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Burns

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A Multicenter Evaluation of Outcomes Following the Use of Nebuliz-ed Heparin for Inhalation Injury (HIHI2 Study).
Cox CL, McIntire AM, Bolton KJ, Foster DR, Fritschle AC, Harris SA, Pape KO, Whitten JA, Harman BC, Sood R, Walroth TA.
J Burn Care Res. 2020 Sep 23;41(5):1004-1008.

Rationale for inclusion: Multicenter evaluation of outcomes for inhalation injury examining rates of systemic bleeding and dosing efficacy for inhaled heparin.

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Key Cell Functions are Modulated by Compression in an Animal Model of Hypertrophic Scar.
Alkhalil A, Carney BC, Travis TE, Muhie S, Miller SA, Ramella-Roman JC, Ghassemi P, Hammamieh R, Jett M, Moffatt LT, Shupp JW.
Wounds. 2018 Dec;30(12):353-362.

Rationale for inclusion: Compression has been known to impact scar maturation in burn patients for decades. Understanding of the cellular mechanisms for this modulation has been lacking; this paper identifies broad transcriptome changes in scar after the application of measured compression.

CAVEAT: Animal work

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Shedding of the endothelial glycocalyx is quantitatively proportional to burn injury severity
Luker JN, Vigiola Cruz M, Carney BC, Day A, Moffatt LT, Johnson LS, Shupp JW.
Ann Burns Fire Disasters. 2018 Mar 31;31(1):17-22.

Rationale for inclusion: Translation of trauma work looking at shock related endothelial damage to the burn population. Dose response of endothelial damage may suggest a mechanism behind burn-related vasodilatory shock

CAVEAT: Animal work

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Inhalation Injury: Pathophysiology, Diagnosis, and Treatment.
Jones SW, Williams FN, Cairns BA, Cartotto R.
Clin Plast Surg. 2017 Jul;44(3):505-511.

Rationale for inclusion: Comprehensive review of pathophysiology and modern approach to diagnosis and management of inhalation injury.

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The Use of CO2 Fractional Photothermolysis for the Treatment of Burn Scars.
Levi B, Ibrahim A, Mathews K, Wojcik B, Gomez J, Fagan S, et al
J Burn Care Res. Mar-Apr 2016;37(2):106-14.

Rationale for inclusion: Retrospective study performed at one institution that focuses on patient reported outcomes.

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Burn wound healing and treatment: review and advancements
Rowan M, Cancio L, Elster E, Burmeister D, Rose L, Natesan S, Chan R, Christy R, Chung K.
Crit Care. 2015;19:243. Published 2015 Jun 12.

Rationale for inclusion: Comprehensive review of modern burn wound treatments

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Laser resurfacing and remodeling of hypertrophic burn scars: the results of a large, prospective, before-after cohort study, with long-term follow-up.
Hultman CS, Friedstat JS, Edkins RE, Cairns BA, Meyer AA.
Ann Surg. 2014 Sep;260(3):519-29; discussion 529-32.

Rationale for inclusion: For the first time, ever, in a large prospective study, laser therapies have been shown to dramatically improve both the signs and symptoms of hypertrophic burn scars, as measured by objective and subjective instruments. Follow up.

 

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Laser therapy for prevention and treatment of pathologic excessive scars.
Jin R, Huang X, Li H, Yuan Y, Li B, Cheng C, et al
Plast Reconstr Surg . 2013 Dec;132(6):1747-1758.

Rationale for inclusion: This study presents the first meta-analysis to confirm the efficacy and safety of laser therapy in hypertrophic scar management.

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Plasma neutrophil gelatinase-associated lipocalin as early biomarker for acute kidney injury in burn patients
Hong DY, Lee JH, Park SO, Beak KJ, Lee KR
Hong DY, Lee JH, Park SO, Baek KJ, Lee KR. Plasma neu- trophil gelatinase-associated lipocalin as early biomarker for acute kidney injury in burn patients. J Burn Care Res 2013;34:e326–32.

Rationale for Inclusion: Renal failure remains a large contributor to burn mortality. This prospective study provides a plasma based marker obtained at admission which identified the later development of AKI during hospitalization with high sensitivity and specificity.

CAVEAT: Small single center study

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Prospective, before-after cohort study to assess the efficacy of laser therapy on hypertrophic burn scars.
Hultman CS, Edkins RE, Wu C, Calvert CT, Cairns BA.
Ann Plast Surg. 2013 May;70(5):521-6.

Rationale for inclusion: One of the first studies on application of laser therapy to hypertrophic burns scars, identifying indications and efficacy.

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Volume overload of fluid resuscitation in acutely burned patients using transpulmonary thermodilution technique.
Aboelatta Y, Abdelsalam A.
J Burn Care Res. 2013 May-Jun;34(3):349-54.

Rationale for inclusion: Comparison of resuscitation endpoint paramenters; physiologic v classic (Parkland). Significant over resuscitation using physiologic parameters, suggesting "normal" is the wrong endpoint during a burn resuscitation.

CAVEAT: Small volume of patients

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Pruritus in adult burn survivors: postburn prevalence and risk factors associated with increased intensity
Carrougher GJ, Martinez EM, McMullen KS, Fauerbach JA, Holavanahalli RK,  Herndon DN, Wiechman SA, Engrav LH, Gibran NS
Carrougher GJ, Martinez EM, McMullen KS, et al. Pruritus in adult burn survivors: postburn prevalence and risk factors associated with increased intensity. J Burn Care Res 2013;34:94–101.

Rationale for Inclusion: Represents the largest longitudinal report of pruritus symptoms post burn injury. Early after injury 90% of patients reported pruritus, and in long term survivors 44% had pruritus symptoms t 40-10 years.

CAVEAT: Based on patient reported symptoms

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Shine on: Review of Laser- and Light-Based Therapies for the Treatment of Burn Scars.
Hultman CS, Edkins RE, Lee CN, Calvert CT, Cairns BA.
Dermatol Res Pract. 2012;2012:243651.

Rationale for inclusion: A review of treatment of burn scars with laser therapy to suggest a new direction in laser reconstruction algorithm.   (1) vascular-specific pulsed dye laser (PDL) to reduce hyperemia, (2) ablative fractional CO(2) laser to improve texture and pliability of the burn scar, and (3) intense pulsed light (IPL) to correct burn scar dyschromia and alleviate chronic folliculitis.

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Review of a fluid resuscitation protocol: "fluid creep" is not due to nursing error.
Faraklas I, Cochran A, Saffle J.
J Burn Care Res. 2012 Jan-Feb;33(1):74-83.

Rationale for inclusion: PI project turned study evaluating effectiveness of nurse-driven resuscitation protocol for burns. Good evaluation of crystalloid vs colloid, discussion, etc.

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The Baux score is dead. Long live the Baux score: a 27-year retrospective cohort study of mortality at a regional burns service.
Roberts G, Lloyd M, Parker M, Martin R, Philp B, Shelley O, Dziewulski P.
J Trauma Acute Care Surg. 2012 Jan;72(1):251-6.

Rationale for inclusion: Single center retrospective looking at 27 years of data. Study concluded that despite improvements in care, the Baux score continues to predict mortality though the point of futility and Baux50 have improved. 

CAVEAT: Single center, UK study

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High-frequency percussive ventilation and low tidal volume ventilation in burns: a randomized controlled trial.
Chung KK, Wolf SE, Renz EM, Allan PF, Aden JK, Merrill GA, Shelhamer MC, King BT, White CE, Bell DG, Schwacha MG, Wanek SM, Wade CE, Holcomb JB, Blackbourne LH, Cancio LC.
Crit Care Med. 2010 Oct;38(10):1970-7.

Rationale for inclusion: Randomized controlled trial evaluating the use of ARDSNet recommendations to a patient population not included in the original LPS studies. Suggests that lung protective strategy in not a one-size-fits-all approach for the critically ill burn patient.

CAVEAT: Group has significant experience with HFOV, not used in a large number of other centers

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Chemical burns: pathophysiology and treatment
Palao R, Monge I, Ruiz M, Barret JP
Palao, R., Monge, I., Ruiz, M., & Barret, J.P. (2010). Chemical burns: pathophysiology and treatment. Burns, 36(3), 295-304.

Rationale for Inclusion: A comprehensive review of chemical burn and its treatment

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Efficacy and safety of a fibrin sealant for adherence of autologous skin grafts to burn wounds: results of a phase 3 clinical study.
Foster K, Greenhalgh D, Gamelli RL, Mozingo D, Gibran N, Neumeister M, Abrams SZ, Hantak E, Grubbs L, Ploder B, Schofield N, Riina LH; FS 4IU VH S/D Clinical Study Group.
J Burn Care Res. 2008 Mar-Apr;29(2):293-303.

Rationale for inclusion: Phase 3, multicentered, prospective, randomized, evaluator-blinded, clinical study was to compare skin graft adherence utilizing ARTISS. Results demonstrated that fibrin glue was safe and effective for skin grafting with outcomes as good or better than staple fixation. 

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Smoking and home oxygen therapy--a preventable public health hazard.
Edelman DA, Maleyko-Jacobs S, White MT, Lucas CE, Ledgerwood AM.
J Burn Care Res. 2008 Jan-Feb;29(1):119-22.

Rationale for inclusion: Retrospective, descriptive study with 14 patients admitted to a single center over a two year period. This study describes the burden of this injury pattern and advocates for a multidisciplinary approach to injury prevention. 

CAVEAT: Single center, retrospective, cohort

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Barriers to return to work after burn injuries.
Esselman PC, Askay SW, Carrougher GJ, Lezotte DC, Holavanahalli RK, Magyar-Russell G, Fauerbach JA, Engrav LH.
Arch Phys Med Rehabil. 2007 Dec;88(12 Suppl 2):S50-6.

Rationale for inclusion: As survival after burn injury improved, the focus of burn teams moved to quality of life and patient reported outcomes. This is a multicenter cohort study with excellent long term follow up that identified barriers to return to work up to 1 year post injury.

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Burns sustained in combat explosions in Operations Iraqi and Enduring Freedom (OIF/OEF explosion burns).
Kauvar DS, Wolf SE, Wade CE, Cancio LC, Renz EM, Holcomb JB.
Burns. 2006 Nov;32(7):853-7.

Rationale for inclusion: Great descriptive paper describing the epidemiology and quality of burn combat casualties in modern day.

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Predictors of survival and length of stay in burn patients older than 80 years of age: does age really matter?
Pomahac B, Matros E, Semel M, Chan RK, Rogers SO, Demling R, Orgill DP.
J Burn Care Res. 2006 May-Jun;27(3):265-9.

Rationale for inclusion: First study looking specifically at a subset of elderly burn patients to determine predictors for survival. Authors demonstrate that a population of very elderly patients (>80 yo) survive after burn injury. 

CAVEAT: Single center, retrospective study. Generalizability is not possible based on this study.

Citations  - To review the number of citations for this landmark paper, visit Google Scholar.

Meta-analysis of early excision of burns.
Ong YS, Samuel M, Song C.
Burns. 2006 Mar;32(2):145-50. Epub

Rationale for inclusion: Meta-analysis of existing literature demonstrating early excision to be associated with decreased mortality and hospital length of stay.

CAVEAT: Meta-analysis

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Gabapentin for the treatment of itching produced by burns and wound healing in children: a pilot study.
Mendham JE.
Burns. 2004 Dec;30(8):851-3.

Rationale for inclusion: Literature describing use of gabapentin in the treatment of children with post-burn injury itch. 35 kids who were on other medications with persistent itch were treated with gabapentin and all had improvements in itching with the medication. 

CAVEAT: Single center, pediatric only, not randomized or otherwise controlled

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Lightning injuries.
O'Keefe Gatewood M, Zane RD.
Emerg Med Clin North Am. 2004 May;22(2):369-403.

Rationale for inclusion: An excellent comprehensive review article on lightening strike injuries including epidemiology statistics, injury patterns, and treatment algorithms. 

CAVEAT: Review article, no new data

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Inpatient depression in persons with burns.
Ptacek JT, Patterson DR, Heimbach DM.
J Burn Care Rehabil. 2002 Jan-Feb;23(1):1-9.

Rationale for inclusion: Large single center study using a validated depression tool (Beck Depression Index) at several points in their hospital stay and post discharge to describe depression in patients admitted with burn injuries. Investigators found that post discharge depression was correlated with inpatient depression and early interventions were a potential source preventing long-term negative outcomes.

CAVEAT: Single center, recall bias regarding preadmission symptoms

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SCORTEN: a severity-of-illness score for toxic epidermal necrolysis.
Bastuji-Garin S, Fouchard N, Bertocchi M, Roujeau JC, Revuz J, Wolkenstein P.
J Invest Dermatol. 2000 Aug;115(2):149-53.

Rationale for inclusion: This study defined a SJS-TEN specific severity of illness score to predict risk of death. 

CAVEAT: Important seminal paper, probably less applicable today with the modern treatment of the disease. 

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Carboxyhemoglobin half-life in carbon monoxide-poisoned patients treated with 100% oxygen at atmospheric pressure.
Weaver LK, Howe S, Hopkins R, Chan KJ.
Chest. 2000 Mar;117(3):801-8.

Rationale for inclusion: Retrospective chart review evaluating the half-life of carbon monoxide in patients revealing that the half-life of carboxyhemoglobin was approximately 74 minutes on 100% O2. They demonstrate that half-life was influenced only by the patient's PaO2.

CAVEAT: Retrospective chart review

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A randomized prospective trial of hyperbaric oxygen in a referral burn center population.
Still J, Haynes M, Orlet H, Rosenbum F, Law E, Thompson WO.
Brannen AL, Still J, Haynes M, et al. A randomized prospective trial of hyperbaric oxygen in a referral burn center population. The American Surgeon. 1997 Mar;63(3):205-208.

Rationale for Inclusion: A large randomized prospective study of humans. Previous controlled studies on humans were very limited and with little power. The majority of studies on animals have contradictory results. This study was unable to demonstrate a significant benefit to burn patients from the use of hyperbaric oxygen therapy.

CAVEAT: Single institution. May only be applicable to less than 21% total body surface area burn as these were the survivors of the study.

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Burn camps and community aspects of burn care.
Doctor ME.
J Burn Care Rehabil. 1992 Jan-Feb;13(1):68-76.

Rationale for inclusion: Burn camps are amazing experiences for campers and counselors alike. This is the first paper to describe burn camp and outline guidelines for institutions who were setting up burn camps. 

CAVEAT: Paper from 1992

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Toxic epidermal necrolysis. A step forward in treatment.
Heimbach DM, Engrav LH, Marvin JA, Harnar TJ, Grube BJ.
JAMA. 1987 Apr 24;257(16):2171-5.

Rationale for inclusion: First paper describing use of porcine xenograft for the treatment of SJS/TEN. Authors found this treatment algorithm was associated with a massive decrease in mortality. 

CAVEAT: Single center, non-randomized

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Electrocardiographic monitoring after electrical injury: necessity or luxury.
Purdue GF, Hunt JL.
J Trauma. 1986 Feb;26(2):166-7.

Rationale for inclusion: Report of 48 consecutive patients who sustained a high-voltage electrical injury. In this observational cohort, no patient with a normal EKG on admission had a serious arrythmia in the 24 hours of monitoring post-injury. This study informs current common practice at many centers across the country. 

CAVEAT: Retrospective, single-center study

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Excision and grafting of large burns: operation length not related to increased morbidity.
Foy HM, Pavlin ED, Heimbach DM.
J Trauma. 1986 Jan;26(1):51-3.

Rationale for inclusion: Retrospective single center study evaluating operative length as a risk factor for mortality. Long-operations, in this study, were those that lasted 180 min or more. The % excised was only slightly more in the long group, 14% compared to 11% but the authors found that operative length was not a risk factor for mortality in this cohort. 

CAVEAT: Single center, retrospective

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Effect of inhalation injury on fluid resuscitation requirements after thermal injury.
Navar PD, Saffle JR, Warden GD.
Am J Surg. 1985 Dec;150(6):716-20.

Rationale for inclusion: Study describing the increased fluid resuscitation needs in patients with inhalation injuries in the presence of severe thermal injury. 

CAVEAT: Single center, retrospective.

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Early surgical excision versus conventional therapy in patients with 20 to 40 percent burns. A comparative study.
Gray DT, Pine RW, Harnar TJ, Marvin JA, Engrav LH, Heimbach DM.
Am J Surg. 1982 Jul;144(1):76-80.

Rationale for inclusion: Retrospective, single center study comparing a historical cohort with a more recent cohort in which early excision was the standard approach. One of the first papers critically looking at, what was at the time, an emerging treatment paradigm. 

CAVEAT: Retrospective historical cohort study at a single center. Study from 1982, many improvements have been made in both burn care and critical care since that time.

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Clinical experience with viable frozen human skin and a frozen skin bank.
Bondoc CC, Burke JF.
Ann Surg. 1971 Sep;174(3):371-82.

Rationale for inclusion: First paper demonstrating that human skin could be frozen and banked both for allo and autograft without diminishing viability. 

CAVEAT: Case study, largely opinion paper

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