Pediatric Thermal Burn Injury in South Western Nigeria.

The pediatric age group has been noted to be particularly vulnerable to burn injuries. Burn is the fifth most common cause of childhood injuries. Nigeria has a very young population with a median age of 18.1 years. Scald is the most common form of burn injuries in this age group globally; however, previous reports from our institution found flame to be the most common form of burn in pediatric age. The most recent report from 13 years ago still maintained flame as the most common cause of pediatric burn injury. This study was carried out to determine the changes in epidemiology and outcome of pediatric thermal burn injury. This was a retrospective study carried out between January 2013 and December 2022. Data were analyzed using the statistical package for social sciences software version 23. The significance was set at a P-value of .05. Two hundred and sixty-five children presented with thermal burn with a male-to-female ratio of 1.3:1. 63.4% occurred in children 0-5 years. Scald (59.6%) was the most common cause of injury. Most flame injuries in females were due to liquified petroleum gas cookstove explosion, while petrol explosion was the most common cause in males (P ≤ .001). There is a yearly increase in burn depth (P = .009). Most inhalation injuries occurred in those aged 11-16 years (P = .006). Mortality rate was 10.2%, with total body surface area burned (P ≤ .001), burn depth (P ≤ .001), and inhalation injury (P ≤ .001) associated with increasing mortality. Scald is now the most common cause of thermal burn in our institution, with a remarkable reduction in mortality rate.

Burn injury characteristics and outcomes among pediatric and adult patients admitted to Ministry of National Guard Health Affairs (MNGHA) hospitals in Saudi Arabia

ObjectiveThis study aims to describe the characteristics and outcomes of burn injuries in pediatric and adult patients admitted to Ministry of National Guard Health Affairs (MNGHA) hospitals in Saudi Arabia. MethodsA multicenter retrospective cohort study was conducted between 2015 and 2021 in five hospitals run by the MNGHA inSaudi Arabia. The study included 555 patients who were admitted to the hospital with burns, and data were collected from an institutional trauma registry on various aspects such as sociodemographic variables, burn clinical characteristics and burn outcomes. The differences in epidemiological data, general characteristics, and outcomes of burn patients with ≤18 and >18 years of age among Saudi hospitalized patients. The associations between patient characteristics and burn outcomes were assessed using multivariable logistic regression. ResultsMost of the participants representing 66.1% males and females 33.9%. Flame and contact were the most common causes of burn injuries, accounting for 43.6% and 43.2% of cases, respectively; followed by chemical (6.7%), then electrical (5.4%), and friction (1.1%). The study revealed that pediatric were the most frequently admitted age group for burn injuries with most cases occurring at home (57%). Pediatric patients had a higher percentage of hot fluid injuries, accounting for 77.5 % of cases (P = 0.00). Flame injuries were more prevalent in adults, accounting for 65.3% of cases (P < 0.05). The study reported that there were significant associations between age, gender, % TBSA, body region affected, and inhalation injury with admission to the ICU in patients with burn injuries. Relative to patients with third degree burns, first and second-degree burns were associated with a lower likelihood of mortality (OR 0.13, 95% CI: 0.03,0.51, p = 0.00). ConclusionThe study’s findings can be utilized to aid in the implementation of different prevention programs and allocate appropriate resources for treatment to reduce the incidence and morbidity of burn injuries. It is essential to continue educating the public on fire safety in the home environment. This can help raise awareness, promote household safety precautions, and encourage early medical care seeking.

The epidemiology of burns in a tertiary care center of Rajasthan

Background: The aim of the present study is to determine the epidemiological pattern and outcome of burn injuries in a tertiary care centre of Rajasthan so that effective evidence based burn prevention programs can be generated and strong burn emergency health system can be established. Methods: This study includes retrospective data analysis of patients conducted over 2 years from January 2020 to December 2021 at burns and plastic surgery department of Sawai Man Singh (SMS) Hospital Jaipur situated in Rajasthan. Results: Total patients managed in SMS hospital were 2007 in 2 years. 65% were males and 35% were females. Most commonly affected age group was 25-39 years with 29% patients. Flame burns was most common mode with 49.6% cases among all age groups and both genders. Median TBSA was 35% as per this study. 37% patients were operated in same admission and definitive reconstruction was done. Mortality was there in 26.7% cases. Conclusions: Our study addresses the need of not only increasing the expenditure over prevention and education programs but also developing resources to improve the survival of burn patients in Rajasthan state. This study may contribute to establishment of strong infrastructure to prevent and treat severe burn injuries.

Outcome of Facial Burn Injuries Treated by a Nanofibrous Temporary Epidermal Layer.

The face is commonly affected in thermal injuries, with a demand for proper recognition and the correct choice of treatment to guarantee optimal aesthetic and functional outcomes. It is highly vascularized and often heals conservatively, highlighting the particular relevance of conservative treatment modalities, many of which require daily re-applications or dressing changes, which can be painful and tedious for both the patient and the healthcare providers. Motivated by encouraging results of a novel temporary nanofibrous epidermal layer, we herein present a case series of this technology in a case series of patients suffering from facial burns and treated in our Burn Center. Patients with superficial partial-thickness facial burns and mixed pattern burns, which were treated with SpinCare™, an electrospun nanofibrous temporary epidermal layer, between 2019 and 2021, at our institution were analyzed retrospectively. The Manchester scar scale (MSS) and numeric rating scale (NRS) were used for scar, pain, and outcome evaluation at different time points by five independent board-certified plastic surgeons with profound experience in burn surgery. Ten patients (m = 9; f = 1) were treated and evaluated retrospectively. The mean age was 38.8 ± years (SD ± 17.85). The mean healing time was 6.4 days (SD ± 1.56). The mean follow-up was 16.4 months (SD ± 11.33). The mean MSS score was 5.06 (SD ± 1.31), and the mean NRS Score for pain was significantly reduced from initially 7 to 0.875 upon application (mean (pre-application) 7 ± 0.7 and (application) 0.875 ± 1.26; p ≤ 0.0001). Patients reported a NRS score of 10 in terms of functional and cosmetic outcomes at their final follow-up appointment. No adverse effects were observed. The application of a nanofibrous temporary epidermal layer such as SpinCare™ represents a relatively easy-to-use, well-tolerated, and effective alternative for the treatment of partial-thickness facial burns.

Pattern, Cause of Childhood Burn injuries and their Management Outcome At Jimma Medical Center, Jimma Zone, Oromia Region, Southwest Ethiopia.

Burn injuries are prevalent worldwide, especially in developing countries; and there are significant pediatric burn injuries in Ethiopia. This study was performed to analyze the pattern, cause, and management outcome of burn injuries in Jimma Medical Center. A hospital‑based retrospective cross‑sectional study was conducted at Jimma university medical center burn unit. Data were collected through chart review of pediatric patients aged 0 to 14 years who were admitted to the burn unit with a burn injury. A total of 92 hospitalized children were studied from Jan 1, 2020 to Dec 31, 2021 GC. Data were analyzed using SPSS version 25. The statistical significance was determined using odds ratio (OR) with a 95% confidence interval (CI) and the corresponding P-value of less than 0.05. The majority of the patients were males (52.2%). Scald burn was the most common cause of burn in 57(62.0%). The TBSA of majority of the patients (52.2%) was found to be between 11% and 20%. After adjusting for possible confounders in the multivariate analysis, preexisting illness and time of presentation to care were found to have a statistically significant association with the outcome of burn at discharge (P= 0.007) (P= 0.021) respectively. The most common cause of burn in our setup was scald burn; upper extremities were also the most affected site. According to our study, the factors associated with the outcome of burn injury were preexisting illness and late presentation to health facilities.

573 The Impact of Burn Injuries on Indigenous Populations

Abstract Introduction Racial and ethnic minorities experience disparities in prevention and treatment of burn injury. However, research on burn injuries in Indigenous populations is limited. This review summarizes literature on burn injuries in Indigenous populations that require consideration due to systemic racism, intergenerational trauma, and health disparities to inform new research. Methods A search was conducted in CINAHL, Ovid MEDLINE, PSYCinfo, and SocINDEX. for “burn OR scars OR scald OR deformity OR disfigurement” and “Aboriginal OR Indigenous OR First Nation OR American Indian OR Maori OR Native OR Torres Strait Islander OR Amerindian OR Inuit OR Metis OR Pacific Islander”. Search criteria were set by the authors with librarian assistance. Inclusion 1) peer-reviewed studies of burns in Indigenous persons 2) in English. Exclusion 1) no data specific to Indigenous burns 2) not peer-reviewed 3) not in full text 4) protocol publications. Selection was performed by a member of the research team and reviewed by the co-authors. Results The search identified 1,091 studies with 51 for review. Fifteen were excluded. Three were editorials or letters. Five were not full text. One was a protocol only, and one did not reference Indigenous persons. Two reported accident rates in Indigenous populations but not burns data. Two excluded articles did not report burns data in the Indigenous population. One was excluded as the conclusions were not supported by the data. Included publications were published between 1987 and 2021 with 24 between 2011 - 2021. Indigenous populations have a rate of burn injury up to two times of the general population in the US, Canada, New Zealand, and Australia. Indigenous people suffered more injuries from flame and inhalation. Burns in Indigenous people are of greater total body surface area and deeper. Indigenous persons had longer lengths of stay, more complications, and need for additional surgeries. The Indigenous population in the US is associated with more hypertrophic scarring. Indigenous patients in Australia struggle with a lack of culturally safe communication and support for aftercare. Conclusions Current literature is limited specific to burns in Indigenous populations. Racial disparities exist in burn injury incidence and outcomes for Indigenous persons. Indigenous populations suffer burn injuries, have more complications, and longer lengths of stay in hospital. Current care practices lack cultural safety considerations. Applicability of Research to Practice Qualitative research in this area will help providers better understand the experiences of Indigenous burn patients to develop more culturally competent care. We are currently developing a study using qualitative hermeneutic methodology to learn about the experiences of Indigenous burn survivors’ injuries, recovery, and social reintegration.