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Long-Term Outcomes after Burn Injuries: Strategies to Optimize Recovery
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Long-Term Outcomes after Burn Injuries: Strategies to Optimize Recovery

A special issue of European Burn Journal (ISSN 2673-1991).

Deadline for manuscript submissions: closed (31 December 2024) | Viewed by 6512

Special Issue Editors

Prof. Dr. Nicole S. Gibran

E-Mail Website
Guest Editor
Professor Emeritus, UW Medicine Department of Surgery, Harborview Medical Center, Seattle, WA 98104, USA
Interests: hypertrophic scarring; neuropathic pain; return to work/school; functional recovery
Dr. Haig Yenikomshian

E-Mail Website
Co-Guest Editor
1. Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
2. LAC+ USC Medical Center, Los Angeles, CA 90033, USA
Interests: reconstructive surgery; burn rehabilitation; disparities of care
Gretchen Carrougher

E-Mail Website
Co-Guest Editor
UW Medicine Department of Surgery, Harborview Medical Center, Seattle, WA 98104, USA
Interests: functional recovery after burn injury; return to work; nursing education; itch/ neuropathic pain
Dr. Samuel Mandell

E-Mail Website
Co-Guest Editor
1. Department of Surgery, UT Southwestern Medical Center, Dallas, TX 75390, USA
2. Burn Center, Parkland Hospital, Dallas, TX 75235, USA
Interests: comprehensive care of the burn-injured patient; quality improvement/ process improvement; extracorporeal membrane oxygenation (ECMO); burn critical care; scar reconstructive surgery

Special Issue Information

Dear Colleagues,

Over the past 50 years, survival after a major burn injury has exponentially increased. The single intervention that is most responsible for this improvement involves early excision and grafting, which closes the wound and mitigates the inflammatory and anabolic responses after injury. As burn providers, we too often myopically congratulate ourselves on survival, reduced lengths of hospital stay, and lower complication rates. However, patients and families invariably view the return to pre-injury lifestyles and roles, including recreational and vocational activities, as optimal an outcome. For too long, patient and medical provider views of successful burn outcomes have been incongruous.

It is time for the international burn community to acknowledge that burn injury may represent a chronic condition that benefits from long-term coordinated care focused on functional recovery.

Prof. Dr. Nicole S. Gibran
Dr. Haig Yenikomshian
Gretchen Carrougher
Dr. Samuel Mandell
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. European Burn Journal is an international peer-reviewed open access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 971 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • psychological recovery trajectories
  • physical recovery trajectories
  • neuropathic pain
  • burns as a chronic condition
  • return to work/ school/ productivity
  • community re-integration
  • metabolic recovery
  • psychometric instruments
  • underserved populations
  • genetic determinants of long-term recovery

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Published Papers (4 papers)

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Research

13 pages, 800 KiB  
Article
Parent-Reported Burn-Specific Health-Related Quality of Life in Children 5–7 Years After Burns: A Multicenter Cross-Sectional Study
by Marina C. Heijblom, J. Nicolaas Dijkshoorn, Marianne K. Nieuwenhuis, Anouk Pijpe, Cornelis H. van der Vlies, Margriet E. van Baar and Inge Spronk
Eur. Burn J. 2025, 6(1), 5; https://doi.org/10.3390/ebj6010005 - 30 Jan 2025
Viewed by 306
Abstract
Surviving a burn can dramatically alter a child’s life, yet few studies examined long-term health-related quality of life (HRQL). This study assessed HRQL 5–7 years post-burn in children with mild/intermediate and severe burns and identified associated factors. Parents of children (5− < 18 [...] Read more.
Surviving a burn can dramatically alter a child’s life, yet few studies examined long-term health-related quality of life (HRQL). This study assessed HRQL 5–7 years post-burn in children with mild/intermediate and severe burns and identified associated factors. Parents of children (5− < 18 years) who were hospitalized or had burn surgery between 08/2011 and 09/2012 completed the Burn Outcomes Questionnaire (BOQ). Outcomes were compared between two subgroups: children with mild/intermediate burns (<10% total body surface area (TBSA) burned) versus severe burns ((1) aged <10 years old at the time of injury with >10% (TBSA) burned; (2) aged ≥10 years with >20% TBSA burned; or (3) >5% full-thickness burns). A total of 102 children were included (mean age at survey: 8.4 (3.0) years; mean former TBSA: 7.1%). At a mean of 5.7 years post-burn, many parents rated their child’s health as excellent (46.1%) or very good (35.3%), with few reporting issues with ‘pain’ (2.3%), ‘physical function and sports’ (1.6%), and ‘upper extremity function’ (0.9%). Parents of children with severe burns indicated significantly more problems with ‘appearance’ (89.2% versus 71.5%; p = 0.014) and ‘parental concern’ (94.1% versus 84.8%; p = 0.021). Upper limb burns, facial burns, burn size, length of hospital stay, full-thickness burns, and the number of surgeries predicted poorer outcomes. In general, these findings indicate positive long-term HRQL, though especially children with full-thickness burns and/or surgical interventions face a higher risk of reduced HRQL. The results can be used to inform children and their families about the long-term implications. Furthermore, healthcare professionals can use these insights to identify children at higher risk of poorer long-term HRQL. Full article
(This article belongs to the Special Issue Long-Term Outcomes after Burn Injuries: Strategies to Optimize Recovery)
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10 pages, 251 KiB  
Article
Establishing a Collaborative Genomic Repository for Adult Burn Survivors: A Burn Model System Feasibility Study
by Stephen Sibbett, Jamie Oh, Gretchen Carrougher, Lara Muffley, Nathaniel Ashford, Maiya Pacleb, Samuel Mandell, Jeffrey Schneider, Steven Wolf, Barclay Stewart and Nicole S. Gibran
Eur. Burn J. 2024, 5(4), 389-398; https://doi.org/10.3390/ebj5040034 - 6 Nov 2024
Viewed by 1048
Abstract
In this study, we aimed to integrate a genetic repository with an existing longitudinal national burn database. We set out two primary objectives, namely (1) to develop standard operating procedures for genetic sample collection and storage, DNA isolation, and data integration into an [...] Read more.
In this study, we aimed to integrate a genetic repository with an existing longitudinal national burn database. We set out two primary objectives, namely (1) to develop standard operating procedures for genetic sample collection and storage, DNA isolation, and data integration into an existing multicenter database; and (2) to demonstrate the feasibility of correlating genetic variation to functional outcomes in a pilot study, using the catechol-O-methyltransferase (COMT) gene. Dubbed the worrier/warrior gene, COMT variants have been associated with varying phenotypes of post-traumatic stress, wellbeing, and resilience. Between August 2018 and July 2020, COMT variants were identified for 111 participants from three sites and correlated with their outcome data. We found no association between COMT variants and functional outcomes, likely due to the inadequate sample size. We also asked all potential participants why they consented to or refused genetic analysis. A thematic analysis of responses revealed altruism and personal interest/enthusiasm in the study as top reasons for consenting. Privacy concerns were the most common reason for refusal. In conclusion, we successfully developed standard operating procedures for genetic sample collection and storage, DNA isolation, and data integration into an existing database, and we demonstrated the feasibility of conducting a multicenter collaborative study using a centralized lab location. Full article
(This article belongs to the Special Issue Long-Term Outcomes after Burn Injuries: Strategies to Optimize Recovery)
12 pages, 940 KiB  
Article
Outcomes of Patients with Amputation following Electrical Burn Injuries
by Eunyeop Kim, Bingchun Wan, Kyra Jeanine Solis-Beach and Karen Kowalske
Eur. Burn J. 2023, 4(3), 318-329; https://doi.org/10.3390/ebj4030029 - 17 Aug 2023
Cited by 1 | Viewed by 1886
Abstract
This study aimed to examine patients who sustained amputation as a result of electrical burns and to evaluate their long-term health outcomes compared to non-electrical burn patients with amputation. A retrospective analysis was conducted on burn patients from 1993 to 2021, utilizing the [...] Read more.
This study aimed to examine patients who sustained amputation as a result of electrical burns and to evaluate their long-term health outcomes compared to non-electrical burn patients with amputation. A retrospective analysis was conducted on burn patients from 1993 to 2021, utilizing the Burn Model System National Database, which includes the Veterans RAND 12-Item Health Survey and the Patient-Reported Outcomes Measurement Information System 29. The data was collected at discharge, 6 months, and 12 months after the burns occurred. The findings revealed that the rate of amputation was significantly higher in electrical burn patients (30.3%) compared to non-electrical burn patients (6.6%) (p < 0.0001). At the time of discharge, electrical burn patients with amputation exhibited significantly lower physical component scores (PCS = 34.00 ± 8.98) than electrical burn patients without amputation (PCS = 44.66 ± 9.90) (p < 0.05). However, there were no significant differences in mental component scores observed between patients, regardless of the burn type or amputation. Among all patient groups, non-electrical burn survivors with amputation faced the greatest challenges in terms of physical and social well-being, likely due to larger total body surface area burns. This study emphasizes the importance of early rehabilitation for electrical burn patients with amputation and highlights the need for ongoing support, both physically and socially, for non-electrical burn survivors with amputation. These findings, consistent with previous studies, underscore the necessity of providing psychological support to all burn survivors. Full article
(This article belongs to the Special Issue Long-Term Outcomes after Burn Injuries: Strategies to Optimize Recovery)
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11 pages, 282 KiB  
Article
Post-Burn Psychosocial Outcomes in Pediatric Minority Patients in the United States: An Observational Cohort Burn Model System Study
by Paul Won, Li Ding, Kara McMullen and Haig A. Yenikomshian
Eur. Burn J. 2023, 4(2), 173-183; https://doi.org/10.3390/ebj4020015 - 3 Apr 2023
Cited by 1 | Viewed by 1967
Abstract
Racial and ethnic minority burn patients face barriers to longitudinal psychosocial support after injury. Studies utilizing the Burn Model System (BMS) National Database report adult minority patients experience worse psychosocial outcomes in domains such as body image during burn recovery. No study to [...] Read more.
Racial and ethnic minority burn patients face barriers to longitudinal psychosocial support after injury. Studies utilizing the Burn Model System (BMS) National Database report adult minority patients experience worse psychosocial outcomes in domains such as body image during burn recovery. No study to date has investigated disparities in psychosocial outcomes by racial or ethnic category in the pediatric population using the BMS database. This observational cohort study addresses this gap and examines seven psychosocial outcomes (levels of anger, sadness, depression, anxiety, fatigue, peer relationships, and pain) in pediatric burn patients. The BMS database is a national collection of burn patient outcomes from four centers in the United States. BMS outcomes collected were analyzed using multi-level, linear mixed effects regression modeling to examine associations between race/ethnicity and outcomes at discharge after index hospitalization, and 6- and 12-months post-injury. A total of 275 pediatric patients were included, of which 199 (72.3%) were Hispanic. After burn injury, of which the total body surface area was significantly associated with racial/ethnicity category (p < 0.01), minority patients more often reported higher levels of sadness, fatigue, and pain interference and lower levels of peer relationships compared to Non-Hispanic, White patients, although no significant differences existed. Black patients reported significantly increased sadness at six months (β = 9.31, p = 0.02) compared to discharge. Following burn injury, adult minority patients report significantly worse psychosocial outcomes than non-minority patients. However, these differences are less profound in pediatric populations. Further investigation is needed to understand why this change happens as individuals become adults. Full article
(This article belongs to the Special Issue Long-Term Outcomes after Burn Injuries: Strategies to Optimize Recovery)
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