bluuebunny/crossref_metadata_2025_split huggingface dataset:
71 Treatment for Chronic-Burn Induced Neuropathy: A Systematic Review and Meta-Analysis
Authors: Bekheet Faraah N , El Eter Leen , Klifto Kevin M , Abeles Elisabeth B , Church Taylor R , Mafla Laura M , Hultman Charles S 
Published: April 2021

Abstract

Introduction
Effective management of chronic burn-induced neuropathy manifesting as pain and/or pruritus presents an ongoing challenge for clinicians. Standards of care are based on limited evidence and vary widely, especially for non-surgical neuropathies that are not associated with a specific nerve distribution. This study aims to quantify and qualify evidence for non-surgical treatments of chronic burn-induced neuropathy to define their efficacy.

Methods
PRISMA and Cochrane guidelines were implemented for review structure. PubMed, Science Direct, Embase, Cochrane Library, and Web of Science databases were searched for relevant studies. Inclusion criteria were patients age 18 years and older, with neuropathy lasting &gt;6 months following burn injury. Studies for inclusion were comparative intervention studies for treatments of chronic burn-induced neuropathies. Mean differences (MD) between interventions eligible for meta-analysis were analyzed for neuropathy outcomes.

Results
Seventeen randomized controlled trials (RCTs) were identified for inclusion with a mean post-burn follow-up of 20.8±39.3 months. Nine studies reported pain and sixteen reported pruritus using patient reported visual analogue scales for 601 and 975 patients, respectively. Pain interventions included transcranial direct current stimulation (tDCS), extracorporeal shockwave therapy (EWST), massage therapy, carbon dioxide (CO2) laser, silicone gel, and pressure therapy. Pruritus interventions included tDCS, ESWT, massage, herbal cream, doxepin cream, enzymatic moisturizer, CO2 laser, silicone gel, and pressure therapy. CO2 laser showed no improvement over standard care for the treatment of pain or pruritus associated with hypertrophic scarring (pain: MD 0.26, 95%CI -0.04, 0.57; p=0.09; pruritus: MD -0.07, 95%CI -0.44, 0.30; p=0.72). ESWT showed no statistically significant improvement over standard care for the treatment of pruritus (MD -2.69, 95%CI -5.42, 0.04; p=0.05). Massage therapy was associated with significantly greater improvements in pruritus than standard care (MD -1.64, 95%CI -2.10, -1.09; p&lt; 0.00001). Doxepin cream was not associated with greater improvements in pruritus than placebo or antihistamines (MD -0.84, 95%CI -3.61, 1.94; p=0.56).

Conclusions
Creative efforts have revealed massage therapy as a potential non-surgical intervention for treating chronic burn-induced neuropathy. Additional RCTs with innovative non-surgical interventions will provide further insights for this challenging condition.
86 Impact of Community-Level Socioeconomic Disparities on Quality of Life After Burn Injury: A Burn Model Systems Database Study
Authors: Mason Stephanie A , Gause Emma L , Archer Helena , Sibbett Stephen H , Holavanahalli Radha K , Schneider Jeffrey C , Gibran Nicole S , Kazis Lewis E , Stewart Barclay T 
Published: April 2021

Abstract

Introduction
Individual- and community-level socioeconomic disparities impact overall health and injury incidence, severity, and outcomes. However, the impact of community-level socioeconomic disparities on recovery after burn injury is unknown. We aimed to characterize the association between community-level socioeconomic disparities and health-related quality of life (HRQL) after burn injury. These findings might inform rehabilitation service delivery and policy making at administrative levels.

Methods
Participants with the NIDILRR Burn Model System who were ≥14 years with a zip code were included. Sociodemographic and injury characteristics and 12-item Short Form Health Survey (SF-12) and Veterans RAND (VR-12) physical (PCS) and mental (MCS) component summary scores 6 months after injury were extracted. Data were deterministically linked by zip code to the Distressed Communities Index (DCI), which combines seven census-derived metrics into a single indicator of economic well-being that ranges from 0 (lowest distress) to 100 (highest distress). Multilevel linear regression models estimated the association between DCI and HRQL.

Results
The 342 participants were mostly male (239, 69%) had a median age of 48 years (IQR 33–57) and sustained a median burn size of 10% TBSA (IQR 3–28%). More than one-third of participants (117, 34%) lived in a neighborhood within the two most distressed quintiles. After adjusting for age, race/ethnicity, and pre-injury HRQL, increasing neighborhood distress was negatively associated with PCS (ß-0.05, SE 0.02, p=0.01). Age and pre-injury PCS were also significantly associated with 6-month PCS. There was no association between neighborhood distress and 6-month MCS. However, pre-injury MCS was significantly associated with 6-month MCS (0.56, SE 0.07, p&lt; 0.001).

Conclusions
Neighborhood distress is associated with lower PCS after burn injury but is not associated with MCS. Regardless of neighborhood distress, pre-injury HRQL is significantly associated with both PCS and MCS during recovery.
113 Long-term Reconstructive Surgery of the Burned Hand: 16-year Experience at a Major Burn Center
Authors: Buta Martin , Abouzeid Callie , Patel Khushbu F , Stockly Olivia , Cauley Ryan , Chen Liang , Wolfe Audrey E , Bojovic Branko , Friedstat Jonathan S , Goverman Jeremy , Schneider Jeffrey C , Ryan Colleen M 
Published: April 2021

Abstract

Introduction
Early excision and grafting for deeper hand burns is important for preservation of long-term hand function. Little information exists on long-term reconstructive and revision operations after acute grafting. Limited quantitative data is available on early predictors of this outcome. This study retrospectively examines a cohort of patients who underwent excision and grafting of acute hand burns and details their reconstructive course in the years after injury. Predictors of future reconstructive hand surgery are examined.

Methods
A retrospective review was conducted using medical records of patients admitted with acute burn injury to a major regional burn center from February 1999 to October 2015 and who subsequently underwent excision and grafting for closure of the acute wound. Information collected included demographics, burn size and etiology, anatomical involvement, grafting, contracture release, local tissue rearrangement, and regional and distant flaps. Regression analysis assessed for demographic and clinical predictors for future contracture release with grafts and/or local tissue rearrangement surgery.

Results
A total of 704 hands in 532 adults (71% male, median age 40 years, average burn size 14.9% TBSA) met study criteria (Table 1). Ninety-eight patients underwent at least one reconstructive surgery (122 burned hands). Mean length of follow-up was 1000 days. Multivariable logistic regression analysis showed that male gender was negatively associated (p&lt; 0.001; OR 0.369; 90% CI, 0.233–0.584) with contracture release with graft whereas white race (p=0.030; OR 2.060; 90% CI, 1.192–3.560) and burn size ≥21% TBSA (p&lt; 0.001; OR 3.962; 90% CI, 2.224–7.057) were positively associated. Males had a negative association (p=0.023; OR 0.527; 90% CI, 0.332–0.837) and burn size a positive association with local tissue rearrangement (5–10% TBSA - p=0.041; OR 2.149; 90% CI, 1.161–3.975 and &gt;21% TBSA - p&lt; 0.001; OR 4.230; 90% CI, 7.927).

Conclusions
Approximately 1 in 6 acutely grafted hands underwent at least one reconstructive surgery of clinically significant contractures, primarily in digits and web spaces. Female gender and burn size were positive predictors of both categories of reconstructive surgery while white race was a positive predictor of release and graft.
116 Cross-cultural Translation, Adaptation and Validation of the Burnt Hand Outcome Tool (BHOT) from English to French Canadian
Authors: Gane Claire , Robillard Anne-Sophie , Royea Claudia , Lacasse Laurence , Calva Valerie , de Oliveira Ana , Nedelec Bernadette 
Published: April 2021

Abstract

Introduction
The Burnt Hand Outcome Tool (BHOT) is a comprehensive patient-reported outcome measure to assess the multiple impacts of hand burn injuries. However, this tool is currently only available in English. The aim of this study was to create a French Canadian, cross-cultural translation and adaptation of the BHOT and to investigate its reliability and validity.

Methods
The BHOT was translated and culturally adapted following published good practice principles for patient-reported outcome measures. The steps included translation to French, backward translation, expert committee review, and cognitive debriefing with 5 adults having burn injuries excluding their hands. Then, 39 adults with hand burn injuries tested the pre-final French version of the questionnaire (BHOT-F) in order to determine its clinimetric properties. Reliability was investigated by determining the Cronbach’s alpha internal consistency coefficient. Construct convergent validity was assessed by comparing the BHOT-F to the shortened version of the Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH). Content validity was evaluated based on comments extracted from interviews with the participants and a committee of burn care experts.

Results
The BHOT-F was modified during the adaption process to ensure its clarity. Cronbach’s alpha was 0.94 indicating excellent internal consistency and was &gt; 0.75 for all sub-domains. The BHOT-F and the QuickDASH were strongly correlated (rs = .86; p &lt; 0.01). Content validity was deemed satisfying.

Conclusions
The French-Canadian version of the BHOT is a reliable and valid tool that can confidently be used in clinical practice for adults with hand burn injuries and compared to data generated with Anglophone populations.
119 Satisfaction with Life and Community Integration Outcomes up to 20 Years after Burn Injury
Authors: Abouzeid Callie , Wolfe Audrey E , Carrougher Gretchen J , Gibran Nicole S , Holavanahalli Radha K , Ni Pengsheng , Roaten Kimberly , Ryan Colleen M , Suman Oscar E , Kazis Lewis E , Schneider Jeffrey C 
Published: April 2021

Abstract

Introduction
Among the many challenges burn survivors face, community integration is often difficult and might affect overall satisfaction with life long-term. The purpose of this study is to examine quality of life, based on life satisfaction and community integration, at long-term follow-ups in the burn population.

Methods
Data from the Burn Model System National Database (1997–2020) were analyzed. Patient-reported outcome measures were collected at discharge with a recall of preinjury status, and at 5, 10, 15, and 20 years after injury. The Satisfaction with Life Scale (SWLS) was used to measure participants’ satisfaction with life and the Community Integration Questionnaire (CIQ) measured level of community integration. A random intercept model was used to fit the data and generate a score trajectory with 95% confidence intervals to demonstrate the changes in scores over time and the impact of the demographic and clinical covariates on the model. SWLS trajectory is depicted in the Figure.

Results
The study population included 214 adult burn survivors with a mean age of 45.2 years. The population was mainly male (65.9%) and white (77.1%) with a mean burn size of 22.5% and average length of hospital stay of 34.7 days. This study found that SWLS scores decrease over time, but CIQ scores were relatively stable. The CIQ model with additional covariates were not statistically significant and did not improve the fit of the model.

Conclusions
Satisfaction with life was significantly worse over time. Community integration showed little or no change over the long term.
121 25 years later: Has the Practice of Splinting Burned Joints Changed?
Authors: Khor Desmond , Liao Junlin , Kowalske Karen J , Parry Ingrid , Schneider Jeffrey C , Richard Reg , Wibbenmeyer Lucy 
Published: April 2021

Abstract

Introduction
Burn scar contracture (BSC) across joints is a common pathological outcome following burn injuries, leading to limitations in range of motion (ROM) of affected joints and impairment in activities of daily living (ADLs). Despite a paucity of research addressing it efficacy, static splinting of burned joints is a common preventative practice. A survey of burn centers performed 25 years ago showed a widely divergent practice of splinting. We undertook this study to determine the current practice of splinting in acute burn injuries.

Methods
This is a retrospective observational study of 246 patients who were included in the Burn Patient Acuity Demographics, Scar Contractures and Rehabilitation Treatment Related to Patient Outcome Study (ACT) database from 2010–2013. The most commonly splinted joints (elbow, wrist, knee and ankle) and their 8 motions were included. Variables included patients’ demographics, burn variables, rehabilitation treatment and hospital course details. Univariate and multivariate analysis of factors related to splinting was performed. P&lt; 0.05 was significant.

Results
Thirty percent of the study population (75 patients) underwent splinting during their hospitalization. On average splinting was initiated about a third of the way into the hospital length of stay (LOS, 35 ± 21% of LOS) and splints were worn for 50% (50±26%) of the LOS. Joints were splinted for an average 15.1 ± 4.8 hours a day. Joints with higher amounts of burn involvement and need for grafting to their associated cutaneous functional units (CFU) were more likely to be splinted (p&lt; 0.001). The wrist was most frequently splinted (30.7%) while the knee was the least frequently splinted joint (8.2%). The knee was splinted the longest (17.6 ± 4.8 hours) and the ankle the least (14.4 ± 4.6 hours). One third had splinting continued to discharge (20, 27%). The requirement for skin grafting in the associated CFU was the only factor that was independently related to splinting, increasing the odds of splinting 2% for every 1% of CFU grafted (adj OR =1.02, 95% CI=1.01–1.03, p&lt; 0.001).

Conclusions
The current practice, especially the timing, hours of wear and duration of splinting following burns remains diverse among burn centers. Splinting is more common in joints that have more burn and deeper burns require grafting in the associated CFU; otherwise there appears to be little consensus in the practice of splinting. Future study looking at splinting application and its outcomes is warranted.
501 Creating a Virtual Burn Camp Experience: Growth, Hope, Dream, Inspire
Authors: Boulter Trudy , Mayer Nichole F , Mikolaj Kerry , Schuetz Tim 
Published: April 2021

Abstract

Introduction
Our Burn Camps program has a suite of well-established residential programs. In 2020 we were forced to pivot to a virtual platform. Our goal was to uphold our mission; “to provide children who have sustained a burn injury and their families healing opportunities by offering inspiration, rehabilitation and shared experiences in a safe, nurturing and supportive environment.” Our theme “Always Together” utilized the following program pillars: creating community, growth, inspire, dream and hope.

Methods
Recruitment Campers/Counselors: The 2018–2020 campers were contacted providing virtual camp logistics and application information. Our best counselors returned as our 2020 staff. We built the same cabin groups as 2019.

Staffing
Camp leadership team and 2 Psychologists

Platform
The conference center provided ZOOM access for planning meetings and staff training. Four Zoom accounts were used to manage 8 cabin groups.

Application
A new online application was developed including the following questions: Coping with the pandemic, current social justice issues and access to technology.

Schedule
The schedule included 4 live meetings per day for 5 days. We included the anchors of camp: morning exercise, crafts, talent show, banquet, and play day.
“Camp in a Box”: 125 boxes were designed and sent to campers, staff and donors. Boxes included envelopes for each day of the week, with content specific for each cabin.

Results
We had 62 campers registered for camp and 35 staff from across the country. Our “Camp in a Box” was successfully sent to 62 campers, 35 staff and 25 donors. We had four Zoom accounts. Each account was managed by a member of the leadership team. There was one primary Zoom account that hosted the large group activities for consistency. Each live activity that was offered was attended by 40–70 participants. Our Zoom calls were a mix of live and prerecorded videos. Counselors filled out a staff survey at the end of each evening allowing the leadership team feedback about the day’s activities and any camper concerns.

Conclusions
During a time when connection is so important, our community rose to the challenge and supported our campers. We were able to show that burn camp lives inside each of us no matter the location. Our campers and their families were engaged throughout the week and grateful for the opportunity. We learned a lot about running a virtual program and hope to use these concepts even when the pandemic is over.
503 Burn Camp Volunteer Engagement
Authors: Yelvington Miranda L , Wilkinson Gretta E 
Published: April 2021

Abstract

Introduction
Much has been published in burn literature regarding the positive impact of camp participation on burn survivors. Less has been said about the positive benefits reaped by the volunteers who freely give their time to support burn camp initiatives. Often these volunteers are fire fighters, members of the hospital’s burn team, family members or burn survivors or adult burn survivors. Occasionally, volunteers have no prior ties to the burn injury community. These individuals donate their time to attending burn camp as a counselor or camp volunteer and many serve through the year on planning and organization committees. Prior studies have reported a positive professional benefit from camp participation including improved job effectiveness and motivation. Counselors also reported personal benefits including personal growth and socialization. The same benefits may be present for non-counselor volunteers.

Methods
This survey-based project explored the attitudes of burn camp volunteers. Surveys were sent to current and past volunteers of one facility’s Pediatric Burn Camp. These include but are not limited to community members, firefighters, medical staff and Burn Team members. Surveys were sent via mail with a follow-up email sent one month later to encourage survey completion.

Results
Surveys were sent to 40 pediatric burn camp volunteers. 28 respondents reported between 1 and 27 years of camp participation. 75% report no regular contact with burn survivors related to their occupation. 29% of respondents were firefighters, 18% were burn team members and 32% were burn survivors. Respondents answered write in questions related to what they love about camp and how their camp experience could be made better. Nine topics related to attitudes were addressed in a Likert scale format. Statistical analysis will be performed to evaluate trends in volunteer attitudes and to compare attitudes to longevity of camp participation, volunteer age and occupation. Trends in recommended camp improvements will be addressed.

Conclusions
Longevity of camp participation is directly related to volunteer believes and attitudes. Whether because of other responsibilities, changing vocations or a loss of interest in the cause, often volunteers fail to return year to year. Volunteer engagement is an essential part of keeping burn camp a viable resource for pediatric burn survivors. By assessing volunteer perceptions, camp directors can discover areas for improvement and camp attributes that draw volunteers to burn camp. Volunteer recruit strategies developed with these trends in mind may be more successful in attainment and retention of dedicated volunteers.
516 Higher Risk of Acute Kidney Injury in Burn Patients with Rhabdomyolysis
Authors: Ko Andrew , Song Juquan , El Ayadi Amina , Golovko George , Wolf Steven E 
Published: April 2021

Abstract

Introduction
Rhabdomyolysis, a rapid breakdown of damaged skeletal muscle, is a serious complication known to occur in approximately 1% of burn patients. Muscle breakdown products can accumulate in the renal tubules leading to acute kidney injury (AKI) and increased deaths. Burn-associated factors such as under-resuscitation, infection, and nephrotoxic drugs likely increase incidence of AKI in those with rhabdomyolysis after burn. Other variables such as age, sex, and pre-existing conditions may also be implicated in this relationship. We investigated whether burn patients with rhabdomyolysis are at greater risk of developing AKI than others with rhabdomyolysis.

Methods
TriNetX, a global health research network, was accessed in September 2020 to create three patient cohorts with a combination of rhabdomyolysis and burns. Data from years 2000 to 2020 from 38 health care organizations was used. Cohort 1 included burned patients who developed rhabdomyolysis within 14 days after injury. Cohort 2 were those with rhabdomyolysis who did not suffer a burn within 14 days prior to diagnosis. Cohort 3 included burned patients who did not develop rhabdomyolysis within 14 days of the burn. Burn diagnosis was identified by ICD-10 codes T20-25, T26-28, or T30-32; rhabdomyolysis was identified with M62.82. We identified 699 patients in Cohort 1. Propensity score matching was done to Cohorts 2 and 3 to balance similar demographics and pre-existing conditions to Cohort 1. Cohorts were then compared to assess the risk of developing AKI (N17) within 14 days of the initial event.

Results
Cohort 1 had a mean age at incidence of 48.4±19.8; 552 patients were male and 146 were female. 154 patients with hypertensive diseases, 66 with diabetes mellitus, 41 with chronic kidney disease, and 51 overweight or obese patients were identified. Matched Cohorts 2 and 3 had the same number of patients and similar demographics and pre-existing conditions as Cohort 1. 391 of 699 burn patients with rhabdomyolysis (56%), 293 of 699 non-burn patients with rhabdomyolysis (42%), and 23 of 699 burn patients without rhabdomyolysis (3%) developed AKI within 14 days. The risk ratio difference for developing AKI between burn patients and non-burn patients with rhabdomyolysis was 14.02% with a 95% CI of 8.831–19.209% (&lt; 0.0001 p-value) and between burn patients with and without rhabdomyolysis was 52.647% with a 95% CI of 48.736–56.557% (&lt; 0.0001 p-value). The odds ratios for developing AKI were 1.759 and 37.312, respectively.

Conclusions
We found the risk of developing AKI in burn patients with rhabdomyolysis to be significantly augmented compared to non-burn patients with rhabdomyolysis or burn patients without rhabdomyolysis.