Epidemiological and clinical characteristics of burns in the older person:a seven-year retrospective analysis of 693 cases at a burn center in south-west China

Background:Burns are one of the major traumas that may affect older individuals.The purpose of this study was to investigate the epidemiological and clinical characteristics of geriatric burns at a major center in south-west China.Methods:This retrospective study was conducted at the Institute of Burn Research,Southwest Hospital of Army Medical University between 2010 and 2016,and the data collected from medical records included admission date,age,gender,premorbid disease,burn etiology,injured anatomical location,burn area and depth,inhalation injury,number of surgeries,length of stay(LOS),clinical outcome,and medical cost.Results:Of the 693 older burn patients included,60.75%were male and 56.85%were aged 60–69 years.Burns peaked in December–March and June.Flamewas the most common cause of burns,making up 51.95%of all cases,and also dominated in the burn patients aged 60–69 years.Limbs were the most common anatomical sites of burns(69.41%),and the median total body surface area(TBSA)was 5%(interquartile range[IQR]:2%–15%).The percentage of the patients who underwent surgeries and number of surgeries significantly increased in the cases of contact burns,younger age and full-thickness burns.Six deaths resulted in a mortality of 0.9%.The median LOSwas 16 days(IQR:8–29 days),and the main risk factors were more surgeries,better outcomes,and full-thickness burns.The median costwas 20,228 CNY(IQR:10,457–46,581.5 CNY),and major risk factors included longer LOS,larger TBSA,and more surgeries.Furthermore,compared to the earlier data from our center,the proportion of older adults among all burns(7.50%vs.4.15%),proportion of flame burns(51.95%vs.33.90%),and mean age(69.05 years vs.65.10 years)were significantly higher,while the proportion of premorbidities(16.9%vs.83.9%),mortality(0.9%vs.7.5%)and median TBSA(5%vs.21%)were significantly lower.Conclusions:This study suggested that closer attention should be paid to prevent burn injuries in older people aged 60–69 years,especially males,regarding incidents in the summer and winter,and flame burns.Moreover,tailored intervention strategies based on related risk factors should be under special consideration.

Synthesis of graphene oxide-quaternary ammonium nanocomposite with synergistic antibacterial activity to promote infected wound healing

Background: Bacterial infection is one of the most common complications in burn, trauma, and chronic refractory wounds and is an impediment to healing. The frequent occurrence of antimicrobial-resistant bacteria due to irrational application of antibiotics increases treatment cost and mortality. Graphene oxide (GO) has been generally reported to possess high antimicrobial activity against a wide range of bacteria in vitro. In this study, a graphene oxide-quaternary ammonium salt (GO-QAS) nanocomposite was synthesized and thoroughly investigated for synergistic antibacterial activity, underlying antibacterial mechanisms and biocompatibility in vitro and in vivo. Methods: The GO-QAS nanocomposite was synthesized through amidation reactions of carboxylic group end-capped QAS polymers with primary amine-decorated GO to achieve high QAS loading ratios on nanosheets. Next, we investigated the antibacterial activity and biocompatibility of GO-QAS in vitro and in vivo. Results: GO-QAS exhibited synergistic antibacterial activity against bacteria through not only mechanical membrane perturbation, including wrapping, bacterial membrane insertion, and bacterial membrane perforation, but also oxidative stress induction. In addition, it was found that GO-QAS could eradicate multidrug-resistant bacteria more effectively than conventional antibiotics. The in vitro and in vivo toxicity tests indicated that GO-QAS did not exhibit obvious toxicity towards mammalian cel s or organs at low concentrations. Notably, GO-QAS topically applied on infected wounds maintained highly efficient antibacterial activity and promoted infected wound healing in vivo. Conclusions: The GO-QAS nanocomposite exhibits excellent synergistic antibacterial activity and good biocompatibility both in vitro and in vivo. The antibacterial mechanisms involve both mechanical membrane perturbation and oxidative stress induction. In addition, GO-QAS accelerated the healing process of infected wounds by promoting re-epithelialization and granulation tissue formation. Overall, the results indicated that the GO-QAS nanocomposite could be applied as a promising antimicrobial agent for infected wound management and antibacterial wound dressing synthesis.