Epidemiologic and clinical characteristics of severe burn patients: results of a retrospective multicenter study in China, 2011–2015

Background: Severe burns injury is a serious pathology, leading to teratogenicity and significant mortality, and it also has a long-term social impact. The aim of this article is to describe the hospitalized population with severe burns injuries in eight burn centers in China between 2011 and 2015 and to suggest future preventive strategies. Methods: This 5-year retrospective review included all patients with severe burns in a database at eight institutions. The data collected included gender, age, month distribution, etiology, location, presence of inhalation injury, total burn surface area, depth of the burn, the length of hospitalization, and mortality. SPSS 19.0 software was used to analyze the data. Results: A total of 1126 patients were included: 803 (71.3%) male patients and 323 (28.7%) female patients. Scalds were the most common cause of burns (476, 42.27%), followed by fire (457, 40.59%). The extremities were the most frequently affected areas, followed by the trunk. The median length of hospitalization was 30 (15, 52) days. The overall mortality rate was 14.21%. Conclusions: Although medical centers have devoted intensive resources to improving the survival rates of burn patients, expenditures for prevention and education programs are minimal. Our findings suggest that more attention should be paid to the importance of prevention and the reduction of injury severity. This study may contribute to the establishment of a nationwide burn database and the elaboration of strategies to prevent severe burns injury.

The clinical effectiveness and safety of using epidermal growth factor,fibroblast growth factor and granulocyte-macrophage colony stimulating factor as therapeutics in acute skin wound healing:a systematic review and meta-analysis

Background:Promoting wound healing is crucial to restore the vital barrier function of injured skin.Growth factor products including epidermal growth factor(EGF),fibroblast growth factor(FGF)and granulocyte-macrophage colony stimulating factor(GM-CSF)have been used for decades although no systematic evaluation exists regarding their effectiveness and safety issues in treating acute skin wounds.This has resulted in a lack of guidelines and standards for proper application regimes.Therefore,this systematic review and meta-analysis was performed to critically evaluate the effectiveness and safety of these growth factors on skin acute wounds and provide guidelines for application regimes.Methods:We searched PubMed/Medline(1980-2020),Cochrane Library(1980-2020),Cochrane CENTRAL(from establishment to 2020),ClinicalTrials.gov(from establishment to 2020),Chinese Journal Full-text Database(CNKI,1994-2020),China Biology Medicine disc(CBM,1978-2019),Chinese Scientific Journal Database(VIP,1989-2020)andWanfang Database(WFDATA,1980-2019).Randomized controlled trials(RCTs),quasi-RCTs and controlled clinical trials treating patients with acute skin wounds from various causes and with those available growth factors were included.Results:A total of 7573 papers were identified through database searching;229 papers including 281 studies were kept after final screening.Administering growth factors significantly short-ened the healing time of acute skin wounds,including superficial burn injuries[mean differ-ence(MD)=−3.02;95%confidence interval(CI):−3.31∼−2.74;p<0.00001],deep burn injuries(MD=−5.63;95%CI:−7.10∼−4.17;p<0.00001),traumata and surgical wounds(MD=−4.50;95%CI:−5.55∼−3.44;p<0.00001).Growth factors increased the healing rate of acute skin wounds and decreased scar scores.The incidence of adverse reactions was lower in the growth factor treatment group than in the non-growth factor group.Conclusions:The studied growth factors not only are effective and safe for managing acute skin wounds,but also accelerate their healing with no severe adverse reactions.

A novel method for objectively, rapidly and accurately evaluating burn depth via near infrared spectroscopy

The accurate and objective evaluation of burn depth is a significant challenge in burn wound care.Herein,we used near infrared spectroscopy(NIRS)technology to measure the different depth of thermal burns in ex vivo porcine models.Based on the intensity of the spectral signals and the diffuse reflection theory,we extracted the optical parameters involved in functional(total hemoglobin andwater content)and structural(tissue scattered size and scattered particles)features that reflect the changes in burn depth.Next,we applied support vector regression to construct a model including the optical property parameters and the burn depth.Finally,we histologically verified the burn depth data collected via NIRS.The results showed that our inversion model could achieve an average relative error of about 7.63%,while the NIRS technology diagnostic accuracy was in the range of 50μm.For the first time,this novel technique provides physicians with real-time burn depth information objectively and accurately.